ATTACHMENT 2 - Missouri Statewide Quarterly Admin Fee Report and Instructions.xlsx
XLSX spreadsheet 18 KB Posted
- Attached to
- Statewide - Adaptive Technology
- Solicitation number
- 300000267262914
- Issued by
- Missouri
About this file
This document is a Quarterly Administrative Fee Report and Instructions template for Missouri statewide contracts administered by the Division of Purchasing. The report applies to all contractors holding statewide contracts with various State of Missouri agencies and requires submission of purchase and payment data on a quarterly basis.
Contractors must submit the Quarterly Administrative Fee Report to the Division of Purchasing no later than the 15th calendar day of the month following each reporting quarter (Q1: January 1–March 31; Q2: April 1–June 30; Q3: July 1–September 30; Q4: October 1–December 31). The report requires contractors to document total payments received from Missouri state agencies, political subdivisions, universities, and governmental entities in other states during the reporting period. An administrative fee of 1% is calculated on the overall total payments received minus returns and credits. Contractors must indicate the payment method used for submitting the administrative fee—including personal check, money order, company check, cashier's check, or ACH electronic payment—and provide the date of payment submission. The report should be submitted to the Division of Purchasing via mail, fax to (573) 526-9815, or email to ereports@oa.mo.gov. If no payments were received during a reporting quarter, contractors must check the designated box rather than submit payment.
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Other files
| File | Type | Posted |
|---|---|---|
| STATE 0000000416SL,3_BidTabulation.pdf | ||
| STATE 0000000416SL- Adaptive Technology - Amendment 03.docx | DOCX document | |
| STATE 0000000416SL- Adaptive Technology.docx | DOCX document | |
| ATTACHMENT 01 - Federal Requirement Language.docx | DOCX document | |
| ATTACHMENT 3 - Missouri Statewide Contract Quarterly Admin Fee Usage Report.xlsx | XLSX spreadsheet | |
| STATE 0000000416SL- Adaptive Technology - Amendment 01.docx | DOCX document | |
| STATE 0000000416SL- Adaptive Technology - Amendment 02.docx | DOCX document |
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Text version
Instructions
| Quarterly Administrative Fee Report |
| The contractor shall submit a "Quarterly Administrative Fee Report" to the Division of Purchasing (Purchasing) for all purchases made under the contract for which payment has been received by the contractor during the reporting quarter. The contractor must submit the "Quarterly Administrative Fee Report" to Purchasing no later than the 15th calendar day of the month following the "Reporting Quarter". The contractor shall complete the "Quarterly Administrative Fee Report" in accordance with the definitions and requirements stated below. Completed electronic forms will feed into a central database for aggregate usage. Please contact Purchasing (573) 751-2387 if you have specific questions about your contract area, the submission of this report, or payment of the administrative fee. |
| Header Definitions. | |
| Contractor Name | Contractor name as it appears on the contract. |
| Statewide Contract Number | Statewide contract number as listed on the first page of your contract with the State of Missouri. |
| Date Report Submitted | Date Administrative Fee Report is submitted. |
| Report Contact Name | Name of the person completing the report on behalf of the contractor. |
| Contact Phone Number | Phone number for person completing the report. |
| Contact Email Address | Email address for the person completing the report. |
| Administrative Fee Payment Calculation - The total amount in payments received (minus returns & credits) from state agency(ies), political subdivision(s), universities, and governmental entities in other states, the Overall Total Payments Received, and the Total Administrative Fee Payment (calculated as 1% of the Overall Total Payments Received) for the Reporting Quarter. | |
| If no payments were received during the Reporting Quarter, check the box below: Complete section if applicable. | |
| Reporting Quarter | Quarter for which the contractor is reporting purchases for which payment has been received. This must be in format QX, where X is the Quarter number as follows: |
| Q1: January 1 - March 31 Q3: July 1 - September 30 | |
| Q2: April 1 - June 30 Q4: October 1 - December 31 | |
| Signature of Reponsible Party for Report Content: The signature and title of the person completing the report on behalf of the contractor and the date the report was completed. |
Attachment
Admin Fee Report
| Contractor Name: | Report Contact Name: |
| Statewide Contract Number: | Contact Phone Number: |
| Date Report Submitted: | Contact Email Address: |
| Administrative Fee Payment Calculation: | |||
| (If no payments received during Reporting Quarter, skip to next section) | Reporting FY Quarter (check one): | ||
| Total Payments Received (minus returns & credits) from Missouri State Agencies during the Reporting Quarter : | [ ] July 1 - September 30 | ||
| Quarter 1 | [ ] October 1 - December 31 |
Quarter 2
| Total Payments Received (minus returns & credits) from Missouri Political Subdivisions (cities, counties, etc.) during the Reporting Quarter: | [ ] January 1 - March 31 | |
| Quarter 3 | [ ] April 1 - June 30 |
Quarter 4
| Total Payments Received (minus returns & credits) from Missouri Universities during the Reporting Quarter: | Submit this report to the Division of Purchasing (Purchasing) using one of the methods below: |
| Total Payments Received (minus returns & credits) from Governmental Entities in Other States during the Reporting Quarter: | 1) Mail: Division of Purchasing, |
P.O. Box 809, Jefferson City MO 65102 - 0809 OR 301 West High Street, Room 630, Jefferson City MO 65101 - 1517
2) Fax: (573) 526-9815
3) Email: ereports@oa.mo.gov
| Overall Total Payments Received (minus returns & credits) during the Reporting Quarter : | $0.00 | Indicate below the method of payment used for submitting the Total Administrative Fee Payment for the Reporting Quarter and date of payment submission: |
| 1% Administrative Fee (Multiply Overall Total Payments by 1% to determine Total Administrative Fee Payment) | 1.00% |
Method of Payment Used:
[ ] Personal check [ ] Money Order [ ] Company check [ ] ACH (Electronic Payment) [ ] Cashier's check
Date of Payment Submission: __/__/20__ (mm/dd/yyyy) Total Administrative Fee Payment for the Reporting Quarter: $0.00
| If no payments were received during the Reporting Quarter, check the box below: | Signature of Responsible Party for Report Content: | ||
| [ ] No payments were received this calendar quarter for any purchases | |||
| on the contract identified above. | Signature: _______________________________________________ |
Title: _______________________________ Date: ______________
&"Arial,Bold"&12 Attachment 2 - Missouri Statewide Contract Quarterly Administrative Fee Report
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