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PART B Recipient/Vendor Relationship Determination The following should be analyzed for each relationship with a non -state organization where it has been determined that the state program provides state financial assistance (i e. is a State Project) and the non -state organization is not exempt based on the questions above This relationship may be evidenced by, but not limited to, a contract, agreement, or application YES NO _ X 1 Does State law or legislative proviso create the non -state organization to carry out this State Project? X 2 Is the non -state organization required to provide matching resources not related to a Federal Program? X 3 Is the non -state organization required to meet or comply with specified State Project requirements in order to receive State resources? (State Project requirements include laws, rules, or guidelines specific to the State Project such as eligibility guidelines, specified types of jobs to be created, donation of specified assets, etc. Specified State Project requirements do not include procurement standards, general guidelines, or general laws/rules.) X 4 Is the non -state organization required to make State Project decisions, which the State agency would otherwise make? (e.g determine eligibility, provide case management, etc.) X 5 Is the non -state organization's performance measured against whether State Project objectives are met? (e g number of jobs to be created, number of patients to be seen, number of disadvantaged citizens to be transported, etc. Performance measures may or may not be related to State performance-based budgeting ) If any of the above is yes, there is a recipient/subrecipient relationship and the non -state organization is subject to the FSAA. Otherwise the non -state organization is a vendor and is not subject to the FSAA. PART C Based on your analysis of the responses above and discussions with appropriate agency personnel, state your conclusion regarding the non -state organization (Check one) Recipient/Subrecipient: X Vendor:— Comments: endor:—Comments: Print Name: ctary I Miller-Nnvalln Title: Signature: 1,11 Exempt Organization: Telephone Number: qr)4-777-449A Date: AA Note it is the program personnel's responsibility to notify Finance and Accounting of which non -state organizations have been determined to be recipients and are receiving state financial assistance (i a disbursements must be coded as 7500 object code in FLAIR) Note it is possible to have a contractual agreement with a non -state organization under Chapter 287, Florida Statutes, and still consider the non -state organization a recipient under the Florida Single Audit Act. If a recipient/subrecipient relationship exists the standard contract audit language, including Exhibit 1, must be included in the document that established the State's, recipient's, or subrecipient's relationship with the non -state organization Questions regarding the evaluation of a non -state organization or if it has been determined that the non -state organization is a recipient and a CSFA number has not been assigned, contact your FSAA State agency liaison or the Executive Office of the Governor, Office of Policy and Budget, Budget Management Policy Unit at (850) 487-3832 or Suncom 277-3832 Reference may be made to Rule 27D-1, FAC Revised January 01, 2002 Form Number FSAA CL2