Date
Project code
2135
Fiscal Year Division
Request for Invoice Form
1. Name of Project Participation Fee (See explanation on page two)
FY06-07
LPD
State
INTERSTATE CONSORTIUM ON Option 1 - $10,000 (state participation fee only) Option 2 - $13,000 (state participation fee + travel SCHOOL LEADERSHIP
expenses for two meetings)
2. Name of State Account Used: 3. State Purchase Order Number:
STATE CONTACT INFORMATION
4. Primary Contact for Accounting Office
Name: Address:
Phone: E-mail: 5. State Program Contact Person
Name Address
Fax:
State Program Contact Person
Name Address
Phone E-mail
Fax
Phone E-mail
Fax
6. BILLING INFORMATION
Special wording on invoice (in addition to the project name, number, contact person, fiscal year, and fee)
7. PAYMENT SCHEDULE
Date of Payment Amount Notes
8. PERSON COMPLETING FORM 9. AUTHORIZED SIGNATURE
Please sign and date Please print name Date
Send completed requests to:
Lucy Cox Council of Chief State School Officers One Massachusetts Avenue, NW, Suite 700 Washington, DC 20001-1431 202.336.7021 -- Fax 202.789.0596
Explanation of the Request for Invoice Form
Due Date: Friday, June 16, 2006
1. Name of Project/Participation Fee/State
Option 1 – State Participation Fee of $10,000. Interstate Consortium on School Leadership state participation fee for FY2006-07 is $10,000. The state participation fee provides CCSSO staff support for convening meetings, communication and information dissemination among members, and conducting projects agreed on by members (such as updating the ISLLC Standards for School Leaders). The state participation fee does not cover travel, hotel or other costs for state representatives to attend meetings. Option 2 – State Participation Fee plus Meeting Costs at 13,000. Under this option, states prepay $3,000 in meeting costs for FY2006-07 meetings, along with the state participation fees of $10,000, for a total of $13,000. Under the $3,000 meeting cost option, CCSSO will pay hotel, travel, and reimbursable expenses for one (1) state representative to attend two (2) national meetings, tentatively scheduled for October 2006 and March 2007. Consortium member states will (1) share information about effective state leadership policies, programs, and practices; (2) leverage scarce state dollars by collaborating on national projects to improve school leadership; and (3) contribute resources to CCSSO’s NET LC Clearinghouse of state policies and research-based leadership resources.
2. Name of State Account Used
If applicable, this might be designated as "Leadership Development” or “Licensure for School Leaders”, or whatever funding source your state may use.
3. State Purchase Order Number
The State purchase order number assigned to this project.
4. Primary Accounting Office Contact Persons
This is the person who will receive the invoice and whose name will be listed on the invoice.
5. Program Contact Persons
This will usually be the name(s) of the people who represent your state with this project. Please include complete contact information.
6. Wording on Invoice
This is the information you would like to appear on the Invoice in addition to the Project Name, Contact Person, Fiscal Year, and Fee.
7. Payment Schedule
When payments need to be split, use this space to indicate the approximate dates and amounts planned in the payment schedule. This will allow CCSSO to anticipate payments appropriately.
8. Person Completing Form
This will usually be one of the people listed in the state contact information above or someone designated by the supervisor.
9. Authorized Signature
The form should be signed by the person with the authority to approve payment of the fee. This signature will authorize CCSSO to move forward with this project before the state payment is received and provide assurance that the state will be a member of the project. Please print your name under your signature. For additional information or assistance, please contact: Nancy Sanders Council of Chief State School Officers One Massachusetts Ave., NW, Suite 700 Washington, DC 20001-1431 nancys@ccsso.org 303.484.8475