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EXHIBIT B <br />FEESCHEDULE <br />For performing the services required by the Contract to which this Exhibit B is attached and in <br />accordance with Exhibit A to IHCDA's satisfaction, Contractor will be paid according to the <br />following fee schedule. Unless otherwise indicated in the schedule, Contractor is responsible for any <br />and all expenses incurred in rendering its services under this Contract. Claims shall be submitted <br />once per month via the IHCDAonline.com system. <br />FEE <br />PAYABLE <br />PROCESS <br />Submit the following required documentation and invoice by <br />the fifth (P) day of each month: <br />I. Intake form; <br />2. Authorization form; <br />$150.00/client <br />Completion of <br />3. Disclosure form; <br />Level 1 <br />4. Privacy policy; <br />5. Household budget; <br />6. Action Plan; <br />7. MHA eligibility determination; and <br />8. Certification that each client is an owner -occupant of <br />his or her home. <br />Submit the following required documentation and invoice by <br />the fifth (P) day of each month: <br />1. Authorization form; <br />2. Disclosure form; <br />3. Privacy policy; <br />4. Verified household budget; <br />Completion of <br />5• Verification of action taken based upon Action Plan. <br />$300.00/client <br />Level2 <br />(Neither Counselor Notes nor telephone logs satisfy the <br />requirement for documenting Verification of Action <br />Taken, as neither provides verifiable proof that any <br />action took place. Fax transmission sheets, e-mails, <br />mail receipts, screenshots of portal communication, or <br />other verification that action took place is required to be <br />retained in the client's file.); and <br />6. Certification that each client is an owner -occupant of <br />his or her home. <br />{00028595-1) <br />Page 34 of 39 <br />