New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 120501
DELHI CSD Municipal Code: 120722700100
2 SHELDON DR Date of Payment: Sept 2, 2008
DELHI, NY 13753-1276 Amount of Payment: $104,107.00
2007-08 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $871,383.00
2. Total Aug State Share Medicaid Amount $7,449.00
3. Total Sept State Share Medicaid Amount $12,405.00
4. Total Oct State Share Medicaid Amount
5. Total Nov State Share Medicaid Amount $5,626.50
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $192,365.25
7. December Net Excess Cost Payment $192,365.25
8. TOTAL EXCESS COST AID (less Estimated or calc) $871,383.00
9. Total Dec State Share Medicaid Amount $3,404.00
10. Total Jan State Share Medicaid Amount $211.00
11. Total Feb State Share Medicaid Amount $5,150.50
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $383,356.85
13. March Net Excess Cost Payment $383,356.85
14. TOTAL EXCESS COST AID (less Estimated or calc) $871,383.00
15. Total Mar State Share Medicaid Amount
16. Total Apr State Share Medicaid Amount $4,269.00
17. Total May State Share Medicaid Amount $7,538.00
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $118,900.45
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $118,900.45
23. TOTAL EXCESS COST AID (less Estimated or calc) $871,383.00
24. Total June State Share Medicaid Amount
25. Total July State Share Medicaid Amount $8,272.00
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $122,435.45
27. August Net Excess Cost Payment $122,435.45
28. TOTAL EXCESS COST AID $975,490.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC) $104,107.00
30. September Net Excess Cost Payment $104,107.00
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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