New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 062201
FREDONIA CSD Municipal Code: 060667800100
425 E MAIN ST Date of Payment: Sept 2, 2008
FREDONIA, NY 14063-1496 Amount of Payment: $18,073.00
2007-08 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $1,290,182.00
2. Total Aug State Share Medicaid Amount $38,740.00
3. Total Sept State Share Medicaid Amount
4. Total Oct State Share Medicaid Amount
5. Total Nov State Share Medicaid Amount $17,402.50
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $266,403.00
7. December Net Excess Cost Payment $266,403.00
8. TOTAL EXCESS COST AID (less Estimated or calc) $1,283,328.00
9. Total Dec State Share Medicaid Amount $3,720.00
10. Total Jan State Share Medicaid Amount $3,504.00
11. Total Feb State Share Medicaid Amount
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $568,560.10
13. March Net Excess Cost Payment $568,560.10
14. TOTAL EXCESS COST AID (less Estimated or calc) $1,296,011.00
15. Total Mar State Share Medicaid Amount
16. Total Apr State Share Medicaid Amount
17. Total May State Share Medicaid Amount $12,030.00
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $191,249.75
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $191,249.75
23. TOTAL EXCESS COST AID (less Estimated or calc) $1,296,011.00
24. Total June State Share Medicaid Amount
25. Total July State Share Medicaid Amount
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $194,401.65
27. August Net Excess Cost Payment $194,401.65
28. TOTAL EXCESS COST AID $1,314,084.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC) $18,073.00
30. September Net Excess Cost Payment $18,073.00
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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