Appendix 4a

FINANCIAL MANAGEMENT SYSTEMS QUESTIONNAIRE

============================Organizational Data============================

Name of Organization: ________________________________________________________________

Address: ___________________________________________________________________________

Representative Name and Title: ________________________________________________________

Phone: __________________  Fax: ___________________    Email: ___________________________

Year Established : ___________  Employer Identification Number (EIN): _______________________

DUNS Number: ______________________________________________________________________

Organization Type:        Non-Profit           For Profit            Educational              State/Local Govt.

Description of Service/Product: ________________________________________________________

Approx. Number of Employees:    Full Time __________________   Part Time __________________

============================Federal Audit Data=============================

Prior Audits/Reviews: 

     OMB A-133                  Incurred Cost                  Accounting System                  Timekeeping 
 
Date of Last Federal Audit/Review: ______________  Audit Agency/Firm: _____________________

If Findings Reported, Explain: __________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

=======================Financial Statement Audit Data========================

Date of Last Financial Statement Audit: ______________  Fiscal Period Audited: _______________

Audit Firm: __________________________________________________________________________

Auditor’s Opinion on Financial Statements Qualified:                           Yes                     No

If Qualified Opinion, State Reason: ______________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Appendix 4b

========================Accounting System Data============================

What books of account are maintained?

General Ledger            	 	     YES          NO     	Cash Receipts Journal	      YES          NO 
    
Project Cost Ledger	 	     YES          NO     	Payroll Journal	      YES          NO 
    
Cash Disbursements Journal       YES          NO

Does the accounting system provide for the recording of grant/contract costs according to
categories of the approved budget?       YES          NO

Does the system identify the receipt and expenditure of funds separately for each grant or
contract?       YES          NO

Does the system provide for the recording of cost sharing/matching for each project, and ensure
that documentation is available to support recorded cost sharing/matching?       YES          NO

Does the system provide for the recording of participant support costs as a separate cost
category?       YES          NO

========================Timekeeping System Data===========================

Are time distribution records maintained for each employee to account for his/her TOTAL effort
(100%)?      YES          NO 

(Attach a sample timesheet and procedures for completing timesheets and for allocating salary
and wage charges to Federal awards.)

Is your organization familiar with the time and effort reporting requirements related to Federal
awards made to your type organization?       YES          NO

===========================Purchasing System=============================

Are asset inventory records maintained?       YES          NO

Does your organization have policies relating to buy/lease analysis and competitive purchases
over $25,000?       YES          NO

What is the dollar threshold for capitalization of equipment? $___________

===========================Funds Management=============================

Is a separate bank account maintained for Federal grant/contract funds?       YES          NO

If a separate bank account is not maintained, can the Federal grant/contract funds and related
expenses be readily identified?       YES          NO

Does your organization have procedures in place to minimize the time elapsing between the
transfer of funds to your organization by a Federal agency and your organization’s expenditure
of such funds?       YES          NO

Prepared by:________________________________________________ Date:_________________
                                             Name & Signature
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