INVOICE AND PAYMENT Clause Samples
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INVOICE AND PAYMENT. A. Grantee will request payment using the State of Texas Purchase Voucher (Form B-13) on a monthly basis and acceptable supporting documentation for reimbursement of the required services/deliverables. Additionally, the Grantee will submit the Financial Status Report (FSR-269A) and the Match Certification Form (B-13A). Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below. Department of State Health Services Claims Processing Unit, MC 1940 ▇▇▇▇ ▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ P.O. Box 149347 Austin, TX ▇▇▇▇▇-▇▇▇▇ FAX: (▇▇▇) ▇▇▇-▇▇▇▇ EMAIL: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇, ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ & ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ B-13, B-13A, and supporting documentation should be sent to: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇, ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ & ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ FSRs should be sent to: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇, ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇, ▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ & ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇
B. Grantee will be paid on a monthly basis and in accordance with Attachment B, Budget.
C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor ▇▇▇▇▇▇▇’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, ▇▇▇▇▇▇▇’s budget may be subject to a decrease for the remainder of the Term of the Contract. Vacant positions existing after ninety days may result in a decrease in funds.
▇. ▇▇▇▇▇▇▇ may request a one-time working capital advance not to exceed 12% of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency.
▇. ▇▇▇▇▇▇▇ will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one- third of the remaining balance of the advance.
INVOICE AND PAYMENT. ▇. ▇▇▇▇▇▇▇ will request payments using the State of Texas Purchase Voucher (Form B-13) at ▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇▇▇.▇▇.▇▇/grants/forms.shtm. Voucher and any supporting documentation will be mailed, submitted by fax, or submitted by electronic mail to the addresses/number below. Department of State Health Services Claims Processing Unit, MC 1940 ▇▇▇▇ ▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ P.O. Box 149347 Austin, Texas ▇▇▇▇▇-▇▇▇▇ FAX: (▇▇▇) ▇▇▇-▇▇▇▇ EMAIL: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ EMAIL: ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ EMAIL: ▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇
B. Grantee will be paid on a cost reimbursement basis and in accordance with ATTACHMENT B BUDGET of this Contract. Travel costs must not exceed General Services Administration (GSA) rates located at ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/travel/plan- book/per-diem-rates unless the Grantee has an established travel policy that has been reviewed and approved by DSHS.
▇. ▇▇▇▇▇▇▇ will submit requests for reimbursement (Form B-13) and financial expenditure template monthly by the last business day of the month following the month in which expenses were incurred or services provided. Grantee shall maintain all documentation that substantiate invoices and make the documentation available to the DSHS upon request. In the event a cost reimbursed under the Contract is later determined to be unallowable then the Grantee will reimburse DSHS for that cost.
▇. ▇▇▇▇▇▇▇ will submit quarterly FSRs to DSHS by the last business day of the month following the end of each quarter of the Contract for DSHS review and financial assessment.
▇. ▇▇▇▇▇▇▇ will submit request for reimbursement (B-13) as a final close-out invoice not later than forty-five (45) calendar days following the end of the term of the Contract. Reimbursement requests received in the DSHS office more than forty-five (45) calendar days following the termination of the Contract may not be paid.
▇. ▇▇▇▇▇▇▇ will submit a final FSR for the service period of September 1, 2019 through August 31, 2020 by October 20, 2020. Grantee will submit a final FSR for the service period of September 1, 2020 through August 31, 2021 by October 20, 2021.
INVOICE AND PAYMENT. 4.1 System Agency will send Grantee an annual funding letter (“Notice of Award”) setting the award amount for the corresponding fiscal year. Annual and funding adjustment Notices of Award will be incorporated into this Contract by reference.
4.2 Grantee will request monthly reimbursements by e-mail to HHSC WIC Program Services Unit at ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇▇▇.▇▇▇ by the last business day of the following month.
4.3 Grantee will submit a separate invoice for reimbursement of actual allowable costs associated with each project as indicated on the Notice of Award funding letter.
A. Grantee will indicate separately on the face of the invoice, the costs associated with administration, nutrition education, and breastfeeding, and/or in the format designated by System Agency.
B. Grantee awarded SNAP-Ed Program funding will indicate separately on the face of the invoice the expense by cost categories as instructed when awarded the SNAP-Ed funding.
4.4 Grantee will submit FSR quarterly reports by e-mail for each project as indicated on the Notice of Award funding letter to HHS WIC Program Services Unit at ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇▇▇.▇▇▇ by the last business day of the month following the end of each quarter of the Contract term for review and financial assessment.
4.5 Grantee will be paid in accordance with the terms of this Contract.
4.6 All payments made by System Agency to Grantee under this Contract will be reimbursements subject to the following requirements, conditions and stipulations:
A. All categories of costs billed to System Agency and allocation of such costs, shall be in accordance with the Plan to Allocate Direct Costs (PADC) submitted by Grantee and accepted by the System Agency. This document is incorporated in the Contract by reference.
B. System Agency will reimburse Grantee up to the earned allowable amount for administrative costs necessary to fulfill program objectives such as determining eligibility, providing appropriate nutrition education and counseling, providing breastfeeding promotion and support, issuing benefits via the WIC EBT cards, making participant referrals, vendor evaluation, outreach, and start-up costs.
C. Administrative funding is based on the Grantee’s participant rate and/or a base rate as established by System Agency.
D. Grantee will be allowed the option of receiving cash advances in accordance with current System Agency's WIC program policy and procedures.
E. Grantee must liquidate all encumbrances and invoice for all costs associ...
INVOICE AND PAYMENT. A. Grantee shall establish and maintain an independent cost center that is accessible and identifies the source and application of funds provided under this Statement of Work and original source documentation substantiating that costs are specifically and solely allocable to this Statement of Work and are traceable from the transaction to the general ledger.
B. Grantee shall submit invoices based on the schedule outlined in Table 1 using the State of Texas Purchase Voucher Form 4116, which is incorporated by reference and can be downloaded at: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/laws-regulations/forms/4000-4999/form-4116-state-texas- purchase-voucher.
C. All invoices not received by the scheduled due date as outlined in Table 1 above are considered late and will require justification from the Grantee for the late submission.
D. Documentation and data required for invoice submission includes:
1. Name, address, and telephone number of Grantee on the State of Texas Purchase Voucher Form 4116;
INVOICE AND PAYMENT. Grantee shall:
A. Request payments monthly using the State of Texas Purchase Voucher (Form B-13) at ▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇▇▇.▇▇▇/grants/forms.shtm, the Voucher Support Form (VSF) and acceptable supporting documentation for reimbursement of the required services/deliverables. Grantee is required to identify expenditures by budget category and funding code. Voucher and all supporting documentation must be submitted to: P.O. Box 149347 Austin, TX 78714-9347 E-mail: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ and ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇;
B. Be paid on a cost reimbursement basis and in accordance with Attachment B-1 of this Contract (i.e., Budget); and
C. Submit to DSHS an annual forecast of all program income generated from DSHS funds and activities. Program income should be expended prior to drawing down or requesting reimbursement from DSHS. Grantee must also make available
1. Report to the contract manager assigned to the Contract, any knowledge of debarment, suspected fraud, program abuse, possible illegal expenditures, unlawful activity, or violation of financial laws, rules, policies, and procedures related to performance under this Contract;
2. Make such report no later than three (3) working days from the date the Grantee has knowledge or reason to believe such activity has taken place;
3. Report any credible evidence that a principal, employee, subgrantee or agent of Grantee, or any other person, has submitted a false claim under the False Claims Act or has committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct involving those funds; and
4. Make this report to the SAO at ▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇▇▇.▇▇▇ and to the HHS Office of Inspector General at ▇▇▇▇://▇▇▇.▇▇▇.▇▇▇.▇▇▇/fraud/hotline/ no later than three
INVOICE AND PAYMENT. ▇. ▇▇▇▇▇▇▇ will request payment using the State of Texas Purchase Voucher (Form B-13) monthly and acceptable supporting documentation for reimbursement of the required services/deliverables. The Grantee will submit the Financial Status Report (FSR-269A). Additionally, the Grantee will submit the Match Certification Form (B-13A), at the end of the fourth quarter. Vouchers, supporting documentation, Financial Status Reports, and Match Certification Forms should be mailed or emailed to the addresses below.
B. Grantee will be reimbursed on a monthly basis and in accordance with Attachment B, Budget.
C. System Agency reserves the right, where allowed by legal authority, to redirect funds in the event of financial shortfalls. System Agency will monitor ▇▇▇▇▇▇▇’s expenditures on a quarterly basis. If expenditures are below that projected in Grantee’s total Contract amount, ▇▇▇▇▇▇▇’s budget may be subject to a decrease for the remainder of the Contract term. Vacant positions existing after ninety (90) days may result in a decrease in funds.
▇. ▇▇▇▇▇▇▇ may request a one-time working capital advance not to exceed twelve percent (12%) of the total amount of the Contract funded by System Agency. All advances must be expended by the end of the Contract term. Advances not expended by the end of the Contract term must be refunded to System Agency. Grantee will repay all or part of advance funds at any time during the Contract’s term. However, if the advance has not been repaid prior to the last three months of the Contract term, the Grantee must deduct at least one-third of the remaining advance from each of the last three months’ reimbursement requests. If the advance is not repaid prior to the last three months of the Contract term, System Agency will reduce the reimbursement request by one-third of the remaining balance of the advance.
INVOICE AND PAYMENT. A. Grantee shall submit requests for reimbursement of required services/deliverables monthly using the State of Texas Purchase Voucher (Form B-13), together with supporting documentation as directed by System Agency. Forms should be mailed, faxed or e-mailed to the addresses below. Invoices will be due the last business day of the month following the month in which expenses were incurred.
B. Grantee shall submit a Financial Status Report (FSR) twice per calendar year for the term of the Contract, beginning on the effective date of the Contract through November 30, 2027. 1 Effective Date - May 31, 2023 June 30, 2023 June 1, 2023 - November 30, 2023 December 30, 2023 2 December 1, 2023 - May 31, 2024 June 30, 2024 June 1, 2024 - November 30, 2024 December 30, 2024 3 December 1, 2024 - May 31, 2025 June 30, 2025 June 1, 2025 - November 30, 2025 December 30, 2025 4 December 1, 2025 - May 31, 2026 June 30, 2026 June 1, 2026 - November 30, 2026 December 30, 2026 5 December 1, 2026 - May 31, 2027 June 30, 2027 June 1, 2027 - November 30, 2027 January 15, 2028 All reporting documents must be submitted by e-mail, fax, or mail. E-mail is preferred, but fax or mail is acceptable.
1. For submission by mail, use address below: Department of State Health Services Claims Processing Unit, MC 1940 ▇.▇. ▇▇▇ 149347 Austin, TX 78714-9347
2. For submission by fax, use number below: (▇▇▇) ▇▇▇-▇▇▇▇
3. For submission by e-mail, see requirements below:
a. Form B-13 with supporting documentation and Form B-13A must be sent to ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ & ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇, with a copy to the System Agency contract manager.
b. FSR must be sent to: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇; ▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇; and with a copy to the System Agency contract manager.
C. Grantee will be reimbursed monthly in accordance with Attachment B, Budget, subject to all Contract requirements, applicable law and governing regulations. Grantee shall include required and appropriate documentation with all reimbursement requests.
INVOICE AND PAYMENT. ▇. ▇▇▇▇▇▇▇ will request payments using the State of Texas Purchase Voucher (Form B-13) at ▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇▇▇.▇▇.▇▇/grants/forms.shtm. The Voucher and any supporting documentation will be mailed or submitted by fax or electronic mail to the address/number below. Department of State Health Services Claims Processing Unit, MC 1940 ▇▇▇▇ ▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ P.O. Box 149347 Austin, TX ▇▇▇▇▇-▇▇▇▇ FAX: (▇▇▇) ▇▇▇-▇▇▇▇ EMAIL: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ EMAIL: ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇
B. Grantee will be paid on a cost reimbursement basis and in accordance with
C. Grantee shall maintain all documentation that substantiate invoices and make the documentation available to System Agency upon request. In the event a cost reimbursed under the Contract is later determined to be unallowable, then the Grantee will reimburse System Agency for that cost.
▇. ▇▇▇▇▇▇▇ will submit quarterly Financial Status Reports (FSRs) to System Agency by the last business day of the month following the end of each quarter of the Contract for System Agency review and financial assessment. The quarters are as follows:
1. September 1 through November 30
2. December 1 through February 28 3. March 1 through May 31
INVOICE AND PAYMENT. 1. Payments are on a monthly cost-reimbursement basis in response to an invoice and purchase voucher.
2. Grantee will submit an invoice and purchase voucher monthly, no later than the last day of the month following that in which the expenditure occurred. If the last day falls on a weekend or holiday, the documents are due the next business day.
3. Grantee shall submit a final close-out invoice annually, not later than 45 calendar days following the end of the fiscal year. Reimbursement requests received more than 45 calendar days following the termination of the Grant may not be paid. CONTRACT (GRANT) NUMBER: HHS000791900004 AGENCY ID: 24813302
4. PEI will pay Grantee from available funds for services rendered in accordance with the terms of this Grant Agreement upon receipt of a proper and verified invoice and after deduction of any known previous overpayment made by DFPS.
INVOICE AND PAYMENT. Grantee shall request monthly payments by the 30th day following the service month using the State of Texas Purchase Voucher (Form B-13) at ▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇▇▇.▇▇▇/grants/forms.shtm. System Agency will issue reimbursement payments to Grantees on a monthly basis for reported actual cash disbursements which are supported by adequate documentation. Invoices must be submitted monthly to prevent delays in subsequent months. Grantees that do not incur expenses within a month are required to submit a “zero dollar” invoice on a monthly basis. Grantee must submit a final close-out invoice and final financial status report no later than 45 days following the end of the Contract term. Invoices received more than 45 days after the end of the Contract term are subject to denial of payment. Grantee shall electronically submit all invoices with supporting documentation to: ▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ and ▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ and a copy to the assigned DSHS Contract Representative identified in the Signature Document.
A. At a minimum, voucher should include:
1. Grantee name, address, email address, vendor identification number, and telephone number;
2. DSHS Contract or Purchase Order number;
3. Dates services were completed and/or products were delivered;
4. The total invoice amount; and
5. Any additional supporting documentation which is required by the Statement of Work or as requested by DSHS. Failure to submit required information may result in delay of payment or return of invoice. Billing invoices must be legible. Illegible or incomplete invoices which cannot be verified will be disallowed for payment.
B. DSHS will pay Grantee monthly on a cost reimbursement basis and in accordance with Attachment B, Budget, of this Contract. DSHS will reimburse Grantee only for allowable and reported expenses incurred within the grant term. Personnel $129,778.00 $129,778.00 Fringe Benefits $30,991.00 $30,991.00 Travel $2,680.00 $2,680.00 Equipment $0.00 $0.00 Supplies $5,621.00 $5,621.00 Contractual $720.00 $720.00 Other $0.00 $0.00 Total Direct Charges $169,790.00 $169,790.00 Indirect Charges $0.00 $0.00 Attachment C CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) r...