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									                                 West Nile Virus Grant Invoicing Instructions

  Basic Information:
 Submission: Submit one copy of the invoice form, time/mileage sheets and copy of all receipts, bills, etc. (Please
  keep your original copies of receipts). The Comptrollers Office does not accept invoices completed in pencil, on
  legal size paper, calculator tapes or rounded figures. Everything must match penny for penny.

 Invoice Due Dates : January 1 to March 31 is due April 30; April 1 to June 30 is due July 31; July 1 to September
    30 is due October 31; and October 1 to December 31 is due January 31.

 Invoice Mailing Address:               DEP - Division of Vector Management
                                                       P.O. Box 1467
                                                Harrisburg, PA 17105-1467
 Invoice Form: The invoice form is a Microsoft Excel spreadsheet. Please press the “Enable Macros” button when
    you open the document and press the tab key to move from one field to the next throughout the document. As you
    input hours, hourly rates (including benefits), miles, etc., the spreadsheet will automatically subtotal and total all of
    your input for you. Always reference the grant’s Detailed Budget page for accuracy regarding input of rates and
    location of category items. Be sure to include the current document number (41000XXXXX), remittance address and
    invoice period.

 Working Capital: Counties that request 20% working capital must deduct it from their invoices starting with the
    first quarter and continuing until it is completely exhausted. If the working capital is not exhausted by September 30,
    the remainder (with interest) must be returned to DEP by check made payable to the “Commonwealth of
    Pennsylvania” by November 29.

 Amendments: Any changes in the Detailed Budget categories require approval from DEP prior to implementation.
    A request for an amendment memo needs to be completed and emailed to your DEP Regional Coordinator. A fill-in-
    the-blank amendment form can be found on the public website. After approval from your Regional Coordinator, they
    will fax the amendment to DEP Central Office for final approval. DEP Central Office will notify you or your
    Regional Coordinator if the request was disapproved.

    Category Specifics:
 Personnel: Staff are to complete a Timesheet and Mileage Log for each month they work for the program. If benefits
    were requested, they are to have been incorporated into the hourly rate as approved on the detailed budget. If
    overtime was approved in the detailed budget, you need to get permission from your DEP Regional Coordinator and
    Central Office staff before using it. Breakout regular hours from overtime hours on the timesheet. If hourly rates
    change, an amendment is necessary.
   Travel/Training: Record your mileage activities on the Timesheet and Mileage Log sheets. Please break it out
    according to whether you were using a leased vehicle or your personal/county vehicle. The State does not pay for
    gasoline, only mileage. Receipts are needed for all training costs (hotel, meals, training materials, registration) all
    training must have been pre-approved in your grant agreement. Remember that all conferences or trainings must be
    WNV oriented. (We do not reimburse for alcohol purchased with meals, or tips).
   Equipment/Supplies: Copies of receipts and/or invoices are needed for everything. Please use the line items given to
    list vendor name(s). Three blank lines have been included for miscellaneous items that do not fall under the line
    items listed.
   Contracted Services: Copies of invoices and/or receipts from the contractor. Note: PSU Extension staff are required
    to submit a West Nile Virus Timesheet and Mileage Log for reimbursement of time. If any other expenses were
    incurred during the invoice period, they may be explained by attaching a letter/memo describing those expenses in
    detail or attach a copy of receipts.
   Administration: Justification in detail on office letterhead as to how administrative costs were calculated and/or
    receipts for items such as postage; copier, telephone and fax usage is required. If office rent was requested and
    approved in your grant, please complete the rent line according to that information.
                                                                                                             Updated: 01/2008
West Nile Virus Invoice Form

County Name:                                                                                     PERIOD From:
DEP Agreement Number:                                                                                     To:
Remittance Address:
County Personnel Name or Title                                Hours Worked                          Rate                      Total
TOTAL from next page (if applicable)
                                                                                                             Total                    $0.00

County Travel/Training (Limited to Commonwealth rates)
County/Personal Vehicle Miles (8/1 to 12/31)                                             at .585 per mile                             $0.00
Leased Vehicle Miles                                                                     at .22 per mile                              $0.00
Instate Training (DEP, Pesticide Certification or WNV-oriented)
Pesticide Applicators Insurance
Pesticide Applicators License fees and testing materials
Vehicle Rental/Leases (trucks, ATVs, trailers, insurance)
                                                                                                             Total                    $0.00
County Equipment/Supplies                            List Vendor Name(s)
Carbon Dioxide/Dry Ice
Surveillance Equip/Supplies (vials, traps, etc.)
Control Equip./Supplies (sprayers, etc.)
Adulticide/Larvicide Products
Educational Materials
Cell Phones
Office Supplies

                                                                                                             Total                    $0.00
Contracted Services                                 All Penn State Cooperative Extension Expenses
                                                    Professional Pesticide Applicator Expenses
                                                                                                             Total                    $0.00
Administration                                      Postage; Copier, Fax, and Telephone Usage
                                                    WNV Exclusive Office Rent
                                                                                                             Total                    $0.00
                                                                                                SUBTOTAL :                            $0.00
                                                                        Less Working Capital (if applicable):
                                                                        TOTAL REIMBURSEMENT:                                          $0.00
I declare that the above expenses are an accurate statement for this county for DEP's West Nile Virus Control Program to the best of my

Signature                                           Title                                                             Date
                                        INELIGIBLE EXPENSES

1.   Freezers, refrigerators, lab furniture, office furniture, generators.
2.   Insect repellants (bug suits are acceptable). Insect repellants contaminate sampling equipment.

3.  All control products (larvicide/adulticide) must be purchased by September 30.
4.  Tire removal or advertising for removal.
5.  Medical expenses (including drug testing) of any staff or contractor.
6.  Business cards and Promotional items (pens, pencils, magnets, note pads, etc.).
7.  Waterproof notepads (information written in pencil will not run or smear).
8.  Purchase of clothing (baseball caps, sport shirts, pants or jackets), including embroidery work or
    dry cleaning expenses.
 9. Maintenance on vehicles (tires, inspection, oil change, car wash, etc.). These costs are incorporated
    in with the mileage rate. These same expenses would be part of the lease agreement should the
    vehicle be leased.
10. Purchase of any type of vehicles (truck, car, ATV, truck caps, etc.). (NOTE: When leasing
    vehicles, be sure that all necessary accessories and insurance are included in the price of the lease).

11. Computer servers, laptops and accessories, USB flash drives, laser printers, LCD projectors, digital
    cameras, copiers, scanners, or fax machines.
12. Membership dues to professional associations (Examples: AMCA, MAMCA, NJMCA, PVCA,
13. Food associated with county-initiated educational activities.
14. Attorney or auditor fees.
15. Travel Status: Charges for tips to bellboys and waiters/waitresses, personal phone calls, alcoholic
    beverages, parking fines and moving vehicle violations, meals and lodging provided by the
    Commonwealth, meals and lodging furnished free by friends, relatives, or any other source.
16. Costs associated with commuting from home to office (time and/or mileage).
17. No more than two cell phones per county at a maximum of $600 each.

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