Reasonable Rate Documents
General State Trust Fund Documents
Policy
- Proof of Payment Policy memo (10/18/05 pdf)
- Examples of acceptable forms of proof of payment of costs (pdf)
- Clarify Codes 3.399, 8.100 and 12.010 (10/19/05 doc)
- Statute of Limitations on filing Eligibility Applications and Reimbursement Claims Memo (11/9/08 pdf)
- Remedial System Certification Policy (10/15/03 pdf)
Free Product Recovery Program
- Free Product Removal Program Preapproval/Claim Authorization Form (01/01/09 xls)
- List of Allowable Task Codes for Preliminary FP Evaluation (01/16/09 doc)
- List of Allowable Task Codes for Passive FP Recovery (doc)
Reasonable Rate Document Updates
- Current Electronic Pre-Approval Task Authorization
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Note: Do not use special characters in Electronic Pre-Approval Task Authorization file names (e.g. “#”, “/,” “$”, etc.). Hyphens are acceptable.
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2022 Reasonable Rate Updates
- 2022 RRD ERRATA (doc)
- 2022 Version Task Scope of Work Document (doc)
- 2022 Claim Forms (xlsx)
- 2022 RRD EPATA w updated task codes
- 2022 RRD Price List
2020 Reasonable Rate Documents
- 2020 Claim Preparation Checklist (doc)
- 2020 RRD Instructions for Completing Claims/Preapprovals (doc)
- 2020 RRD Task Scope of Work Document
- 2020 RRD Task/Analytical Price List
- 2020 RRD Claim Forms (xlsx)
- 2020 Project Summary Form (doc)
- 2020 Remedial System Certification Form (doc)
- 2020 Certification of Cost Form (doc)
- 2020 Certification of Payment Form (doc)
- 2020 Reimbursement Identification Form (doc)
- 2020 Electronic PreApproval Task Authorization Form (xlsx)
Hard copies of the PATA form are no longer being accepted for manual processing. The current version of the ePATA form should be utilized for pre-approval requests.