Financial Monitoring Form

Note:	 All financial activities must comply with the Uniform Administrative Requirements for Federal Grants: 2 CFR, Part 200 which replaces the Circular OMB A-87.

Grantee:  	

Grant Number:  	

Prepared by:  	

Date Prepared:  	

Project Name:  	

Authorization to Incur Costs	

1.	

Has the governing body adopted a project or budget ordinance? If yes indicate type of ordinance adopted and date adopted.	

Yes	

No		

2.	
What is the date for release of funds?

What date were the Funding Approval and Grant
Agreement Signed?		
		
	Type of Activity	Release Date	Date of Obligation	Source Documentation	
	Exempt (administration
& planning)				
	Non-Exempt (hard
costs)				

3.	
Has the grantee obligated funds prior to the allowable dates? If yes, list items below:	

Yes	

No		
	
Vendor or Contractor	
Date	
Amount	
Activity	

					

					

Grantee Financial System	

4.	
Do the requisitions represent advance payments or reimbursements? If the grantee is on advance payments complete the chart below:	

Advance

Reimbursements	
	Requisition Number:		
	Total Amount:		
	Date of EFT:		

Date	

Check #	

Amount	

Vendor	
Days Between Deposit and Disbursement	

						

	
Total:			
		
	Requisition Number:		
	Total Amount:		
	Date of EFT:		

Date	

Check #	

Amount	

Vendor	
Days Between Deposit and Disbursement	

						

	
Total:			

5.	

Was there a violation of the 3-day rule?		

6.	
Is the depository for CDBG funds interest- bearing?	
Yes	
No		
	
a.   If yes has the grantee earned more than
$100 during the most recent fiscal year?			
	
b.   If yes, has the amount over $100 been returned to REDD?			

7.	
Perform a spot check on back up documentation for disbursements. List disbursements examined, amount, payee, check number and authorization. If the check reveals any instances of unnecessary, unreasonable, or unallowable costs, make a copy of the documentation and attach to the monitoring sheet.	
	
Requisition Number:		
Total Amount:		
Date of EFT:		
Check #	Date	Amount	Vendor	Authorization (Y/N)	

					

Total:			
	
Requisition Number:		
Total Amount:		
Date of EFT:		
Check #	Date	Amount	Vendor	Authorization (Y/N)	

					

Total:			

Grantee Personnel and Administrative Charges	

8.	
Are any local staff persons (full or part time) paid from CDBG funds? If no proceed to next section.		
Name	FTE	Job Title	Duties	Salary	Paid to Date	

						

						

9.	
Are the amounts charged reasonable when compared to time worked, responsibilities of the workers, and the needs of the grant? Describe any discrepancies or concerns.		

10.	
Are there time sheets on file that are signed by the employee and conform to payroll records? Describe any discrepancies or concerns.		
Debarment	

11.	
Is there evidence that the grantee is using the federal and state debarment lists prior to procuring goods and services? Describe the method used by the grantee and identify their documentation of the process.		
Purchase of Equipment and/or Real Property	

12.	
Does the grantee intend to purchase equipment or real property with CDBG funds? If yes, what is the anticipated purchase date?	
Yes	
No		

13.	

Has the grantee purchased equipment or real property with CDBG funds?	
Yes	
No		

14.	
Describe the equipment (make, model etc.) or provide a description of real property purchased.		

15.	
What procurement method was used?		

16.	

What is the purchase price of the equipment or real property?		

17.	
List the check number, date, and amount of the check issued for the purchase?		

18.	
Does the purchase price meet the grantee’s threshold for depreciation?		

19.	
Is the equipment or real property listed on the grantee’s inventory record?		

20.	
Is the purchase allowable under current guidelines?		

21.	
If not, what is the suggested remedy?		

22.	Is the grantee reminded to reflect the purchase on the Property Disposition Report form at closeout?		
Grantee Allowable Costs, Indirect Costs, Cost Allocation	

23.	

Are allowable cost guidelines, pursuant to Uniform Administrative Requirements for Federal Grants 2 CFR, Part 200 which replaces the Circular OMB A-87 being followed? What documents support compliance or non- compliance?		

24.	
Are any indirect costs being charged to the grant? (i.e. electricity, rent, phones, postage, copies etc.)		

25.	
If yes, has the plan been approved by REDD?		

26.	
What is the basis for the allocation of costs? (i.e. square footage, hours, FTEs etc.)		

27.	

Review the Indirect Cost Allocation Plan with actual expenses charged to the grant. Are the amounts charged reasonable when compared with time worked, responsibilities, and the needs of the grant? If not state any problems or concerns.		
Grantee Program Income	

28.	
Are revenue generating activities being undertaken? If yes, complete the table below:		
Date of Receipt	Source	Amount	Use	REDD Approval?	
				
Yes	No	
				
Yes	No	
				
Yes	No	
				
Yes	No	
				
Yes	No	
				
Yes	No	

Total:			

29.	
Has the grantee established a revenue account to record the receipt of program income? Describe the adequacy of the process.		

30.	
Did the grantee expend program income before requesting additional drawdowns of CDBG funds? If no, explain:		

31.	

Were all expenditures of program income for
CDBG eligible activities?		
Non-CDBG Funds	

32.	

Are there any local or non-local funds committed to the grant? If yes, complete the chart below:		
Source of Funds	Amount Committed	Expended to Date	

			

Total:			

33.	

If non-CDBG funds are not fully expended, indicate the anticipated date of final expenditure. Note any problems or non- compliance.		

NOTES:	

_________________________________________	        _______________________
Grantee Representative				                    Date

____________________________________	          ___________________
Grant Management Representative				Date