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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): <br />Authorized Chief Financial Officer (central accounting office): <br />Address: <br />Email: Phone #: <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 MIL/EMD 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 is 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 subject to the audit requirements of 2 CFR Part 200 Subpart F <br />Our entity is not subject to the requirements of 2 CFR Part 200 Subpart F because (check all that apply): <br /> We did not expend $750,000 or more of total federal awards during the fiscal year. <br /> We are a for-profit agency. <br /> 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 the audit requirements of 2 CFR Part 200 Subpart F <br />(Complete the information below and check the appropriate box) <br /> We completed our last 2 CFR Part 200 Subpart F Audit on [enter date] ________ for Fiscal Year ending [enter date] ________. There <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 />___________________. <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@mil.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 />________[enter date]. We will provide electronic copy of the audit report to contracts.office@mil.wa.gov at that time or <br />provide the state auditor report 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 closed. <br />Signature of Authorized Chief Financial Officer: Date: <br />Print Name & Title: <br />WMD Form 1009-13, 8/19/2013, Updated 9/9/2015