Financial Certification of US Partner Institutions



Financial Certification of US Partner Institutions

This assessment questionnaire has been developed to determine the experience of partner institutions on aspects of financial management relevant to partnerships established and coordinated by the American International Health Alliance (AIHA) through our HIV/AIDS Twinning Center Program. Considerations include the size (or prospective size) of the award requested or received and the institution's experience with previous government-funded grants. Depending on the overall evaluation, AIHA will determine the appropriate level of financial monitoring and oversight the partnership will require.

Institutions determined to be Level 1 will be monitored sufficiently by a review of their monthly financial reports identifying the monthly and projected spending activity (No documentation will be required). Institutions determined to be Levels 2 or 3 will have certain agreed upon monitoring procedures performed during the award period. Those determined to be Level 4 will be required to submit invoices for verification of expenditures.

Organization Name: ___________________________________________________________

Program Coordinator (Name, Title, Contact): ______________________________________

Date: _____________

1. Dollar Value of Actual or Proposed Grant - risk due to the size of this award

|________ a. |$0 - 150,000 |

|________ b. |$150,000 - 500,000 |

|________ c. |Over $500,000 |

|________ a. |Institution has a successful history of work in Government Funded programs |

|________ b. |Institution has experience in prior Government Funded programs; but, has not received prior A-133 audit |

|________ c. |Institution is new and inexperienced or program is or will be operated as an offshoot of an experienced institution|

2. Institutional Experience - risk due to the institution's lack of experience

3. Sources of Financial Support (other US Federal funds)

|________ a. |Yes |

|________ b. |No |

4. Familiarity with OMB Super Circular 2 CFR, part 200 - risk due to the lack of familiarity with OMB circulars concerning cost principles 

|________ a. |Management is familiar with OMB Super Circular 2 CFR, part 200 |

|  | |

|________ b. |Management has reviewed the OMB Super Circular contained within the sub-agreement and has a general understanding |

|  |of the cost principles that should be applied for the administration of this program |

|________ c. |Management is unfamiliar with OMB Super Circular 2 CFR, part 200 |

|  | |

5. Fund Control - risk due to the lack of adequate control of funds

|________ a. |Separate bank account can be established for AIHA funds or funds will be administered on a cost reimbursable basis |

|________ b. |Separate bank account cannot be established and cash must be maintained outside of a bank |

6. Supporting Documentation - risk due to the lack of maintaining invoices, vouchers, and timesheets

|________ a. |Invoices, vouchers, and timesheets are maintained for all payments |

|________ b. |Circumstances may preclude maintaining invoices, vouchers, and timesheets; these circumstances appear reasonable |

| |and should not pose a significant audit risk |

|________ c. |Circumstances may preclude the maintenance of invoices; these circumstances may pose a significant audit risk |

7. Audit Coverage (Part I)

|________ a. |Institution has regular (or recent) Government Auditing Standards Audits performed by an external auditor; one copy|

| |of the most recent Financial Audit Report must be submitted |

|________ b. |Institution has regular (or recent) generally accepted auditing standards (or equivalent) audits performed by an |

| |external auditor; one copy of the Financial Audit Report must be submitted |

|________ c. |Institution does not have regular GAAS or GAGAS audits performed by an external auditor; one copy of the most |

| |recent A-133 Audit Report must be submitted |

|________ d. |Institution has never had an external audit |

8. Audit Coverage (Part II)

|________ a. |Institution has previous (or recent) Inspector General Audit from federally funded award program |

|________ b. |Institution has not had previous (or recent) Inspector General Audit from federally funded award program |

9. Audit Findings/Resolution

|________ a. |No audit findings identified in the audit report |

|________ b. |Material/significant audit findings that relate to the organization's ability to administer an AIHA award |

Certification of the information provided in this questionnaire is hereby acknowledged by:

_____________________________________ _____________________

Chief Financial Officer or Grants Administrator Date

_____________________________________ _____________________

Program Coordinator Date

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