SUBRECIPIENT ANNUAL AUDIT CERTIFICATION – SUBJECT TO A-133
SECOND REQUEST
Subrecipient Information:
Name
Address
Reference:
Current Date:
Name of Project
Institutional records indicate that your organization was a subrecipient of federal funds from the Colorado
School of Mines during the fiscal year ended June 30, _____. Office of Management and Budget (OMB)
Circular A-133 requires us to ascertain that you, as a subrecipient, are in compliance with the audit
requirements of the Circular. Accordingly, please identify the statement below that indicates the status of
your audit compliance. Failure to respond will result in all funding being suspended.
_______
Our A-133 audit for fiscal year _____ has been completed and no material
instances of non-compliance, material weakness and/or reportable conditions
were found related to any sub-award(s) from the Colorado School of Mines.
Enclosed is a copy of our A-133 or a web site where it can be accessed.
_______
Our A-133 audit for fiscal year _____ has been completed and included material
instances of non-compliance, material weakness and/or reportable conditions.
Enclosed is a copy of the audit report, or a web site where it can be accessed,
and our corrective action responses.
________
Our A-133 audit report for fiscal year _____ is not yet available. We expect that
the report will be completed on or about the following date: _______________.
Upon completion, we will provide you a copy, or a web site where it can be
accessed, and advise you of the results.
________
We are not subject to the requirements of A-133 because:
____ We are a for-profit organization
____ We expended less than $500,000 in Federal funds during FY ____.
____ Other (please explain)
________________________________________________________________
________________________________________________________________
If you are not subject to the requirements of A-133, please provide the following
documents and answer the questions on page 2.


An audited financial statement for the most current fiscal year and
Independent auditor’s management letter
As a representative for ______________________ I certify that the above information is accurate and all
relevant material findings contained in the audit report have been disclosed.
Name
Authorized Signature
Title
Phone #
Date
Please complete and return this form to my attention, at the address listed above by _______________.
If there are any questions concerning the information requested, please do not hesitate to contact me.
Thank you for your cooperation and assistance in complying with these requirements.
Sincerely,
Grant Administrator
SUBRECIPIENT ANNUAL AUDIT CERTIFICATION – SUBJECT TO A-133
Entities not subject to the requirements of A-133:

Does your organization have a designated federal cognizant audit agency?
______Yes – which one?___________________________________
______No

Do you have knowledge of the OMB Circular A-21 Cost Principles, the OMB A-110
Administrative Requirements and the other relevant Federal guidelines that are
applicable to the subcontract?
______Yes
______No – How do you ensure compliance with these regulations? _________
____________________________________________________

Does your organization have a financial management system that provides records
that can identify the source and application of funds for award supported activities?
______Yes
______No – Please explain

Does you organization have controls to prevent expenditures in excess of approved,
budgeted amounts?
______Yes
______No – Please explain

How do you ensure that costs deemed unallowable, per the Federal guidelines noted
above, are excluded from the amount bill to the Colorado School of Mines under this
subagreement?