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Commonwealth of Pennsylvania Department of General Services RFP #6100042271 APPENDIX M APPENDIX M Claim Payment Process Overview The Contractor does not prepare checks. Checks or Automated Clearing House (ACH) payments are paid by the Pennsylvania Treasury Department after authorizations for payments are received from the contractor. As explained in Appendix S, Legal Defense Services, this process does not apply to authorizations for legal defense services. To meet statutory deadlines for payments, the payment processing times and schedules must be met. This process is not negotiable. There are two interface formats (depending on the payment type) and one file is communicated via electronic mail. However, the interface files must be separated for each program and payment types. A report of the information interfaced must be provided to Commonwealth and Comptroller Operations. The interface files are validated and released to the Treasury Department for payment by check or ACH payment (ACH only upon approval by the Commonwealth). The Treasury Department retains and exercises its pre-audit authority under all circumstances; therefore, additional documentation on certain payments may be requested prior to releasing the payment. If errors to the authorized payments are discovered after the file has been processed, but before the Treasury Department has mailed the payment, authorizations may be voided (or deleted or rejected), but payment amounts cannot be changed. File Details Delivery of payment authorization files occurs by FTP transfer to the Commonwealth’s Public FTP Server, using credentials provided by the Commonwealth. Files will be in an XML format and named according to specifications provided. Files must be encrypted. Page 1 of 50
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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

APPENDIX MClaim Payment Process

Overview

The Contractor does not prepare checks. Checks or Automated Clearing House (ACH) payments are paid by the Pennsylvania Treasury Department after authorizations for payments are received from the contractor. As explained in Appendix S, Legal Defense Services, this process does not apply to authorizations for legal defense services. To meet statutory deadlines for payments, the payment processing times and schedules must be met. This process is not negotiable.

There are two interface formats (depending on the payment type) and one file is communicated via electronic mail. However, the interface files must be separated for each program and payment types. A report of the information interfaced must be provided to Commonwealth and Comptroller Operations.

The interface files are validated and released to the Treasury Department for payment by check or ACH payment (ACH only upon approval by the Commonwealth). The Treasury Department retains and exercises its pre-audit authority under all circumstances; therefore, additional documentation on certain payments may be requested prior to releasing the payment.

If errors to the authorized payments are discovered after the file has been processed, but before the Treasury Department has mailed the payment, authorizations may be voided (or deleted or rejected), but payment amounts cannot be changed.

File Details

Delivery of payment authorization files occurs by FTP transfer to the Commonwealth’s Public FTP Server, using credentials provided by the Commonwealth. Files will be in an XML format and named according to specifications provided. Files must be encrypted. Exact file formats and specifications will be provided upon execution of the contract. The current file specifications are provided with this appendix for informational purposes, but these should not be considered to be final requirements.

Initial Indemnity Payment (Advancement) File. The initial indemnity payments are paid through a Treasury Department advancement account that is processed by Comptroller Operations. No interface is required. Initial indemnity payments must be authorized so that payment is made within the statutory timeframe of 21 days. The authorizations must be provided in readable/writable PDF format by an e-mail attachment each Tuesday and Thursday morning. Although this process is ordinarily used for first checks, it is also available on a limited basis for use for processing checks when timing is critical. However, it is not used for initial payments when the workers’ compensation check is turned over to the agency for claimants receiving Heart and Lung or Act 632/534 supplemental benefits.

Indemnity Treasury Check Payment File. After the first indemnity payment is made, the claim is put on a regular biweekly payment schedule; an extract of the current schedule is provided

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

with this Appendix. This is processed using the 398 file layout provided in this appendix. Note: This file also contains payments made on behalf of claimants to attorneys, widows, or court ordered payees.

Indemnity Transfer Voucher Payment File. The transfer voucher interface includes all reimbursements that will be sent to the Bureau of Commonwealth Payroll Operations (BCPO) for reimbursement of the salary paid under Heart and Lung and Act 632/534. If a payment is being made to an attorney or other payee, that payment must be included on the indemnity treasury check payment file. This file is sent every other week in accordance with the same schedule mentioned above and provided with this appendix.

Medical/Other Payments. The medical/other payment interface contains all payments to providers for medical care as well as for allocated expenses (with the exception of legal defense fees). Payment authorization must be sent daily to ensure timely payment. The interface file also contains information to print a remittance advice on the check, which is the EOR. The 407 layout will be used for these payments. Payment is typically made ten business days from the receipt of the interface file. An extract of the current payment schedule is provided with this appendix.

Processing Information

Indemnity Deletions. After the Indemnity Treasury Check Payment File interface is sent by the contractor and before the checks are mailed by the Treasury Department, there is a window when checks can be deleted/voided and not sent. The deletion information must be provided in Microsoft Excel by an email attachment by the time identified by the Commonwealth. Only deletions (also known as voids or redlines) are possible; payment amounts cannot be changed.

Supporting Reports. Reports and copies of the data for EOR’s must be provided by the contractor to the Commonwealth and Comptroller Operations at the same time the interface file is transferred. These must be provided in a readable/writable PDF format.

Direct Deposit. Direct deposit is currently offered to claimants who consent and whose claims meet one or more of the following conditions: claims open at least one year; claims with catastrophic injuries; or claims receiving survivor benefits. The contractor shall gather and securely maintain all bank routing numbers, account numbers, and checking or savings data. Such data must be included in the Indemnity Treasury Check Payment interface file. The contractor must also file the required LIBC form with the Bureau of Workers’ Compensation. Direct deposit options may be expanded during this contract to include more claimants and vendors; details about the expansion of direct deposit will be provided upon award of the contract.

Vendor Record Synchronization. The contractor will be required to utilize Commonwealth vendor numbers for payments to most claimants and to attorneys, providers, or other payees. Payee records from the contractor will be interfaced to the Commonwealth to obtain vendor numbers and ensure synchronization of data. The vendor identification number shall be required to be provided with the interface. Details about this process will be provided upon award of the contract.

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Return Check Information. Upon issuance of the check, the Offeror will receive messages about the status of the check. The check identification information must be stored with the payment authorization for reference in the event that a copy of the canceled check or a stop payment is later required.

1099 Requirements. An IRS form W-9 shall be obtained for all non-claimant payments. If a payment is made to a name other than the IRS recognized name as shown on the W-9, a copy of the W-9 associated with the other name shall be provided. The payee name and address data should remain fixed for a payee from payment to payment. Changes to payee information, for both indemnity and medical payments after an initial payment is processed, shall be limited to material changes to the payee name/address data. For payments where a vendor identification number is utilized, the Office of the Budget, Bureau of Comptroller Operations Office will maintain all payee, address, and W-9 data. The Internal Revenue Services assesses fines for each 1099 form that is reported where the name/SS number or federal identification number combination does not agree with their records. Any fines assessed against the Commonwealth for such infractions which are the fault of the contractor will be paid by the contractor.

Testing Requirements

Commonwealth testing standards require Unit Testing along with end-to-end integration testing by the Office of Administration, Bureau of Integrated Enterprise Systems to ensure all functionality and interfaces work properly. A formal signoff by the Commonwealth on full system testing is required to assure a quality implementation. The contractor shall allow enough time to complete this testing and include this timeline in a full project plan that shall be submitted with the proposal. At a minimum the contractor shall plan on all testing to be completed with formal signoff on system interfaces and functionality 30 days in advance of the implementation date. Shall testing not be completed by this date due to contractor delays, daily negotiations to solve the problems will begin between the Commonwealth and the contractor’s project manager. Upon completion of successful system testing the Commonwealth will provide formal notification that system functionality and interface testing is complete and the system is acceptable.

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Processing Schedule

This schedule provides the timing of events related to payments. The date for a particular action may be adjusted at the discretion of Comptroller Operations staff. Adjustments due to holidays are highlighted or bolded. The schedules will be provided upon award of the contract.

WC Indemnity Payment Schedule Sample

COMPTROLLER TREASURY TO * TREASURY TO CHECKFILE RECEIVED, RECEIVE DELETIONS IN RECEIVE DELETIONS PAYDATE PAYMENTS BEING

THIRD PARTY PROCESSED & CLEARS TO ORDER TO PROCESS IN ORDER TO PROCESS (Mailed MADE ARE FOR TWO PROCESSING TREASURY REJECTIONS CHECK PULLS 2 Days Prior) WEEK PERIOD ENDING

FRIDAY MONDAY Friday Monday THUR FRIDAY16-Sep-16 19-Sep-16 23-Sep-16 26-Sep-16 29-Sep-16 30-Sep-1630-Sep-16 3-Oct-16 6-Oct-16 7-Oct-16 13-Oct-16 14-Oct-1614-Oct-16 17-Oct-16 21-Oct-16 24-Oct-16 27-Oct-16 28-Oct-1628-Oct-16 31-Oct-16 3-Nov-16 4-Nov-16 9-Nov-16 11-Nov-1610-Nov-16 14-Nov-16 17-Nov-16 18-Nov-16 22-Nov-16 25-Nov-1623-Nov-16 28-Nov-16 2-Dec-16 5-Dec-16 8-Dec-16 9-Dec-16

WC Medical/Other Payment Schedule Sample

October 2016File Date File Received Pay Date

Monday, October 03, 2016 Tuesday, October 04, 2016 Tuesday, October 18, 2016Tuesday, October 04, 2016 Wednesday, October 05, 2016 Wednesday, October 19, 2016

Wednesday, October 05, 2016 Thursday, October 06, 2016 Thursday, October 20, 2016Thursday, October 06, 2016 Friday, October 07, 2016 Friday, October 21, 2016

Friday, October 07, 2016 Tuesday, October 11, 2016 Tuesday, October 25, 2016HOLIDAY

Tuesday, October 11, 2016 Wednesday, October 12, 2016 Wednesday, October 26, 2016Wednesday, October 12, 2016 Thursday, October 13, 2016 Thursday, October 27, 2016

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RFP #6100042271APPENDIX M

Sample Initial Indemnity Payments (Advancement) Report

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RFP #6100042271APPENDIX M

Sample Indemnity Treasury Check Payments Report

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RFP #6100042271APPENDIX M

Sample Indemnity Transfer Voucher Payments Report___________________________________________________________________________________________________

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RFP #6100042271APPENDIX M

Sample Medical/Other Payments Report

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RFP #6100042271APPENDIX M

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RFP #6100042271APPENDIX M

Interface File Mapping Details for Medical/Other PaymentsThese mapping details are provided for informational purposes. They are subject to modifications, and the final format details will be provided upon award of the contract. Each payment will be on a separate file. All payments issued for the day will be shown on one PDF report.

407 Layout

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

1Header Required Contains transmission

relevant information

2InterfaceID Required string Max. 16 Unique identifier for the

interfaceHardcodeINTF_0407

2

InterfaceType Required string Max. 20 Interface Type

HardcodeREQUEST-800 Must be all Caps

2 SourceSystem

3 Name Required string Max. 50 Name of Source System Provided by IES

3

DocumentID Required string Max. 16 Unique document number in source system (used on reply messages)

Usually same as DH - DOCNUM

3Date Required date 10 yyyy-mm-dd Date message created in

source system

3Time Required time 8 hh:mm:ss Time message created in

source system2 TargetSystem

3Name Required string Max. 50 Name of Target System

SAP Hardcode "SAP:

3

DocumentID Optional string Max. 16 Unique document ID in target system (used on reply mssages) optional

3Date Optional date 10 yyyy-mm-dd Posting date on target system Same as Source System

date

3 Time Optional time 8 hh:mm:ss Posting Time in target system Same as Source System

time

1Body Required Contains Data relevant

information

2 Z1FI_MESSAGE_DT Optional

3 MSGSTATUS Optional string 2

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3 TYPE Optional string 13 ID Optional string Max. 203 NUMBER Optional string 3

MESSAGE Optional string Max. 220

2Z1FI_COPA_DH Required Document header relevent

infromationSingle Occurance per transmission

3 BUS_AREA Optional string 2-4 Business Area Optional - Not Used

3

DOC_TYPE Required string 2 Document Type Required ZI-Invoice KG or KS-Credit Memo

Doc Type - BKPF-BLART

3

DOC_NUM Required string Max. 16 Document Number Required, usually vendor's invoice number or other unique identifier. Used as Duplicate check. Sent to Treasury for printing on Remittance Advice

Reference - BKPF-XBLNR

3

TR_BATCH_PONO Optional string max. 50 Treasury Batch PO Number Optional Digits 1-2 = Business Area; Digit 3 = BA Interface number; Digits 4-5 = YY; Digit 6-8 = Julian Date; Digit 9-10 = Sequential Number of Interfaces that Day. E.g. 7910326701. Used as a batch control number for Treasury.

Header Text - BSEG-SGTXT

3RECORD_TYPE Optional string 2 Record Type (DH)

(Hard code ‘DH’)Optional, hard code to DH

3

TCODE Optional string Max. 6 Transaction Code (FB60, FB65) Optional,

FB60 for invoices FB65 - for credit Memo

3

HEADER_AMOUNT Required decimal 16 [\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d

Header Amount (2 explicit decimal; explicit sign in first position; i.e. +000000000000.00)

Required, Total amount of Invoice. Leading sign, zeros fill, explicit decimal ex. +000000000000.00

Amount - BSEG-WRBTR

3LINEITEM_COUNT Optional string 3 Number of lines on Contract Optional, control total for

invoice

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3

REFDOC_NUM Optional string Max. 16 Reference Document Number (not used; blank fill)

optionalNot used on request - Will contain SAP document number on return

3

HEADER_LIQUIDATION_AMOUNT Optional decimal 16 [\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d

Header Liquidation Amount (2 explicit decimal; explicit sign in first position; i.e. +000000000000.00)

Optional, Amount of Earmarked Fund Liquidation, no negatives. Leading sign, zeros fill, explicit decimal ex. +000000000000.00

3

PAYDATE_BASELINEDATE Optional date 10 yyyy-mm-dd Payment date Optional. For requested pay date, enter that date in Baseline Date & input P066 in Payment Terms. If no requested pay date, enter same date as Document Date.

Baseline date - BSEG-ZFBDT; Payment Terms - BSEG-ZTERM

3

DOCDATE_INVOICEDATE Required date 10 yyyy-mm-dd Invoice Date Required-Date of receipt of invoice by Commonwealth

Invoice Date - BKPF-BLDAT

3

PARTNER_NUM Required string Max. 10 Vendor / Customer Number Required:600000 - 1099 Eligible Vendor600001 - Non-1099 Eligible Vendor

Vendor -LFA1-LIFNR

3 PARTNER_PAYEE Optional string 10 Vendor (Alternate Payee) DO NOT USE

3

PAYMENT_METHOD Required string 2 Method of Payment (check, ACH ... )

Required-01 for check, 02 for ACH.

One digit field in SAP. Payment Method - BSEG-ZLSCH

3BANK_PARTNER Optional string 4 Identifies Vendor master for

ACH Account DO NOT USE

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3

PAYMENT_METHOD_SUPPL Required string 2 Identifies how payment is distributed

Required – 01 TREASURY MAILS02 RETURN TO PAYABLES SERVICE CTR03 RETURN TO BCPO04 RETURN TO ATT GEN PAYROLL05 ACH W/O REMITTANCE06 INDIVIDUAL ACH W/O REMITTANCE08 INDIVIDUAL PMT TREASURY MAILS09 INDIVIDUAL PMT RETURN PAYABLES

One digit field in SAP. Payment meth. Supp. - BSEG-UZAWE

3

PAYMENT_BLOCK Optional string 1 Identifies the reason why a payment does not go to Treasury

Optional- Use A for Block Type. Based on Comptroller Office Decision. BSEG-ZLSPR

3

PAYMENT_TERMS Required string 4 Terms the payment is requested by

optional. Enter normal Commonwealth payment terms = P001 If requesting a payment date, populate Baseline Date field with Requested Pay date and enter P066. BSEG-ZTERM

3HEADER_TEXT Optional string Max. 25 Description on document

OptionalDoc Header Text

3

NOTES Optional string Max. 79 Notes from Treasury

Required-Will copy to Check Transmittal to identify payment

First 79 characters of Item Long Text on the Notes Tab

3

PARK Optional string 1 Indicator to denote POST and PARK Optional 'X' if Park ; Else

spaces

3

VENDOR_VALDN_SKIP Optional string 1 Indicator for vendor validationOptional 'X' if validation is to be skipped

3 DOCHEADER_ADDL_DATA Optional string Max. 65 Additional Data Optional

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3 WARRNO Optional string 14 Treasury Warrant Number N/A3 BANKNO Optional string 2 Treasury Bank Number N/A3 CHKNO Optional string 8 Treasury Check Number N/A3 PAYDATE Optional date 10 yyyy-mm-dd Treasury Pay Date N/A3 BANKACCT_ID Optional string 4 Treasury Bank Acct Number N/A

3 WARRANT_ID Optional string 10 Treasury Warrant ID N/A

2Z1FI_COPA_ADVICE Document Remittance

Advice relevant information3 LINE_TYPE Optional string 2 Specifies the type of line on

the remittance advice. It must be one of the following values:AG – Agency/Program Description: prints as the first line in the header section of all printed pages. Mandatory.CH – Column Heading: up to 3 column heading lines are supported. They print beneath the AG record in the header section of all printed pages. Optional.DL – Detail Line: values that correspond to their matching column headers. Presently, the number of detail lines is limited to a maximum of 275 which will fill the front and back of the check page and the front and back of two additional white sheets of paper.Should the number of detail lines exceed 275, the detail lines will be replaced by a single text line on the check page with the caption “Remittance data provided by Agency was

ZFI_T_INV_ADVICE table

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

invalid. See Note for payment inquiry.” Mandatory.TL – Total Line: values that correspond to their matching column details. The totals are at your discretion ex: Count, Qty, Amount. Optional.NL – Note Line: ip to 4 note lines are supported. The note lines print adjacent to and beneath the “Note:” label in the footer section on the front side of the check page. Mandatory.

3 LINE_NUMBER Optional string Max. 4 Specifies the order to print each record within the line type. Sequentially number each line starting at 1 for each line type.

Note the following rules for assigning sequence numbers: AG – Must always be 1. Only one AG line (Agency – program identifier) is permitted.CH – If used, must be between 1 and 3. Zero to three column headers may be passed. No more than three CH lines are permitted.DL – Consecutively numbered starting with 1 up to the number of detail lines present with a maximum value of 9999. Note that 275 is the maximum number of detail lines that will print.TL – If used, must be 1.NL – Must be between 1 and 4 since no more than four NL lines are

ZFI_T_INV_ADVICE table

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

permitted.

3

LINE_ADVICE Optional string Max. 80

Free form text to be printed on the appropriate section of the page as specified by the line type.

Because the Advice record prints in columnar format, it is necessary for the column headings and detail lines to be aligned so the details line up beneath the appropriate column heading. A non-proportional font will be used when printing these lines. Use spaces to align the elements, do not use tabs or other unprintable characters. Additionally, there are limits on the number of characters that will print for some of the line types. These limits are:AG – Use up to 80 character string.CH – Use up to 80 character string.DL – Use up to 80 character string.TL – Use up to 80 character string.NL – Use up to 40 character string.

ZFI_T_INV_ADVICE table

2Z1FI_COPA_DT Required Document Detail relevent

infromation Segment may repeat3 BUS_AREA Optional string 2-4 Same as DH segment Optional - Not Used

3DOC_TYPE Optional string 2 Same as DH segment Optional - DH Value

used

3DOC_NUM Optional string Max.

16Same as DH segment Optional - DH Value

used3 RECORD_TYPE Optional string 2 Same as DH segment Optional - DT

3LINEITEM_NUM Required string 3 Sequential line number

starting with 001 Required

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Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3

FUND Optional string Max. 10

Fund Used for Account Assignment. Optional if Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. Otherwise, it is Required

BSEG-GEBER

3

GL_ACCOUNT Optional string Max. 10

General Ledger account number

Used for Account Assignment. Optional if Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. Otherwise, it is Required

BSEG-HKONT

3

COST_CENTER Optional string Max. 10

SAP Cost Center Used for Account Assignment. If Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. At least one Cost Object (Cost Center, Interal Order, WBS) is required. BSEG-KOSTL

3 INT_ORDER Optional string 12 Must equal 12 characters. Pad with zeros at beginning of number.

Internal Order Used for Account Assignment. If Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. At least one Cost Object (Cost Center,

BSEG-AUFNR

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Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

Interal Order, WBS) is required.

3

WBS_ELEMENT Optional string Max. 24

Blank (not used) Used for Account Assignment. If Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. At least one Cost Object (Cost Center, Interal Order, WBS) is required.

BSEG-PS_POSID

3

AMOUNT Required decimal

16 [\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d

Line amount (2 explicit decimal; explicit sign in first position; i.e. +000000000000.00)

Required Leading sign, zeros fill, explicit decimal ex. +000000000000.00

BSEG-WRBTR

3

DR_CR Optional string 1 Debit/Credit Indicator Optional Leave blank, not used on invoice interface

3

VENDOR Optional string max. 10

SAP Vendor ID Optional Leave blank, not used on invoice interface

3

DUE_ON Optional date 10 yyyy-mm-dd Due on date Optional Leave blank, not used on invoice interface

3

ITEM_TEXT Optional string Max. 50

Item text description Optional Leave blank, not used on invoice interface

3

REFDOC_EMFUND Optional string 10 Referenced Document / Earmarked Fund

Optional. Funds Commitment document number. Alphas must be CAPITAL letters

BSEG-KBLNR

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RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3

EMFUND_LINEITEM Optional string 3 Earmarked fund document line number

Optional: if Reference Doc / Earmarked Fund & Earmarked Fund Line Item populated, find line item on Earmarked Fund document to determine Fund, G/L, Cost Center, Internal Order, and WBS. If Earmarked Fund document is entered & this field is blank, then determine line item by using Fund, G/L, Cost Center, Internal Order, and WBS to find an exact match on the document

BSEG-KBLPOS

3

LIQUIDATION_AMOUNT Optional decimal

16 [\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d

Liquidation Amount (2 explicit decimal; explicit sign in first position; i.e. +000000000000.00)

Optional If Earmarked Fund Document is populated, must equal DT Line Item Amount. Used as control total. Leading sign, zeros fill, explicit decimal ex. +000000000000.00

3

GAAP_CODE Optional string 1 Gaap Code Optional Leave blank, not used on invoice interface

3

SERVICE_PERIOD_BEGIN_DATE Required date 10 yyyy-mm-dd Service period beginning date Required-Value date

used for GAAP purposes

BSEG-VALUTMap it to Value Date

3SERVICE_PERIOD_END_DATE Optional date 8 yyyy-mm-dd Service period end date

OptionalNot entered into SAP

3 ASSIGNMENT Optional string Max. Assignement Required to generate BSEG-

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Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

18 follow on messages (810, 811, 820, 830) ZUONR

3REFKEY1 Optional string Max.

12Reference Key 1

Optional BSEG-XREF1

3

REFKEY2 Optional string Max. 12

Reference Key 2 If sending Z1FI_COPA_ADVICE segment, then send 'ADVICE'. Needed to send ADVICE data to Treausry. BSEG-XREF2

3

REFKEY3 Optional string max. 12

Reference Key 3 Optional Leave blank, not used on invoice interface

3

TYPE_CODE Optional string Max. 2 Type Code Optional Leave blank, not used on invoice interface

3

DOCDETAIL_ADDL_DATA Optional string Max. 38

Additional data Optional Leave blank, not used on invoice interface

3 SET_TO_COMPLETE Optional string 1set earmarked fundto complete optional

3 PUR_DOC_NUM Optional string Max. 10 purchasing doc number optional

3 PUR_DOC_LINE_NUM Optional integer Max. 10purchasing doc line number

optional00001-99999

3 BUDGET_PD Optional string Max.10 FM Budget Period

Used for Account Assignment. Optional if Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. Otherwise, it is Required

BSEG-BUDGET_PD

2 ZFI_COPA_VEND

Fields Below are only used if there is no SAP Vendor Number

3 GSBER Optional string Max. 4 business area optional3 DOC_TYPE Optional string Max. 2 document type optional

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3 DOC_NUMBER Optional string Max. 16 document number optional3 RECORD_TYPE Optional string Max. 2 record type optional - DV

3 VENDOR Required string Max. 10 vendor number

optional -(600000 or 600001) must equal PARTNER_NUM

3 NAME1 Required string Max. 35 vendor nameVendor NAME (ALL CAPS)

BSEC-NAME1

3 NAME2 Optional string Max. 35 vendor name 2

Optional - Vendor NAME - 2nd Line (ALL CAPS)

BSEC-NAME2

3 STREET1 Optional string Max. 35 street address

Either STREET or PO BOX required, but both fields can't be populated. (ALL CAPS) BSEC-STRAS

3 STREET2 Optional string max. 35 street address 2

Optional - NAME 4 to be populated as a 2nd Street address. Sent to Treasury as Street 2. (ALL CAPS)

BSEC-NAME4

3 POBOX Optional string Max. 10 PO Box Number

Either STREET or PO BOX required, but both fields can't be populated. (ALL CAPS) BSEC-PFACH

3 CITY Required string Max. 18 CityRequired (ALL CAPS) BSEC-ORT01

3 REGION Optional string Max. 2 Region/State CodeRequired (ALL CAPS) BSEC-REGIO

3 POSTAL_CODE Required string Max. 9 Zip Code Required BSEC-PSTLZ

3 COUNTRY Optional string Max. 4 Country

optional - 'US' for United StatesRequired for foreign countries BSEC-LAND1

3 TAX_CODE1 Optional string Max. 9 Social Security Number

Optional: Either Tax Code 1 or Tax Code 2 Required. Must be 9 digits in length BSEC-STCD1

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Level Input Field Name Mandatory? TypeTotalLength

Min/MaxLength Input Mask Field Description Comment SAP Value

3 TAX_CODE2 Optional string Max. 9 Federal ID Number

Optional: Either Tax Code 1 or Tax Code 2 Required. Must be 9 digits in length BSEC-STCD2

3 BANK_KEY Optional string Max. 9 ABA Routing Number

If PAYMENT_METHOD = 01; BlankIf PAYMENT_METHOD = 02; Required

BSEC-BANKL

3 BANK_ACCOUNT Optional string Max. 17 Bank Acct Number

If PAYMENT_METHOD = 01; BlankIf PAYMENT_METHOD = 02; Required

BSEC-BANKN

3 BANK_ACCOUNT_TYPE Optional string Max. 2 Bank Acct Type

If PAYMENT_METHOD = 01; BlankIf PAYMENT_METHOD = 02; Required 01 = CHECKING 02 = SAVINGS

BSEC-BKONT

3 REFERENCE Optional string Max. 21 Additional Bank Data optionalBSEC-BKONT

3 ONETIME_ADDL_DATA Optional string Max. 46Additional Data for One time vendors optional

3 BANK_COUNTRY Optional string Max. 3 Bank Country

If PAYMENT_METHOD = 01; BlankIf PAYMENT_METHOD = 02; Required BSEC-BANKS

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Interface File Mapping Details for Indemnity PaymentsThese mapping details are provided for informational purposes. They are subject to modifications, and the final format details will be provided upon award of the contract. A separate file is needed for WC indemnity payments (other than special benefits), and WC special benefits (referred to as transfer payments). All payments are on one interface.

398 Layout

Record Type Field NameField

Length Required Data Type Description CommentHEADER HEADER

InterfaceID Max. 16 Required STRINGUnique identifier for the interface (i.e. INTF_0396B) "INTF_0396B"

InterfaceType Max. 20 Required STRINGInterface identifier (i.e. Request-396) "Request-396"

SourceSystem

Name Max. 50 Required STRING

File Name - Must be same on each file, used for validating authenticity OA-811, OA-814 as appropriate

DocumentID Max. 16 Required STRINGUnique document number in Source System

Required for the WC - 13 character field - Format 081FFFYYDDDSS. FFF = 811 for Treasury Check Payment file, 812 for Medical/Other Payments, or 814 for Transfer Voucher Payment File, YYDDD is the Julian date equilavent to the date the file is created/sent, SS is a 2 digit sequence number to allow multiple files for a given payment group to be submitted on the same day (SS = '05' for One Time Vendor interface)

Date 8 Required DATE MMDDYYYY Date Document Created Time 6 Required TIME HHMMSS Time Document CreatedTarget System Name Max. 50 Required STRING Name of Target System "SAP"

DocumentID Max. 16 Optional STRINGUnique document number in Source System Not Needed

Date 8 Optional DATE MMDDYYYY Date Document Created

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description Comment Time 6 Optional TIME HHMMSS Time Document Created

HEADER HD_REC (1 for each file)HD REC_TYP Max. 6 Optional STRING Record Type Not NeededHD CRE_DT 8 Required DATE MMDDYYYY File Creation DateHD CRE_TM 6 Required TIME HHMMSS File Creation TimeHD CP_NM Max. 40 Required STRING Contact Person Name File Contact Person for Problems

HD CP_TEL Max. 10 Required STRINGContact Person Telephone Number Contact Person Telephone Number

HD EMAIL Max. 25 Optional STRING Contact Person Email Required for WC - Contact Person Email HD FILE_NM Max. 40 Required STRING Agency and Program Name "OA WORKERS COMP"

HD REC_CNT 8 Optional STRINGIncludes all data records plus header

Required for WC. Leading zeros "00000156" (will include all data records plus header). Control total

HD HD_AMT 16 Optional DECIMAL

File Total Amount (2 explicit decimal; explicit sign in first position; ie +000000000000.00)

Required for WC. Pattern value: "[\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d"

HD TRS_PO Max. 19 Required STRING

A Number Which Will be Applied In SAP Text Field. Will be known to Comptroller office and will be on hard copies sent to Comptroller offices. This will also be unique number for tracking this interface in Treasury systems

Digits 1-2 = Business Area; Digit 3 = BA Interface number; Digits 4-5 = YY; Digit 6-8 = Julian Date; Digit 9-10 = Sequential Number of Interfaces that Day. EX. 8110326701. Used as a batch control number for Treasury. 811 file will start with 811 and 812 file will start with 812 as shown in 811 example above. (Last two digits will be '05')

HD CYCLE Max. 15 Optional STRING Cycle Number

Required for the WC - (Same as DOCID on header erecord) 13 character field - Format 081FFFYYDDDSS. FFF = 811 for Treasury Check Payment file, 812 for Medical/Other Payments, or 814 for Transfer Voucher Payment File, YYDDD is the Julian date equilavent to the date the file is created/sent, SS is a 2 digit sequence number to allow multiple files for a given payment group to be submitted on the same day. (Last two digits will be '05')

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description CommentDocument Header DH_REC

DH BA 2 - 4 Optional STRING SAP Business AreaRequired for WC - Business Area for the agency for which the claim applies

DH DOC_T 2 Required STRING Document Type "ZI" DH DOC_NO Max. 16 Optional STRING Document Number Not neededDH REC_T 2 Optional STRING Record Type (DH) Not neededDH TR_CD Max. 6 Optional STRING Transaction Code (FB60) Not needed

DH DH_AMT 16 Required DECIMAL

Invoice Total Amount (2 explicit decimal; explicit sign in first position; ie +000000000000.00)

Pattern value: "[\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d"

DH LN_CNT 3 Optional INTEGERNumber of linesof detail for invoice

Number of Detail line items (DT Records) for the invoice (DH Record)Min. value = 001 Max. value = 999

DH REF_DOC Max. 16 Optional STRINGInvoice Reference Number; left justify; blank fill

Required for WC - 15 character vendor invoice number

DH DH-LIQ 16 Optional DECIMAL

Invoice Liquidation Amount (2 explicit decimal; explicit sign in first position; ie +000000000000.00) Not needed

DH PAY_DT 8 Optional DATERequested Payment Date - MMDDYYYY

If used, Enter in Baseline Date & input P066 in Payment Terms. If blank, system assigned based on document date

DH DOC_DT 8 Required DATEMMDDYYYY, SAP document date Date of receipt of invoice by Commonwealth

DH V_NO Max. 10 Required STRINGSAP Headquarter Vendor Number

600000 = 1099 Eligible600001 = Non-1099 Eligible

DH ALT_V 10 Optional STRINGSAP Alternate Payee Vendor Number Not needed

DH PAY_M 2 Required STRINGMethod of payment (check, ACH, etc)

Required-06 for check, 07 for ACH. 814 file - always 01

DH BNK_PRTNR 4 Optional STRING N/A for One Time Vendors Not needed

DH SUP_PAY_M 2 Required STRING

Identifies how payment is distributed (mailed by Treasury, returned to "01" - Treasury Mails check

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description CommentComptroller, etc)

DH PAY_BLK 1 Optional STRING

Identifies the reason why a payment does not go to Treasury Always "A"

DH PAY_TRMS 4 Optional STRINGThe date the payment is requested to be paid

If Baseline Date field is populated to request a pay date, enter P066.

DH HDR_TXT Max. 50 Optional STRING Additional Data on File. Not needed

DH NOTES Max. 79 Required STRING

Addendum data, printed on Remittance Advice. Claimants Name or any other information to be put on Remittance Advice by Treasury

Will print on Check Transmittal to help identify payment811 - Will provided vendor with requirements for what is to be placed in this text field814 - Always "Transfer Payment"

Vendor Detail DV_RECDV BA 2 - 4 Optional STRING Not neededDV DOC_T Max. 2 Optional STRING Document Type Not neededDV DOC_NO Max. 16 Optional STRING Document Number Not neededDV REC_T Max. 2 Optional STRING Always "DV" Not needed

DV VEND_NO Max. 10 Required STRING

600000 - 1099 Eligible Vendor600001 - Non-1099 Eligible Vendor

Required-If not one of these records, fail record

DV V_NAME1 Max. 35 Required STRING First SAP Name Field

Vendor NAME (ALL CAPS)If payee is an individual, person's first name is placed in this field. If payee is a company, company name is placed in this field

DV V_NAME2 Max. 35 Optional STRING Second SAP Name Field

Optional - Vendor NAME - 2nd Line (ALL CAPS)If payee is individual, person's last name is placed in this field. Else, blank

DV ST Max. 35 Optional STRING First SAP Street FieldEither STREET or PO BOX required, but both fields can't be populated. (ALL CAPS)

DV ST2 Max. 35 Optional STRING Second Street Address

Optional - NAME 4 to be populated as a 2nd Street address. Sent to Treasury as Street 2. (ALL CAPS)

DV PO Max. 19 Optional STRING PO BOX Either STREET or PO BOX required, but both fields can't be populated. (ALL CAPS)

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description CommentDV CITY Max. 18 Required STRING City Required (ALL CAPS)DV REG Max. 2 Required STRING State Required (ALL CAPS)

DV ZIP Max. 9 Required STRING Zip CodeRequired-Hyphen will be inserted at SAP level for 9 digit code

DV CNTY Max. 4 Required STRING Optional for US.

DV TX_CD1 Max. 9 Optional STRING USA: Social Security numberOptional: Either Tax Code 1 or Tax Code 2 Required. Must be 9 digits in length

DV TX_CD2 Max. 9 Optional STRING USA: Corporate ID numberOptional: Either Tax Code 1 or Tax Code 2 Required. Must be 9 digits in length.

DV BNK_KY Max. 9 Optional STRING ABA Rounting number

Ignore if Payment is Check; Required if Payment method is ACH. Must be 9 digits in length.

DV BNK_ACT Max. 17 Optional STRING Bank Account NumberIgnore if Payment is Check; Required if Payment method is ACH.

DV ACT_TYP Max. 2 Optional STRING

Optional: 01 for checking accounts, 02 for savings accounts

Ignore if Payment is Check; Required if Payment method is ACH.

DV OPT_INFO Max. 21 Optional STRING Additional Refenece Data Not neededDV WC_CLMNT_NAME 35 Optional STRING Claimant's name Required for 811 and 814 file

DV WC_CLAIM_NO 13 Optional STRINGClaim Number to which the payment applies Required for 811 and 814 file

DV WC_CLMNT_TAX_CD 9 Optional STRINGClaimant Social Security Number Required for 811 and 814 files

DV WC_INJURY_DT 8 Optional DATE MMDDYYYY Required for 811 and 814 files

DV WC_BEGIN_DIS_DT 8 Optional DATE MMDDYYYY

Required for 811 and 814 files - Date disability began, Not necessarily the injury date

DV WC_SVC_FROM_DT 8 Optional DATE MMDDYYYY Required for 811 and 814 filesDV WC_SVC_TO_DT 8 Optional DATE MMDDYYYY Required for 811 and 814 files

DV WC_COMP_TYPE 2 Optional STRINGType of compensation being paid

Required for 811 file - 01 = DL/IL, 02 = Heart & Lung, 03 = Act 632/534, 04 = No spec. Benefits, 05 = NBH (no longer H&L), 06 = NBA (no longer Act 532/534, 07 = Salary in lieu

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description Comment

DV WC_PAY_TYPE 2 Optional STRING Type payee

Required for 811 file - 01=Claimant/trustee/spouse/dependent; 02=Courts: or 03=Lawyers

Document DetailDT_REC (May Have Multiple for Each Doc Header)

DT BA 2 - 4 Optional STRING SAP Business Area Not neededDT DOC_T 2 Optional STRING Document Type Not needed

DT DOC_NO Max. 16 Optional STRING Document NumberRequired for WC - 15 characters vendor invoice number

DT REC_T 2 Optional STRING Always "DT" Not needed

DT LN_ITM 3 Required INTEGERSequential Line Number starting with 001 Min. value = 001 Max. value = 999

DT FUND 10 Optional STRING SAP Fund

Required on all WC files. Constant value which will be provided to vendor by the Commonwealth once SAP Fund has been determined

DT GL_ACT Max. 10 Optional STRING SAP G/L Account Number

Required on all WC files. Constant value which will be provided to vendor by the Commonwealth once SAP GL Account has been determined

DT CC 10 Optional STRING SAP Cost Center

Required on all WC files. Constant value which will be provided to vendor by the Commonwealth once SAP CC (Cost Center) has been determined

DT INT_ORD 12 Optional STRINGSAP Internal Order. Pad with Leading Zeros Not needed

DT WBS Max. 24 Optional STRING SAP WBS Element Not needed

DT DT_AMT 16 Required DECIMAL

Line Item Amount (2 explicit decimal; explicit sign in first position; ie +000000000000.00)

Pattern value: "[\+|\-]\d\d\d\d\d\d\d\d\d\d\d\d\.\d\d"Claim Amount

DT DB_CR 1 Optional STRING "D" or "C" Not neededDT VEND Max. 10 Optional STRING Not neededDT DUE_ON 8 Optional DATE MMDDYYYY Not neededDT ITM_TXT 50 Optional STRING Not needed

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Record Type Field NameField

Length Required Data Type Description Comment

DT REF_NO 10 Optional STRING

SAP Earmarked Fund document number used when liquidating an encumbrance Not needed

DT REF_LN 3 Optional INTEGER

Line Item of Earmarked Fund to be charged and liquidated. Leading zero filled Not needed

DT DT_LIQ 16 Optional DECIMAL

Line Item Liquidation Amount (2 explicit decimal; explicit sign in first position; ie +000000000000.00) Not needed

DT GAAP_CD 1 Optional STRING Not needed

DT SRV_BEG 8 Required DATE MMDDYYYY

Value date used for GAAP purposes. First day of service period or good receipt date.For all WC files - Service Begin Date

DT SRV_END 8 Optional DATE MMDDYYYY Not neededDT ASSGNT Max. 18 Optional STRING SAP Assignment Field Not neededDT REF_KY1 Max. 12 Optional STRING SAP Reference Key 1 field Not neededDT REF_KY2 Max. 12 Optional STRING SAP Reference Key 2 field Not neededDT REF_KY3 Max. 20 Optional STRING Not neededDT TYP_CD Max. 2 Optional STRING Not needed

DT STC_CD 1 Optional STRINGSet to complete indicator for EM funds Not needed

DT BUDGET_PD Max. 10 Optional STRING SAP Budget Period

Used for Account Assignment. Optional if Earmarked Fund & Earmarked Fund Line Item both present, data is determined from the Earmarked Fund line Item. Otherwise, it is Required.f fund starts with 1, 2, 3, 7, 8; enter FY (ex. 2013) If fund starts with 4, 5, 6; enter 0000 If fund starts with 9; enter 9999

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Web Service Mapping Details for SAP Vendor DataThese mapping details are provided for informational purposes. They are subject to modifications, and the final format details will be provided upon award of the contract. The contractor will be required to match their payment records to SAP vendor data and submit the SAP vendor number with all payment files. This is a “call” service where information is returned to be added to the payment files before they are interfaced.

Vendor Web Service Layout

Column Length NoteVendorNumber 10 Format must be 4 Zeros followed by 6 digits 0000XXXXXX, just 6

digits XXXXXX, or 6 digits, hypen, followed by 3 digits XXXXXX-XXX.

VendorStatus 1AcctGroup 4EIN 11 9 Digit Numeric (No hypen)SSN 16 9 Digit Numeric (No hyphen)TIN 16 9 Digit Numeric (Either the SSN or EIN, Not Both. No hyphen)LegalName 40 Name1TradingName 40 Name2SearchTerm1 20Address1 60Address2 40POBox 10 Numeric data only, no POBox text acceptedCity 40State 3 State Abbreviation Zip 10 XXXXX-XXXX FormatCountyName 10Country 3 Defaulted to USContactName 50PhoneNumber 30 XXX-XXX-XXXX FormatPhoneExt 10Email 241FaxNumber 30 XXX-XXX-XXXX FormatComment 50ReconAcct 10

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Column Length NoteInterestIndic 2PaymentTerm 4DblInvoice 1PaymentMethod 10 1 = CHECK, 2 = ACH, 5 = EFT WIRE TRANSFERIndividualPmnt 1BankKey 15 ABA Routing NumberBankAcct 18 Bank Account NumberCK 2 Control Key – 01=Checking 02=SavingsBnkt 4 Commonwealth Assigned field (normally BN01)Ctry 3 Country for BankAcctHolder 60

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

Return MessagesThis example is provided for informational purposes. The exact schema will be provided upon award of the contract. The contractor will be required to store the check identifying information with the authorization made in the claims system for payments. The return messages also alert the contractor when a check is paid or if it was rejected for any reason. The three fields to be stored on the contractor’s system are: paid date, bank account id and warrant id.

Schema Example for 407 – 830 Messages

<IPA_ZFI_COPA_PAYWARR><Header><InterfaceID>INTF_0407</InterfaceID><InterfaceType>REQUEST-830</InterfaceType><SourceSystem><Name>SAP</Name><DocumentID>0000000009344594</DocumentID><Date>2015-05-07</Date><Time>14:45:26</Time></SourceSystem><TargetSystem><Name>INS-CFA</Name><DocumentID>LICFA01</DocumentID><Date>2015-05-08</Date><Time>10:54:14</Time></TargetSystem></Header><Body><ZFI_MESSAGE_DT><MSGSTATUS>53</MSGSTATUS><TYPE>S</TYPE><ID>00</ID><NUMBER>000</NUMBER><MESSAGE>2000053569 PAYMENT APPROVED</MESSAGE></ZFI_MESSAGE_DT>

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Commonwealth of PennsylvaniaDepartment of General Services

RFP #6100042271APPENDIX M

<Z1FI_COPA_DH><BUS_AREA>79</BUS_AREA><DOC_TYPE>ZP</DOC_TYPE><DOC_NUM>LICFA01</DOC_NUM><TR_BATCH_PONO>7971303002</TR_BATCH_PONO><RECORD_TYPE>DH</RECORD_TYPE><TCODE>F110</TCODE><HEADER_AMOUNT>+000000000622.00</HEADER_AMOUNT><REFDOC_NUM>2000053569</REFDOC_NUM><DOCDATE_INVOICEDATE>2015-04-21</DOCDATE_INVOICEDATE><PARTNER_NUM>0000600001</PARTNER_NUM><PAYMENT_METHOD>01</PAYMENT_METHOD><HEADER_TEXT>BankAcctID: 6260 WarrantID: 0055330511</HEADER_TEXT><PAYDATE>2015-05-01</PAYDATE><BANKACCT_ID>6260</BANKACCT_ID><WARRANT_ID>0055330511</WARRANT_ID><Z1FI_COPA_DT><BUS_AREA>79</BUS_AREA><DOC_TYPE>ZP</DOC_TYPE><DOC_NUM>LICFA01</DOC_NUM><RECORD_TYPE>DT</RECORD_TYPE><LINEITEM_NUM>002</LINEITEM_NUM><GL_ACCOUNT>0002100000</GL_ACCOUNT><AMOUNT>+000000000622.00</AMOUNT><VENDOR>0000600001</VENDOR><SERVICE_PERIOD_BEGIN_DATE>2015-04-21</SERVICE_PERIOD_BEGIN_DATE></Z1FI_COPA_DT></Z1FI_COPA_DH></Body></IPA_ZFI_COPA_PAYWARR>

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