New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 530301
NISKAYUNA CSD Municipal Code: 420658700100
1239 VAN ANTWERP RD Date of Payment: SEP 01, 2009
SCHENECTADY, NY 12309-5317 Amount of Payment: $171,059.00
2008-09 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $2,437,098.00
2. Total Aug State Share Medicaid Amount $14,105.45
3. Total Sept State Share Medicaid Amount $14,469.65
4. Total Oct State Share Medicaid Amount $20,331.40
5. Total Nov State Share Medicaid Amount $28,668.27
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $531,699.73
7. December Net Excess Cost Payment $531,699.73
8. TOTAL EXCESS COST AID (less Estimated or calc) $2,437,098.00
9. Total Dec State Share Medicaid Amount $28,298.58
10. Total Jan State Share Medicaid Amount $20,718.00
11. Total Feb State Share Medicaid Amount $9,049.50
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $1,038,628.02
13. March Net Excess Cost Payment $1,038,628.02
14. TOTAL EXCESS COST AID (less Estimated or calc) $2,437,098.00
15. Total Mar State Share Medicaid Amount $8,926.00
16. Total Apr State Share Medicaid Amount $34,104.52
17. Total May State Share Medicaid Amount $8,733.52
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $313,800.66
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $313,800.66
23. TOTAL EXCESS COST AID (less Estimated or calc) $2,437,098.00
24. Total June State Share Medicaid Amount $26,171.04
25. Total July State Share Medicaid Amount $20,547.97
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $318,845.69
27. August Net Excess Cost Payment $318,845.69
28. TOTAL EXCESS COST AID $2,608,157.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC) $171,059.00
30. September Net Excess Cost Payment $171,059.00
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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