4_ Financial Components Workbook FTA 5310 FY2.xlsx
XLSX spreadsheet 216 KB Posted
- Attached to
- NOFA800 - FTA Section 5310 FY2028-FY2029
- Solicitation number
- PE-29016-NONST-2028-000000074
- Issued by
- Fulton County, Georgia
About this file
Summary
This is a Financial Components Workbook for the FTA Section 5310 program administered by the Atlanta Regional Commission (ARC), the designated Area Agency on Aging for the 11-county metro Atlanta region including Cherokee, Clayton, Cobb, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, and Rockdale counties. The workbook serves as the application and budgeting instrument for organizations seeking FTA Section 5310 funding to provide transportation services for seniors aged 65 and older and individuals with disabilities under 65. Applicants must indicate their project intent (continuing/expanding existing services or beginning new services), specify service types (demand response, fixed route, employment, dialysis, other medical, or quality of life services), identify operating days and hours, and document their vehicle fleet composition. The workbook requires applicants to provide detailed information regarding their service capacity, current ridership, anticipated service needs, volunteer programs, participation in DHS Coordinated Transportation, and demographic breakdowns of persons to be served by race and disability status.
The workbook incorporates a comprehensive budget summary requiring applicants to calculate unit costs per service type, identify the number of one-way trips or service hours to be provided, and specify total funding requests. Applicants must demonstrate their capacity to provide required matching funds and leverage grant funding to maximize program outcomes. The document includes a pre-award risk assessment tool scored on a scale of 0-255 points to evaluate contractor risk levels (Low: 0-85, Moderate: 86-170, High: 170+), assessing factors such as entity compliance history, accounting systems, program complexity, staff qualifications, prior audit findings, and timely reporting performance. Organizations deemed moderate or high risk require approval from the division director or program manager before funding allocation.
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Other files
| File | Type | Posted |
|---|---|---|
| 5_ Uniform Cost Methodology (UCM) ARC FY28 _ .xlsx | XLSX spreadsheet | |
| 2_ Transmittal Cover Page FTA 5310 FY28_FY29.pdf | ||
| 6_ UCM Instruction Manual 2024.pdf | ||
| 3_ Proposal Response Template FTA 5310 FY28_F.docx | DOCX document | |
| 1_ ARC FTA 5310 NOFA FFY28 _ FFY29.pdf |
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Text version
Instructions
| FINANCIAL COMPONENTS WORKBOOK |
| General Requirements: |
| Project Information |
| Budget Summary |
| UCM Personnel |
| UCM Support |
| Budget Narrative |
| Pre-Risk Assessment |
| *REMINDER: Fill out each tab completely |
Project Information
| PROJECT INTENT | |||||||
| Indicate the intent of the project with an "X" | |||||||
| Continuing/expanding a service you are currently operating | |||||||
| Beginning a new service you are not currently operating | |||||||
| PROJECT TYPE & COUNTY(IES) OF SERVICE | |||||||
| Indicate the county of clients receiving this service. Mark "X" to all that may apply | |||||||
| Demand Response | Fixed Route | # of Fixed Routes | Employement | Dialysis | Other Medical | Quality of life |
(e.g. grocery, hair, visiting, shopping etc.)
| Cherokee |
| Clayton |
| Cobb |
| Dekalb |
| Douglas |
| Fayette |
| Forsyth |
| Fulton |
| Gwinnett |
| Henry |
| Rockdale |
| OPERATING DAYS & HOURS | |||||||
| Indicate the days you operate by entering the hours of operation. | |||||||
| Mon | Tues | Wed | Thur | Fri | Sat | Sun | |
| Hours |
Number of Days Transportation Services are Needed Annually
Will you use subcontractors? Yes No
Do you have an in-house fleet? Yes No Total # of passenger seats in fleet
| If using in-house fleet, please give description of current vehicle fleet: include DHS owned, and all other vehicles. (Attach additional sheets, if needed) | |||
| Year | Make/Model | Capacity (amb / lift) | Owner |
Do you have a Volunteer Program? Yes No
Does your agency participate in DHS Coordinated Transportation? Yes No
| Number of Persons likely to receive Service (estimate) | ||
| % of Service Area Population | # of Persons expected to be served | |
| White | 0 | |
| Black | 0 | |
| Hispanic | 0 | |
| Asian-Pacific | 0 | |
| Asian-Indian | 0 | |
| Native American | 0 | |
| total | 0% | 0 |
&G &"Arial,Bold"&12 5310 Transmittal Cover & Finance Components
Page &P of &N
Budget Summary Table
| Offeror Budget Summary Work Sheet | |||||||||||
| Agency Name: | |||||||||||
| TOTAL 5310 FUNDING REQUEST | |||||||||||
| CURRENT # of One Way Trips / Service Hours Served | ESTIMATED # of one-way trips / Service Hours Needed | TOTAL COST OF CURRENT & ANTICIPATED NEED (cost per trip x total trips = total cost) | |||||||||
| Service | Unit of measure | Unit Cost (per UCM support) | Units of Service to be provided with ARC Funding | 5310 Funding Request | Unduplicated Persons Served by ARC Funding | Individuals with Disabilities (under 65) | Elderly (65+) | Individuals with Disabilities (under 65) | Elderly (65+) | Individuals with Disabilities (under 65) | Elderly (65+) |
| Demand Response - Individual | one-way trip | $ - 0 | $ - 0 | $ - 0 | |||||||
| one hour | $ - 0 | $ - 0 | $ - 0 | ||||||||
| Demand Response - Voucher | one-way trip | $ - 0 | $ - 0 | $ - 0 | |||||||
| one hour | $ - 0 | $ - 0 | $ - 0 | ||||||||
| Fixed route | one hour | $ - 0 | $ - 0 | $ - 0 | |||||||
| $ - 0 | $ - 0 | $ - 0 | |||||||||
| Total Line Item Cost | |||||||||||
| Mobility Management | $ - 0 | ||||||||||
| Total | $ - 0 |
| 1. Enter Units of Service to be provided from the UCM Support Spreadsheet |
| 2. Enter the Unit Cost of the Service |
| 3. Enter the unduplicated persons expected to be served |
| 4. Enter the ARC funding provided in the allocation that will be used to fund the services. |
Budget Narrative
| BUDGET NARRATIVE |
| Your Budget Narrative should address the following bullet points: |
| * The budget justification is clear, logical and specifically describes the program and corresponds with unit costs and total funding requested. |
| * The budget proposal clearly demonstrates capacity to provide required match funds and leverage grant funding to maximize program outcomes. |
**The three spaces below are meant to be for separate paragraphs for your narrative. If you need more or less room, feel free to format as needed.**
Pre-Award Risk Assessment
| Contractor Name: | Yes | Yes | 5 | |
| CFDA/Contract/Grant Award Number(s): | No | No | 10 | |
| Division/Program Name(s): | N/A | 15 | ||
| Risk Assessment Completed by: | 20 | |||
| Risk Assessment Completed Date: | X | 25 | ||
| Contract/Grant Period(s): | 30 | |||
| Contract/Grant Amount(s): | 35 | |||
| Total Score: | 0 | |||
| Risk Level: | Low Risk |
| 1. Amount | Small <$25,000 | Medium | Large | |||
| $25,000 to $250,000 | >$250,000 | |||||
| Amount of the award (If award amount is unknown, an estimated award amount should be used.) | 0 | 0 | 0 |
| 2. Accounting System | Automated | Manual | Combination | |||
| Type of accounting system used by the entity | 0 | 0 | 0 |
| 3. Program Complexity | Slightly Complex | Moderately Complex | Highly Complex | |||||
| Rate the complexity of the program | 0 | 0 | 0 | 0 | ||||
| Programs with complex compliance requirements have a higher risk of non-compliance. In your determination of complexity consider whether there are complex contract/grant requirements (If you choose one item, select slightly complex; if you choose two items, select moderately complex; if you choose three or four items, select highly complex). The following are some examples of reasons a program would be considered more complex: | ||||||||
| ► Complex programmatic requirements and/or must adhere to regulations | ► Various types of program reports are required | |||||||
| ► Matching funds or Maintenance of Effort are required | ► The entity further subcontracts out the program | |||||||
| 4. Entity Risk | Yes/No | |||||||
| Rank the entity based on your knowledge of the following: | ||||||||
| a. Is the entity receiving an award for the first time? | 0 | |||||||
| b. Did the entity adhere to all terms and conditions of prior grant awards? | 0 | |||||||
| c. Does the entity have adequate and qualified staff to comply with the terms of the contract/grant? | 0 | |||||||
| d. Does the entity have prior experience with similar programs? | 0 | |||||||
| e. Does the entity maintain policies which include procedures for assuring compliance with the terms of the contract/grant? | 0 | |||||||
| f. Does the entity have an accounting system that will allow them to completely and accurately track the receipt and disbursements of funds related to the contract/grant? | 0 | |||||||
| g. Does the federal/state program require staff to track their time associated with the contract/grant? | ||||||||
| h. If yes, does the entity have a system in place that will account for 100% of each employee's time? (If answered no to 4g, leave blank) | 0 | |||||||
| i. Did the entity's key staff members attend required trainings and meetings during prior contract/grant awards? | 0 | |||||||
| j. Did the entity's key staff members respond to State requests timely during prior contract/grant awards? | 0 | |||||||
| k. Did the entity have one or more audit findings in their last audit and/or single audit regarding program non-compliance? | 0 | |||||||
| l. Did the entity have one or more audit findings in their last audit and/or single audit regarding significant internal control deficiency? | 0 | |||||||
| m. Was the entity audited by the Federal government in the prior year(s)? | 0 | |||||||
| n. If yes, did the audit result in one or more audit finding? (If answered no to 4m, leave blank) | 0 | |||||||
| (Assign 5 points for each issue below (1-7) that are applicable) | Briefly explain which numbers were chosen and why. | |||||||
| o. Other issues that may indicate high risk of non-compliance? | We had no compliance issues and we have adequate systems to segregate indirect from direct | |||||||
| Other issues: (1) Having new or substantially changed systems or software packages, i.e. accounting, payroll, technology; (2) Turnover in personnel, i.e. business, award management, program; (3) External risks including: economic conditions, political conditions, regulatory changes; (4) Loss of license or accreditation to operate program; (5) New activities, products, or services; (6) Organizational restructuring; (7) Where indirect costs are included, does the organization have adequate systems to segregate indirect from direct costs. | ||||||||
| 5. Reporting & Budget | Yes/No | |||||||
| Rank the entity based on your knowledge of the following: | ||||||||
| a. Were performance reports submitted timely for prior contract/grant awards? (i.e. within the agency specified timeframe) | 0 | |||||||
| b. Was reasonable progress made towards performance goals for prior contract/grant awards? | 0 | |||||||
| c. Were financial reports (i.e. expenditure) submitted timely for prior contract/grant awards? | 0 | |||||||
| d. Were financial reports (i.e. expenditure) accurate for prior contract/grant awards? | 0 | |||||||
| e. Did the entity stay on budget in prior year(s)? | 0 | |||||||
| Low = 0 - 85 Moderate = 86 - 170 High = 170 and higher | TOTAL RISK POINTS: | 0 |
| Common Attributes of Grantees with Low, Moderate and High Risk: | |
| Low Risk | High Risk |
| Most of the following attributes should be present to be considered low risk | One or more of the following attributes may be present to be considered high risk |
| ► Entity has complied with the terms and conditions of prior grant awards. | ► History of unsatisfactory performance or failure to adhere to prior grant terms and conditions |
| ► No known financial management problems or financial instability | ► Financial management problems and/or instability; inadequate financial management system |
| ► High quality programmatic performance | ► Program has highly complex compliance requirements |
| ► No, or very insignificant, audit or other monitoring findings | ► Significant findings or questioned costs from prior audit |
| ► Timely and accurate financial and performance reports | ► Untimely, inadequate, inaccurate reports |
| ► Program likely does not have complex compliance requirements | ► Recurring/unresolved issues |
| ► Entity has received some form of monitoring (e.g., single audit, on-site review, etc.) | ► Lack of contact with entity or any prior monitoring |
| ► Large award amount | |
| Moderate Risk ► Entities that fall between low risk and high risk are considered moderate risk. | |
| Considerations/Justification/Notes specific to the Contractor/Grantee: |
| _________________________________________________________ | ___________________________ | ___________________________ |
| Name: | Title: | Date: |
Contractor/Grantee has been deemed moderate/high risk. To acknowledge the use of a moderate/high risk contractor/grantee, the division director/program manager is required to sign.
Name: ____________________________________________________ Title:__________________________ Date:________________________
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&"Arial,Bold"&18Pre-Award Risk Assessment Form
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