The monthly expense report ACS Preventive Services providers submit against their contract budget, covering personnel, fringe, OTPS and indirect for the reporting period.
Rebuilt from a real filed form with every client name, amount, and identifying detail removed. Columns, categories, and formulas are preserved exactly as the funder issues them.
Who files this
ACS-contracted preventive services providers — General Preventive, Family Treatment/Rehabilitation, and related program models.
Key requirements
Funder
NYC Administration for Children's Services
Jurisdiction
New York City
Fringe range
8.25%–36%
Indirect cost basis
Accepted ICR via one of three entryways — 10% de minimis, a Negotiated Indirect Cost Rate Agreement (NICRA), or an Independent Accountant's Report — each valid for three fiscal years; budgets default to 10% if no rate is on file
What gets this form kicked back
Fringe above 36% has to be itemized line by line, not stated as a single blended rate.
The six "distorting factors" — client stipends, client transportation, incentive payments, rent, subcontracts over $25,000, and equipment over $5,000 — must appear as their own budget lines and be excluded from the indirect cost base.
If no rate is on file, ACS defaults your indirect to 10%, not the 15% federal de minimis most other city agencies use.
Allowable OTPS categories
The categories NYC ACS recognizes on a budget or voucher. Using wording outside this list is a routine cause of returned submissions.
Fees — Professional Development
Fees — Professional Fee (Other)
Program Consultants
Food — Participants Only
Supplies — Office
Supplies — Program
Travel — Staff
Transportation — Participants
Equipment
Equipment Repair & Maintenance
Program Activities
Postage & Delivery
Printing & Copying
Staff Training
Telephone — Program Lines
Utilities — Program Facility
Permits & Fees
Unallowable costs
Costs NYC ACS will not reimburse under this contract.
Alcohol
Entertainment
Fundraising
Gift cards for anything but approved Participant Support Costs — no cigarettes, resale, or gambling
Rules worth knowing before you file
Fringe above 36% must be itemized in full, per ACS's own FY27 Budget Submission Guidelines
"Distorting factors" — Client Stipends, Client Transportation, Incentive Payments, Rent, Subcontracted Services over $25,000, and Equipment over $5,000 — must be budgeted as their own line items; bundling them into the ICR base gets a budget returned
Three written estimates for purchases over $25,000; subcontracts at or above $20,000 require ACS Responsibility Determination vetting
Gift cards (Participant Support Costs only) are capped at $50 face value per card and $2,500 held by a custodian at once, and require a Gift Card Recipient Log plus signed Payment Acknowledgement Forms
Cost Allocation Plans must name every shared staff title by person, with FTE percentages summing to exactly 100% across all programs
Eligible HHS contracts get a Local Law 156 advance of 50% of the total provider budget, recouped at 10% per month starting September
Free voucher checker: upload a completed copy of this form and it flags unallowable costs, fringe above the ceiling, allocations that don't total 100% and totals that don't reconcile before you file. No signup; the file never leaves your browser.
Why vouchers get returned: the six checks behind most returned vouchers, and what each one looks like in a real file.
Stop filling this in by hand
Prove It Financials generates this exact form every month, populated from your own budget, payroll and invoices — with allocation percentages, fringe, and indirect already calculated and validated against NYC ACS's own rules.