Exhibit_B_Contractor_Invoice_for_Reimbursement.xlsx
XLSX spreadsheet 39 KB Posted
- Attached to
- AZ|CTR078356
- Contract number
- CTR078356
- Issued by
- Arizona
About this file
This document is an invoice guidance and reimbursement form for the Supplemental Nutrition Assistance Program (SNAP) Career Advancement Network (SNAP CAN), administered by the Arizona Department of Economic Security (ADES). The contract involves the Workforce Development Administration, with the contract ID number 1789, located in Phoenix, Arizona. The document provides detailed instructions for contractors on how to submit invoices for reimbursement under various budget categories for employment and training services.
The contract covers reimbursement for services including personnel costs, professional services, travel, facility expenses, equipment, materials, and participant support services. Contractors can seek up to $10,000 in 100% participant reimbursement and administrative reimbursement at 50% of eligible expenses. Reimbursable items include training materials, vehicle repairs, uniforms, childcare, utility assistance, transportation support, and technology purchases specifically for SNAP-eligible participants. The invoice requires detailed documentation, including a Participant Activity Spreadsheet, and must adhere to federal cost principles outlined in OMB Regulations, Departmental Rules, and SNAP Rules. Invoices are to be submitted electronically within ten calendar days following the end of each month.
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Other files
| File | Type | Posted |
|---|---|---|
| CTR078356_Contract_Documents.pdf | ||
| CTR078356_Debarment_Check.pdf | ||
| Exhibit_A_Participation_Activity_Spreadsheet.xlsx | XLSX spreadsheet | |
| CTR078356_Attachment_7_ISB.pdf | ||
| CI22016_CI_Determination.pdf | ||
| CTR078356_Pre-Contracts_Documents.pdf |
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Text version
Instructions
| Supplemental Nutrition Assistance Program Career Advancement Network (SNAP CAN) |
| Invoice Guidance |
| BUDGET CATEGORY | BREAKOUT | ALLOWABLE TYPES OF INVOICE COSTS |
| Personnel | Costs include employee salaries; fringe benefits including but not limited to: Social Security (FICA); unemployment insurance; worker’s compensation; health and life insurance; and retirement. | |
| Professional & Outside Services | Services to include subcontractor or vendor services that relate directly to the proposed service, but are not provided by agency staff. Services may be provided by individuals or organizations. | |
| Travel | Mileage reimbursement for staff-owned vehicles not to exceed the Federal rate as may be amended (http://www.gsa.gov/portal/content/104877; http://www.gsa.gov/portal/content/100715); maintenance and repair, operating expenses and depreciation for contractor-owned vehicles; subcontracted travel services; leased vehicles; government motor pool vehicles; public transportation; per diem. Staff-related Travel Costs only (Participant-related Travel Costs captured under "Participant Reimbursement" category). | |
| Space | Facilities costs associated with SNAP CAN service provision such as: rent; depreciation or use allowance; building services and utilities such as: fuel; electricity; water; trash removal; maintenance (subcontracted services only); and sewer; insurance for buildings and contents. Minor renovation costs such as: repairs, alterations, partitioning, paneling, rejuvenation and redecorating which do not create a major modification of the building structure. | |
| Capital Equipment ($10,000 plus) | Rental/lease/purchase of equipment costing $10,000 and above; **Providers should not submit any costs under 'Capital Equipment' unless be pre-approved by ADES. | |
| Non Capital Equipment (Under $10,000) | Rental/lease/purchase of equipment costing less than $10,000; use allowance; equipment maintenance and repair costs | |
| Materials & Supplies | Consumable supplies such as: general office and program supplies; Postage; reproduction and subcontracted printing services. | |
| Operating Services | Telephone; Training for contractor’s employees; Subscriptions for professional literature; membership dues; library purchases & fees; Professional activities such as: clubs, meetings; and, General liability insurance. | |
| Indirect | Costs benefiting more than one service and not easily directly chargeable to each service. Indirect cost pool(s) may be established to facilitate equitable distribution of indirect costs to services. **Provider must have an approved Federal Indirect Cost Allocation Rate or a Cost Allocation Plan that supports methodology for indirect costs. | |
| Participant Reimbursement (Support Services) | Training Materials, Fees etc | Test fees, course fees, books, training materials, supplies, fingerprinting, background checks, driver’s license, registration fees, legal assistance |
| Vehicle Repairs/Bike Purchase | Vehicle repairs or bike purchase. | |
| Uniforms, clothing, hygiene, medical | Clothing, personal hygiene, uniforms, grooming, medical, dental, vision | |
| Childcare | Childcare | |
| Utility/Housing Assistance | Utility or housing assistance | |
| Cellphone/Laptop Purchase | Cellphone or laptop purchase | |
| Transportation- Gas/Bus | Gas cards or bus passes |
| INVOICE SUBMISSION | |
| Participant Activity Spreadsheet | A correctly completed Participant Activity Spreadsheet is due within ten (10) calendar days following the end of each calendar month. Submit the completed PAS to EASNAETreports@azdes.gov. ADES will perform the data match to find the SNAP-eligible participants (SNAP Billable Hours). After completion, the contractor will receive the data match results with the SNAP-eligible participant number that should be entered on the invoice (Eligible Non-TANF SNAP Participants Served). |
| Contractors Invoice | Submit Contractors Invoice for Reimbursement and SNAP Billable Hours within ten (10) calendar days following the confirmation of SNAP-eligible participants. Submit the completed invoice to EASNAETreports@azdes.gov. |
Essential Cost Principles for E&T Partnerships -Employment and Training expenses must be directly related to an approved E&T Program component.
-Costs must be reasonable and necessary. A cost is reasonable if, in its nature and amount, it does not exceed that which a prudent person would pay under the circumstances prevailing at the time the decision was made to incur this cost. Necessary costs are incurred to carry out essential functions, cannot be avoided without adversely affecting Program operation, and do not duplicate existing efforts.
-Costs reimbursed must be allowable under the following sections of the Code of Federal Regulations: OMB Regulations: 2 CFR 200, Departmental Rules: 2 CFR 400, and SNAP Rules: 7 CFR 271 through 285.
Additional Guidance -Approval of the ISB does not correlate to allowable invoice amounts. Billings must be based on actual direct charges, allowable cost allocation methodologies, and/or approved indirect cost rates. Documentation demonstrating allocation methodologies must be kept on file and provided upon request by the state and/or federal entity liable for the award.
-A partner agency must charge the Federal government consistently with how other participants, local, State or Federal grants are charged in accordance with Federal grant circulars. If a service is offered at no cost to non-E&T participants and it is not allocated to any other grant, a partner agency cannot charge the E&T program for this service. (For example, Helping ABC center has a computer lab open to the public at no charge. Helping ABC does not cost allocate the operating expenses of this lab to any grant. If a SNAP E&T participant uses this computer lab, Helping ABC cannot charge the E&T program because no one else is charged for lab use. The services provided by an E&T partner agency are reimbursable if the cost of these services is allowable and consistently charged to the general public or to other grants.)
-Federal funds may not be used to supplant non-Federal funds for existing educational activities. If a community-based organization provides services that are funded through a State or local entitlement, E&T cannot be charged for these services. (For example, all adults in the State are entitled to free GED classes and the State provides funds to community-based organizations that offer these services; the community-based organizations in this example cannot bill SNAP E&T for GED classes.)
SNAP CAN Invoice Revision 08/07/2024
| CONTRACTOR'S INVOICE FOR REIMBURSEMENT | ||||
| Division of Employment & Rehabilitation Services | I.Contractor Name | |||
| Workforce Development Administration | ||||
| Attn: Administrator | II. DES Contract ID Number | |||
| 1789 W. Jefferson St. 2nd Flr SW, Mail Drop 59F1 | ||||
| Phoenix, AZ 85007 | III. Service Delivery | |||
| Date (Mo./Yr.): | ||||
| Invoices should be submitted electronically to EASNAETreports@azdes.gov | ||||
| IV. Invoice Number | ||||
| 100% Participant Reimbursment Up To: | $ 10,000.00 | |||
| Administrative Reimbursement: | 50% | |||
| FALSE | ||||
| V. Contractor Information | ||||
| Prepared By: | Date Prepared: | Amount Requested: | - 0 |
| Budget Categories | ||
| 1 | Personnel | $ - 0 |
| 2 | Professional and Outside Services | $ - 0 |
| 3 | Travel | $ - 0 |
| 4 | Space | $ - 0 |
| 5a | Capital/Non-Capital Equipment (10,000 and over) | $ - 0 |
| 5b | Non-Capital Equipment (less than $10,000) | $ - 0 |
| 6 | Materials and Supplies | $ - 0 |
| 7 | Operating Expenses | $ - 0 |
| Total Direct Expenses | $ - 0 |
| Indirect Expenses | $ - 0 |
| Total Administrative Expenses | $ - 0 |
Participant Reimbursement (SNAP-Eligible Clients only)
| 8 | Training Materials, Fees etc | ||
| 9 | Vehicle Repairs/Bike Purchase | ||
| 10 | Uniforms, clothing, hygiene, medical | ||
| 11 | Childcare | ||
| 12 | Utility/Housing Assistance | ||
| 13 | Cellphone/Laptop Purchase | ||
| 14 | Transportation- Gas/Bus | ||
| Total Participant Reimbursement | $ - 0 |
| Total Number of Persons Served: | |
| Eligible Non-TANF SNAP Participants Served: | |
| SNAP-Eligible as % of Persons Served: | 0% |
Total SNAP-Eligible Administrative Expenses $ - 0
Total Administrative Reimbursement (50% of Total SNAP-Eligible Administrative Expenses) $ - 0
Total SNAP-Eligible Participant Reimbursement $ - 0
Total Reimbursement Requested $ - 0
| 1/ I certify that to the best of my knowledge and belief that this report is correct and complete and that all expenditures are for the purposes set forth in the contract | ||||
| identified on this report. | ||||
| Print Name: | Signature: | Date: | ||
| 2/ It is understood that non-federal funds identified in this budget will not be used to match any other federal funds other than the Supplemental Nutrition | ||||
| Assistance Program Employment and Training Expansion Project though the ADES. The contractor agrees to submit additional background information to ADES upon request. | ||||
| Print Name: | Signature: | Date: |
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