County of Los Angeles
Department of Public Health
Substance Abuse Prevention & Control
1000 S. Fremont Avenue
Building A9 East, 3rd Floor
Alhambra, CA 91803
Phone: (626) 299-4193
Fax: (626) 458-7637
FY2011-2012 Annual Cost Report Forms and Instructions
The Substance Abuse Prevention and Control, Financial Services Division is making available for Contract Services
Providers, the Annual Cost Report Forms and Instructions for FY 2011/2012.
• Per Contract, the annual Provider cost reports are due 45 days after end of Fiscal Year.
• The last due date to submit cost report(s) to SAPC is
August 15, 2012.
• If the cost report(s) is/are not received by the due date, your agency will be listed as a delinquent provider.
• Delinquent provider(s) could experience stop payment on
current billings after August 15, 2012.
• Send cost report(s) original and copy with all working papers as applicable to:
County of Los Angeles Department of Public Health
Substance Abuse Prevention and Control
1000 S. Fremont Ave., Bldg A-9 East
3rd Floor, North Wing, Unit 34
Alhambra, California 91803
CARE Certification & Cost Report Certifications: To be attached to ALL cost reports