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2 CFR Part 200 Subpart F Audit Certification Form <br /> Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations <br /> Contact Information <br /> Subrecipient Name(Agency,Local Government,or Organization):City of Everett Office of Emergency Management <br /> Authorized Chief Financial Officer(central accounting office):Susy Haugen <br /> Address:City of Everett, 2930 Wetmore Avenue, Everett WA 98201 <br /> Email: shaugen@everettwa.gov Phone#:(425) 257-8700 <br /> Purpose: As a pass-through entity of federal grant funds,the Washington Military Department/Emergency Management Division(Department) <br /> is required by 2 CFR Part 200 Subpart F to monitor activities of subrecipients to ensure federal awards are used for authorized purposes and <br /> verify that subrecipients expending $750,000 or more in federal awards during their fiscal year have met the 2 CFR Part 200 Subpart F Audit <br /> Requirements. Your entity is a subrecipient subject to such monitoring by MIL/EMD because it is a non-federal entity that expends federal grant <br /> funds received from the Department as a pass-through entity to carry out a federal program. 2 CFR Part 200 Subpart F should be consulted <br /> when completing this form. <br /> Directions: As required by 2 CFR Part 200 Subpart F, non-federal entities that expend $750,000 in federal awards in a fiscal year shall have <br /> a single or program-specific audit conducted for that year. If your entity is not subject to these requirements, you must complete Section A of <br /> this Form. If your entity is subject to these requirements, you must complete Section B of this form. When completed, you must sign, date, <br /> and return this form with your grant agreement and every fiscal year thereafter until the grant agreement is closed. Failure to return this <br /> completed Audit Certification Form may result in delay of grant agreement processing, withholding of federal awards or disallowance of costs, <br /> and suspension or termination of federal awards. <br /> SECTION A: Entities NOT subject to the audit requirements of 2 CFR Part 200 Subpart F <br /> Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because(check all that apply): <br /> ❑ We did not expend $750,000 or more of total federal awards during the fiscal year. <br /> ❑ We are a for-profit agency. <br /> ❑ We are exempt for other reasons (describe): <br /> However, by signing below, I agree that we are still subject to the audit requirements, laws and regulations governing the program(s)in <br /> which we participate, that we are required to maintain records of federal funding and to provide access to such records by federal and state <br /> agencies and their designees, and that WMD/EMD may request and be provided access to additional information and/or documentation to <br /> ensure proper stewardship of federal funds. <br /> SECTION B: Entities that ARE subject to the audit requirements of 2 CFR Part 200 Subpart F <br /> (Complete the information below and check the appropriate box) <br /> ❑■ We completed our last 2 CFR Part 200 Subpart F Audit on[enter date] 7/27/2018 for Fiscal Year ending [enter date] 2017 . There <br /> were no findings related to federal awards from WMD/EMD. No follow-up action is required by WMD/EMD as the pass-through entity. <br /> A complete copy of the audit report,which includes exceptions,corrective action plan and management response, is <br /> either provided electronically to contracts.officeOmil.wa.gov or provide the state auditor report number: <br /> ❑ We completed our last 2 CFR Part 200 Subpart F Audit on[enter date] for Fiscal Year ending[enter date] . There <br /> were findings related to federal awards. <br /> A complete copy of the audit report,which includes exceptions,corrective action plan and management response, is either <br /> provided electronically to contracts.officeOmil.wa.gov or provide the state auditor report number: <br /> ❑ Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date]for Fiscal Year ending <br /> [enter date]. We will provide electronic copy of the audit report to contracts.office(a)mil.wa.gov at that time or <br /> provide the state auditor report number: <br /> I hereby certify that I am an individual authorized by the above identified entity to complete this form. Further, I certify that the <br /> above information is true and correct and all relevant material findings contained in audit report/statement have been disclosed. <br /> Additionally, I understand this Form is to be submitted every fiscal year for which this entity is a subrecipient of federal award <br /> funds from the Department until the grant agreement is closed. <br /> 9 <br /> Signature of Authorized Chief Financial Officer: , , Date: 11/2/2018 <br /> Print Name & Title: Susy Haugen,Finance Director-Treasurer <br /> WMD Form 1009-13,8/19/2013,Updated 9/9/2015 <br />