HomeMy WebLinkAbout20132404.tiffF-
State of Colorado
Contract Management Information
FINAL Contractor Performance Evaluation
Colorado Revised Statutes §24-102-205(6)
Upon completion of each personal services contract with a value over $100,000, the individual selected by the state agency or
institution of higher education (IHE), pursuant to CRS §24-103 5-101(3), to monitor the contractor's work under the contract
(Contract Monitor) shall complete this FINAL Contractor Performance Evaluation (Evaluation) and submit the completed Evaluation
to the contractor for review and comment pursuant to CRS §24-103 5-101(6) This Evaluation and contractor's response, if any, shall
be added to the statewide Contract Management System (CMS) within 30 days after contract completion and become publicly
available as part of the State's public website Soliciting state agencies and IHEs are required to review completed Evaluations prior to
making future contract awards to ensure that the prospective contractor meets required standards of responsibility A contractor who
disputes any information contained in an Evaluation may exercise the contract rights set forth in CRS §§24-109-106, 107, 201 or 202
Completing this Form
• Before completing this Evaluation, the Contract Monitor shall ensure that ALL applicable fields in CMS are completed upon
completion of the contract
• Within 30 days of contract completion, the Contract Monitor or procurement staff shall I ) scan and attach a pdf copy of this
Evaluation to the CMS record and 2) submit the completed Evaluation to the contractor for review and comment
• The state agency or IHE shall maintain this Evaluation and contractor's response, if any, as part of its official contract file.
• This Evaluation shall remain a part of CMS for at least 5 -years following the date it is attached to the CMS contract record
CRS §24-105.102(4)
• If the contract is for construction services with a value of $500,000 or more, the Contract Monitor also shall complete the form
entitled "Construction Contractor Final Performance Evaluation Report"
This Evaluation is not required for contracts under Medicare, the "Colorado Medical Assistance Act", Articles 4 to 6 of Title
25 5, CRS, the "Children's Basic Health Plan Act", Article 8 of Title 25 5. CRS, or the `Colorado Indigent Care Program", Part I
of Article 3 of Title 25 5, CRS
CMS Identification Number 38158
Contract Completion Date 6/30/2015
Name of State Agency IHE CDLE - Workforce Development Programs
Name of Contractor Grantee Employment Services of Weld County
Name of Project Program WIA
»Contractor Performance — evaluation conducted after completion of services <<
Contractor met requirements related to Quality Yes
Contractor met requirements related to Cost Yes
Contractor met requirements related to Timeliness Yes
*Briefly ind,cate area(s) of non-compliance and steps taken to remedy
Indicate number and dates of interim performance evaluation
worksheets completed for this contract
Overall Rating of Contractor Performance
t/
No.
No*
Below Standard (i) Standard (2)
X
No*
Above Standard (3)
The following to be completed by the State following submittal to Contractor for review <<
Prot,ided contractor sith t'pportumty to retisco Evaluation ` Yes
Cortr& tot >�.bm tted response to E alsatton Yes
ontracr,ir disputed Evaluator' Ycs
*11 No f sp:a�^
No*
No
Nc
By signing below, 1 acknowledge that I has completed thi. Final Cuntrxctot Performance I' i duals in in ;ircnrdance with
C.R.S. :24102-205(6)
6 `u ' 0
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Prtr1 lone
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Ph,irr :303-313-3002
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FACT SHEET
Statewide Contract Management System
Labor & Employment
Senate Bill 07-228, as incorporated in the Colorado Revised Statutes at §§24-102-205, 24-102-206,
24-103.5-101 and 24-105-102, requires the Colorado Department of Personnel and
Administration (DPA), to implement and maintain a centralized contract management system
for the purpose of monitoring all State personal services contracts that are subject to the
requirements of the bill and its implementing statutes. The Office of Contract Administration,
within the Office of the State Controller, was created to accomplish the objectives of the bill to
include the implementation and oversight of the centralized system. The contract management
system will be implemented no later than June 30, 2009.
Personal services contracts of $100,000 or more over the life of the contract are subject to the bill.
The bill does not apply to contracts which the State is a party to under Medicare, Colorado
Medical Assistance Act, Children's Basic Health Plan Act, Colorado Indigent Care Program and
some higher education contracts. Construction contracts that exceed $500,000 will have special
reporting requirements.
The bill denotes contract information that must be entered into the system and requires each
governmental body be responsible for gathering and entering the information. Each
governmental body is required to designate at least one person to oversee its contract
performance, performance data and the use of the management system.
The legislation also stipulates vendor performance procedures and authorizes the State to
pursue specified remedies for vendor nonperformance. In addition, an appeal process is
provided should a vendor dispute any information contained in a performance report produced
by the contract management system.
In accordance with the bill, the public will be given access to limited contract information
entered into the system through development of a website maintained by DPA. The information
will not be real-time, but updated on an established routine schedule.
In addition the bill contains requirements concerning sole -source contracts, contractor
performance outside of Colorado and the right to audit contractor and subcontractor records.
To access the bill and other contract monitoring guidance documents, go to the Office of the
State Controller website by clicking on the link below and scrolling down to section VII.
Contract Administration. _,_ ',�. v vv _!.;i
Esther Gesick
From: Cecilia Moreno
Sent: Monday, June 29, 2015 10:24 AM
To: Esther Gesick
Subject: FW: Contract Close Out Weld County
Attachments: CDLE CMS Fact Sheet -email final eval attachment.pdf; 38158 Weld county 6-30-2015 final
evalu.pdf
Per Lennie's directive, can the two attached items be stored in TylerCM with the Grant Close-out Documents? The
Document ID he gave for TylerCM is "Report 20132404". If there are any issues please let me know.
Cecilia Moreno
Employment Services Support Specialist
Employment Services
315 N 11 Ave 8 Greeley, CO 80631
970-353-3800 ext. 6756
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Linda Perez
Sent: Monday, June 29, 2015 10:19 AM
To: Cecilia Moreno
Subject: FW: Contract Close Out Weld County
See Lennie's comments.
Linda Perez, Division Head
Employment Services of Weld County
3158 N 11th Avenue
P.O. Box 1805
Greeley Colorado 80632
970-353-3800 ext 6750
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
1
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Thomas - CDLE, Sandra[mailto:sandra.thomas@state.co.us]
Sent: Wednesday, June 24, 2015 12:00 PM
To: Linda Perez
Subject: Contract Close Out Weld County
Dear Ms. Lopez:
The email is in regard to the close-out of the Contract this Department (Labor & Employment) had with The
Board of County Commissioners of
Weld
County for the Workforce Investment Act Programs. The Contract listed the Board Chair in the Notice
provision for The Board of County Commissioners of
Weld
County and you as the Workforce Director.
Please share this email with the Board of County Commissioners and let me know if there are any comments.
The contract close-out item is in regard to legislation that passed in 2007, SB07-228, and attached is an
informational fact sheet. One item in the legislation requires a "Final Contractor Performance Evaluation",
which this Department has completed and is attached. The "Final Contractor Performance Evaluation" overall
rating is "standard".
To finalize matters relating to this Contract, please:
Review the attached "Final Contractor Performance Evaluation"; and
Let me know if you have any questions or written comments. Comments provided will be included with
the Contract information on the State of Colorado
W
ebsite http://contractsweb.state.co.us/. Please send written comments to me by
July 6, 2015.
Thank you for providing valuable services to Colorado citizens as a CDLE Contractor.
Regards,
Sandra Thomas, CLA
Manager, Contract Management/
Administration Program
Procurement and Contract Services
We Keep Colorado Working.
2
P 303.318.8056 I F 303.318.8068
633 17th St., Suite 1100, Denver, CO 80202
Sandra.Thomas@state.co.us www.colorado.gov/cdle
**********************************************************************************This electronic mail transmission may
contain confidential legally privileged information, intended only for the person(s) named. Any use, distribution, copying, or
disclosure by another person is strictly prohibited.
**********************************************************************************
3
RESOLUTION
RE: APPROVE GRANT CLOSEOUT SUMMARY FOR VARIOUS WORKFORCE INVESTMENT
ACT PROGRAMS AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with the Grant Closeout Summary for Various
Workforce Investment Act Programs from the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Human
Services, Employment Services Division, to the Colorado Department of Labor and Employment,
with terms and conditions being as stated in said closeout summary, and
WHEREAS, after review, the Board deems it advisable to approve said closeout summary, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Grant Closeout Summary for Various Workforce Investment Act
Programs from the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Employment
Services Division, to the Colorado Department of Labor and Employment, be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said closeout summary and all necessary documents.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 26th day of August, A.D., 2013.
BOARD OF COUNTY COMMISSIONERS
Weld County Clerk to the Board
SEP 12 2013
Date of signature:
arbara Kirkmey r
cc /150
9-79%73
2013-2404
HR0084
MEMORANDUM
DATE: August 22, 2013
TO: William F. Garcia, Chair, Board of County Commissioners
�j7
FROM: Judy A. Griego, Director, Human er A s D4oartmeni
RE: Year -End Close -Out Report for the Weld County Department
of Human Services' Employment Services' WIA Program to
the Colorado Depai intent of Labor and Employment
Enclosed for Board approval is the Year -End Close -Out Report for the Department's Employment
Services' WIA Program to the Colorado Department of Labor and Employment. This Report was
reviewed under the Board's Pass -Around Memorandum dated August 19, 2013, and approved for
placement on the Board's Agenda.
The Workforce Investment Act (WIA) Grant Closeout packet is required by the Year -End
Contract Closeout Procedures of the Colorado Department of Labor and in accordance with their
Policy Guidance Letter # 06-12-F1 for all programs that have Expenditure Authorizations ending
during the period July 1, 2012 to June 30, 2013. Revenues and expenses are reconciled and grant
obligations are released for those projects that are fully expended by the Department's
Employment Services.
If you have questions, please give me a call at extension 6510.
2013-2404
Attachment K
Colorado Department of Labor and Employment
Grant Closeout Signature Page
Workforce Region: Employment Services of Weld County
Address: P. O. Box 1805, Greeley, Colorado 80632
Director: Linda Perez
Phone Number: (970)352-1551ext 6750
Fiscal Manager: Leonard Bottorff
Phone Number: (970)352-1551 ext 6537
Master Grant/Contract Agreement Number: 13KAA 38158
CLOSEOUT SUMMARY
This closeout packet signature page includes the following contracts:
Program
Year
Funding Stream
Amount
Vax
#
Line Item
FSC123#
PY 09
WIA 10 % Statewide Act -Sectors
$ 118,046.05
1686
9DSS2F/9YSS2P
PY 10
WIA Adult
$ 76,342.00
1760
0NAOIP/0NO01P
PY 10
WIA Dislocated Worker
$ 129,984.00
1762
0NAD1P/0ND0IP
PY 09/FY 10
TAA Case Management
$ 5,200.00
1786
9Na02F
PY 10
WIA 10 % Statewide Act -Sectors
$ 45,000.00
1839
0DSSIF
PY 11/FY 12
WIA Adult
$ 205,556.00
1966
1NAO I F/1ND02F
PY 11
WIA Youth
$ 637,034.00
1967
1NAY1P/INY01P
PY i 1/FY 12
WIA Dislocated Worker
$ 312,220.00
1968
1NAD1P/1ND01P/1NAD1F/
1ND01F
PY 11
Wagner Peyser
$ 904,848.00
1969
1NW01
PY 10/FY 11
TAA Case Management
$ 47,684.00
2013
0Na01F/0Na03F
PY 11/FY 12
DVOP
$ 8,000.00
2043
1NV01
PY 10
Wagner Peyser 10% -MSFW
$ 24,720.00
2097
0NE01
PY 11/FY 12
LVER
$ 8,000.00
2130
1NL01
PY 11
Wagner Peyser 10% Summer Job
Hunt
$ 40,000.00
2135
1NJ01
PY 12/FY 13
WIA Adult
$ 82,231.00
2207
2NAO 1 P/2NO01 P/2NAD2P/
2ND02P
PY 12/FY 13
WIA Dislocated Worker
$ 39,535.00
2209
2NAD1P/2ND0IP
PY 12/FY 13
WIA Fed EUC Program
$ 19,172.50
2228
2Nu01 F/2Nu02F
PY 11
WIA Fed EUC Re-employment
Services
$ 96,900.00
2240
1Nu01F/1Nu02F
PY 12
CWDC-ESF ( Performance
Incentive)
$ 16,670.00
2285
2Ns01
Total
$ 2,817,142.55
Each Program Year (PY) and funding stream listed above will have the following forms completed:
Form Attachment I and Attachment H:
• Grant Recipient's Release (Attachment I: page 1 of 6)
• Contract Closeout Tax Certification (Attachment I: page 2 of 6)
• Schedule of Unclaimed Checks (Attachment I: page 3 of 6)
• Grant Recipient's Assignment of Refunds, Rebates, and Credits (Attachment I: page 4 of 6)
• Sub -recipient Certification of Physical Inventory (Attachment I: page 5 of 6)
• Physical Inventory List (Attachment I: page 6 of 6)
• Grant Closeout Reconciliation Worksheet (Attachment H)
I cert( to the best of my knowledge and belief the following financial data reported in this
closeout packet is correctly stated.
By:
AUG 2 6 2013
Local Elected Official Date
Chair, Board of County Commissioners or
Authorized Signature
Attachment I
Page 1 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S RELEASE
Grant Recipient's Name: Employment Services of Weld County
Address: PO Box 1805, Greeley, CO 80632
Release Date: 8/19/13Release Date: 8/19/13
Pursuant to the terms of Contract/Grant Agreement Number 13KAA 38158 , including the Expenditure
Authorizations (EAs) awarded under said Contract/Grant Agreement, as VAX/FCS123 number(s): 1686/9DSS2F
1686/9YSS2P 1760/ONAO1P 1760/0NO01P 1762/0NAD1P , 1762/OND01P 1786/9Na02F , 1839/0DSS1F
1966/1ND02F , 1967/1NAY1P , 1967/1NY01P , 1968/1NAD1P 1968/1ND01P , 1968/1NAD1F
1969/1NW01 , 2013/0Na01F , 2013/0Na03F , 2043/1NV01 2097/ONE01 , 2130/1NLO1
2207/2ND02P 2209/2NAD1P 2209/2ND01P
2285/2Ns01
1966/1NAO1F
F
1968/1N D01F
2135/1NJ01
2228/2Nu01F
2207/2NAO1 P
2228/2Nu02F
2207/2NO01 P
2240/1Nu01F
2207/2NAD2P
2240/1Nu02F
and in consideration of the sum of Total amount paid of $2,817,142.55 and payable of
($ of Unclaimed Checks Total) under the said Contract to
(Contractor's Name and Address)
hereafter called the Grant Recipient or to its assignees, if any, the Grant Recipient, upon payment of the said sum by the
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT, hereinafter called CDLE, does remise, release, and
discharge CDLE, its officers, agents, and employees, of and from all liabilities, obligations, claims, and demands
whatsoever under or arising from said Contract/Grant Agreement except:
1. Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible of exact
statement by the Grant Recipient, as follows( if none, so state):
NONE
VAX/
FCS123
Number
Invoice
Date
(If Known)
Vendor
Invoice
or P.O. #
Line
Item
Cost
Category
Amount
Expected
Payment
Amount
NONE
2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Grant
Recipient to third parties arising out of the performance of the said contract, which are not known to the
Grant Recipient on the date of the execution of this release and of which the Grant Recipient gives notice in
writing to the CDLE within the period specified in the said Contract/Grant Agreement.
3. Claims after closeout, for costs which results from the liability to pay Unemployment Insurance costs under
a reimbursement system or to settle Worker's Compensation claims.
This release has been executed this 19th day of Aygust, 2013
BY /4/190
Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach l-1Gran RecRelForm2013.xls
Attachment I
Page 2 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
CONTRACT CLOSEOUT TAX CERTIFICATION
In the performance of Contract/Grant Agreement Number 13KAA 38158 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified
as VAX/FCS123 number(s) : 1686/9DSS2F 1686/9YSS2P , 1760/0NAO1P
1760/0NO01 P ,
1966/1 NAO1 F ,
1968/1 ND01 P ,
2013/0Na03F ,
2207/2NAO1 P
2209/2ND01P , 2228/2Nu01F , 2228/2Nu02F
2285/2Ns01
I certify that I have complied with requirements of the law and the Colorado Department of
Labor and Employment, regarding the obtaining of employer identification/account numbers;
collection, payment, deposit, and reporting of federal, state, and local taxes; and the provision
of W-2 forms to employees/enrollees who are not now my employees. For present
employees/enrollees (formerly employed under the contract), W-2 forms will be furnished as
specified in Circular E. Employer's Tax Guide.
1762/ONAD1 P
1966/1 ND02F
1968/1 NAD1 F
2043/1 NV01
2207/2NO01 P
1762/OND01 P
1967/1 NAY1 P
1968/1ND01F
F
2097/ONE01
2207/2NAD2P
1786/9Na02F , 1839/0DSS1F
1967/1NY01P P , 1968/1NAD1P
1 P
1969/1NW01 , 2013/0Na01 F
2130/1NL01
2207/2ND02P , 2209/2NAD1P
2240/1 Nu01 F , 2240/1 Nu02F
, 2135/1 NJ01
Grant Recipient Name: Employment Services of Weld County
Grant Recipient Address: PO Box 1805
Greeley, CO 80632
Grant Recipient Employer: Weld County Dept of Human Services
Employer's Identification Number: 84-6000813
This certification has been executed this 19th day of August 2013
By
171524)
Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach I-2ContractCloseoutTaxCert2013.xls
Attachment I
Page 3 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
SCHEDULE OF UNCLAIMED CHECKS
Grant Recipient Name: Employment Services of Weld County
Contract/Grant Agreement Number: 13KAA 38158
Release Date:
8/19/2013
VAX/FSC123
Number
Check
Number
Payee
Check
Amount
Payee's Last Known
Address
NONE
Total Amount Unclaimed
This schedule has been executed this 19th day of a gust
BY
2013
Authori ed Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach 1-3 ScheduleofUnclaimedChecks 2013.x!s
Attachment I
Page 4 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S ASSIGNMENT OF REFUNDS, REBATES, AND CREDITS
Grant Recipient's Name: Emp Svcs of Weld County
Contract/Grant Agreement
No: 13KAA 38158
Street Address: PO Box 1805
City and State: Greeley, CO 80632
Pursuant to the terms of Contract/Grant Agreement Number 13KAA 38158 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified as
VAX/FCS123 number(s) :
1760/0NO01 P
1966/1 NAO1 F
1968/1ND01P
P
2013/0Na03F
2207/2NAO1 P , 2207/2NO01 P , 2207/2NAD2P , 2207/2ND02P , 2209/2NAD1 P
2209/2ND01 P
2285/2Ns01
1686/9DSS2F
1686/9YSS2P
, 1760/0NAO1P
1762/0NAD1P , 1762/0ND01P , 1786/9Na02F , 1839/0DSS1F
1966/1ND02F , 1967/1NAY1P P , 1967/1 NY01 P , 1968/1 NAD1 P
1968/1 NAD1 F , 1968/1ND01F F , 1969/1 NW01 , 2013/0Na01F
2043/1NV01 . 2097/ONE01 2130/1NL01 2135/1NJ01
2228/2Nu01 F , 2228/2Nu02F , 2240/1 Nu01 F , 2240/1 Nu02F
and in consideration of the reimbursement of costs and payment of fee, as provided in the said
Contract/Grant Agreement and any assignment thereunder, the Grant Recipient's Name and Address
(hereinafter called the Grant Recipient) does hereby:
1. Assign, transfer, set over and release to the Colorado Department of Labor
and Employment (hereinafter called CDLE), all right, title and interest to all
refunds, rebates credits or other amounts (including any interest thereon)
arising out of the performance of the said contract/grant agreement, together
with all the rights of action accrued on which may hereafter accrue
thereunder.
2. Agree to take whatever action may be necessary to effect prompt collection of
as such refunds, rebates, credits or other amounts (including any interest
thereon due or which may become due, and to forward promptly to CDLE.
i
3. Agree to cooperate fully with CDLE as to any claim or suit in connection with
such refunds, rebates, credits or other amounts due (including an interest
thereon): execute any protest, pleading, application, power of attorney or
other papers in connection therewith; and to permit CDLE to represent it at an
hearing, trial or other proceeding arising out of such claim or suit.
This assignment has been executed this 19th day of August 2013
Authorized Sign
Title Division Head of Employment Services
Revised: 6/1/06 Attach I-4RefRebCredits2013.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 12/01/09
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 09
TITLE/PROGRAM/PROJECT WIA 10 % Sectors
VAX ERF (VERF) # 1686
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 9YSS2P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
MINIMUM. M. _ __ -.;
71,562.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=1.3.)
71,562.00
IL PROGRAM EXPENSE REPORT (ER) Vax # 168641119Miltitst."Tint
I . Total Expenses + Accruals Previously Reported (Through Last Month)
2, Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+11.2=11.3.)
71,562.00
71,562.00
ADMINISTRATIVE EXPENSE (ER) Pax #
a 2't(1IMN
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+II.5.=1I.6.)
0.00
III PROGRAM INCOME (PI) EXPENSE REPORT Vax #
lu lu 'f= M
I. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1.+ 111.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)};#}tt₹'
:a: 's'
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
• 2. FINAL Expenses Through End of Contract (1I.3. + II 6.+II1.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
71,562.00
71,562.00
YES Ld/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTEDlitti(IIitliE
1. Total PT Cash Previously Reported on CR (Last CR # )
;
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.I. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (1I1.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = V1.3.) (Refund * Extend )
g #9t:tt'
0.00
0.00
0.00
VIL MATCH RECONCILIATION Vax #
Milliffillitiiiillik
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
71,562.00
0.00
YESk MOH
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
7 ti
Signature ,r dry ,
iPreparer's
G'
Date
/,�'
`
Date
/),1
Authorized Signatur/
G
See instructions for completing this form on the next page.
Revised: 8/1/138
2013At!ac`if ICIoseRec;1686A.x sx
Attachment H
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 12/01/09
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 09
TITLE/PROGRAM/PROJECT WIA 10 % Sectors
VAX ERF (VERF) # 1686
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 9DSS2F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
ink
46,484.05
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2 .=1.3.)
46,484.05
II. PROGRAM EXPENSE REPORT (ER) Vax # 1686
i f
I. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II. 1.+11.2.---11.3.)
46,484.05
46,484.05
ADMINISTRATIVE EXPENSE (ER) Vax #
.still
-0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5 =II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
LU1J .
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (l1I.1.+ III.2.= I11.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
I . FINAL CR Contract to Date (I.3.) if not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
Eh
46,484.05
46,484.05
YES I i/NOLi
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
iiiiiiiithfiNgliiiiiiik
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VL RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
...._.2.-_—______—..._ --,,, .
li
0.00
0.00
0.00
j VII. MATCH RECONCILIATION Vax #
>�
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+I1I.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x V11.3.)
5. Total Match Reported (V1I.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
46,484.05
0.00
YESL_l /NOLJ
* The Program income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
•
9`(,
Date P/K3
_
Authorized Sign r
_
if"
Date / %/
See instructions for completing this form on the next page.
Revised: 6/1/06
2013Attac hHC IoseRe c16868. xfsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/10
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT WIA Adult Admin
VAX ERF (VERF) # 1760
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 0NAO1P
1. Total Program and Adm in Cash Needs Previously Reported (Last CR # 1847 )
allIMUNIRMIN
7,634.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2=I3,)
7,634,00
IL PROGRAM EXPENSE REPORT (ER) Vax #
�` } E.A {''
�sa'tl1
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2.=11.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1760
t .ti ;.. NV ;:i kl
7,634.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# 0AONIP
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5.=II.6.)
7,634.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
a.:
I. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ III.2: 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+II1.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
1-
7,634.00
7,634,00
YES IJ/NO(
V. CASH REQUEST PROGRAM INCOME CASH REPORTEDEl'
1. Total PI Cash Previously Reported on CR (Last CR # )
iii ilUUIi iiltl'L tM9
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (HD.)
3. Total PI Cash Balance (V1.1 - VI.2. = VI3.) (Refund * Extend
1 $:b ;I ':{1iii;jt} ' 1
0.00
0.00
0.00
VIL MATCH RECONCILIATION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. + II6.+III.3.)
7,634.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x V1I.3.)
0.00
5. Total Match Reported (VII. I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YESLI /NO0
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
0.,. . ` vr
Date
OM
Authorized Signatur
�2--0-4_ G
Date
k .3
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec1760A.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/10
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT WIA Adult
VAX ERF (VERF) # 1760
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 0NO01P
11, ` {.''';'` "r
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
68,708.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=I.3.)
68,708.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 1760
I. Total Expenses + Accruals Previously Reported (Through Last Month)
68,708.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (I1.1.+II.2.=11.3.)
68,708.00
ADMINISTRATIVE EXPENSE (ER) Vax #
_„.eci
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5.=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
;',,,ii, � , I�t
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ 111.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
x
8 ila
I. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
68,708.00
2. FINAL Expenses Through End of Contract (11.3. + II 6.+111.3.)
68,708.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
�
YES LJ/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
X11;:l z i!' i i l l:I i iii i i
I. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V. I. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (III.3.)
0.00
3. Total PI Cash Balance (VI.1 - V1.2. = VI.3.) (Refund * Extend )
0.00
VII. MATCH RECONCILIATION Vax #
_
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. + II6.+III.3.)
68,708.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
0.00
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES U /NO H
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature - vy ,/,
Date
J7W3
�._
Date
/7'V.3
Authorized Signatur
See instructions for completing this form on the next page.
Revised: 6/1 /06
2013AttachHCloseRe c17608. xtsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/1 0
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT WIA DW Admin
VAX ERF (VERF) # 1762
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 0NAD1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
E3s' :AtIMMilik
12,998.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+I.2=1.3.)
12,998.00
II. PROGRAM EXPENSE REPORT (ER) Vax #
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (I1.1.+I1.2.=11.3.)
0, 00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1762
inithiF, . .,,
12,998.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# 0ADN 1 P
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (I1.4.+II.5=II.6.)
12,998.00
IIL PROGRAM INCOME (PI) EXPENSE REPORT Vax #
is=tr' it litha
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1 .+ I11.2.=111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+11I.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
ItRISIMilalitiV21.
12,998.00
12,998.00
YES L i/NOL'
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
`ir��{
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
9 Pe )
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (11I.3.)
3. Total P1 Cash Balance (VI.1 - VI.2. = VI.3.) (Refund " Extend )
li`r�' .r:: } 1#
.yu �HZ=
0.00
0.00
0.00
;(III•1t1i�',_:�
VII. MATCH RECONCILIATION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII. l.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
12,998.00
0.00
YES L1 /NO L
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
Q
Date
/ X3
Authorized Signatur
,Z''C-
Date
��}
See instructions for completing this form on the next page.
Revised; 6/1/08
2013A t -iCloseRec1762A.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/10
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT WIA DW
VAX ERF (VERF) # 1762
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# ONDO1P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
ill _
I 16,986.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+I.2 =I.3.)
116,986.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 1762
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+11.2.=1I.3.)
116,986.00
116,986.00
ADMINISTRATIVE EXPENSE (ER) Vax #:.ii.analifitWilib
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5.=1I.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
^i�xr , }���g{{}�
r'l tank_
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract (III.1.+ III.2= III.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense),_.
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
116,986.00
116,986.00
YES kJ/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total P1 Cash Previously Reported on CR (Last CR # )
MEN.; - _
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VL RECONCILL4 TION (P1 Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
. ,
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
I . FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + II6.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VI1.2 x VII.3.)
5. Total Match Reported (VII.I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
116,986.00
0.00
YES L) /NOL
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
cl,_,
Date
r
Authorized Signatur
F'
,-/---',7Date
4/(-;
See instructions for completing this form on the next page.
Revised: 6/1/06
2013Attac hHCloseR ec17626. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 05/03/10
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 09/FY 10
TITLE/PROGRAM/PROJECT TAA
VAX ERF (VERF) # 1786
END DATE 06/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 9NaO2F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
pp, vim!.
`,200.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=1.3.)
5,200.0()
II. PROGRAM EXPENSE REPORT (ER) Vax # 1786
IMMINLI;gillitih,
I. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2.=11.3.)
5,200.00
5,200.00
ADMINISTRATIVE EXPENSE (ER) Vax #
- U�' :1
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5=I1,6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vex #
111111111111111EMIIMI
I. Total Program Income Expenses Reported. (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ I1I.2 = 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
fitt111,1101
5,200.00
5,200.00
YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
MIlitifiti,I'
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (I11.3.)
3. Total PI Cash Balance (VI. I - VI.2. = VI.3.) (Refund * Extend )
WZILHIMIIMI
0,00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
...Y _
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + [I6.+1[1.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII. 1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
5,200.00
0.00
YES LI /NOLI
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
•
Preparer's Signature
IC 47
gr.
Date
6��
Authorized Signatur7.-
Date
7'/i
See instructions for completing this form on the next page.
Revised: 811/06
2013AttachHClo s eRec 1786. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/1 0
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT Sectors
VAX ERF (VERF) # 1839
END DATE 06/30/13
END DATE
L
CASH REQUEST (CR) VAX CR# 1847 FCS123#0DSS1F
i i
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
45,000.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (LI.+I.2 =1.3.)
45,000.00
H.
PROGRAM EXPENSE REPORT (ER) Vax # 1839
•`;
1. Total Expenses + Accruals Previously Reported (Through Last Month)
45,000.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (1I.I.+11.2=II.3.)
45,000.00
ADMINISTRATIVE EXPENSE (ER) Vax #
di
_ . . .
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSl23#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5; II.6.)
0.00
III.
PROGRAM INCOME (PI) EXPENSE REPORT Vax #
' 111
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1.-1- lil.2= 111.3.)
0.00
IV.
RECONCILIATION (Cash Request = Expense)
.
,
1. FINAL CR Contract to Date (I.3.) If riot explain on the Remark below
45,000.00
2. FINAL Expenses Through End of Contract (11.3. + II 6.+III.3.)
45,000.0.0_
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES L/NOL I
V.
CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI.
RECONCILIATION (PI Cash Request = PI Expenses)
1l
illi tlh1h _ .
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (III.3.)
0.00
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
VII.
MATCH RECONCILIATION Vex #
............................_........
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. +116.+111.3.)
45,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VI1.2 x VII.3.)
0.00
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VHI.4.)? (Check Box)
YES L /NOLJ
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
Date
�� ��
3
se
Authorized Signatur
Date
Of3
./
See instructions for completing this form on the next page.
Revised: 611106
2013AttachHC IoseRec 1839.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11 /FY 12
TITLE/PROGRAM/PROJECT WIA Adult Admin
VAX ERF (VERF) # 1966
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAXCR# 1847 FCS123# 1NAO1F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
__
40,674.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2 .=1.3.)
40,674.00
II. PROGRAM EXPENSE REPORT (ER) Vax #
I. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses -I- Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+II.2.=II.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1966
.. ._ _.
40,674.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# IAO01 F
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date 01.4.1-11.5 .=11.6.)
40,674.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
•ti_
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ 111.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (I.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
! 10 j•5 l iiii ts. hill',
40,674.00
40,674.00
YES L I/NO U
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
1111 qiiiiil I'ki _ .. _ .
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
ft L 1illt
0.00
0.00
0.00
VII. MATCHRECONCILL4TION Vax #,
• V,':tN
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. +116.1-111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VI1.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (V11.4.)? (Check Box)
40,674.00
0.00
YES L /NO IL
* The Program Income Expense Report and Cash Request can only be extended Through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
` °,i.-4.zr-7 c2?
Date
SX�
Authorized Signatur
,,,-'`.���r
Z,.
Date
�.J
See instructions for completing this form on the next page.
Revised' 6/1/06
2013Attach,CloseRecl 660A. xisx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11 /FY 12
TITLE/PROGRAM/PROJECT WIA Adult
VAX ERF (VERF) # 1966
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCSI23# IND02F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
164,882.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2 =I.3.)
164,882.00
H. PROGRAM EXPENSE REPORT (ER) Vax # 1966
If IM11111 `}:
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+II.2.=1I.3.)
164,882.00
164,882 00
ADMINISTRATIVE EXPENSE (ER) Vax #
t}I .1vi s i 's Il it; 2
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+11.5=11.6.)
0.00
IlL PROGRAM INCOME (PI) EXPENSE REPORT Vax #
__ ____
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ III.2= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+II1.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
L
164,882.00
164,882.00
YES Ld/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
UMW_
2. Current Program Income Cash (Through End Date of Contract) (CR # , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (I11.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = V1.3.) (Refund * Extend )
. __
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
,.:
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. + 1I6.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.I .) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
164,882.00
0.00
YES Li /NO L
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
•
Preparer's Signature
(7--(1 _,,z/A.,..41„
k).17:2017F
Date
�g�
Authorized Signatur
�/
Date
/y�3
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec 19668.xIsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT WIA Youth Admin
VAX ERF (VERF) # 1967
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123# INAY1 P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
iillili. ill
42,703.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=1.3.)
42,703.00
II. PROGRAM EXPENSE REPORT (ER) Vax #
lagliMINKilii01111
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+II.2.=11.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1967
Mk natilliktil
42,703.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23# IAY01 P
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+II.5 =II.6.)
42,703.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vex #
a,x" )'4y
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ 111.2 .= 11I.3.)
0.00
IV. RECONCILIATION (CashRequest=Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
3i!#§ nil
42,703.00
42,703.00
YES Ld/NO
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # l
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = P1 Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
0.00
0.00
VII. MATCHRECONCILIATION Vax #
,111 10filli .
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
42,703.00
0.00
YES U /NO U
* The Program Income Expense Report and Cash Request can only be extended through the availability of thewes nd/or Federal funding period.
•
Preparer's Signature bt
4
V:c; L
Date
Authorized Signat}.����,�'
-752,, +'
et , )'_-
Date
i.W•
,fi,
See instructions for completing this form on the next page.
Revised: 6/1/0B
2013Atta c h H C l ose Rec 1967A. x l sx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT WIA Youth
VAX ERF (VERF) # 1967
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAXCR# 1847 FCS123# 1NY01P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
Allmon '
594,331.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
594,331.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 1967
;' `: r(I IIIIMMI
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+II.2.=11.3.)
594,331.00
594,331.00
ADMINISTRATIVE EXPENSE (ER) Vax #
1 ,
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5.=1I.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
IliIJ ifillin 1 lit.. '
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ 111.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+Ifl.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
litligilF"
594,331.00
594,331.00
YES Ll/NO LJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
__.: _ _
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
i liglilikii .
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (V11.2 x V11.3.)
S. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
594,331.00
0.00
YESLI /NOLJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
;2---'14.71.-4
Date
f7
���
Authorized Signatur l�?�L
/,:ejtd"
Date
rg3
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AtlachHCloseRe s 1967B. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT WIA DW Admin
VAX ERF (VERF) # 1968
END DATE 06/30/13
END DATE
L
CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NADIP
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
5,940.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1 . -14.2.=I3.)
5,940.00
H
PROGRAM EXPENSE REPORT (ER) Vax #
RIIJ1F : `ty
1. Total Expenses + Accruals Previously Reported (Through Last Month)
0.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2.-11.3.)
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1968
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# l ADO I P
5,940.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+11.5.=11.6.)
5,940.00
III
PROGRAM INCOME (PI) EXPENSE REPORT Vax #
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1 + III.2: II1.3.)
0.00
IV.
RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (I.3.) If not, explain on the Remark below
5,940.00
2. FINAL Expenses Through End of Contract (11.3. + II 6.+III.3.)
5,940.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES LJ/NOU
V.
CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.I. + V.2 = V.3.)
0.00
VI.
RECONCILIATION (P1 Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (III.3.)
0.00
3. Total PI Cash Balance (V1.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
VII.
MATCH RECONCILIATION Vex #
§3lf 3
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+11I.3.)
5,940.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
0.00
5. Total Match Reported (VII.I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YESLL /NOL
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding peried.
Preparer's Signature
Date
Sys
rL�y
Authorized SignattF
,/G� Z
7 --4---i
Date
%/3
See instructions for completing this form on the next page.
Revised: 611106
2013AttachHGloseRec1966A,xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT WIA DW
VAX ERF (VERF) # 1968
END DATE 06/30/13
END DATE
CASH REQUEST (CR) VAX CR# 1847 FCS123# 1ND01P
If
I . Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
53,457.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+I.2.=1.3.)
53,457.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 1968
OL�_ �.; , l
1. Total Expenses + Accruals Previously Reported (Through Last Month)
53,457.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.I .+11.2=I1.3.)
53,457.00
ADMINISTRATIVE EXPENSE (ER) Vax #
l 1. =-.:.. -.
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+II.5 =1I.6.)
0.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #1::*
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (I11. I.+ III.2.= I11.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
#2z` .''tfiii
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
53,457.00
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
53,457.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES LI/NO U
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
11 111111111h,-.....-.
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses}
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (111.3.)
0.00
3. Total PI Cash Balance (VI.1 - V1.2. = V1.3.) (Refund * Extend )
0.00
VII. MATCHRECONCILL4TION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+111.3.)
53,457.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
0.00
5. Total Match Reported (VII. I .) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES IA /NO U
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark
Signature
�(4 ,n r ,� (]�'
•Preparer's
-
Date
0/3
Authorized Signatur
f rfJriii 4._/4._/
�`/Ir�«-�
— - .7
Date
ph
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec19568. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11/FY12
TITLE/PROGRAM/PROJECT WIA DW Admin
VAX ERF (VERF) # 1968
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 1 NAD1 F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
I E
24,732.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
II. PROGRAM EXPENSE REPORT (ER) Vax #
qri1+t #j}�}}l�(t)yy24,732.00{
}}�tflgffnaliiflrz J,:' fU
4
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+II.2 =11.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 1968
tf, *# x;11
#jt
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# 1 ADO I F
24,732.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5 =II.6.)
24,732.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
j .t' =°
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (II1.1.+ I1I.2 = 1II.3.)
0.00
IV RECONCILIATION (Cash Request = Expense)
I . FINAL CR Contract to Date (I.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
ilailinitlitLA,1
24,732.00
24,732.00
YES L� I/NO LI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
X14`i IiiiiipiiiiMingi
2. Current Program Income Cash (Through End Date of Contract) (CR # , column 0)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = P1 Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (11I.3.)
3. Total PI Cash Balance (V1.1 - VI.2. = VI.3.) (Refund * Extend )
:- i 1lllulll
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
illi1 F`°' 11191111ffig
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x V11.3.)
S. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
24,732.00
0.00
YES Ld /NOLI
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
? r
C3?�
,
Date
OA
Authorized Signatu
Date
/
,�'�/�
See instructions for completing this form on the next page.
Revised: 6/1106
2013AttachHCloseRec 1966C.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11 /FY 12
TITLE/PROGRAM/PROJECT WIA DW
VAX ERF (VERF) # 1968
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCSI23# I ND01F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
' ) tat �., _r
228,091.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.I.+I.2.=1.3.)
228,091.00
M?liEta: 4#(91f
II. PROGRAM EXPENSE REPORT (ER) Vax # 1968
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+11.2.=II.3.)
228,091.00
228,091.00
ADMINISTRATIVE EXPENSE (ER) Vex 11
41EMI111I1i _ :111
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5.=II.6.)
0.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
allotimiLiltaii
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ 11I.2. III.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) if not, explain on the Remark below
2. FINAL Expenses Through End of Contract (113. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
iii;MIMMilffir
228,091.00
228,091.00
YES IJ/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
y
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VL RECONCILIATION (P1 Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (II1.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
0.00
0.00
itgilikkisii6M41011
VIL MATCH RECONCILIATION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + I16.+II1.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (V1I.1.) > or = to Match Expenditure Requirement (V1I.4.)? (Check Box)
228,091.00
0.00
YESLI /NOLI
` The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
1Hernark
Preparer's Signature
-w✓i z;ei
J
C_ /.__a
Date
(��3
Authorized Signatur
q K2.(
Date
O/3
See instructions for completing this form on the next page.
Revised: 8/1/06
2D 13AtlachHCloseRec1968D.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT Wagner Peyser
VAX ERF (VERF) # 1969
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NW01
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
EL• to 41 it{ li tti}j
904,848.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
904,848.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 1969
NHi = it (1
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (I1.1.+II.2 =I1.3.)
904,848.00
904,848.00
ADMINISTRATIVE EXPENSE (ER) Vax #
WEL?! I!ili i III _
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+II.5.=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1 .+ 1'1.2.= I11.3.)
WililititrZitllallia
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (I1.3. + II 6.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
r , :{#;' Hf
904,848.00
904,848.00
YES /NO Li
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
_
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (III.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend 1
Aft _ ('',.,
0.00
0.00
0.00
VII MATCH RECONCILIATION Vax #
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + II6.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (V11.2 x V11.3.)
5. Total Match Reported (VII. I .) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
904,848.00
0.00
YESLd /NOLI
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark.:
Preparer's Signature
t-
. ��
Date
,V3
Authorized Signatur
Gt
Date
Aff3'
See instructions for completing this form on the next page.
Revised: 611106
2013Attach HCIoseRec 1989.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10/FY 11
TITLE/PROGRAM/PROJECT TAA
VAX ERF (VERF) # 2013
END DATE 06/30/13
END DATE
I CASH REQUEST (CR) VAX CR# 1847 FCS123# ONa01 F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
'': .I
35,345.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+I.2=I.3.)
35,345.00
IL PROGRAM EXPENSE REPORT (ER) Vax # 2013
liffilifritfilltitillii
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (I1.1.+11.2=1I.3.)
35,345.00
35,345.00
Silint.li`
0.00
ADMINISTRATIVE EXPENSE (ER) Vax #
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+I1.5.=1I.6.)
0.00
III. PROGRAM INCOME PI EXPENSE REPORT Vax #
{`
'NffilifiallithE
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ III.2= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) if not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
i1111101111111ELIta
35,345.00
35,345.00
YES L //NOU
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
) I 1 iili,;i1p.t
2. Current Program Income Cash (Through End Date of Contract) (CR # , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI RECONCILIATION (PI Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = V1.3.) (Refund * Extend )
!4
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
' ;ship
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (I1.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VI1.2 x VII.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
35,345.00
0.00
YESLI /NO U
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark::
Preparer's Signature
-°ell"—
Date
"`
Date
iN
Authorized Signatur X--
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHC loseRe c2013A. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10/FY 11
TITLE/PROGRAM/PROJECT TAA
VAX ERF (VERF) # 2013
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCSI23# oNa03F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
iiiffi1lll f EI
12,339.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=1.3.)
12,339.00
H. PROGRAM EXPENSE REPORT (ER) Vax # 2013
MK ' .: ,4141111111Illi
1. Total Expenses + Accruals Previously Reported (Through Last Month)
12,339.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2 .41.3.)
12.339.00
ADMINISTRATIVE EXPENSE (ER) Vax #
gar>,. ,4
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+11.5. 41.6.)
0,00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
___e ,
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (11I.1.+ 111.2.= 111.3.)
0.00 T
IV. RECONCILIATION (Cash Request = Expense)
rf��( ', `
I. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
12,339.00
2. FINAL Expenses Through End of Contract (11.3. + 11 6.+I1I.3.)
12,339.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
$,UI>tt`,
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request — PI Expenses)
i
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (111.3.)
0.00
3. Total PI Cash Balance (VI.1 - V1.2. = VI.3.) (Refund * Extend )
0.00
VII. MATCH RECONCILIATION Yea #
� _, _
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + I16.+III.3.)
12,339.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x V11.3.)
0.00
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES6J, /NOLI
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Signature/
Date
pa%
, , = �
CAlaPreparer's
Authorized Signatur%L%''="''—
(/
Date
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec2013B xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 10/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11 /FY 12
TITLE/PROGRAM/PROJECT DVOP
VAX ERF (VERF) # 2043
END DATE 09/30/12
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NV01
I. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
lnffilili 41fniit
8,000.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
8,000.00
II. PROGRAM EXPENSE REPORT (ER) Fax # 2043
( ',
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (1I.1.+II.2.=11.3.)
8,000.00
r
8,000.00
ADMINISTRATIVE EXPENSE (ER) Vax #
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23#
-` k
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5 =I1.6.)
0.00
III PROGRAM INCOME (PI) EXPENSE REPORT Vax #
liiliit+i� MIENS
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III. 1.+ II1.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense);-_;
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
„_`11UUIWi
8,000.00
8,000.00
s
YES U/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
lti1V-Difilll
2. Current Program Income Cash (Through End Date of Contract) (CR #_ , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (I11.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
W __,_ _ _.
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.I.)> or = to Match Expenditure Requirement (VII.4.)? (Check Box)
8,000.00
0.00
YES [Id /NOJ
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparers Signature
,� �,
c) -
Date
�����
�+/�'�)
Authorized Signatur
/s` ;�G2%
Date
��0
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHC IoseRe c2043. xisx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 10/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 10
TITLE/PROGRAM/PROJECT WP 10% (MSFW)
VAX ERF (VERF) # 2097
END DATE 09/30/12
END DATE
. CASH REQUEST (CR) VAX CR# 1847 FCS123# 0NE01
41_ , .... _ .
I. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
24,720.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=1.3.)
24,720.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2097
§} 1 : <;>t, .
I . Total Expenses + Accruals Previously Reported (Through Last Month)
24,720.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.I.+II.2.=II.3.)
24,720.00
ADMINISTRATIVE EXPENSE (ER) Vax II
ft1416:, t f 1
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS/23#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+1I.5=II.6.)
0.00
HI PROGRAM INCOME (PI) EXPENSE REPORT Vax #
3# lligli.4, .:,
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (I1I.1.+ II1.2.=111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
flI r,nr, ,:
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
24,720.00
2. FINAL Expenses Through End of Contract (I1.3. + II 6.+111.3.)
24,720.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES L/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
i . ¶IWiffiBIPW ,, _
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (I1I.3.)
0.01)
3. Total PI Cash Balance (V1.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
VII. MATCH RECONCILIATION Vax #
_ _
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. +116.1111.3.)
24,720.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VIl.2 x VII.3.)
0.00
5. Total Match Reported (V11.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES L /NOLJ
The Program income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
\
��
14✓14.i-, ,
GE 4-
Date
'2/if j
Authorized Signatur
//
„1.--77.--e..--4
e.>
Date
/:
See instructions for completing this form on the next page.
Revised: 611/06
201 3Attach H C lose Re c20 97. x lsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 12/01/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11 /FY 12
TITLE/PROGRAM/PROJECT LVER
VAX ERF (VERF) # 2130
END DATE 09/30/12
END DATE
1. CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NL01
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
;
8,000.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=1.3.)
8,000.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2130
i1ta�"" ,_:,� �lfv
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2.=11.3.)
8,000.00
8,000.00
ADMINISTRATIVE EXPENSE (ER) Vax #
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSl23#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+1I,5=1I.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
alitti11111111111g,1 __L
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (II1.1.+ III.2= 111.3,)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (I1.3. + II 6.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
8,000.00
8,000.00
YES Ll/NO LL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
f '-
tt__�zrr:. „.
����,._
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.I. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (II1.3.)
3. Total PI Cash Balance (VI.1 - V1.2. = VI.3.) (Refund * Extend )
1...AMMODElliii
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
1 RIM 'j (Nf
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (II.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
8,000.00
0.00
YESH, /NO LJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signatures
Date
7
ff
G`�C
Authorized Signatur
�
/t
�
,----�
Date
t3
See instructions for completing this form on the next page.
Revised. 6/1106
2013AttachHC lose Re c2130. x Isx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 12/19/11
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT WP 10% SJH
VAX ERF (VERF) # 2135
END DATE 08/31/12
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NJ01
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
_Ai 11' L..
40,000.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=1.3.)
40,000.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2135
.,9111MIMINtitii
I. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II. I.+11.2.=1I.3.)
40,000.00
40,000.00
ADMINISTRATIVE EXPENSE (ER) Vax #MMIMt..;..,:
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSl23#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (I1.4.+II.5.=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
t``'u'ak111
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ II1.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
I. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+I11.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
uuin>iu„,{n_—_.
40,000.00
40,000.00
YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total P1 Cash Previously Reported on CR (Last CR # )
Ili .0 11111 ,
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request =PlExpenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (I11.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
, Minn i1 tl ;l i 1i'
0.00
0.00
0.00
VII. MATCHRECONCILLATION Vax #
�us,,,e,,j„
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. + I16.+III.3.)
40,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VI1.3.)
0.00
5. Total Match Reported (V II.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES IJ /NO U
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
q
'
ti
CI_
Date
7/1-3
Authorized Signatur
>�!
G�%
/
( `
Date
vI
ro73
See instructions for completing this form on the next page.
Revised: 611/06
2013AttachHCloseRec2135.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA Adult Admin
VAX ERF (VERF) # 2207
END DATE 06/30/14
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS 123# 2NA01 P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
' .J;,
4,269.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=I.3.)
4,269.00
II. PROGRAM EXPENSE REPORT (ER) Vax #
Ij } -Mitt
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2=1L3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vox # 2207
UWI at, .
4,269.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23# 2AO01P
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (I1.4.+11.5.=I1.6.)
4,269.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
inifitiffillill
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract (III.I.+ 111.2.= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + 116.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
Mir
4,269.00
4,269.00
YES IJ/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total P1 Cash Previously Reported on CR (Last CR # i
_,gj}jlli
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.I. + V.2 = V.3.)
0.00}
VI. RECONCILL4TION (P1 Cash Request = P1 Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (III.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
NIL ,_`_ `:
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
!"'#Mtl!E10
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
4,269.00
0.00
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES H /NO LJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
mark:
Preparerts Signature
r. -ti Lam!
—
4t ---
Date
/CM
Authorized Signatur
Date
4Y3
v�
See instructions for completing this form on the next page.
Revised: 6/1108
2013Atta c h HC lose Re c2 207A. x Isx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA Adult
VAX ERE (VERF) # 2207
END DATE 06/30/14
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 2No01 P3iff6
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
utineu=1.:;..
•
38,428.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
38,428.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2207
'I1UtU}tUll}}}k;.;.
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (IL1.+1I.2.=II.3.)
38,428.00
38,428.00
ADMINISTRATIVE EXPENSE (ER) Vax #
€Li...,
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+11.5=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
1 . Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (MA .+ Ill.2= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark belay
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
_
38,428.00
38,428.00
YES1d /NO I I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED.
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VL RECONCILIATION (PI Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.I - VI.2. = VI.3.) (Refund * Extend )
~
%E,.i : i 1
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
'lliliBililliillffiffilitlE
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (II.3. + I16.+III.3.)
38,428.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VIi.2 x VII.3.)
0.00
5. Total Match Reported (VIM.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES L /NO L
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
0 ,
Date
gia(1/3 -
(159() -'(.(
Authorized Signatur
/�,
' —
Date
OA
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec2207S. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA Adult Admin
VAX ERF (VERF) # 2207
END DATE 06/30/14
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 2NAD2P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
2411101I111111911114j,
3,953.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2 .=1.3.)
3,953.00
IL PROGRAM EXPENSE REPORT (ER) Vax #
a, tMWJHtHt
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (1I.1.+II.2.�II.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 2207
f wit ,-.. g 1
3,953.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23# 2AD02P
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (I1.4.+11.5. 11.6.)
3,953.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
litili2Mifillfflie
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (HI.1.+ 111.2 .= 111.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) if not, explain on the Remark below
2. FINAL Expenses Through End of Contract (II.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
IP1;11Plaffititnlii
3,953.00
3,953.00
YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
h'I. ,:: r "I 1s
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
vi. RECONCILIATION (PI Cash Request = PI Expenses)
9
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (V1.1 - VI.2. = VI.3.) (Refund * Extend )
_0.00
rr��1� II{#� f§ "` "" }�p
ti�lJi<l��3�E�,c��I
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
Mid "larili
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + II6.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
3,953.00
0.00
YES IA /NOLJ
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
a,,, , a�
"teei
Date
/M.7
Authorized Signatur
e,
Date
, p'
See See instructions for completing this form on the next page.
Revised; 8/1/08
2013AttachH C I oseR ec2207C. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA Adult
VAX ERF (VERF) # 2207
END DATE 06/30/14
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 2ND02P
I. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
1111111101:MMI
35,581.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2=I.3.)
35,581.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2207
It1 ' NM
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+II.2=II.3.)
35,581.00
35,581.00
ADMINISTRATIVE EXPENSE (ER) Vax #
iillet ,xta
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (I1.4.+I1.5=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
D - tag
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1.+ III.2= [II.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (1I.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
l' , i i1 � ; ° " '*,
35,581.00
35,581.00
YES L/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
Elliffilliffillifiliblik
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VL RECONCILIATION (P1 Cash Request = PI Expenses)
I. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (I11.3.)
3. Total PI Cash Balance (Vl.l - VI.2. = VI.3.) (Refund * Extend )
Diliffillumaim
0.00
0.00
0.00
VIL MATCH RECONCILIATION Vex #
LIME
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (1I.3. + I16.+II1.3.)
3. Match Percentage of Expenditure Contractual Requirement
35,581.00
4. Match Expenditure Requirement (VI1.2 x VTT.3.)
0.00
5. Total Match Reported (VII.1.) .) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES 12J /NOU
" The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature Qi?i,c_1L14 A
2r-
Date
e71/3
Authorized SignaJ�rt' �:��
t/"
Date
.?
See instructions for completing this form on the next page.
Revised: 611!06
2013Atta ch HClose Rec22 07 D xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA DW Admin
VAX ERF (VERF) # 2209
END DATE 06/30/14
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123# 2NADIP
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
0 .. _ "Ilinif
3,953.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=1.3.)
3,953.00
II. PROGRAM EXPENSE REPORT (ER) Vax #
MilltiMMIL
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2 .=I1.3.)
0.00
0.00
ADMINISTRATIVE EXPENSE (ER) Vax # 2209
1 li
k �t,.sd _
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123# 2ADOIP
3,953.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5 =1L6.)
3,953.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #f,.
,.. ..
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1 .+ 111.2.= III.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
,,,, __4 _„ ,,, ,
I. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
3,953.00
2. FINAL Expenses Through End of Contract (11.3. + II 6.+111.3.)
3,953.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES H/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
Mit- .
I. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
t ..L:.`n,
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (III.3.)
0.00
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
VII. MATCH RECONCILIATION Vax #
-...>..__..,_.. ____,
I . FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (II.3. + 116.+III.3.)
3,953.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
0.00
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES IJ /NO U
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Signature . „,ndo
Date
0Preparer's
"t1
_
(/�—
Date
/
d7��
Authorized Signatur ,�%�
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHC1oseRec2209A. xl sx
Attachment B
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 07/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT WIA D W
VAX ERF (VERF) # 2209
END DATE 06/30/14
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 2ND01P
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 1
i; AMINO
35,582.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=I.3.)
35,582.00
IL PROGRAM EXPENSE REPORT (ER) Vax # 2209
i linnillillitil
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.1.+11.2= I1.3.)
35.582.00
35,582.00
ADMINISTRATIVE EXPENSE (ER) Vax #
,
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11.4.+11.5 .=11.6.)
0.00
HL PROGRAM INCOME (PI) EXPENSE REPORT Vax #
µ z n
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1.+ 111.2.= 1II.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+11I.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
inlitillinti
35,582.00
35,582.00
YES LI/NOL]
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
= rlBEalltil
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
V/. RECONCILIATION (PI Cash Request = P1 Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (111.3.)
3. Total PI Cash Balance (VI.I - V1.2. = VI.3.) (Refund * Extend )
HillifilliFi ea`
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #i
---,_„_ .
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. +116.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
35,582.00
0.00
5. Total Match Reported (VII. 1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES L /NO Li
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
„t ,r./
, G
U-:
Date
4./�_
Authorized Signatur
�'2-
Date
A/✓
L.
See instructions for completing this fonn on the next page.
Revised: 611106
2013Atta c h HC I ose Rec2209B. xl sx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley. CO 80632
CONTRACT or EA START DATE 02/01/13
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT EUC
VAX ERF (VERF) # 2228
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 2Nu01F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
Mifllillilll 3t L
4,052.50
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (I.1.+1.2.=1.3.)
4,052.50
II. PROGRAM EXPENSE REPORT (ER) Vax # 2228
IOW�.
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2 .=11.3.)
4,052.50
4,052.50
ADMINISTRATIVE EXPENSE (ER) Vax #[�
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (11,4.+11.5. 41.6.)
0.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
'y
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (1II.1.+ 111.2= 1I1.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (I.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (II.3. + II 6.+I1I.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
M,21IIRREMOIt
4,052.50
4,052.50
YES LI/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
t1III IUUIIH#HHTI'i{UT FI'!
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (1I1.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
illtlii«,e
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
_011111
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + II6.+II1.3.).
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII. I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
4,052.50
0.00
Y) SL /NOU
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's SignatureO.
t
rr
1.)(te
Date
Authorized Signatkfr
-�G�
--e�
Date
C�
/�h
See instructions for completing this form on the next page.
Revised: B/1/06
20' 3A`.tacl.HCloseRec222EA.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 02/01/13
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12/FY 13
TITLE/PROGRAM/PROJECT EUC
VAX ERF (VERF) # 2228
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123#2NuO2F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
t1, 111111i 'i. `ktal
15,120.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.A.3.)
15,120.00
IL PROGRAM EXPENSE REPORT (ER) Vax # 2228
ilanil' °? gli li
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (I1. I.+II.2 =1I.3.)
15,120.00
15,120.00
ADMINISTRATIVE EXPENSE (ER) Vax #
211llitlifflilliffill
0,00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCSI23#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+II.5.=I1.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vax #;y
: .11_.
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3, TOTAL PI Expenses Through End Date of Contract (1II.1.+ 111.2.= 111.3.)
0.00
IV RECONCILIATION (Cash Request = Expense)l
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
,',-$tx.,
15,120.00
15,120.00
YEST/NOLI -
V CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR # )
h1fuaillt
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (P1 Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (III.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #ll111lillth
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + I16.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
15,120.00
0.00
5. Total Match Reported (VII.I.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YES ILI /NOLJ
* The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature 7 ,,
-
I.)atc
ft/--
Authorized Signatk�/~~—~/l,��i�
��'C
c..
Dale
16/j
See instructions for completing this form on the next page.
Revised: 9/1/08
2013Atta c h H C i o se R ec2 228 B. x l sx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 04/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT EUC
VAX ERF (VERF) # 2240
END DATE 06/30/13
END DATE
I. CASH REQUEST (CR) VAX CR# 1847 FCS123# 1NuO1F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
__ __AMMOI:
86,615.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2.=1,3.)
86,615.00
II. PROGRAM EXPENSE REPORT (ER) Vax # 2240x4
t
86,615.00
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (II.I .+1i.2 =11.3.)
86,615.00
ADMINISTRATIVE EXPENSE (ER) Vax #
allitaliffil
0.00
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+I1.5.=II.6.)
0.00
III. PROGRAM INCOME (PI) EXPENSE REPORT Vaxii
IIMMINIIIIII
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (III.1.+ .+ III.2: 11I.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) It -not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + II 6.+III.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
:!ltl llifillitiiau..:.
86,615.00
86,615.00
YES L]/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total P1 Cash Previously Reported on CR (Last CR # )
'fnnit..
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (III.3.)
3. Total PI Cash Balance (VI.I - V1.2. = VI.3.) (Refund * Extend )
_.._
0.00
0.00
0.00
VII. MATCH RECONCILIATION Vax #
_ a-- 1?S1i
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (11.3. + 116.+III.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII. I.) > or = to Match Expenditure Requirement (VI1.4.)? (Check Box)
86,615.00
0.00
YES U1 /NO U
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
—
l
Date
Ay:,
a
Authorized Signatur
Date
%:43
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AItw i CloseRec224OA.x:sx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 04/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 11
TITLE/PROGRAM/PROJECT EUC
VAX ERF (VERF) # 2240
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS123# 1Nu02F
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
71111ffiliifilhOnr
10,285.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+1.2.=1.3.)
10,285.00
IL PROGRAM EXPENSE REPORT (ER) Vax # 2240
., ., t ntlUnii# ';
1. Total Expenses + Accruals Previously Reported (Through Last Month)
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.1.+11.2 .=11.3.)
10,285.00
10,285.00
ADMINISTRATIVE EXPENSE (ER) Vax #
Ell '. 1 a Mt.
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (II.4.+II.5: II.6.)
0.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #flilitjt,
° +_'." :'W
1. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111.1.+ 111.2.= I11.3.)
0.00
IV RECONCILIATION (Cash Request = Expense)
I. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
2. FINAL Expenses Through End of Contract (11.3. + I16.+111.3.)
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
4' __ _M
10,285.00
10,285.00
YES LJ/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
hI11=llltt
2. Current Program Income Cash (Through End Date of Contract) (CR # , column O)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.0i1
VI RECONCILIATION (PI Cash Request = Pt Expenses)
1. FINAL Program Income Cash (V.3.)
2. Less Program Income Expenses Through Contract End Date (III.3.)
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
ilk
0.00
(1.00
0.00
VII. MATCH RECONCILIATION Vax #
f ffl a___m:,
I, FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (I1.3. + II6.+111.3.)
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
5. Total Match Reported (VII.1.) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
10,285.00
0.00
YESL?J /NOLJ
' The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark
Preparer's Signature
Date
/iy3
T /
Signat
��/%
eG
Date
/a)
AOAuthorized
See instructions for completing this form on the next page.
Revised: 6/1/06
2013AttachHCloseRec2240B. xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County
ADDRESS PO Box 1805
Greeley, CO 80632
CONTRACT or EA START DATE 11/01/12
PROGRAM INCOME START DATE
YEAR OF FUNDS PY 12
TITLE/PROGRAM/PROJECT CWDC-ESF
VAX ERF (VERF) # 2285
END DATE 06/30/13
END DATE
L CASH REQUEST (CR) VAX CR# 1847 FCS 123# 2Ns01
1. Total Program and Admin Cash Needs Previously Reported (Last CR # 1847 )
1 :iii 4l>. z2, t«,
16,670.00
2. Current Program and Admin Cash Needs (CR # , Column F)
3. FINAL Program and Admin Cash Needs Contract to Date (1.1.+I.2=I.3.)
16,670.00
H. PROGRAM EXPENSE REPORTER) Yax # 2285
MINNOW
1. Total Expenses + Accruals Previously Reported (Through Last Month)
16,670.00
2. Current Expenses + Accruals (Through End Date of Award)
3. FINAL Program Expenses Contract to Date (11.I.+11.2.=11.3.)
16,670.00
ADMINISTRATIVE EXPENSE (ER) Yax #
4. Total Expenses + Accruals Previously Reported (Through Last Month) FCS123#
0.00
5. Current Expenses + Accruals (Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date (1I.4.+11.5.=I1.6.)
0.00
HI. PROGRAM INCOME (PI) EXPENSE REPORT Vax #
_ ---
I. Total Program Income Expenses Reported (Last Quarter)
2. Current Program Income Expenses (Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract (111. 1.+ 111.2 .= 1II.3.)
0.00
IV. RECONCILIATION (Cash Request = Expense)
1. FINAL CR Contract to Date (1.3.) If not, explain on the Remark below
16,670.00
2. FINAL Expenses Through End of Contract (II.3. + II 6.+III.3.)
16,670.00
3. CR to Date = Expense reported Through End Date of Contract? (Check Appropriate Box)
YES H/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR # )
2. Current Program Income Cash (Through End Date of Contract) (CR # , column G)
3. FINAL Program Income Cash Contract to Date (V.1. + V.2 = V.3.)
0.00
VI. RECONCILIATION (PI Cash Request = PI Expenses)
1. FINAL Program Income Cash (V.3.)
0.00
2. Less Program Income Expenses Through Contract End Date (111.3.)
0.00
3. Total PI Cash Balance (VI.1 - VI.2. = VI.3.) (Refund * Extend )
0.00
VII. MATCH RECONCILIATION Vax #
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract (I1.3. +116.+111.3.)
16,670.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement (VII.2 x VII.3.)
0.00
5. Total Match Reported (VII. L) > or = to Match Expenditure Requirement (VII.4.)? (Check Box)
YESLJ /NOLJ
• The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature
I/
Pc//Date
Authorized Signatur(
et--
T/
Date
0/9
See instructions for completing this form on the next page.
Revised: 6/1/06
2 013Attac h H C lose Re c2285. x lsx
Hello