Amended Annual Year End Supplemental (2017) for TENNESSEE CAPTIVE INSURANCE ASSOCIATION INC. PAC submitted on 02/01/2018
Beginning Balance
$3,860.75
Receipts
Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
| Contributor | C/P | Date | Amount |
|---|---|---|---|
|
AMERIGROUP
22 CENTURY BLVD, STE 220 NASHVILLE , TN 37214 |
09/30/2018 | $1,500.00 |
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
(other than adjustments, loans, and interest)
$11,100.00
Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$11,100.00
Disbursements
Expenditures, Unitemized
$0.00
Expenditures, Itemized
| Vendor | C/P | Purpose | In-Kind | Independent | S/O | Date | Amount |
|---|---|---|---|---|---|---|---|
|
BAILEY
, PAUL
252 LOWERY ROAD SPARTA , TN 38583 |
C | CONTRIBUTION | 08/03/2018 | $500.00 | |||
|
STEWART
, MIKE
412 NORTH 16TH AVENUE NASHVILLE , TN 37206 |
C | CONTRIBUTION | 08/03/2018 | $1,000.00 |
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
(other than adjustments)
$9,609.75
Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$9,492.75
Ending Balance
ENDING BALANCE
$5,468.00
Outstanding Loans
TOTAL OUTSTANDING LOAN BALANCE
$0.00
In-Kind Contributions
In-Kind Contributions are not included in the report ending balance.
Unitemized
$0.00
Itemized
$0.00
TOTAL IN-KIND CONTRIBUTIONS
$0.00
Obligations
Obligations are not included in the report ending balance.
Unitemized
$0.00
Itemized
$0.00
Obligations, Outstanding from Previous Reports
$0.00
TOTAL OBLIGATIONS OUTSTANDING
$0.00