| Submitted by: | Gordon Irlam |
| Date: | 2011-09-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2011-GRICF-03 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2011-07-05 | Health | Insurance | $426.00 |
| 2011-07-06 | Health | Group | $180.00 |
| 2011-07-22 | Health | Doctor | $25.00 |
| 2011-07-22 | Health | Prescription | $30.00 |
| 2011-07-23 | Health | Prescription | $9.35 |
| 2011-08-05 | Health | Insurance | $426.00 |
| 2011-08-17 | Health | Group | $300.00 |
| 2011-08-23 | Health | MedicAlert | $35.00 |
| 2011-08-27 | Accounting | Annual meeting | $375.00 |
| 2011-09-05 | Health | Prescription | $70.00 |
| 2011-09-06 | Health | Insurance | $426.00 |
| 2011-09-14 | Health | Group | $180.00 |
| 2011-09-28 | Health | Periodontist | $1100.00 |
| 2011-09-29 | Health | Dentist | $866.00 |
| 2011-09-31 | Health | Therapy (9 x $170) | $1530.00 |
| Total expenses | $5978.35 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $5978.35 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.55/mile, lodging, M&IE |
Signature:
| Approved by: | Purobi Phillips |
| Signature: | |
| Date: |