Monthly Invoice Statement

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					                                       Monthly Invoice Instructions
                      Only an original invoice with original signature will be accepted

The invoice is due on the last day of the month immediately following the month for which reimbursement is requested,
with the exception of the final invoice which is due within 45 days after the end of the grant period. Monthly invoices are
for the purpose of reimbursing the agency for approved VOCA Grant expenditures that were actually paid during the
month.



Backup documentation must be submitted to the OAG with each invoice. Backup documentation includes, but is
not limited to, payroll (check) registers/journals i.e., accounting/payroll printouts which reflect employee name, time
worked, gross salary & employer paid benefits i.e., proof of payment of payroll taxes; invoices/bills and proof of
payment for workers compensation, state unemployment, health, dental and life insurance, etc. (provide a statement of
explanation if the individual is self-insured); time sheets; invoices/bills and proof of payment for telephone expenses,
utilities, office supplies, travel/mileage. Additional backup documentation may be needed to support the request for
VOCA funds and the reported Match upon request of the OAG. Supporting documentation for all invoices must be
maintained at the office of the provider and be available to the OAG upon request.

Items to Complete:

   Grant No.: Enter the number as it appears in the VOCA Agreement (e.g. V8000).

   Invoice Period: Enter the month/year for which reimbursement is requested. Invoices must be submitted each
   month, even if no reimbursement is requested. Providers must submit 12 monthly invoices. The entire grant
   award cannot be expended before the end of the grant period.

   Provider/Payee: Enter the name as it appears in the VOCA Agreement.

VOCA Budget:

   TOTAL VOCA AWARD: Enter the amounts approved in your grant budget (or approved Budget Modification) in
   this column by the appropriate category.

   INVOICE AMOUNT: Enter the amount of reimbursement requested by the appropriate budget category based on
   the expenditures paid during the invoice period.

   VOCA EXPENDITURES TO DATE: This column is a cumulative total of the invoice amounts. For October, this
   amount will be the same as the INVOICE AMOUNT. For November, add the invoice amounts for October and
   November for the cumulative VOCA EXPENDITURES TO DATE amount.

   VOCA BUDGET BALANCE: This column is the TOTAL VOCA AWARD amount by budget category, minus the
   VOCA EXPENDITURES TO DATE amount by category.

   TOTAL: Total each column and enter the number on this line. The total in the TOTAL VOCA AWARD column
   should be the amount of the award as it appears in the VOCA Agreement. The TOTAL VOCA BUDGET BALANCE
   is equal to TOTAL VOCA AWARD minus VOCA EXPENDITURES TO DATE.

Required Match Budget: (Report the required match amount.)

   TOTAL REQUIRED MATCH: Enter the amounts approved in your grant budget (or approved Budget Modification)
   in this column by the appropriate category.




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   MATCH AMOUNT: Enter the reported match amount for the invoice period in this column by the appropriate
   category. Unless otherwise approved by the OAG, Match must be reported on a monthly basis consistent with or
   greater than the amount of funding requested for reimbursement.

   MATCH EXPENDITURES TO DATE: This column is a cumulative total of your matching contribution to date. For
   October, this amount will be the same as the MATCH AMOUNT. For November, add the match amounts for
   October and November for the cumulative MATCH EXPENDITURES TO DATE amount.

   MATCH BALANCE: This column is the TOTAL REQUIRED MATCH amount by budget category, minus the
   MATCH EXPENDITURES TO DATE amount by category.

   TOTAL: Total each column and enter the number on this line. The amounts entered for each category in the
   TOTAL REQUIRED MATCH column should equal the total of the approved match budget. The MATCH BALANCE
   is equal to TOTAL REQUIRED MATCH minus MATCH EXPENDITURES TO DATE.


Certification: This certifies that the expenditures are in compliance with the Final Program Guidelines and the VOCA
Agreement. Include the date, name and signature of the person who completed the invoice. The date of signature
must be no earlier than the last day of the month for which reimbursement is requested.


For use by Bureau Staff: The bottom portion is to be completed by the Bureau of Advocacy and Grants Management.


                                        ** DOUBLE CHECK ALL FIGURES**



                     Mail the ORIGINAL invoice and accompanying spreadsheets/reports to:
                                 Bureau of Advocacy and Grants Management
                                         Office of the Attorney General
                                               PL-01, The Capitol
                                        Tallahassee, Florida 32399-1050


                           Questions? Call your OAG Grant Manager at (850) 414-3300




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                       2008-2009 VICTIMS OF CRIME ACT (VOCA) MONTHLY INVOICE
                                                             (Refer to Instructions)


       Provider/Payee:

             Grant No.:V                                  Invoice Period: (Month/Year)


                                                              VOCA BUDGET
          CATEGORIES                      TOTAL VOCA                    INVOICE             VOCA EXPENDITURES             VOCA BUDGET
                                            AWARD                       AMOUNT                    TO DATE                   BALANCE
PERSONNEL
CONTRACTUAL
EQUIPMENT
OPERATING
TOTAL                                $                   -      $                      -   $                   -      $                   -


                                                     REQUIRED MATCH BUDGET
          CATEGORIES                   TOTAL REQUIRED                    MATCH             MATCH EXPENDITURES                MATCH
                                           MATCH                        AMOUNT                    TO DATE                   BALANCE
PERSONNEL                                                                                                             $                   -
CONTRACTUAL                                                                                                           $                   -
EQUIPMENT                                                                                                             $                   -
OPERATING                                                                                                             $                   -
TOTAL                                $                   -      $                      -   $                   -      $                   -

Certification: I certify that the expenditures listed on this invoice have been paid by the provider in accordance with the
Agreement and that these costs have not been and will not be reimbursed by any other source (e.g., victim compensation,
insurance, client fees, Medicaid, Medicare, local or other grant funds, etc.). Furthermore, I certify that documentation to support
the VOCA and Match expenditures on the invoice are maintained on file, in the manner described by the OAG office and as
provided by the VOCA Agreement.



PRINT NAME OF AUTHORIZED SIGNATURE                             AUTHORIZED SIGNATURE OF SUBGRANTEE                              DATE

NOTES: (1) Only an original Invoice with original signature will be accepted. No fax copies will be accepted. (2) Errors in the invoice will
result in a delay in processing.



FOR USE BY BUREAU STAFF:




AMOUNT REIMBURSED              OAG GRANT MANAGER / DATE                                                              DATE TO FINANCE




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