| Submitted by: | Gordon Irlam |
| Date: | 2016-03-31 |
| Purpose: | Quarterly expense report |
| Reference: | 2016-GRICF-01 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2016-01-05 | Health | Insurance | $612.00 |
| 2016-01-08 | Health | Group | $135.00 |
| 2016-01-08 | Health | Group | $135.00 |
| 2016-01-08 | Health | Group | $540.00 |
| 2016-01-09 | Health | Group | $135.00 |
| 2016-01-28 | Health | Therapy | $185.00 |
| 2016-02-05 | Health | Insurance | $612.00 |
| 2016-02-24 | Health | Prescription | $20.00 |
| 2016-02-25 | Health | Therapy | $100.00 |
| 2016-02-25 | Health | Group | $540.00 |
| 2016-03-05 | Health | Insurance | $612.00 |
| 2016-03-10 | Health | Dentist | $160.00 |
| 2016-03-24 | Health | Therapy | $185.00 |
| Total expenses | $3971.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $3971.00 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.56/mile, lodging, M&IE |
Signature:
| Approved by: | Purobi Phillips |
| Signature: | |
| Date: |