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FLORIDA SINGLE AUDIT ACT CHECKLIST FOR NON -STATE ORGANIZATIONS - <br />RECIPIENT/SUBRECIPIENT VS. VENDOR DETERMINATION <br />This checklist and the standard contract audit language may be obtained electronically from the Executive Office of the <br />Governor's website (http.//www myflorida.com/myflorida/government/governorinitiatives/fsaa/index.htm1) <br />If a Florida Single Audit Act State Project Determination Checklist has not been previously completed, please complete it <br />now (Applies only to State agencies) <br />This checklist must be used by State agencies to evaluate the applicability of the Florida Single Audit Act (FSAA) to non - <br />state organizations' after a state program has been determined (using the Florida Single Audit Act State Project <br />Determination Checklist) to provide state financial assistance (i a is a State Project as defined in 215 97 (2)(r), F S ) This <br />checklist assists in determining if the non -state organization is a vendor, recipient/subrecipient, or an exempt organization <br />' A non -state organization is defined as a nonprofit organization, for-profit organization (including sole proprietors), or <br />Florida local government (excluding district school boards, charter schools and community colleges), which receives <br />State resources <br />Recipients and subrecipients of state financial assistance must also use this checklist to evaluate the applicability of the <br />FSAA to non -state organizations to which they provide State resources to assist in carrying out a State Project. <br />Name of Non -state Organization Inriian Rivar Cniinty <br />Type of Non -state Organization. I nral Govern ment-Miri. MY <br />(i e. nonprofit, for-profit, local government; if the non -state organization is a local government, please indicate the type of <br />local government — municipality, county commission, constitutional officer, water management district, etc.) <br />Awarding Agency: Flnriria rlapartmant of Trnncpnrtatinn <br />Title of State Project: l lighwiV 2laaning R Cnnctnirtinn <br />Catalog of State Financial Assistance (CSFA) Number- N/A <br />Contract/Grant/Agreement Number: ARI -9g, FM #491186-9-58168-01 <br />PART A <br />YES NO <br />X 1 Is the non -state organization a district school board, charter school, community college, <br />government/public university outside of Florida or a Federal agency? <br />X 2 Is the relationship with the non -state organization only to procure commodities (as defined in <br />287 012(4) F S )? <br />X 3 Does the relationship with the non -state organization consist of only Federal resources, State <br />matching resources for Federal Programs or local matching resources for Federal Programs? <br />_ X 4 Does the relationship with the non -state organization consist of only State maintenance of effort <br />(MOE)2 resources that meet all of the following criteria? <br />X A. Do Federal Regulations specify the requirements for the use of the State MOE resources and <br />are there no additional State requirements? <br />X B Do contracts contain sufficient language to identify the State MOE resources and the associated <br />Federal Program? <br />X C Do A-133 audit requirements apply to the State MOE resources and do contracts stipulate that <br />the State MOE resources should be tested in an A-133 audit in accordance with Federal <br />Program requirements? <br />2 MOE refers to the Federal maintenance of effort/level of effort requirements as defined by OMB Circular A-133 <br />Compliance Requirement G (Matching, Level of Effort, Earmarking) <br />If any of 1-4 above is yes, the recipient/vendor relationship determination does not need to be completed because the <br />FSAA is not applicable to the non -state organization. <br />Revised January 01, 2002 <br />Form Number: FSAA CL2 <br />