| Submitted by: | Gordon Irlam |
| Date: | 2019-04-02 |
| Purpose: | Quarterly expense report |
| Reference: | 2019-GRICF-01 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2019-01-01 | Health | Prescription | $20.00 |
| 2019-01-07 | Health | Insurance | $674.00 |
| 2019-02-05 | Health | Insurance | $674.00 |
| 2019-02-11 | Health | Dentist | $224.00 |
| 2019-03-05 | Health | Insurance | $674.00 |
| 2019-03-07 | Health | Prescription | $40.00 |
| 2019-03-25 | Health | Doctor | $25.00 |
| Total expenses | $2331.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $2331.00 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.58/mile, lodging, M&IE |
Signature:
| Approved by: | Manjula Jonnalagadda |
| Signature: | |
| Date: |