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V is i • .. .. , «.. •. ,.J•,l.• '•. •.tom,, , LILgeneral '� revenue E] ...... i sharing -STATEMENT of ASSURANCES: (continued) <.. Documentation establishing eligibility of such a waiver the recipient government as a part of its records and under paragraph (1), (2), or (3) shall be retained by shall be subject to public inspection and audit verifi- the recipient government as part of Its records, and cation. When requested by the Director, supporting shalt be subject to public Inspection and Federal audit documentation shalt be submitted within 15 days of j verification. When requested by the Director, such the request. documentation shall be submitted within 15 days of the request. %• 111. Special Accounting, Auditing, and Evaluation Assurances — _ 'Publication (does not apply to governments receivir+^ less than $25,000 C. for a fiscal year - see instruction A(6)) Requirement Requirement Section 121(c)(1) of the Slate and Local Fiscal Section 123(c)(1) of the State and Local Fiscal Assistance Act of 1972, as amended, requires a recipient government to publish in a newspaper of general cir- Assistance Act, as amended, and Section 51.101(a) of the culation within its geographic area, a notice of the regulations promulgated thereunder require a recipient government to have an independent audit of its financial budget hearing and a summary of the enacted budget statements conducted in accordance with generally ac- Waiver Provisions cepted auditing standards not less often than once every The publication requirements may be waived by the three years, and Include an audit of the entire three years. Check Director of the Office of Revenue Sharing under Section Waiver Provisions only 51.14(8) of the regulations for any recipient government which assures one of the following: The above requirements shalt not apply if the Chief o one Check Executive Officer assures one of the following: to block ❑ (1) Publication of proposed use of entitlement only ❑ (1) Government financial statements are audited by z funds and budget summaries is impractical or unfeasi- one Independent public accountants or independent auditors ble, and an alternative method will be used. Documen- ble,tati block In accordance with State or local law. Such independent rr C n describing the alternative method which informs describingwhich audits are conducted in accordance with generally ac- the citizens the jurisdiction regarding use cepted auditing standards, not less than once every three � meat funds shall be retained be the recipient govern- p years and include an audit of the entire three years. , y ment as a part of its records and shall be subject to o public inspection and audit verification. When re- r7 (2) A series of independent audits are conducted over quested by the Director, supporting documentation a period of time, in accordance with generally accepted shall be submitted within 15 days of the request. auditing standards which does not exceed three fiscal a ❑ • (2) Tlie cost of publication of oudgei summaries years, covering ali the accounts for the three-year period. -. - will exceed one percent of the entitlement funds to ❑ (3) Government financial accounts are not currently c' ' which the budget applies. Documentation supporting auditable. (If it is not known whether the financial accounts o the costs In excess of one percent shall be retained by are auditable, refer to Section 51.102 of the regulations.) a I hereby assure the Director of the Office of Revenue Sharin that with res g pest to payment received under the Act, to w the mandatory requirements of the State and Local Fiscal Assistance Act of 1972 (as amended) enumerated in Section e sof the foregoing assurances will be compiled with by the recipient government named herein. w further assure the Director of the Office of Revenue Sharing that the public hearing and public participation Jeuirements and the accounting, auditing and fiscal procedures requirement of the Act, when applicable, will be compiled s' w' by this government 9 1 understand that the acceptance of the foregoing assurances by the Director of the Office of Revenue Sharing does not prevent the Director from holding a recipient government responsible for noncompliance with the Act and the i regulations. •t SIGNATURE OF CHIEF EXECUTIVE OFPdEh y . •RIP OVOCPWTy c•OIfIf • _) . �. Nor 3-2- 77 NAME AND TITLE (PLEAS PRINT) DATE i NAME OF GOVERNMENT (PLEASE P NT) This form must be received BEFORE MARCH 10, 1977 by: Office of • Revenue Sharing I i 2401 E Street, N.W. Washington, D.C. 20226 • tt� I • c MAR" 919-77 p,h soot 9r .�> QL. 07