DAS Website: Forms and Documents

Directors Office

ADA Task Force
ADA Grievance Form
ADA Notice
ADA Task Force Charter

General Counsel and Compliance
Contracts for Personal Services, Title 12, Chapter 1, Department of Administrative Services, Rules and Regulations Concerning the Approval of
Guidance Document Request Form
Nebraska State Government International Relations Policy
Accounting
Social Security Bureau, Title 10, Department of Administrative Services, Administration Rules and Regulations
Building Division
Building Division Rules and Regulations, Title 7
Capital Construction Projects Manual
External Leasing Manual
Leasing Privately Owned Real Property, Title 7, Chapter 2
Parking Manual
Materiel Division
Materiel Division Rules and Regulations, Title 9
Vendor Application and Instructions
Vendor Manual
Vendor Protest/Grievance Procedures
Risk Management
State Claims Board Rules and Regulations
Transportation Services Bureau
Transportation Services Bureau Rules and Regulations, Title 8

Office of the Capitol Commission
Use of the State Capitol, Lincoln, Nebraska, State Capital, Title 6, Office of the Capitol Commission, Rules and Regulations Governing
Campaigning Guidelines
Drone and UAV Guidelines
Exterior Lighting Guidelines
Family Photo Guidelines
First Floor Display Guidelines
Leafletting Guidelines
News Conference Guidelines
Printed Material Distribution Guidelines
Promenade Deck Access Guidelines
Rally Guidelines
Second Floor Rotunda Program Guidelines
Smoking Guidelines
Wedding Guidelines
Wedding Photography Guidelines

Accounting

Payroll

MANUALS
Accounting Manual
Accounts Payable
2023 Expense Reimbursement Doc - EFFECTIVE 1-1-2023 - XLSX
2022 Expense Reimbursement Doc - EFFECTIVE 10-1-2022 - XLSX
2022 Expense Reimbursement Doc - EFFECTIVE 7-1-2022 - XLSX
ERD Training Video
Accounts Payable Warrant Cancellation Form
Fund Application - PDF
Investment Authorization" - PDF
Petty Cash Fund Application- PDF
Request for Stop Pay-Replacement Warrant Form
Warrant Cancellation Certification - PDF
State of Nebraska W9 - PDF
State of Nebraska Form 13 - PDF
Interims
Interim Payroll Information
Payroll Card
Video – Focus Payroll Card
Direct Deposit Enrollment Form - PDF
Focus Card Enrollment Form" - PDF
Payroll Card Instruction
Payroll Card Fees - PDF
Payroll Card Limits - PDF
Payroll Certification Mini-Manual
Mini-Manual
Payroll Certification Form Instructions - DOC
Payroll Certification Form - XLS
Payroll Certification Checklist - PDF
Payroll Processing Schedules
2021 Payroll Processing Schedule - Biweekly - PDF
2021 Payroll Processing Schedule - Monthly - PDF
2020 Payroll Processing Schedule - Biweekly - PDF
2020 Payroll Processing Schedule - Monthly - PDF
2019 Payroll Processing Schedule - Biweekly - PDF
2019 Payroll Processing Schedule - Monthly - PDF
2018 Payroll Processing Schedule - Biweekly - PDF
2018 Payroll Processing Schedule - Monthly - PDF
Payroll Hours in Calendar or Fiscal Year - XLS
Payroll Forms
Employer
Employer Report of Special Payments - PDF
Instructions for the Payroll Calculation Form
Interim Direct Payment Worksheet - XLS
Interim Worksheet - XLS
Payroll Calculation Form - XLSX
Payroll Certification Checklist - PDF
Payroll Certification Form - XLS
Payroll Certification Form Instructions - DOC
Service Date Adjustment Form - XLS
E1 W4 Instructions - PDF
W2 Reprint Request Form - PDF
Employee
Direct Deposit Enrollment Form - PDF
Employee Electronic Receipt of Form W-2 - PDF
Payroll Calculation Tables
FOCUS Card Information Form - PDF
Payroll Card Instructions
Retirement Estimator

Internal Control

Internal Control Guidance
About Internal Control & Five Components of Internal Controls Memorandum of Understanding - Shaping a Culture of Accountability Memorandum of Understanding - Shaping a Culture of Accountability(Agency with less than 7 employees)
Internal Control Tools
Brainstorming Techniques Continuous Risk Process Event Tree - Actions applied to an event (risk) and expected consequences of those actions Model Internal Control Plan Process Matrix Risk Assessment Methods and Measures Risk Identification and Evaluation Risk Assessment Tool Kit Risk Assessment Technique Considerations SWOT (Strengths, Weaknesses, Opportunities, Threats) Profile Response Profile Fill-in Form
Self-Assessment Tools
Entity Level Controls Expenditures and Disbursements Example Questions for Individuals or Focus Groups
Other Tools
Sample Internal Controls Checklist Small Agency Finance Management Self-Assessment Tool
Correspondence
Federal Grant Reform Webinars (05/01/14) Employee Expense Reimbursement (03/18/14)

Purchasing Card

Purchasing Card Program
Purchasing Card Manual Purchasing Card Request Form Send a completed and signed form to AS State Account via email. Purchasing Card Instructions Agency and Individual Card Blocking

Master Lease

Master Lease Purchase Program
Master Lease Purchase Program Manual Certificate of Official Intent Form (PDF fillable) Agency Authorization Form (PDF fillable) Equipment Schedule Form (PDF fillable)

Annual Budgetary Report

Fiscal Year
2020 2019 2018 2017 2016 2015

Comprehensive Annual Financial Report

Fiscal Year
2020 2019 2018 2017 2016 2015

Monthly Reports
Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Allotment Status Report Budget Status Report Budget Status Summary Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Allotment Status Report Budget Status Report Budget Status Summary Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal_Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Allotment Status Report Budget Status Report Budget Status Summary Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Allotment Status Report Budget Status Report Budget Status Summary Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report Statewide Budget Summary Status Report Allotment Status Report Budget Status Report Construction Summary Report Fund Summary by Fund Report Grant Project Status Report Grant Project Summary Report Personal Service Limitation Status Report Program Summary by Subprogram Report Program Summary Report

The Nebraska Investment Council invests the available money from the State’s general fund and State boards, commissions, departments or agencies, and any other state funds not currently needed, into the Operating Investment Pool. The Department of Administrative Services - State Accounting Agency calculates the average daily balance for each participant and distributes the earned income monthly on a pro-rata share basis.

2020

January (2/24/20 G/L Date)

February (3/24/20 G/L Date)

March (4/22/20 G/L Date)

April (5/21/2020 G/L Date)

May (6/23/2020 G/L Date)

June (7/21/2020 G/L Date)

July (8/24/2020 G/L Date)

August (9/25/2020 G/L Date)

September (10/27/2020 G/L Date)

October

November

December

2019

January (2/22/19 G/L Date)

February (3/26/2019 G/L Date)

March (4/22/2019 G/L Date)

April (5/24/2019 G/L Date)

May (6/19/2019 G/L Date)

June (7/24/2019 G/L Date)

July (8/26/2019 G/L Date)

August (9/24/2019 G/L Date)

September (10/25/2019 G/L Date)

October (11/21/2019 G/L Date)

November (12/19/2019 G/L Date)

December (1/27/2020 G/L Date)

2018

January (2/21/18 G/L Date)

February (3/23/18 G/L Date)

March (4/23/18 G/L Date)

April (5/24/18 G/L Date)

May (6/22/18 G/L Date)

June (7/26/18 G/L Date)

July (8/22/18 G/L Date)

August (9/25/18 G/L Date)

September (10/23/18 G/L Date)

October (11/12/18 G/L Date)

November (12/21/18 G/L Date)

December (1/24/19 G/L Date)

2017

January (2/28/17 G/L Date)

February (3/23/17 G/L Date)

March (4/24/17 G/L Date)

April (5/31/17 G/L Date)

May (6/23/17 G/L Date)

June (7/20/17 G/L Date)

July (8/28/2017 G/L Date)

August (9/28/2017 G/L Date)

September (10/25/2017 G/L Date)

October (11/22/2017 G/L Date)

November (12/22/2017 G/L Date)

December (1/24/2018 G/L Date)

2016

January (2/26/16 G/L Date)

February (3/22/16 G/L Date)

March (4/21/16 G/L Date)

April (5/23/16 G/L Date)

May (6/21/16 G/L Date)

June (7/22/16 G/L Date)

July (8/29/16 G/L Date)

August (9/26/16 G/L Date)

September (10/17/16 G/L Date)

October (11/23/16 G/L Date)

November (12/21/16 G/L Date)

December (1/26/17 G/L Date)

2015

January (2/20/15 G/L Date)

February (3/24/15 G/L Date)

March (4/17/15 G/L Date)

April (5/19/15 G/L Date)

May (6/18/15 G/L Date)

June (7/22/15 G/L Date)

July (8/24/15 G/L Date)

August (9/22/15 G/L Date)

September (10/23/15 G/L Date)

October (11/24/15 G/L Date)

November (12/28/15 G/L Date)

December (01/26/16 G/L Date)

The Statewide Cost Allocation Plan (SWCAP) is a statistical method of allocating central government costs to the state agencies that receive central government supportive services.

2017

PDF | approved 05/31/19
2016

PDF | approved 02/14/17
2015

PDF | approved 12/17/15
ISF Balance Guidence

PDF

Date	Subject
12/14/20	Other Taxable Income
1/28/21	2021 Expense Reimbursement Request
12/1/20	2020 Expense Reimbursement Request
12/1/20	December 1, 2020 BUG PowerPoint
12/1/20	December 1, 2020 BUG Meeting
12/1/20	ERD Training Video
12/1/20	State Accounting Updated Policies
5/7/20	May 28, 2020 BUG PowerPoint
5/7/20	Fiscal Year End (June 30, 2020) Closing Schedule
2/21/20	February 25, 2020 BUG PowerPoint Feedback Form
1/3/20	Mileage Reimbursement Rates 2020
12/11/19	Annual Notice for Commuting and Taxable Meals
10/15/19	Annual Budgetary Report for FY 2019
9/10/19	September 11, 2019 BUG Slides
6/12/19	May 23, 2019 Fiscal Year End BUG video
5/21/19	May 23, 2019 BUG PowerPoint
5/07/19	Fiscal Year End (June 30, 2019) Closing Schedule
3/21/19	March 27, 2019 BUG PowerPoint

Budget

Publications
Federal COVID-19 Supplemental Appropriation (April 2020 \| YouTube)
Federal COVID-19 Supplemental Appropriations PowerPoint (UPDATED June 3, 2020 \| PDF)
Funding Provided to Nebraska for COVID-19 (UPDATED June 3, 2020 \| PDF)
Initial Guidance for Local Government Requests for Reimbursement for COVID-19 Related Expenses (June 10, 2020 \| PDF)
COVID-19 Expenditure Tracking Memo PDF \| April 2020
Federal Funding Guidance Memo to All Agencies, Boards and Commissions PDF \| March 24, 2020
Federal Grant Award Summary Spreadsheet March 24, 2020
Federal HHS COVID-19 Grant Awards
NASBO Website
NEMA – COVID-19 Status of Funds
Nebraska Coordinating Commission for Postsecondary Education – Postsecondary Education COVID-19 Related Information
U.S. Department of Treasury – Assistance for Small Businesses
Federal HHS COVID-19 Grant Awards
U.S. Department of Treasury - Coronavirus Relief Fund Information

Building

Construction Bids
State Building Plan Room
Builders Bureau, Lincoln, NE
Omaha Exchange Builders, Omaha, NE
Design
Design and Construction manual
Project Request form
Space requirement worksheet
Design standards examples
Leasing
External Leasing Manual
Lease Requisition Form - Blank
Facility Use Manual
Parking
Parking Manual
Parking Application
Vehicle Updates, Additional AVI Stickers, and Permits
Parking Exit Form
Bike Room Application
Visitor Parking Request Form
Handicapped Accessible Parking Request
Parking Rates and Fees
Tax Exemption Parking Plan
Car Pool Registration
Instructions on how to place AVI sticker
List of Vehicles with Metallized Windshield List
Vacant BLDGS & Excess Land(VBEL)
VBEL Request Form
VBEL Quarterly Meeting Agenda

Center of Operational Excellence

Publications
On-Site Training Brochure (PDF)
Remote Huddle Board (XLSX)
Process Identification Tool (Word)

DAS Human Resources

Human Resources Shared Services ("HRSS")

These forms are internally created for State of Nebraska Human Resources Shared Services (“HRSS”) and are intended for HRSS Customer Agencies only. No State of Nebraska Agency is required to use these forms unless otherwise instructed.

American's with Disabilities Act (ADA) Accommodations
Healthcare Provider Reasonable Accommodation Form
Reasonable Accommodation Checklist for Teammates
Reasonable Accommodation Request Form
Family and Medical Leave (FMLA) and Leave Without Pay (LWOP)
FMLA Information for Leaders
Medical Leave Request Form
Teammate Medical Leave Request Checklist-Guide
Off-Boarding/Exiting Teammate Information
Knowledge Transfer Questionnaire
Off-Boarding Process Workflow
Return of State Property Form
Teammate Resignation Guide
Teammate Retirement Guide
Teammate Transfer Guide
On-Boarding/New Hire Information
OnBoarding Process Workflow
Orientation Process Workflow
Welcome Packet 1.0
Payroll
2023 Bi-Weekly Payroll Calendar
2023 Monthly Payroll Calendar
2023 Comp-Time or Overtime Election Form
Performance Management
Coaching -Documentation Form - Non Disciplinary
Direct Conversations - Guide
Performance Management Checklist - Leader
Non-Disciplinary Performance Improvement Plan - PIP
Providing Effective Feedback - Guide
Setting Expectations - Guide
Recruitment
Advanced Hire Rate Request Workflow
Competency-Based Interview Question Collection
New Requisition Questionnaire
New SOS Requisition Questionnaire
Recruitment Process Workflow
SOS Recruitment Process Workflow
Teammate Resources
SMART Goals Guidance-Template
Tuition Reimbursement
Tuition Reimbursement Application
Tuition Reimbursement Checklist-Guide
Workday Help
Create and Monitor a Help Center Case - User Guide
Finding Help Articles - User Guide
Working Out of Classification
Working Out of Class Request Form
Workplace Injury/Workers' Compensation
Employee Incident Report Form
Workability Form
Lost Hours Spreadsheet
Teammate Injury Checklist and Guide
Supervisor Investigation Report
Witness Report Form

Employee Relations

Labor Contract Information
Labor Contracts 2021-2023 2021-2023 NAPE/AFSCME Labor Contract - PDF Summary of Changes for the State of Nebraska and NAPE-AFSCME 2021-2023 Labor Contract - PDF Consolidation Project Outline - PDF 2019-2021 2019-2021 NAPE/AFSCME Labor Contract - PDF Historical NAPE/AFSCME Labor Contracts Letters of Agreement NAPE COVID-19 Supplemental Leave Letter of Agreement - PDF June 10, 2019 - PDF June 18, 2019 - PDF October 29, 2019 - PDF COVID-19 Administrative Leave - PDF Labor Contract 2021-2023 2021-2023 FOP Labor Contract - PDF Summary of Changes for the State of Nebraska and FOP 2021-2023 Labor Contract - PDF 2019-2021 2019-2021 FOP Labor Contract - PDF Letters of Agreement July 1, 2019-PDF August 6, 2019-PDF January 6, 2020-PDF COVID-19 Administrative Leave-PDF Labor Contracts 2021-2023 2021-2023 SLEBC Labor Contract - PDF Summary of Changes for the State of Nebraska and SLEBC 2021-2023 Labor Contract - PDF 2019-2021 2019-2021 SLEBC (Law Enforcement) Labor Contract -PDF Historical SLEBC Labor Contracts Letters of Agreement SLEBC COVID-19 Supplemental Leave Letter of Agreement- PDF SLEBC Vacation Bidding Process Letter of Agreement - PDF March 13, 2020-PDF COVID-19 Administrative Leave-PDF Labor Contracts 2021-2023 2021-2023 SCATA Labor Contract - PDF Summary of Changes for the State of Nebraska and SCATA 2021-2023 Labor Contract - PDF 2019-2021 2019-2021 SCATA (Teachers) Labor Contract - PDF Historical SCATA Labor Contracts Letters of Agreement SCATA COVID-19 Supplemental Leave Letter of Agreement- PDF SCATA COVID-19 Administrative Leave - PDF Rules and Regulations Title 273 Classified System Personnel Rules and Regulations (Dec 2021) Personnel Director Rules Memorandum July 2022 - PDF State Personnel Rules and Regulations Revised Rules FAQ (April 27, 2022) State Personnel Rules and Regulations Revision Webinar (April 27, 2022) State Personnel Rules and Regulations Changes – Revised 2021 vs 2006 Guidelines Telecommuting Guidelines - PDF Furlough Guide - PDF HR Implications-Natural Disasters - PDF NAPE Reduction In Force Packet - DOC FOP Reduction In Force Packet - DOC Re-Employment Program - PDF The Leader's Guide to Discipline - PDF NAPE/AFSCME Grievance Form - PDF Grievance Form - DOC Discovery Form - DOC FOP Grievance Form - PDF Grievance Form - DOC Classified Rules & SCATA Grievance Procedures - PDF Rules Grievance Form - PDF State Law Enforcement State Law Enforcement Bargaining Council Grievance Form - PDF
Discipline and Grievance Information
NAPE/AFSCME FOP Classified Rules Information State Law Enforcement SCATA
Leave & Workplace Resources
Donation Form - PDF Leave Request Form - PDF Frequent Questions FMLA Information FMLA Request Form FMLA Employee Rights Insurance Coverage Form Certification of Health Care Provider for Employee's Serious Health Condition Form Certification of Health Care Provider for Family Member's Serious Health Condition Form Certification for Serious Injury or Illness of a Current Servicemember - for Military Family Leave Form Certification for Serious Injury of Illness of a Veteran for Military Caregiver Leave Form Certification of Qualifying Exigency for Military Family Leave Form The following forms are for HR Agency use only, and do not need to be filled out by employees requesting leave: Designation Notice Form Notice of Eligibility and Rights & Responsibilities Form Request Form for Maternity Leave Donation - PDF Maternity Leave Donation Memo and Maternity Leave Donation Form - PDF Maternity Leave Donation Program Overview - PDF
Training
PowerPoints and Handouts Leader's Guide to Discipline (pdf) Discipline Training (pdf) FMLA Powerpoint (pptx) FMLA Road Map (PDF) Leave Training (PDF) ADA Amendments (ppt) 2019-2021 NAPE Contract Training(PDF) 2019-2021 FOP Contract Training (PDF)

Materiel

Vendor Information

Description	Last Revised	Format
Vendor Application	12/14/2020	Excel
Vendor Manual	12/14/2017	PDF

Surplus/Asset Management

Description	Last Revised	Format
Annual Fixed Asset/Annual Inventory Letter FY 21/22	05/10/2022	PDF
Asset Management Manual 2022	08/05/2022	PDF
Barcoding Manual	08/18/2022	PDF
SPN Form for Non-Fixed Asset	10/15/2018	Excel
SPN Form Instructions	10/10/2018	Word
Agency Instructions for Surplus Property	09/21/2020	PDF

Procurement Governmental Agency Information

Office Depot Contract Information
Office Depot Account Application
On-Line Return Instructions
Return Authorization Form

Vehicle Information
Vehicle Cut Off Dates - 06/13/22
2023 Vehicle Season Master Agreement Terms and Conditions
2023 Vehicle Season Master Agreement Terms and Conditions
2023 Vehicle Season Master Agreement Terms and Conditions Letter
2023 Vehicle Season Completed Master Agreement Terms and Conditions
2023 Master Agreement Anderson Ford of Lincoln
2022 Vehicle Season Master Agreement Terms and Conditions
2022 Master Agreement Terms and Conditions
2022 MA Terms and Conditions Letter
2022 Vehicle Season Completed Master Agreement Terms and Conditions
2022 Master Agreement Anderson Ford of Lincoln
2022 Master Agreement Baxter Chrysler Dodge Jeep Ram Fiat of Lincoln
2022 Master Agreement Gene Steffy Auto Group
2022 Master Agreement Husker Auto Group LLC

Moving and Installation Services Information
Agency Instructions for Office Relocations
Moving and Installation Services Guide
Procurement Training Guide Generating PO Moving and Installation Services
Example Installation Services Quote Form
Example Moving Services Quote Form
Moving Services Quote Form

EnterpriseOne and Other General Information

Description	Last Revised	Format
Request to Increase Contract Quantity Form	03/28/2018	XLS
Approval Route Worksheet	09/18/2017	Word
Two-Way Match Policy	03/30/2006	PDF
National Institute of Governmental Purchasing (NIGP) Codes	07/18/2017	XLS
Pre-Approved IT Items for Purchase (on OCIO website)	More information
MMCAP Pharmaceutical Information	04/17/2017	PDF
Purchase Order Terms and Conditions	10/01/2020	PDF
Market Research Powerpoint	11/29/2016	PPT
Contract Location Report	07/02/2018	XLS
Contract Administration Plan (CAP)	12/08/2016	PDF
Manuals
Contract Manager Handbook	05/28/20	PDF
State of Nebraska Procurement Manual	09/14/2018	PDF
Proof of Need Analysis Information
Proof of Need Analysis Guide	02/27/20	Word
Proof of Need Analysis Template	02/27/20	Word
Proof of Need Analysis Checklist for Agencies	02/27/20	Word
Personal Services Guide
Personal Services Guide Template	07/14/2015	Word
Vendor Performance
Vendor Performance Program (VPP)	VPP Resources

Commodities/Goods Information

#	Description	Last Revised	Format
ITB Boilerplate Changes		07/01/2019	PDF
Specification Tutorial and Introduction to ITB Boilerplates Powerpoint		09/15/2015	PDF
Processing Timeline for Commodities/Goods		01/15/2014	PDF
Printing 101: Guidelines for a Successful Print Project		04/17/2017	PDF
ITB Boilerplate
1.	Invitation To Bid Boilerplate	07/01/2019	Word
Forms
1.	Solicitation Announcement Letter	04/01/2015	Word
2.	Pre-Bid Attendance Sheet	10/16/2014	Word
3.	Pre-Bid Conference Questions	10/01/2008	Word
4.	Addendum - Questions and Answers	09/23/2015	Word
5.	Addendum - Amendment to ITB	10/16/2014	Word
6.	Addendum - Change of Scope	10/16/2014	Word
7.	Addendum - Schedule of Events Change	10/16/2014	Word
8.	Addendum to Contract	07/21/2015	Word
9.	Amendment to Contract	07/21/2015	Word
10.	Rejection of Bids	10/01/2008	Word
11.	Request for Fax or Electronic Quote	08/25/2015	XLS
12.	Specification Comparison Tool	12/10/2013	XLS
13.	Non-CSI Justification Form (Non-CSI OW Requisition Example and Instruction)	08/25/2017 08/17/2017	PDF PDF
14.	Sole Source Justification for Commodities	12/19/2016	PDF
15.	Declaration Concerning Conflict of Interest and Confidential Information for Invitations to Bid	07/11/2014	PDF
Purchase Authority Information
1.	Unrestricted Open Market Purchase Authority Letter	09/14/2022	PDF
Policies/Procedures
1.	Protest/Grievance Procedure	08/04/2021	PDF
2.	Preference Policies	10/01/2008	PDF

Services Information

#	Description	Last Revised	Format
Deviation Requests from Contractual Services & Emergency Contracts Process PowerPoint		07/01/2014	PDF
Boilerplate Changes		07/01/2019	PDF
Processing Timeline for Services		01/15/2014	PDF
Request for Information (RFI) Boilerplate
1.	Request for Information Boilerplate	09/25/2017	Word
Boilerplate
1.	Request for Proposal Boilerplate	07/01/2019	Word
Additional Forms
1.	Deviation from Contractual Services Contract Process Form	02/24/2015	Word
2.	Request for Proposal Check-Off List	08/06/2015	Word
3.	Solicitation Announcement Letter	07/22/2015	Word
4.	Public Notice Cover and Announcement - (Lincoln Journal Star/Beatrice Daily Sun Public Notice Form)	11/08/2018	Word
5.	Pre-Proposal Attendance Sheet	10/16/2014	Word
6.	Pre-Proposal Conference Questions	06/04/2014	Word
7.	Addendum - Questions and Answers	09/23/2015	Word
8.	Addendum - Addendum to RFP	10/16/2014	Word
9.	Addendum - Change of Scope	10/16/2014	Word
10.	Addendum - Schedule of Events Change	10/16/2014	Word
11.	Addendum to Contract	07/21/2015	Word
12.	Amendment to Contract	07/21/2015	Word
13.	Respondents List	10/16/2014	Word
14.	Intent to Award Letter	10/16/2014	Word
15.	Rejection of Proposals	10/16/2014	Word
16.	Mandatory Requirements Checklist	10/16/2014	XLS
17.	Request for Fax or Electronic Quote	08/25/2014	XLS
RFP Evaluation & Scoring
1.	RFP Evaluation & Scoring Manual for Services	01/26/2017	Word
2.	Declaration Concerning Conflict of Interest and Confidential Information	08/23/2017	PDF
3.	Evaluator Scoring Worksheet	10/16/2014	Word
4.	Criteria for Evaluation	07/30/2015	Word
5.	Cost Proposal Evaluation Worksheet	01/08/2013	XLS
6.	Reference Check Worksheet	10/01/2008	Word
7.	Final Evaluation Document	08/26/2014	XLS
8.	Final Evaluation Document for Cafeteria & Vending Services	02/27/2014	Word
9.	Oral Interview Letter - Version One	10/01/2008	Word
10.	Oral Interview Letter - Version Two	10/01/2008	Word
11.	Oral Interview Letter - Version Three	10/01/2008	Word
12.	Oral Interview Scoring Worksheet	10/01/2008	Word
13.	Final Evaluation Document with Oral Interviews	08/26/2014	XLS
14.	Final Evaluation Document with Oral Interview for Cafeteria & Vending Services	02/27/2014	Word
15.	Best and Final Offer (BAFO) Letter	09/12/2017	Word
16.	Final Evaluation Document with Best and Final Offer (BAFO)	08/26/2014	XLS
17.	Award Instructions Letter	02/26/2015	Word
Policies/Procedures
1.	Unrestricted Open Market Purchase Authority Letter	09/14/2022	PDF
Policies/Procedures
1.	Protest/Grievance Procedure	08/04/2021	PDF
2.	Preference Policies	10/01/2008	PDF

Materiel Miscellaneous Information

Description
State Purchasing Bureau Records Request Form
Training - First Half
Training - Second Half
Mail Services Guide
Change of Address Form
Copy Center Requisition

Purchase Order/Vendor Information Reports

Description	Format
July 2022 - September 2022	PDF
April 2022 - June 2022	PDF
January 2022 - March 2022	PDF
October 2021 - December 2021	PDF
July 2021 - September 2021	PDF
April 2021 – June 2021	PDF
January 2021 - March 2021	PDF
October 2020 - December 2020	PDF
July 2020 - September 2020	PDF
April 2020 - June 2020	PDF
January 2020 - March 2020	PDF
October 2019 - December 2019	PDF
July 2019 - September 2019	PDF
April 2019 - June 2019	PDF
January 2019 - March 2019	PDF
October 2018 - December 2018	PDF
July 2018 - September 2018	PDF
April 2018 - June 2018	PDF
January 2018 - March 2018	PDF
October 2017 - December 2017	PDF
July 2017 - September 2017	PDF
April 2017 - June 2017	PDF
January 2017 - March 2017	PDF
October 2016 - December 2016	PDF
July 2016 - September 2016	PDF
April 2016 - June 2016	PDF
January 2016 - April 2016	PDF
2015	PDF
2014	XLSX
2013	XLSX
2012	XLSX
2011	XLSX

Government Procurement Act Report (§ 73-603)

Description	Format
09/01/2022	PDF
09/01/2020	PDF
09/01/2019	PDF
09/01/2018	PDF
09/01/2017	PDF

Personnel

State Personnel Systems

Employee Work Center and Workday

Career Center

statejobs.nebraska.gov

Recruitment & Selection Center

Employee Development Center

SOS Temporary Employee Benefits

Section	Title
1	Health & Prescriptions Plans
2	Dental
3	Flexible Spending Accounts (Dependent Care ONLY)
4	Health Savings Account
5	Long & Short Term Disability

COBRA

COBRA Rights Information PDF
COBRA Termination Form - PDF

Payroll Deduction Codes

Payroll Deduction Codes for the Employee Work Center - EXCEL

COBRA

The State of Nebraska offers the following benefits for Cobra and Retirees.

Click here to review the COBRA section of the 2020-21 Options Guide - PDF.

Resources

COBRA

COBRA Rights Information PDF
COBRA Termination Form PDF

2020-21 Plan Year

2019-20 Plan Year

Real Appeal

Open Enrollment Information

UnitedHealthcare (UHC) Medical and Pharmacy (Handout)
Strada (Direct Primary Care) ) (Handout)
Public Employees Retirement System - Deferred Compensation Plan (Handout)
Deer Oaks - Employee Assistance Program (EAP) (Handout)
Ameritas - Dental Plan (Handout)
EyeMed - Vision Plan (Handout)
UHC - Short-Term Disability/Long-Term Disability (Handout)
ASI/Flex - Flexible Spending Accounts (Handout) (FSA Video) (Dependent Care FSA Video)
The Hartford - Life Insurance (Handout)

Pay Plan

Job Code changes, effective October, 2011

Quarterly Pay Plan Changes

Q1 January - March, 2020

Previous Classification & Pay Plans

Employees covered by Bargaining Units, visit the Bargaining Unit Pay Plans page.

2015
October - December, 2015
July - September, 2015
April - June, 2015
January - March, 2015

2014
2014 Pay Plan
October - December, 2014
July - September, 2014
April - June, 2014
January - March, 2014

2013
2013 Pay Plan
July - December, 2013
January - March, 2013

2012
September - December, 2012
July - September, 2012
April - June, 2012
February - March, 2012

2011 - 2012
2012 (last revised June 14, 2013)
2011 (last revised March 31, 2012)
October 2011 - January 2012

2011
July - September, 2011
April - June, 2011
January - March, 2011

2010
October - December, 2010
July - September, 2010
April - June, 2010
January - March, 2010

2009
October - December, 2009
July - September, 2009

To view previous pay plans, visit the State Government Publications ONLINE at the Nebraska Library Commission

Temporary Employment Program (SOS)

Temporary Employment Program (SOS)
Final Rules
Manager Time Entry Approval
Payroll Schedule
Reimbursement Request
Daily Time Entry

Risk Management

Risk Management Forms
Tort Form
How to File a Tort Claim
Tort/Misc. Claim Form
Tort/Misc. Claim Form - Inmates at NDCS Only
Affidavit Regarding Lost or Missing Warrant
How to File a Claim for an Uncashed Warrant
W9 Form
Contract Claim Form
How to File a Contract Claim
Foster Parent Claim Form
Report Unsafe Conditions
State of Nebraska COI Certificate of Insurance FY 20-21
Line of Duty Compensation Act Claim Form
Standard Operating Procedures – How to File a Line of Duty Compensation Act Claim

309 Task Force

309 Task Form Forms
Allocation Request Form
Allocation Increase Request Form
Final Report Form
Roof Scan Request Form

Transportation Services Bureau

TSB Forms
Form J To be completed and returned to TSB when your agency requests a new permanently assigned TSB lease vehicle – OR – for a change in vehicle type/upgrade of designated TSB lease vehicles. Please note – changes in vehicle type/upgrades are reviewed ONLY during TSB’s annual vehicle replacement cycle. Form J instructions may be accessed here. Completion of Form J does not guarantee an upgrade and/or change in vehicle type.
Form S To be completed and returned to TSB when your agency anticipates the need for additional vehicles on a temporary basis. Requests for seasonal or summer use vehicles will be reviewed and approved based on existing fleet availability. New vehicles will not be purchased solely to fill seasonal or summer requests.
Transportation Requests To be completed and presented to TSB staff when renting a TSB Motor Pool vehicle. The Transportation Request is exempt if your agency has a Universal Travel Authorizations form (below) on file with TSB.
Universal Travel Authorizations Utilized by your agency in lieu of the Transportation Requests form (above).
Official TSB Travel Logs To be completed per Statute 81-1025.
If you are unable to access or open the Transportation Services Bureau (TSB) forms, please contact (402) 471-2897 or (402) 471-2898 for assistance.

Forms and Documents

Directors Office

Accounting

Employer

Employee