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aSingle Audit Certification Form <br />The Single Audit Act of 1984 established audit requirements for non -Federal entities that receive Federal aid. On <br />December 26, 2014, the implementing document, OMB Circular A-133 (Audits of States, Local Governments, and Non - <br />Profit Organizations) was superseded by 2 CFR Part 200 (Uniform Administrative Requirements, Cost Principles, and <br />Audit Requirements for Federal Awards). if your current fiscal year began before December 26, 2014, then OMB <br />Circular A-133 is still applicable. If your fiscal year begins on or after January 1, 2015, then 2 CFR Part 200 applies. <br />Under OMB A-133, State or local governments (City, County, Airport Authority, Airport Board) that expend $500,000 or <br />more a year (calendar or fiscal) in total Federal financial assistance must conduct an audit and submit it to the Federal <br />Audit Clearinghouse. If the single audit is required under 2 CFR Part 200, then the total Federal financial assistance <br />expenditure limit is $750,000 or more. For more information on the Single Audit Act requirements please reference the <br />following web site: httv://ha"ester.census.gov/sac/ <br />This notice is our request for a copy of your most recent audit, whether or not there are any significant findings. In <br />accordance with your Airport Improvement Program (AIP) grant agreement, you must also provide that information to <br />your local Airports District Office (ADO). Please fill out the information below by checking the appropriate line(s), sign, <br />date, and return this form to the FAA local ADO identified at the bottom of the form. <br />Airport Sponsor Information <br />1 !AL11 <br />POJ <br />Name <br />lusovS Re[CC <br />Airport Name <br />Please check the appropriate line(s): <br />P ) <br />Fiscal/Calendar Year Ending <br />Representative's Title <br />❑ We are subject to the Single Audit requirements and are taking the following action: <br />❑ The Single Audit for this fiscal/calendar year has been submitted to the FAA. <br />❑ The Single Audit for this fiscal/calendar year is attached. <br />❑ The Single Audit report will be submitted to the FAA as soon as this audit is available. <br />2/We are exempt from the Single Audit requirements for the fiscal/calendar noted above. <br />Sponsor Certification: <br />Date <br />Return to: FAA, Seattle Airports District Office <br />2200 S. 216th Street <br />Des Moines, WA 98198 <br />sponsor's Representative Name <br />Telephone <br />Please check the appropriate line(s): <br />P ) <br />Fiscal/Calendar Year Ending <br />Representative's Title <br />❑ We are subject to the Single Audit requirements and are taking the following action: <br />❑ The Single Audit for this fiscal/calendar year has been submitted to the FAA. <br />❑ The Single Audit for this fiscal/calendar year is attached. <br />❑ The Single Audit report will be submitted to the FAA as soon as this audit is available. <br />2/We are exempt from the Single Audit requirements for the fiscal/calendar noted above. <br />Sponsor Certification: <br />Date <br />Return to: FAA, Seattle Airports District Office <br />2200 S. 216th Street <br />Des Moines, WA 98198 <br />