HomeMy WebLinkAbout08_2011-05_10-KLocal Assistance Procedures Manual Exhibit 10-K
Consultant Annual Certification of Indirect Costs and Financial Management System
EXHIBIT 10-K CONSULTANT ANNUAL CERTIFICATION OF
INDIRECT COSTS AND FINANCIAL MANAGEMENT SYSTEM
(Note: If a Safe Harbor Indirect Cost Rate is approved, this form is not required)
Consultant's Full Legal Name:
Important: Consultant means the individual or consultant providing engineering and design related
services as a party of a contract with a recipient or sub -recipient of Federal assistance. Therefore, the
Indirect Cost Rate(s) shall not be combined with its parent company or subsidiaries.
Indirect Cost Rate:
Combined Rate % OR
Home Office Rate % and Field Office Rate (if applicable) %
Facilities Capital Cost of Money -% (if applicable)
Fiscal period *
* Fiscal period is annual one year applicable accounting period that the Indirect Cost Rate was developed (not
the contract period). The Indirect Cost Rate is based on the consultant's one-year applicable accounting period
for which financial statements are regularly prepared by the consultant.
I have reviewed the proposal to establish an Indirect Cost Rate(s) for the fiscal period as specified above and have
determined to the best of my knowledge and belief that:
• All costs included in the cost proposal to establish the indirect cost rate(s) are allowable in
accordance with the cost principles of the Federal Acquisition Regulation (FAR) 48, Code of
Federal Regulations (CFR), Chapter 1, Part 31 (48 CFR Part 31);
• The cost proposal does not include any costs which are expressly unallowable under the cost
principles of 48 CFR Part 31;
• The accounting treatment and billing of prevailing wage delta costs are consistent with our
prevailing wage policy as either direct labor, indirect costs, or other direct costs on all federally -
funded A&E Consultant Contracts.
• All known material transactions or events that have occurred subsequent to year-end affecting the
consultant's ownership, organization, and indirect cost rates have been disclosed as of the date of
this certification.
I am providing the required and applicable documents as instructed on Exhibit 10-A.
Financial Management System:
Our labor charging, job costing, and accounting systems meet the standards for financial reporting, accounting
records, and internal control adequate to demonstrate that costs claimed have been incurred, appropriately
accounted for, are allocable to the contract, and comply with the federal requirements as set forth in Title 23
United States Code (U.S.C.) Section 112(b)(2); 48 CFR Part 31.201-2(d); 23 CFR Chapter 1, Part 172.11(a)(2;
and all applicable state and federal rules and regulations.
Our financial management system has the following attributes:
• Account numbers identifying allowable direct, indirect, and unallowable cost accounts;
• Ability to accumulate and segregate allowable direct, indirect, and unallowable costs into separate cost
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Local Assistance Procedures Manual Exhibit 10-K
Consultant Annual Certification of Indirect Costs and Financial Management System
accounts;
• Ability to accumulate and segregate allowable direct costs by project, contract and type of cost;
• Internal controls to maintain integrity of financial management system;
• Ability to account and record costs consistently and to ensure costs billed are in compliance with FAR;
• Ability to ensure and demonstrate costs billed reconcile to general ledgers and job costing system; and
• Ability to ensure costs are in compliance with contract terms and federal and state requirement
Cost Reimbursements on Contracts:
I also understand that failure to comply with 48 CFR Part 16.301-3 or knowingly charge unallowable costs to
Federal -Aid Highway Program (FAHP) contracts may result in possible penalties and sanctions as provided by
the following:
• Sanctions and Penalties - 23 CFR Part 172.11(c)(4)
• False Claims Act - Title 31 U.S.C. Sections 3729-3733
• Statements or entries generally - Title 18 U.S.C. Section 1001
• Major Fraud Act - Title 18 U.S.C. Section 1031
All A&E Contract Information:
• Total participation amount $
Engineering services that the consultant
on all State and FAHP contracts for Architectural &
received in the last three fiscal periods.
The number of states in which the consultant does business is
Years of consultant's experience with 48 CFR Part 31 is
Audit history of the consultant's current and prior years (if applicable)
❑ Cognizant ICR Audit ❑ Local Gov't ICR Audit ❑ Caltrans ICR Audit
❑ CPA ICR Audit
❑ Federal Gov't ICR Audit
I, the undersigned, certify all of the above to the best of my knowledge and belief and that I have reviewed the
Indirect Cost Rate Schedule to determine that any costs which are expressly unallowable under the Federal cost
principles have been removed and comply with Title 23 U.S.C. Section 112(b)(2), 48 CFR Part 31, 23 CFR Part 172, and
all applicable state and federal rules and regulations. I also certify that I understand that all documentation of
compliance must be retained by the consultant. I hereby acknowledge that costs that are noncompliant with the
federal and state requirements are not eligible for reimbursement and must be returned to Caltrans.
Name":
Signature:
Email**:
Title**:
Date of Certification (mm/dd/yyyy):
Phone Number**:
**An individual executive or financial officer of the consultant's or subconsultant's organization at a level no lower than a Vice President, a
Chief Financial Officer, or equivalent, who has authority to represent the financial information used to establish the indirect cost rate.
Note: Both prime and subconsultants as parties of a contract must complete their own Exhibit 10-Kforms.
Caltrans will not process local agency's invoices until a complete Exhibit 10-Kform is accepted and approved by
Caltrans Audits and Investigations.
Distribution: 1) Original - Local Agency Project File
2) Copy - Consultant
3) Copy - Caltrans Audits and Investigations
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