7897 APPENDIX 3 UnitServiceMoReport (DOC-1026).doc

This is a Unit Service Monthly Report form (DOC-1026) from the Wisconsin Department of Corrections, Division of Community Corrections, used by supplier agencies to request reimbursement for services provided to eligible correctional offenders under Wisconsin Statutes Section 301.08. The form serves as a standardized reporting mechanism between contracted service providers and the state corrections department for monthly billing and reimbursement processes.

The document establishes a framework for providers to report units of service delivered to correctional offenders, requiring detailed information including unit descriptions, number of units provided, cost per unit, and total net reimbursable amounts. Providers must submit both this Unit Service Report and a separate Offender Monthly Report within 30 days after the final day of each reporting month. The form includes certification requirements where the provider's authorized representative must attest that claimed services are accurate, have not been previously reimbursed, represent actual services delivered, and comply with Wisconsin Department of Corrections laws, rules, and regulations. The reimbursement system operates through purchase orders and invoicing processes, with original documentation maintained by the DCC Central Business Office.