STATE CONTRACT FORMS

• DSS6844S Budget Forms (Rev. 11/10)* excel version
• DSS6844S Instructions
• DSS6844S Sample Budget Narrative
• DSS2517S Budget Amendment Form and Instructions*
• DSS2517S Sample Form
• Terms and Conditions - Duke Medical
• Terms and Conditions - Health Care Providers
• Terms and Conditions - Private Sector
• Terms and Conditions - Private University
• Terms and Conditions - Public Sector
• Terms and Conditions - State Departments
• 5006A Direct Client Services Narrative Face Sheet*
• 5006A Instructions
• 5006B Administrative Support Narrative Face Sheet*
• 5006B Instructions
• 5006T Training Narrative Face Sheet*
• 5006T Instructions
  
• Agency Contractor Sign

• Consolidated Federal Certification
• Conflict of Interest Acknowledgement
• IRS Verification Form
• IRS Verification Form - Other than Non-Profit
• No Overdue Tax Certification (non governmental)
• Notice of Certain Reporting ( Attachment F)
• Scope of Work Elements Chart
• SOW Guide
• Work Sheet 1 Service Implementation Plan
• Work Sheet 2 Goals, Outcomes, Evaluation Plans
• Work Sheet 3 Board Member Profile
• Work Sheet 4 Anticipated Revenue Summary
• Work Sheet 5 Funding Chart
• Federal Funding Accountability and Transparency Act (FFATA) Form

Invoicing Forms

• DSS1571 Instructions (Reimbursement)
• DSS-1571* excel version
• DSS-1571- Two Page Form* excel version

Miscellaneous Forms/Instructions

• F2329 Staff Time Sheet* (For time and effort tracking)
• 3613 Travel Authorization Form* (For Prior Approval for Travel)
  

Cost Principles/Audit requirements

• A21 Principles for Determining cost applicable to Grants, contracts and other Agreements with Institutions
  • See: http://www.whitehouse.gov/omb/circulars_a021_2004/
• A87 Cost Principles for State, Local, and Indian Tribal Governments
  • See: http:See: http://www.whitehouse.gov/omb/circulars_a087_2004/
• A110 Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations
  • See: http://www.whitehouse.gov/omb/circulars/a110/a110.html
• A122 Cost principles for Non Profit Organizations
  • See: http://www.whitehouse.gov/omb/circulars/a122/a122.html§
• A133 Audits of States, Local Governments, and Non-Profit Organizations
  • See: http://www.whitehouse.gov/sites/default/files/omb/assets/a133/a133_revised_2007.pdf
• GS 143-6.1 Audit Requirements for State Funds
• Catalog of Federal Domestic Assistance (CFDA) is a government-wide compendium of Federal programs, projects, services, and activities that provide assistance or benefits to the American public. It contains financial and non-financial assistance programs administered by departments and establishments of the Federal government.

*One special note of mention. Forms with an * next to it are interactive and can be completed and then printed. In order to reuse the form you will need to complete the form and then do "save as" to save the form with a new name.