| Submitted by: | Gordon Irlam |
| Date: | 2021-03-28 |
| Purpose: | Quarterly expense report |
| Reference: | 2021-GRICF-01 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2021-01-05 | Health | Insurance | $770.00 |
| 2021-02-05 | Health | Insurance | $770.00 |
| 2021-02-21 | Health | Prescription | $39.13 |
| 2021-03-05 | Health | Insurance | $770.00 |
| Total expenses | $2349.13 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $2349.13 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.575/mile, lodging, M&IE |
Signature:
| Approved by: | Manjula Jonnalagadda |
| Signature: | |
| Date: |