VENDOR DEPARTMENT OF ELDER AFFAIRS DATE I06/1112018 II CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

VENDOR INFORMATION

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.-. -VENDOR NUMBER ii DATE OF CRIMES STATEMENT

VENDOR ID NUMBER j LIABILITY INSURANCE CERT DATE 11

a NAME

ADDRESS1

ADDRESS2

CITY STATE [dz1P l JI CONTACT II PHONE I 11

MONITORING DATE II SAMAS ACCOUNT II DESK REVIEW I_JI FISCAL YEAR II

I Record: 111 I I I I I <OSC>

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MANAGER :·:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•: :;;'; X

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MANAGER DEPARTMENT OF ELDER AFFAIRS DATE !06/11/20181

CONTRACT TRACKING SYSTEM PAGE 1 OF 1 SUPPORTING TABLES MAINTENANCE

CONTRACT MANAGERS

ID NAME

= II UNKNOWN J • r

02 JOHNNY APPLESEED I==

~ ANNE ROGERS

= 04 SHELIA GLENN

05 JUDY BOWERS I== 06 NICOLE TRAINOR i==

~ BEVERLY FRIEDBERG

~ CRAIG MCCORMIC

09 AMIE BOUNDS i== ~ TERESA GOODSON r

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METHOD DEPARTMENT OF ELDER AFFAIRS DATE 106/11/2018 JI CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

METHOD OF PAYMENT

CODE DESCRIPTION

ADV/CR/UR ADV/COST REIMB/UNIT RATE (9) - r ADV ADVANCE

ADV/CR ADVANCE/COST REIMBURSMENT (3)

ADV/FR ADVANCE/FIXED PRICE (4)

ADV/FP ADVANCE/FIXED PRICE/FEE (7)

CASH CASH

REIMB COST REIMBURSMENT (1)

DEUV DELIVERABLE (8)

FP/DELIV FIXED PRICE / DELIVERABLE

FP FIXED PRICE/FIXED FEE (6) ~

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OCA : ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ·: ;;; X

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OCA DEPARTMENT OF ELDER AFFAIRS DATE !06111/2018) CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

OCA TABLE CODES OCA CATEGORIES

ID NAME CODE DESCRIPTION

I• 0 DISASTER 2006 ~ ..~ 100547 COMM CARE FOR THE ELD .

10DCF DISASTER ~ 100604 OLDER AMERICANS ACT

5AD02 TITLE V 01-02 ADMIN L I 102001 LOCAL SERVICE PROGRAM

5AD03 TITLE V 03 ADMIN ... e 1 100778 CONTRACTED SERVICES

5AD04 TITLE V ADMIN 04 ~ 105256 HURRICANE/DISASTER

5AD05 TITLE V 05 ADMIN H 100570 EHEAP

5AD06 TITLE V 06 ADMIN -!:il. 101099 ELDERLY MEALS

5AD07 TITLE V 07 ADMIN f'.J 100096 ALZHEIMER'S PROJECTS iii

5AD08 TITLE V 08 ADMIN T 100007 TRAINING iii

5AD09 TITLE V 09 ADMIN ,., = E 100548 HOME CARE FOR THE ELDER •

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FUND "" DEPARTMENT OF ELDER AFFAIRS DATE I06/1112018j CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

FUND VALIDATION

ID NAME

13 10-1-000503 • ]

17 J 0-1-000503

AD 20-2-021065

AF 20-2-021039A

AH 20-2-021039

CA 10-1-000503

cc 10-1-000503

CD 20-2-261001

CE 10-1-000503

cw 10-1-000503 ~

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~ ACTION : , '.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-'.-: ;;; X

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ACTION DEPARTMENT OF ELDER AFFAIRS DATE I06/11/2018J CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

-ACTION CODES

ID NAME

ACTUAL EXPENDITURES

ADM0 ADJUSTMENTS

ADM5 AMENDMENT FIVE

ADM4 AMENDMENT FOUR

ADM1 AMENDMENT ONE

ADM3 AMENDMENT THREE

ADM2 AMENDMENT TWO

ENC ENCUMBRANCE

PMT PAYMENT

REF ,, _..R""'E'"F"'U'-NaaDaa3========~" I

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Record: 1/1 0 I I I <OSC>

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REJECT DEPARTMENT OF ELDER AFFAIRS DATE )06/11/2018 CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

REJECT CODES

ID NAME

REJ6 ADJUSTMENT (DOEA) • ]

5F APPR FOR EMP MOV EXP NOT SUBM

4D ATTY GEN'S NOT SUBMITTED

3B BENEFITS TO STATE NOT SHOWN

5L CERT OF COMPLETION NOT SUBM

5H CMP APPR NOT SUBM/APP# NOT SHW

4C CNT DOC DOESNT MEET FS REO

4E CONT NUMBER NOT PROVIDEDNALID

4B CONTRACT/PO NOT SUBMITTED

2D DATE INV/SVCS RECD/APPR PYMT ~1 ,, Enter The Reject Code I Record: 1/? I I I I I <OSC>

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MILE DEPARTMENT OF ELDER AFFAIRS DATE 106/1112018

CONTRACT TRACKING SYSTEM PAGE 1 OF 1 SUPPORTING TABLES MAINTENANCE ~

CONTRACT MILESTONES

Lio I[ NAME ]

~ GRANT MANAGER/INITIATOR •

CONTRACT ADMINISTRATION

FISCAL & BUDGET

4 LEGAUGENERAL COUNSEL I

5 PROVIDER FOR SIGNATURE

6 SEC/DEP SEC FOR SIGNATURE

7. AGREEMENT/AMENDMENT EXECUTED

8 DIRECTORIOFMC

g 9 EXECUTED CONTRACT TO PROVIDER

AREA AGENCY STAFF • '

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ORGCODE DEPARTMENT OF ELDER AFFAIRS DATE 06/11/2018

CONTRACT TRACKING SYSTEM PAGE 1 OF 1 SUPPORTING TABLES MAINTENANCE

ORGANIZATION CODES

ID NAME

65200000000 OFC OF VOLUNTEER & COMM SVCS •

65600100000 AA.A01

65600200000 AA.A02

65600300000 AA.A03

65600400000 AA.A04

65600500000 AA.A05

65600600000 AA.A06

65600700000 AA.A07

65600800000 AA.A08

65600900000 AA.A09

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[CONTINll] DEPARTMENT ~ELDER AFFAIRS Date 06/11/2018

Automated Contract Management System User smidracms contc

CONTRACTNUMBER ~f';:=jI

ll __ v:_:e:::_nd::.:o::_r :ID~l==J~l !==:::===i.11!

Contract Manager~_J n ContractTitle _ I!

Org Code : ::::::::::::::::::::ii1j======F=is=ca=.1 Yr I ll From Date I n To Date I ii Services End Date J JI Payment;.Me.:.t:;;hoo~ l===;-lil

Original Contract Amount "-====-"'m ' Current Contract Amount 1-=====:ill YTD Payments Contract Bal YTD Encumbered To Be Encumber YTD Expenses

I II I II I II I II I II

CODE

J ll~========ORIGINATOR ( FROM)

=lll.--...!Ll:DATE CODE

= :!Ll=FORWARD

= TO

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Ill !II II I ~ l j JF-iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii~

111 llJl~J I ................ --.....:.1..1-;;;;iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii

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I Record: 1/1 I I I <OSC>

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CONTAMD DEPARTMENT OF ELDER AFFAIRS DATE 06/11/2018

CONTRACT TRACKING SYSTEM PAGE 1 OF 1

===============coNTRACT -===="'============:::;;i

CONTRACT NO. 1AMEND ~1 NO. DATE CURR. AMT. ~END. AMT.

ll REV CONT AMT

J u 111 DESCRIPTION

CODE ORIGINATOR (FROM) DATE CODE FORWARD TO ,., Il l 111 II I '-'

II Ill 11 1

1n Ill II I

IU Ill 11 1 ;J

Record: 1/1 ... I List ofValu ... I <OSC>

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·e, ~ r ft r~'b tei r [CONTRACT] DEPARTMENT OF ELDER AFFAIRS Date j06/11/2018 l

Automated Contract Management System User !smidracms contg

CONTRACT NUMBER 11 Vendor ID ~ I II Contract Manager l=~Ill ==========-----""'""II 11 Fiscal Yearl cl=====il II

ContractTitle

Org Code r===a;;======;;aa=aa!lLI -----., From Date ii To Date l ll Payment Met;:..h.:..od:...&;l

Original Contra~c"'t"'A"'m"'t "l;;;;;:.:...._ __ _____,lj &====c.rlurrent Contract Amt l \a=====el """'==+I

YTD Payments Contract Bal YTD Encumbered To Be Encumb YTD Expenses

11 I II I II I II I .II

llr=~--------------[:'i ~ OCA==---------------~=,,

OC~_A _____ ......, Year

l-===Beginning

~l~==ENC Balance

=J~,

~l~=-=_=_=_=_=-YTD Paid

~j·;::::::To Be ENC

~~-1 YTD Expenses

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Record: 1/1 I I I <OSC>

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[CONTFIX] DEPARTMENT OF ELDER AFFAIRS Date 106/11/2018 II Automated Contract Management System user lsmidracms contgll

CONTRACT NUMBER ] vendorlD I ~I Contract Manager ij Fiscal Yearj..------,,1!

Contract Title bu

Org Code jj From Date I _.g To Date II Payment Met;;.hod;.;;_,1;l iiiiiiiiiiiiiiiiii~11.

Original Contract Amount .__! =====-"ij Current Contract Amount 1=====.aa1''. lYTD Payment Contract Bal YTD Encumbered To Be Encumbe. YTD Expenses

I II I II I ii I 11 1 JI

1-i===============OCA===============ilOCA -==~ FN Year Beginning ENC Balance YTD Paid To Be ENC YTD Expenses

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I Record: 1/1 I I I <OSC>

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CAT DEPARTMENT OF ELDER AFFAIRS DATE 106/l 1/2018 II CONTRACT TRACKING SYSTEM PAGE 1 OF 1

SUPPORTING TABLES MAINTENANCE

OCA CATEGORY CODES

ID NAME

i!a 100007 TRAINING • '

~ 100096 ALZHEIMER'S PROJECTS

p

Ii. "" 100096 ALZHEIMER'S EBOJECTS I 100547 AMERICORPS MATCH "

C 100547 COMM CARE FOR THE ELD ~ E 100548 HOME CARE FOR THE ELDER iaa

~ 100570 EHEAP

~ 100604 OLDER AMERICANS ACT

"" I 100778 AME RI CORPS ELDERSERVE

~ 100778 CONTRACTED SERVICES I.'

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