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

Office of Mental Health
Appendix C-2
For Legislative Special Grants Only
Payment and Reporting Schedule for Period
_______________ to _______________
Region: County: Provider Code:
Provider Name:
OMH Contract Number:
OMH Contract Term:
To receive final payment, the provider must submit final expenditure reports/documentation as required by
Office of Mental Health
Payments Dates of Service Amount Payment Conditions
First Scheduled Advance
(90%)
90% Advance made upon approval
of contract.
Final Scheduled
Payment (10%)
Final scheduled payment will not be
due until thirty days after completion
of OMH‘s audit of the final
expenditure report/documentation
showing total grant expenses
submitted by vendor with its final
invoice. Deadline for submission of
the final report is August 1. OMH
shall complete its audit and notify
vendor of the results no later than
August 30 th . Payment will be
adjusted by OMH to reflect only
those services/ expenditures that
were made in accordance with this
contract.
Total Grant
Submit New York State Voucher for final payment with supporting documentation and final expenditure reports
to:
NYS Office of Mental Health
Community Budget and Financial Management
44 Holland Avenue, 7th Floor
Albany, New York 12229
2010-11 ATL Direct Contract Forms and Instructions 34