Ex3_Pre-Award Risk Assessment Questionnaire_FY24FOA.pdf

Denali Commission Pre-Award Risk Assessment Questionnaire: 14 October 2022 Page 1

Denali Commission Pre-Award Risk Assessment Questionnaire

Recipient: ___________________________________________________________________________

Formal Partner Other

Program: Energy/Bulk Fuel Village Infrastructure Protection

Other_________________________________________________________________

This questionnaire is part of a 2 CFR 200 process for evaluating the risks associated with Financial Assistance Awards (FAA) issued by the Denali Commission. The responses will be used in conjunction with other information collected by the Commission to make go/no-go decisions on individual Awards, and/or to establish risk management measures such as reporting frequency, insurance requirements, the need for site visits, etc. for individual Awards. Formal non-federal partners (AEA, ANTHC, AVEC) that receive one or more FAA’s or major FAA Amendments each year must complete this questionnaire annually. Other non-federal Recipients must complete this questionnaire during the pre-award process for each specific new FAA, or major amendment to an existing FAA if deemed appropriate by the responsible Denali Commission Program Manager.

Yes No n/a

1. Has your organization operated or managed Federal funds for any projects within the last three years?

2. Is this a new program, or project type, for your organization? (managed less than three years)

3. Are key personnel experienced with the types of projects managed under the program referenced above, or the specific FAA being proposed?

(worked with the program or on similar projects more than two years)

4. Is the program, or specific FAA, unusually complex? (funding match requirements, new technology, remote location, etc.)

5. Will your organization issue any sub-awards or contracts in excess of $25,000 with funds provided by the Commission for the program referenced above, or the specific FAA being proposed?

6a. Does your organization have effective internal controls, including written procurement policies?

6b. If your organization is not a state agency, are your procurement policies consistent with 2 CFR 200.318 – 326?

7. Has your organization had a lawsuit(s) filed against it in the past five years? If yes, please attach detailed documentation regarding who filed, reason for filing, and final judgment.

8. Has your organization currently or previously been suspended or debarred, or have employees on an excluded parties list?

If yes, please attach a detailed explanation.

Denali Commission Pre-Award Risk Assessment Questionnaire: 13 December 2022 Page 2

Yes No n/a

9. Does your organization have a current registration in Sam.gov? Please provide you UEI and the date your registration expires:

UEI__________________________________ Exp. Date:___________________

10. Does your organization have any current tax liens or judgments against it? If yes, provide an explanation of how they were addressed.

11a. Does your organization have a financial management system in place that can track different awards/accounts, and different types of expenditures?

11b. If yes, will the system track expenditures by the cost categories typical in FAA budgets for the program referenced above, or the budget in the specific FAA being proposed?

12a. Has your organization had a Single Audit completed for any past, or existing federally funded projects? Please provide your TIN:________________

12b. If yes, were there any findings? If so, attach a detailed explanation of the findings, and management’s response.

13a. Does your organization have a federally approved indirect cost rate?

13b. If yes, please list the rate, cognizant federal agency that approved the rate, and date the current rate was approved. Please provide a copy of the approved rate agreement.

Rate: __________________ Agency: _____________________ Date: ___________________

Recipient Remarks/Notes:

Certification

By signing this document, I certify to the best of my knowledge and belief that this information is true, complete, and accurate. I am aware that any false statements or misrepresentation may jeopardize my organization’s ability to receive a Denali Commission Financial Assistance Award.

Name (print) Title

Authorized Signature Date

Denali Commission Use Only

Program Manager Comments:

PM Initial/Date____________________