Free Instructions for Completion of Form F-80890 - Wisconsin


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Category: Health Care
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http://dhs.wisconsin.gov/forms/F8/F80890a.pdf

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DEPARTMENT OF HEALTH SERVICES Division of Enterprise Services F-80890A (07/08)

STATE OF WISCONSIN Contract Administration 4.0 Attachment #1a

INSTRUCTIONS FOR COMPLETION OF FORM F-80890
Profile Expense Budget Summary (worksheet F-80890 Page 1)

FIELD NAME
CARS Log Number Contract Period Type of Contract Program Name Contracting Division Profile ID Number Profile Name Funding Source/FMS

INSTRUCTIONS
Log number assigned by CARS Unit. Enter beginning and ending date of contract (MMDDYY) Identify whether contract is new, change of time, and/or change of amount. (optional) Identify program name, i.e, CSBG, rather than program as identified on CARS that refers to program providing funds Check box identifying division responsible for issuing contracts. Enter CARS Profile ID number (maximum six characters). Enter CARS Profile Name (maximum 25 characters) as it appears on CARS reports. Enter as much FMS coding as you know. Appn: 3 digit FMS appropriation code FMS Budget Account: 6 digit summary budget account Center: 10 digit FMS appropriation center (4 digit sublevel 1 & 2, 3 digit project, 3 digit Responsibility Area code) Amount: Total funds to be budgeted for this prepacket. Comments: If needed, use for additional information.
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Total of All Funds Purchasing RGA/RIA/RPA Number

Purchases & Services Section Date and Initials

Division Contact Telephone Number Date Prepared Division Profile Name (max 25 characters) Profile ID Number (max 6 char.) Type of Contract CARS Log Number Contract Period beginning and end date Has the funding split changed? BFS Approval Date

Funding Source (D*)--Enter the Appropriation, Project, and R/A the funding source came from. BFS needs to know which funds the program plans to use for the contracts in order to reserve budget and ensure sufficient funding. This may be done either by: (a) specifying the program funds to be used , or (b) specifying the appropriation and center (project) codes, breaking funding between which is current and which will be available (for example a subsequent state or federal fiscal year). Excel calculated. Enter the number of: - Request for Granting Authority, or - Request for Interagency Agreement, or - Request for Purchasing Authority. To be completed by Purchases & Services Section staff, indicating whether the request for authority or agreement is in process or has been received. Date & initials of staff approval. Name of person to be contacted if there are questions. Phone number. Date form prepared/submitted. (optional). In the Excel workbook, the entry for these fields on F-80890 Page 1 will be auto-filled here.

Indicate whether or not the funding percentages have changed. Approval to be completed by BFS accountant.

INSTRUCTIONS FOR COMPLETION OF FORM F-80890, Page 2
Profile Expense Budget Summary (worksheet F-80890 Page 2 to be completed by BFS)

FIELD NAME
Budget Document Number Funding Table Detail

INSTRUCTIONS
This field will be auto-filled from Operating Budget Form worksheet*. Required field. FMS coding to be provided by BFS accountant. If future project number is undetermined, put TBD in project field and list code string in this area. Appn: 3 digit FMS appropriation code Funding Period (From/To): Format is MMDDYY. Dates identifying the beginning and ending date for each funding segment of the contract. Center: 10 digit FMS appropriation center (4 digit sublevel 1 & 2, 3 digit project, 3 digit Responsibility Area code) Amount: Amount for each funding segment of the contract.. Comments / BFS Initials: If needed, use for additional information. Initials of approving BFS accountant(s). Used for payment lines on the CARS vouchers. Appn: 3 digit FMS appropriation code Voucher Table Account: Five digit code as identified on CARS FUNDING GUIDE. Center: 10 digit FMS appropriation center (4 digit sublevel 1 & 2, 3 digit project, 3 digit Responsibility Area code) SL3: Sublevel 3 coding. Percent of all Funds: Total funding percentage for each known appropriation/center code string. Do not list code strings where a part of the string is undetermined. Comments / BFS Initials: If needed, use for additional information. Initials of approving BFS accountant(s).
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CARS Voucher Table Coding Detail