Direct Contract Forms and Instructions - New York State Office of ...

Description of Appendices
Appendix A
Appendix A-1
Appendix B
Appendix C
Appendix C-1
Appendix C-2
Appendix D
Appendix E
Appendix F
Appendix H
Appendix X
Standard Clauses for NYS Contracts
These are clauses that are required by OMH. If a multi-term
contract, indicate the period on the first line of Page 1.
Contract budget to be developed by contractor, using the
Consolidated Budget Report (CBR) software unless otherwise
specifically directed in a funding source spending plan guideline.
Payment and Reporting Schedule.
Payment and Reporting Schedule – For Shelter + Care Contracts
only.
Payment and Reporting Schedule - For Legislative Special Grants
Only.
Program description to be developed by contractor.
To be completed by OMH‘s Community Budget and Financial
Management group.
Confidentiality Agreement
Regulations for Shelter + Care HUD contracts only.
To be left blank and included in initial contract submittal.
Is completed when the original contract requires an amendment or
at annual renewal. The amendment or renewal will consist of
Appendix X completed by the contractor and any other applicable
appendices, i.e. Appendix B-Budget, Appendix C-Payment
Schedule, Appendix D Workplan attached to the back of Appendix
X.
When using this Appendix for amendments and renewals,
complete the following: Contract number
Amendment number
Period
Contract amount for period
Provider agency name
Additional attached appendix(ces)
Authorized individual signature – must be notarized
Complete acknowledgment
2010-11 ATL Direct Contract Forms and Instructions 3