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2 CFR Part 200 Subpart F Audit Certification Form <br />Audits of States, Local Governments, Indian Tribes, and Non-Profit Organizations <br />Contact Information <br />Subrecipient Name (Agency, Local Government, or Organization): Kittitas County <br />Authorized Chief Financial Officer (central accounting office): Judy Pless <br />Address: 205 W. 5th Suite 105 Ellensburg, WA 98926 <br />Email: judy.pless@co.kittitas.wa.us Phone#: 509-962-7502 <br />Purpose: As a pass-through entity of federal grant funds, the Washington Military Department/Emergency Management Division (Department) <br />is required by 2 CFR Part 200 Subpart F to monitor activities of subrecipients to ensure federal awards are used for authorized purposes and <br />verify that subrecipients expending $750,000 or more in federal awards during their fiscal year have met the 2 CFR Part 200 Subpart F Audit <br />Requirements. Your entity is a subrecipient subject to such monitoring by MIUEMD because it is a non-federal entity that expends federal grant <br />funds received from the Department as a pass-through entity to carry out a federal program. 2 CFR Part 200 Subpart F should be consulted <br />when completing this form. <br />Directions: As required by 2 CFR Part 200 Subpart F, non-federal entities that expend $750,000 in federal awards in a fiscal year shall have <br />a single or program-specific audit conducted for that year. If your entity is not subject to these requirements, you must complete Section A of <br />this Form. If your entity~ subject to these requirements, you must complete Section B of this form. When completed, you must sign, date, <br />and return this form with your grant agreement and every fiscal year thereafter until the grant agreement is closed. Failure to return this <br />completed Audit Certification Form may result in delay of grant agreement processing, withholding of federal awards or disallowance of costs, <br />and suspension or termination of federal awards. <br />SECTION A: Entities NOT subiect to the audit rtMruirements of 2 CFR Part 200 Suboart F <br />Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because (check all that apply): <br />0 We did not expend $750,000 or more of total federal awards during the fiscal year. <br />0 We are a for-profit agency. <br />0 We are exempt for other reasons (describe): <br />However, by signing below, I agree that we are still subject to the audit requirements, laws and regulations governing the program(s) in <br />which we participate, that we are required to maintain records of federal funding and to provide access to such records by federal and state <br />agencies and their designees, and that WMD/EMD may request and be provided access to additional information and/or documentation to <br />ensure proper stewardship of federal funds. <br />SECTION B: Entities that ARE subject to rhe audit regui.rements of 2 CFR Pgrt 200 Sub~rt F <br />(Complete the information below and check the aooropriate box) <br />We completed our last 2 CFR Part200 Subpart F Aµditon [enle( date] 1 l--li,1i 1 for Fiscal Year ending [enter.date] ..£,,.;,J , 1 . There f;t <br />were no findings related to federal awards from WMD/EMD. No follow-up action is required by WMD/EMD as the pass-through entity. <br />A complete copy of the audit report, which includes exceptions, corrective action plan and management response, is <br />either provided electronically to contracts.office@mil.wa.gov or provide the state auditor report number: <br />I 0 4,_,n ;-;, <br />• We completed our last 2 CFR Part 200 Subpart F Audit on [enter date] for Fiscal Year ending [enter date] . There <br />were findings related to federal awards. <br />A complete copy of the audit report, which includes exceptions, corrective action plan and management response, is either <br />provided electronically to contracts.office@mll.wa.gov· or provide the state auditor report number: <br />• Our completed 2 CFR Part 200 Subpart F Audit will be available on [enter date] for Fiscal Year ending <br />renter date]. We will provide electronic copy of the audit report to contracts.offlce@mll.wa.gov at that time or <br />orovide the state auditor reoort number: <br />I hereby certify that I am an individual authorized by the above identified entity to complete this form. Further, I certify that the <br />above information is true and correct and all relevant material findings contained in audit report/statement have been disclosed. <br />Additionally, I understand this Form is to be submitted every fiscal year for which this entity is a subrecipient of federal award <br />funds from the Department until the grant agreement is close1: J f .)y Date.· /! / 0 /. <br />1 <br />t) <br />Signature of Authorized Chief Fin ncial Officer: _ __, ..... CM~":1------~-=--------I ' r1 <br />.,. ! 1 /!J ...--- <br />PrintName&Title:' j '--')V I /C V [)1.td s .vlf e 11,4 1-tC{ n1n-,-r~-c'/'- <br />f ' ,WPtl) Folm lQ09..13. tJ/1Dl20 13~ Updi'ILC119.1Sl2 015