app 3 - applicant organization information sheet.docx

Appendix 2 Required Document Applicant Organizational Information

Appendix 3 Required Document Applicant Organizational Information

Instructions: The Applicant Organizational Information template should be filled out in its entirety. Any information that is included in blue text should be deleted prior to submitting this document as Attachment #2 with your application package. Please note that the response “Not Applicable,” or “N/A,” is generally not acceptable. Instead, a sufficient explanation should be provided in either the project narrative or within each field to explain why an item is not applicable.

GENERAL INFORMATION

1. Organization Name:

2. Type of Organization (check all that apply) Overseas:

Non-Profit:

Non- Governmental:

Domestic:

For-Profit:

(Commercial)

Educational Institution:

3. Is your Organization incorporated, registered, or licensed as a legal entity

(State/County):

Incorporation or Registration Date:

4. Program Director (The person who will oversee the day to day activities of the grant):

Program Director Title:

Email Address:

Address:

Telephone Number

5. Financial or Business Official (The person who is responsible for the financial components of the grant.)

Budget Officer Title:

Email Address:

Address:

Telephone Number

ORGANIZATION STRUCTURE AND POLICIES

6. Is your organization governed by Board of Directors? (Yes or No):

7. Does your organization have a written personnel policy and procedure manual? (Yes or No):

8. Does your organization have a written accounting and financial policy and procedure? (Yes or No):

FINANCIAL AND ACCOUNTING MANAGEMENT

9. What is the ending date of your organization’s fiscal year (MM/DD/YYYY)?

10. Does your organization have an automated accounting system? (Yes or No):

Can the accounting system generate reports that show these specific costs incurred for individual awards? (Yes or No):

Does the accounting system allow for reporting of Cash and In-kind contributions (from non-federal sources) i.e., cost share? (Yes or No):

11. Are there written procedures for determining reasonableness, allocability, and allowability of costs?

12. Does your organization prepare annual financial statements (e.g., balance sheet, income and expense statement)?

13. Does your organization have written policies and procedures for monitoring sub-awardees or sub-recipients, including consultants?

14. Does your organization have a current A-133 audit? (Yes or No)

15. Has your organization received grant or agreement funds before? (Yes or No):

(Yes or No)

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