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Single Audit Certification Form The Single Audit Act of 1984 established audit requirements for non-Federal entities that receive Federal aid. On December 26, 2014, the implementing document, OMB Circular A-133 (Audits of States, Local Governments, and Non- Profit Organizations) was superseded by 2 CFR Part 200 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards). If your current fiscal year began before December 26, 2014, then OMB Circular A-133 is still applicable. If your fiscal year begins on or after January 1, 2015, then 2 CFR Part 200 applies. Under OMB A-133, State or local governments (City, County, Airport Authority, Airport Board) that expend $500,000 or more a year (calendar or fiscal) in total Federal financial assistance must conduct an audit and submit it to the Federal Audit Clearinghouse. If the single audit is required under 2 CFR Part 200, then the total Federal financial assistance expenditure limit is $750,000 or more. For more information on the Single Audit Act requirements please reference the following web site: http://harvester.census.gov/sac/ This notice is our request for a copy of your most recent audit, whether or not there are any significant findings. In accordance with your Airport Improvement Program (AIP) grant agreement, you must also provide that information to your local Airports District Office (ADO). Please fill out the information below by checking the appropriate line(s), sign, date, and return this form to the FAA local ADO identified at the bottom of the form. Airport Sponsor Information: __________________________________________________ ____________________________ Sponsor Name Fiscal/Calendar Year Ending __________________________________________________ Airport Name __________________________________________________ ____________________________ Sponsor’s Representative Name Representative’s Title __________________________________________________ ____________________________ Telephone Email Please check the appropriate line(s): We are subject to the Single Audit requirements and are taking the following action: The Single Audit for this fiscal/calendar year has been submitted to the FAA. The Single Audit for this fiscal/calendar year is attached. The Single Audit report will be submitted to the FAA as soon as this audit is available. We are exempt from the Single Audit requirements for the fiscal/calendar noted above. Sponsor Certification: _____________________________________________________________ ________________ Signature Date Return to: FAA, Seattle Airports District Office 1601 Lind Ave. SW, Ste. 250 Renton, WA 98057-3356