| Submitted by: | Gordon Irlam |
| Date: | 2018-10-15 |
| Purpose: | Quarterly expense report |
| Reference: | 2018-GRICF-03 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2018-07-05 | Health | Insurance | $658.00 |
| 2018-07-29 | Health | Prescription | $20.00 |
| 2018-08-05 | Health | Insurance | $658.00 |
| 2018-08-14 | Health | Prescription | $30.00 |
| 2018-08-14 | Health | Therapy | $630.00 |
| 2018-08-17 | Health | Doctor | $25.00 |
| 2018-08-27 | Health | Emergency room | $100.00 |
| 2018-09-05 | Health | Insurance | $658.00 |
| 2018-09-12 | Health | Doctor | $25.00 |
| 2018-09-15 | Health | Prescription | $20.00 |
| Total expenses | $2824.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $2824.00 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.545/mile, lodging, M&IE |
Signature:
| Approved by: | Manjula Jonnalagadda |
| Signature: | |
| Date: |