| Submitted by: | Gordon Irlam |
| Date: | 2003-09-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2003-GRICF-03 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2003-07-02 | Health | Psychologist | $125.00 |
| 2003-07-16 | Health | Dentist | $150.00 |
| 2003-07-18 | Health | Prescription copay | $35.00 |
| 2003-07-27 | Health | Insurance - August 2003 | $178.00 |
| 2003-08-01 | Office | Office supplies | $92.91 |
| 2003-08-15 | Office | 2 Black ink cartridges | $61.53 |
| 2003-08-25 | Health | Insurance - Sep-Dec 2003 | $712.00 |
| 2003-08-29 | Health | Dentist | $1637.00 |
| 2003-09-10 | Health | Prescription copay | $35.00 |
| various | Health | Group Therapy x 8 | $160.00 |
| various | Health | Psychologist x 8 | $1080.00 |
| various | Health | Psychiatrist x 3 | $60.00 |
| Total expenses | $3026.44 | ||
| Less advances | $0 | ||
| Reinbursement due | $3026.44 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.365/mile, lodging, M&IE |
Comments:
Signature:
| Approved by: | Marantha de Araujo |
| Date: | 2003-10-01 |
| Signature: |