| Submitted by: | Gordon Irlam |
| Date: | 2017-06-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2017-GRICF-02 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2017-04-06 | Health | Insurance | $628.00 |
| 2017-04-06 | Health | Therapy | $195.00 |
| 2017-04-13 | Health | Prescription | $26.15 |
| 2017-04-19 | Health | Periodontist | $1204.74 |
| 2017-04-26 | Health | Periodontist | $70.00 |
| 2017-05-04 | Health | Therapy | $195.00 |
| 2017-05-06 | Health | Insurance | $628.00 |
| 2017-05-10 | Health | Dentist | $1400.00 |
| 2017-06-03 | Health | Prescription | $20.00 |
| 2017-06-05 | Health | Insurance | $628.00 |
| 2017-06-05 | Legal | Annual meeting | $1700.00 |
| 2017-06-15 | Health | Therapy | $195.00 |
| 2017-06-24 | Health | Prescription | $20.00 |
| 2017-06-26 | Health | Dentist | $196.00 |
| Total expenses | $7105.89 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $7105.89 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.54/mile, lodging, M&IE |
Signature:
| Approved by: | Manjula Jonnalagadda |
| Signature: | |
| Date: |