New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 580501
BAY SHORE UFSD Municipal Code: 470642100100
75 W PERKAL ST Date of Payment: Sept 2, 2008
BAY SHORE, NY 11706-6696 Amount of Payment: $284,683.00
2007-08 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc)
2. Total Aug State Share Medicaid Amount $1,776.50
3. Total Sept State Share Medicaid Amount $8,398.00
4. Total Oct State Share Medicaid Amount $14,707.50
5. Total Nov State Share Medicaid Amount $8,649.50
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid)
7. December Net Excess Cost Payment
8. TOTAL EXCESS COST AID (less Estimated or calc) $5,747,724.00
9. Total Dec State Share Medicaid Amount
10. Total Jan State Share Medicaid Amount $9,951.50
11. Total Feb State Share Medicaid Amount $6,218.00
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $3,973,705.80
13. March Net Excess Cost Payment $3,973,705.80
14. TOTAL EXCESS COST AID (less Estimated or calc) $5,747,724.00
15. Total Mar State Share Medicaid Amount $17,552.00
16. Total Apr State Share Medicaid Amount $12,851.00
17. Total May State Share Medicaid Amount $28,986.00
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $802,769.60
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $802,769.60
23. TOTAL EXCESS COST AID (less Estimated or calc) $5,747,724.00
24. Total June State Share Medicaid Amount $45,565.00
25. Total July State Share Medicaid Amount $39,247.50
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $777,346.10
27. August Net Excess Cost Payment $777,346.10
28. TOTAL EXCESS COST AID $6,032,407.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC) $284,683.00
30. September Net Excess Cost Payment $284,683.00
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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