Billed Entity:
135767
FRN:
2199037638
Funding Year:
2021
470#:
210017502
471#:
211026045
Category of Service:
INTERNAL CONNECTIONS
Status:
Funded
FCDL Date:
2021-09-30
Wave:
25
FCDL Comment:
MR1:The amount of the funding request was changed from $21,950.94 to $2,387.41 to remove the ineligible product(s) or service(s): FOUNDATION CARE - H8HU9E (19% ineligible), FOUNDATION CARE - HR7H8E (ineligible), FOUNDATION CARE - HR4T1E (ineligible), FOUNDATION CARE HR5X8E (ineligible), FOUNDATION CARE - HL6A8E (ineligible).
Service Start Date (471):
2021-07-01
Service Start Date (486):
2021-07-01
Committed Amount:
$1,909.93
Last Date of Service:
2022-09-30
Disbursed Amount:
$0.00
Payment Mode:
NOT SET
Remaining:
$1,909.93
Last Date to Invoice:
2024-01-29

Original
Committed
Monthly Cost:
$0.00
$0.00
Ineligible Monthly Cost:
$0.00
$0.00
Months of Service:
12
12
Annual Recurring Charges:
$0.00
$0.00
One Time Cost:
$21,950.94
$2,631.00
One Time Ineligible Cost:
$0.00
$2,387.41
Total Cost:
$21,950.94
$2,387.41
Discount Percent:
80
80
Requested Amount:
$17,560.75
$1,909.93