New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 010201
BERNE-KNOX-WESTERLO CSD Municipal Code: 010706800100
1738 HELDERBERG TRL Date of Payment: Sept 2, 2008
BERNE, NY 12023-2926 Amount of Payment: $64,582.00
2007-08 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $1,295,021.00
2. Total Aug State Share Medicaid Amount $2,886.00
3. Total Sept State Share Medicaid Amount $3,273.50
4. Total Oct State Share Medicaid Amount $525.00
5. Total Nov State Share Medicaid Amount $20,446.00
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $296,624.75
7. December Net Excess Cost Payment $296,624.75
8. TOTAL EXCESS COST AID (less Estimated or calc) $1,295,021.00
9. Total Dec State Share Medicaid Amount $1,532.00
10. Total Jan State Share Medicaid Amount $766.00
11. Total Feb State Share Medicaid Amount
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $580,461.45
13. March Net Excess Cost Payment $580,461.45
14. TOTAL EXCESS COST AID (less Estimated or calc) $1,295,021.00
15. Total Mar State Share Medicaid Amount $1,026.00
16. Total Apr State Share Medicaid Amount $780.00
17. Total May State Share Medicaid Amount $1,022.00
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $191,425.15
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $191,425.15
23. TOTAL EXCESS COST AID (less Estimated or calc) $1,295,021.00
24. Total June State Share Medicaid Amount $77,361.91
25. Total July State Share Medicaid Amount
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $116,891.24
27. August Net Excess Cost Payment $116,891.24
28. TOTAL EXCESS COST AID $1,359,603.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC) $64,582.00
30. September Net Excess Cost Payment $64,582.00
Deposit will take place sometime during the payment day and funds will be
available the following day.
(ST-3 Code A3101 Basic Formula Aid - Excess Cost Only)
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