| Submitted by: | Gordon Irlam |
| Date: | 2013-09-27 |
| Purpose: | Quarterly expense report |
| Reference: | 2013-GRICF-03 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2013-07-05 | Health | Insurance | $526.00 |
| 2013-08-05 | Health | Insurance | $526.00 |
| 2013-08-15 | Health | Prescription | $90.00 |
| 2013-08-22 | Health | Group | $232.50 |
| 2013-09-05 | Health | Insurance | $526.00 |
| 2013-09-27 | Health | Therapy (5 x $170; 4 x $185) | $1590.00 |
| Total expenses | $3490.50 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $3490.50 | ||
| * - 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: |