| Submitted by: | Gordon Irlam |
| Date: | 2024-04-01 |
| Purpose: | Quarterly expense report |
| Reference: | 2024-GRICF-01 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2024-01-02 | Health | Insurance | $855.73 |
| 2024-01-03 | Health | Insurance | $1014.00 |
| 2024-01-04 | Filing fees | Statement of Information | $20.00 |
| 2024-01-10 | Health | Periodontist | $173.00 |
| 2024-01-29 | Health | Prescription | $8.01 |
| 2024-01-29 | Health | Prescription | $39.13 |
| 2024-02-01 | Health | Insurance | $855.73 |
| 2024-02-01 | Health | Insurance | $1014.00 |
| 2024-02-22 | Health | Laboratory | $40.00 |
| 2024-03-01 | Health | Medical supplies | $49.10 |
| 2024-03-01 | Health | Insurance | $855.73 |
| 2024-03-01 | Health | Insurance | $1014.00 |
| Total expenses | $5938.43 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $5938.43 | ||
| * - 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: |