| Submitted by: | Gordon Irlam |
| Date: | 2011-06-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2011-GRICF-02 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2011-04-01 | Health | Doctor | $25.00 |
| 2011-04-01 | Health | X-ray | $10.00 |
| 2011-04-05 | Health | Insurance | $426.00 |
| 2011-04-05 | Health | Periodontist | $165.00 |
| 2011-04-06 | Health | Group | $120.00 |
| 2011-05-04 | Health | Group | $240.00 |
| 2011-05-05 | Health | Insurance | $426.00 |
| 2011-05-25 | Health | Periodontal exam | $75.00 |
| 2011-05-27 | Health | Prescription | $70.00 |
| 2011-06-04 | Legal | Annual meeting | $1700.00 |
| 2011-06-06 | Health | Insurance | $426.00 |
| 2011-06-08 | Health | Group | $240.00 |
| 2011-06-17 | Health | Prescription | $20.00 |
| 2011-06-30 | Health | Therapy (12 x $170) | $2040.00 |
| Total expenses | $5983.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $5983.00 | ||
| * - 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: |