SUBRECIPIENT ANNUAL AUDIT CERTIFICATION – SUBJECT TO A-133 URGENT Subrecipient Information: Name Address Reference: Name of Project Current Date: NOTE: Two letters have been sent and a phone call/email placed in an attempt to obtain the below requested information regarding your A-133 audit. To date, we have received no response. Therefore, the current authorized funding on your subcontract with Colorado School of Mines has been frozen and no anticipated future funding will be forthcoming until your response has been received. 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. _______ 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 website 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?