HomeMy WebLinkAbout20122511.tiff RESOLUTION
RE: APPROVE YEAR-END CLOSE-OUT REPORT FOR WIA PROGRAM 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 a Year-End Close-Out Report for the WIA
Program 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 report, and
WHEREAS, after review, the Board deems it advisable to approve said report, 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 Year-End Close-Out Report for the WIA Program 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 report and all necessary documents.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 17th day of September, A.D., 2012.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: /fi . - �3� p
,.tl� Sean P. Crw'ay, Chair c
Weld County Clerk to the`� •1. .� to
••. F F.Garcia, P o-Tem
BY: O ' k' cZ L���_ li , `s,
Deputy Clerk to the Board % ? t '� � _ft-/-•
arb Kirkrkme �r
APP ORM: Oct J
David E. Long
unt ttorney �—�akc Cn,r J
Doug R„demacher
Date of signature: IC/9
/oral *Susan!
9//721/ /'
2012-2511
HR0083
MEMORANDUM
1II61 "
DATE: September 13, 2012
E \ TO: Sean P. Conway, Chair, Board of County Commis oner
GOUNT T
FROM: Judy A. Griego, Director, Human Servi e art e11
RE: Year-End Close-Out Report for the Weld County Department
of Human Services' Employment Services' WIA Program to
the Colorado Department 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 September 6, 2012,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, 2011 to June 30, 2012. 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.
2012-2511
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: KAA 00008
CLOSEOUT SUMMARY
This closeout packet signature page includes the following contracts:
Program Funding Stream Amount Vax Line Item
Year # FSC123#
PY 09/FY 10 WIA Adult $ 26,092.00 1557 9NFU1F, 9AFE2F
PY 09/FY 10 WIA Dislocated Worker $ 26,095.00 1562 9NFU2F, 9AFE2F
PY 09 WIA 10% Statewide Activities $ 40,859.00 1686 9OSS1F, 9YSPIP
PY 10 WIA Adult $ 397,095.00 1760 ONANIF, OAONIF
ONO01 F, ONFU1F
F
OAFUIF
PY 10 WIA Youth $ 609,298.00 1761 ONAYIP, OAYN1P
ONY01 P
PY 10 WIA Dislocated Worker $ 345,190.00 1762 ONADIF, OADNIF
ONDO1F
PY 10 Wagner Peyser(Carry in) $ 198,045.00 1763 ONWO2
FY 11 DVOP $ 8,852.00 1764 ONV0I
PY 09 Wagner Peyser 10% Special Pops-MSFWs $ 24,720.00 1778 9NE01
FY 10 TAA $ 14,111.00 1786 9Na03F
PY 10 WIA 10% Statewide Activities $ 73,972.00 1839 OOSKIF, OYSP1P
OYSJ 1 P
PY l0/FY 11 WIA 25% Enhanced Dislocated Worker $ 62,609.00 1883 ONFU2F, OAFU2F
ONFE1F, OAFEIF
FY 09 ARRA National Emergency Grant $ 64,840.00 1903 9NK01, 9AN01
PY 10 Wagner Peyser 10% Summer Job Hunt $ 32,000.00 1924 ONJO1
PY 11 WIA Adult $ 445,274.00 1966 INA01P, IAO01P
1NO01P, 1NAD2P
1ADO2P, 1NDO2P
1NOOI F
PY 11/FY12 WIA 25 % Dislocated Worker $ 10,000.00 2109 1NRUIF
Total $2,379,052.00
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 certify to the best of my knowledge and belief the following financial data reported in this
closeout packet is correctly stated.
By: S€P a 7 2012
Local Elected Official Da -
Chair, Board of County Commissioners or
Authorized Signature
Attachment E
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
PROGRAM INCOME EXPENSE REPORT FROM (PIERF)
SUBRECIPIENT: Employment Services of Weld County Calendar Qrtr End Date: 06/30/12
CDLE PIER VAX#: NA
1. CUMULATIVE PROGRAM INCOME CASH REPORTED ON CASH REQUEST THRU QUARTER END DATE:
VAV EXP REPORT FCS123 AMOUNT
NUMBER
NET(Undisbursed)LINE ITEM NONE
2. BUDGET ALLOCATION:
COST CATEGORY/BUDGET Total Disbursed Prog Income Net(Undisbursed)
LINE ITEM(S)-FCS123#on Expense Report Program Income (Expended) Program Income
VAX# FCS#: NONE 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
Total(total net must equal amount on Pa 0.00 0.00 0.00
CERTIFICATION:
I certify to the best of my knowledge and belief the above reported information is accurate and
complete for the period reported.
-"Authorized Signature Date
See instructions for completing this form on the next page.
Revised: 6/1/01 Attach E-Prog Inc Exp 2012.xls
Attachment F
Page 1 of 3
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
STAND-IN COST REPORT FORM (SICRF)
AND LEVERAGED RESOURCES REPORT FORM
Subrecipient Emp Svcs of Weld County Stand In/Leveraged Costs from 7/1/11 to 6/30/12
Name: CDLE Assigned VAX SICRF#:
Program COST CATEGORY(IES /BUDGET LINE ITEM(S)
Year Stand-In Stand-In Leveraged Leveraged Other Federal
GRANTS of Funds Administration Program Cash Match In-Kind ?ands Expender Total
GRANT NAME: WIA Adult
PY or FY Current PYI I 34,270.00 34,27(
Prior PY10
Year Before Prior PY09
GRANT NAME: WIA Dislocated Workers
PY or FY Current PYII 5,929.00 5,925
Prior PY10 22,304.00 22,304
Year Before Prior PY09
GRANT NAME: WIA Youth
PY or FY Current PYII 30,597.00 30,591
Prior PY10 14,399.00 14,399
Year Before Prior PY09 0
GRANT NAME: WIA 10%Statewide Actv.
PY or FY Current PY 11 (:'ra t=.i 6,640.00 6,640
Prior PY10 ; 0
Year Before Prior PY09 ,� �,_.....� 0
GRANT NAME: WIA 25%Enh. DW
PY or FY Current PY11 0
Prior PY10 0
Year Before Prior PY09 0
GRANT NAME: WIA 25%RR Pro'.
PY or FY Current PY11 r 0
Prior PY10 e 0
Year Before Prior PY09 0
GRANT NAME: WIA ARRA NEG Grant
0
;:.
0,
GRANT NAME:ARRA SESP Green Jobs '7 I
0.
PY09 0.
0.
CERTIFICATION:
I certify to the best offmm�knowledge and belief the above reported information is accurate and complete of the period reported.
Sj _a`7/z__
Authorized Signature' Date
Revised: 2/28/10 Attachment F-Stand In Cost Report 2012.xls
Attachment F
Page 2 of 3
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
STAND-IN COST REPORT FORM (SICRF)
AND LEVERAGED RESOURCES REPORT FORM
Subrecipient:Emp Svcs of weld County Stand In/Leveraged Costs from 7/1/11 to 6/30/12
'DLE Assigned VAX SICK#:
Program/ COST CATEGORY(IES /BUDGET LINE ITEM(S)
fiscal Yea Stand-In Stand_in Leveraged Leveraged Other Federal
GRANTS of Funds dministratior Program Cash Match In-Kind ,unds Expended Total
GRANT NAME:H-1B Tech Skills Training
PY11 r
GRANT NAME: Wagner Peyser
PY 11 92,813.00 92,81:
PY I0 30,938.00 30,93E
PY09
GRANT NAME: WP 10%SJH
PY 11 r �...' 3,009.00 3,00S
PY 10 2,006.00 2,006
t:' o
GRANT NAME: Vets DVOP
0
0
0
GRANT NAME: Vets LVER
` 33 0
0
:... 0
GRANT NAME:Ul Reemployme
0
0
0
GRANT NAME:STATE P.I. GRANT
10 0.
11 0.
12 0.
CERTIFICATION:
I certify to the best of my knowledge and belief the above reported information is accurate and complete of the peri
Authorized Signature Date
See instructions for completing this form on the next page.
Revised: 2/28/10 Attachment F-Stand In Cost Report 2012 xis
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: 08/31/12
Pursuant to the terms of Contract/Grant Agreement Number KAA 00008 , including the Expenditure
Authorizations (EAs) awarded under said Contract/Grant Agreement, as VAX/FCS123 number(s): 1557/9NFU1F ,
1562/9NFU2F , 1686/9OSS1F , 1686/9YSP1P , 1760/ONAO1F , 1760/ONO01F , 1760/ONFU1F , 1761/ONAY1P ,
1761/ONY01P , 1762/ONAD1F , 1762/OND01F , 1763/ONW02 , 1764/ONV01 , 1778/9NE01 , 1786/9Na03F ,
1839/OOSK1F , 1839/OYSP1P , 1839/OYSJ1P , 1883/ONFU2F , 1883/ONFE1F , 1903/9NK01 , 1924/ONJ01 ,
1966/1NA01P , 1966/1NO01P , 1966/1NAD2P , 1966/1ND02P , 1966/1NO01F , 2109/1NRU1F ,
and in consideration of the sum of Total amount paid of $2,379,052.00 and payable of
NONE ($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):
VAX/ Invoice Expected
FCS123 Date Invoice Line Cost Payment
Number (If Known) Vendor or P.O.# Item Category Amount 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 31st day of August, 2012
By !R
Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach I-1 Grant Rec Rel Form 2012.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 KAA 00008 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified
as VAX/FCS123 number(s) : 1557/9NFU1F , 1562/9NFU2F , 1686/9OSS1 F ,
1686/9YSP1P , 1760/ONAO1F , 1760/ONO01 F , 1760/ONFU1 F , 1761/ONAY1P ,
1761/ONY01P , 1762/ONAD1F , 1762/OND01F , 1763/ONW02 , 1764/ONV01 ,
1778/9NE01 , 1786/9Na03F , 1839/OOSK1F , 1839/OYSP1P , 1839/OYSJ1P ,
1883/ONFU2F , 1883/ONFE1F , 1903/9NK01 , 1924/ONJ01 , 1966/1NA01P ,
1966/1NO01P , 1966/1NAD2P , 1966/1ND02P , 1966/1NO01F , 2109/1NRU1F ,
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.
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 31st day of August 2012
By
Authorized Signature Th
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach 1-2 Contract Closeout Tax Cert 2012.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: KAA 00008
Release Date: 8/31/12
VAX/FSC123 Check Check Payee's Last Known
Number Number Payee Amount Address
NONE
Total Amount Unclaimed
This schedule has been executed this 31st day of August 2012
By r '
Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 Attach 1-3 Schedule of Unclaimed Checks 2012.xls
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
Street Address: PO Box 1805 No: KAA 00008
City and State: Grreley, CO 80632
Pursuant to the terms of Contract/Grant Agreement Number KAA 00008 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified as
VAX/FCS123 number(s) : 1557/9NFU1F , 1562/9NFU2F , 1686/90SS1F ,
1686/9YSP1P , 1760/ONAO1 F , 1760/ONO01 F , 1760/ONFU1F , 1761/ONAY1P ,
1761/ONY01P , 1762/ONAD1F , 1762/OND01F , 1763/ONW02 , 1764/ONV01 ,
1778/9NE01 , 1786/9Na03F , 1839/OOSK1 F , 1839/OYSP1P , 1839/OYSJ1 P ,
1883/ONFU2F , 1883/ONFE1F , 1903/9NK01 , 1924/ONJ01 , 1966/1NA01P ,
1966/1N001P , 1966/1NAD2P , 1966/1ND02P , 1966/1N001F , 2109/1NRU1F ,
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.
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 3/ day of , 201 I
Authorized Signat r
Title Division Head of Employment Services
Revised: 6/1/06 Attachl-4RefRebCredits2012.xls
Attachment I
Page 5 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
SUBRECIPIENT CERTIFICATION OF PHYSICAL INVENTORY
Subrecipient Name: Emp Svcs of Weld County Contact Person: Dennis Bogott
Address: PO Box 1805 Phone Number: 970-352-1551 ext 6662
Greeley, CO 80632
I hereby certify that all property/equipment previously purchased with or transferred from the
Comprehensive Employment and Training Act (CETA) or the Job Training Partnership Act (JTPA)
program to the Workforce Investment Act (WIA) programs or purchased under any Colorado
Department of Labor and Employment (CDLE) federally funded grant or transferred with the
CDLE's approval is included in the attached listing for the above-noted subrecipient.
The attached listing has been verified by a physical inventory. Changes/revisions are:
❑ Noted O Not Applicable
I certify that this property is being used for purposes that it was originally purchased for and will be
repaired or replaced by my insurance if damaged, lost, or stolen.
I certify that all property/equipment previously purchased with or transferred from the CETA or the
JTPA programs to WIA program or purchased under a CDLE federally funded grant or transferred
with the CDLE's approval with a fair market value (FMV), established by our existing local
procedures, of$5,000 or more, has been identified.
I further certify that the proceeds of all property/equipment previously purchased with or transferred
from the CETA or JTPA program to the WIA program, with a FMV of $5,000 or more, will be
returned to CDLE, in order to return the proceeds to the U.S. Department of Labor.
Subrecipien Director's S nature Date
Revised: 6/1/06 Attacht 1-5 Cert of Phys Inv 2012.xls
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Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult UI
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 09/15/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9NFU1F IIIIIIIIIIME
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 26,092.00
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.) 26,092.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1557
1. Total Expenses+Accruals Previously Reported(Through Last Month) 23,485.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2.II.3.) 23,485.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1557
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSl23# 9AFE2F 2,607.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.-11.6.) 2,607.00
III. 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(III.1+111.2.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 26,092.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 26,092.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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
VL RECONCILIATION (P!Cash Request=PI Expenses) MIIIIIIIS
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
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+111.3.) 26,092.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VIII)>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 k11 . it t— Orit,
Authorized Signatur 7- __/ Date S/d- Za—
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AaachHCloseRecl 557.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA DW UI
Greeley, CO 80632 VAX ERF(VERF)# 1562
CONTRACT or EA START DATE 09/15/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9NFU2F IIIIIIIIMIlla
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 26,095.00
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.) 26,095.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1562
I. Total Expenses+Accruals Previously Reported(Through Last Month) 25,125.03
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+II.2.-11.3.) 25,125.03
ADMINISTRATIVE EXPENSE(ER) Vax# 1562
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23# 9AFE2F 969.97
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+II.5=II.6.) 969.97
IIL 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(III.l.+111.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) 1/not,explain on the Remark below 26,095.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 26,095.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLJ
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 (Pt Cash Request=P/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.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vex# r
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+III.3.) 26,095.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/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: f (�,�/ q/
Preparer's Signature (� Ft� r Date �2 %/Z�/
Authorized Signatur Date re/� /�l
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AaachHCloseRec1562.xis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Sectors
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9OSS1F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 3 5,859.00
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.) _.._ 5,859.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1686
I. Total Expenses+Accruals Previously Reported(Through Last Month) 5,859.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 5,859.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
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#
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 @II.I+111.2.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) t
1. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 5,859.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 5,859.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/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.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 5,859.00
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) YESH/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 U . Date �7�glz
Authorized Signatur � Date U/t�//72_,
See instructions for completing this form on the next page.
Revised' 6/1/06 2012AttachHCloseRec1686A.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA 10% SW Act
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 10/03/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9YSP1 P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 35,000.00
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.) 35,000.00
II. PROGRAM EXPENSE REPORT(ER) vax# 1686
I. Total Expenses+Accruals Previously Reported(Through Last Month) 35,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(ILL-W.2.-11.3.) 35,000.00
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(11.4.+11.5.=11.6.) 0.00
HL 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.+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 35,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 35,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'I/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+V.2=V.3.) 0.00
VL RECONCILIATION (PI Cash Request=PI Expenses)
I. 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.I -VI.2.=V1.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+1II.3.) 35,000.00
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) YESLI/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: jai �.//�y�
(//�� /j v/'�."((/
Preparer's Signature D'-(-/ r �W Date / /
Authorized Signaturr- Date
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AaachHCloseRec16868.xis
Attachment II
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult Admin
Greeley, CO 80632 VAX ERF(VERF)# 1760
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS123#ONAOIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 30,200.94
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+L2.I.3.) 30,200.94
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+II.2.11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1760
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# OAONIF 30,200.94
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.-11.6.) 30,200.94
HI. 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./+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 30,200.94
2. FINAL Expenses Through End of Contract(11.3.+II 6+III.3.) 30,200.94
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II1.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V I.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116+111.3.) 30,200.94
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) YESH/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: 7%}�
r / C Date "/2 q//2
Preparer's Signature .vl e l
Authorized Signatu Date 57/97/2
/2
See instructions for completing this form on the next page.
Revised' 6/1/06 2012AitachHCloseRec1760A.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1760
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS723#ONO01F '.
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 333,284.06
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.) 333,284.06
II. PROGRAM EXPENSE REPORT(ER) Vax# 1760 t _
I. Total Expenses+Accruals Previously Reported(Through Last Month) 333,284.06
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+II.2.=11.3.) 333,284.06
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(11.4.-111.5.=11.6.) 0.00
IlL 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+Ill,2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) @
I. FINAL CR Contract to Date(1.3.) It not,explain on the Remark below 333,284.06
2. FINAL Expenses Through End of Contract(II.3.+11 6.+111.3.) 333,284.06
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=P/Expenses) "
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II1.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V 1.3.) (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.+111.3.) 333,284.06
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VIl.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/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 if/ Date 7'7/tz,�
Authorized SignatF/'-- Date
See instructions for completing this form on the next page.
Revised' 6/1/06 2012AttachHCloseRec1760B.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult UI
Greeley, CO 80632 VAX ERF(V ERF)# 1760
CONTRACT or EA START DATE 09/15/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAX CRF#1847 FCS123#ONFUIF aillalMall
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 33,610.00
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.) 33,610.00
IL PROGRAM EXPENSE REPORT(ER) Fax# 1760
I. Total Expenses+Accruals Previously Reported(Through Last Month) 31,854.35
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2=11.3.) 31,854.35
ADMINISTRATIVE EXPENSE(ER) Fax# 1760
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# OAFU I F 1,755.65
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+IL5=11.6.) 1,755.65
III. PROGRAM INCOME(PI)EXPENSE REPORT Fax#
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(M.+III.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 33,610 00
2. FINAL Expenses Through End of Contract(II.3.+II 6+III.3.) 33,610.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=PI Expenses) allINIMIE
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 -V1.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vex#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 33,610.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/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 Date ( ' Z
Authorized Signatur 4
Date 87�y/2_
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AttachHCloseRec1760CGxis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Youth Admin
Greeley, CO 80632 VAX ERF(VERF)# 1761
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CRF#1847 FCSt23#ONAYIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 56,001.53
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.=I.3.) _ 56,001.53
II. PROGRAM EXPENSE REPORT(ER) Vax#
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(II.1+11.2.=11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1761
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# OAYN I P 56,001.53
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+11.5=11.6.) 56,001.53
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(III.l+IIl.2.II1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) II not,explain on the Remark below 56,001.53
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 56,001.53
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED "
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)
I. 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(VIA -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(11.3.+116.+111.3.) 56,001.53
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) YESL/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.' �j�
Preparer's Signature Date 8 y/Z
Authorized Sign �i%� , Date yiXly/ —
See instructions for completing this form on the next page.
Revised. 6/1/06 2012AttachHCloseRec1761A.xls
Attachment H
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1761
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS123#ONY01 P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 553,296.47
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.) 553,296.47
II. PROGRAM EXPENSE REPORT(ER) Vax# 1761
I. Total Expenses+Accruals Previously Reported(Through Last Month) 553,296.47
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(It.1.+11.2:11.3.) 553,296.47
ADMINISTRATIVE EXPENSE(ER) Vax# MIS
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.=116.) 0.00
HL 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+III.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
L FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 553,296.47
2. FINAL Expenses Through End of Contract(11.3.+II 6.+11I.3.) 553,296.47
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOLl
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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 (P/Cash Request=PI Expenses)
I. 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.I -VL2.=VL3.) (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.+III.3.) 553,296.47
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(V11.4.)?(Check Box) YESW/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 ` "l Date 002—
Authorized Signal Date
See instructions for completing this form on the next page.
Revised 6/1/06 2012AttachHCloseRec1761B.xls
Attachment H
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT DW Admin
Greeley, CO 80632 VAX ERF(VERF)# 1762
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS123#ONADI F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 32,741.51
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.) 32,741.51
IL 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(II.I+11.2.=B.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1762
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# OADN IF 32,741.51
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+II.5.=11.6.) 32,741.51
IIL 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(III.I.+II1.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) I1 not,explain on the Remark below 32,741.51
2. FINAL Expenses Through End of Contract(II.3.+II 6+I1I.3.) 32,741.51
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOLJ
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
VL RECONCILIATION (P/Cash Request=P1 Expenses) IMIIIIIIIIIIIIMII
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.I -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+111.3.) 32,741.51
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) YESW/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: Jam(¢//--
Preparer's Signature / e �"c/ Date r��/ lna_
Authorized Signa iJ�ir�i'°
7 Date 5(1//7--
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AttachHCloseRec1762A.xls
Attachment If
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA DW
Greeley, CO 80632 VAX ERF(VERF)# 1762
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS123#OND01F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 312,448.49
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2:1.3.) 312,448.49
... .. ........_....
IL PROGRAM EXPENSE REPORT(ER) Vax# 1762
I. Total Expenses+Accruals Previously Reported(Through Last Month) 312,448.49
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+II.2.=II.3.) 312,448.49
ADMINISTRATIVE EXPENSE(ER) Vax#
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.+11.5.=11.6.) 0.00
IIL 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(W I++I11.2.=111.3.) 0,00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 312,448.49_
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+1II.3.) 312,448.49
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'I/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=PI Expenses)
I. 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.] -VI.2.=VI.3.) (Refund r Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 312,448.49
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) YESLJ/ /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 Q Y� /. rer Date / /0_,
Authorized Signatur — Date 7�,��
See instructions for completing this torn on the next page.
Revised: 611/06 2012AttachHCloseRecI782B.xls
Attachment H
Page 1of2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WP Carry In
Greeley,CO 80632 VAX ERF(VERF)# 1763
CONTRACT or EA START DATE 08/22/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#ONW02
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 198,045.00
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.) 198,045.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1763
1. Total Expenses+Accruals Previously Reported(Through Last Month) 198,045.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+0.2.=11.3.) 198,045.00
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(11.4.+11.5.=l1.6.) 0.00
IIL 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.+111.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) he not,explain on the Remark below 198,045.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 198,045.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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
VL RECONCILIATION (PI Cash Request=P/Expenses)
I. 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.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 198,045.00
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) YESL/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: r 8� /
Preparer's Signature �< tit— Date 921/s2n
Authorized Signatur ...1.--72 Date p`/9//Y
See instructions for completing this form on the next page.
Revised 6/1/06 2012AttachhCloseRec1163.xIs
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT DVOP
Greeley, CO 80632 VAX ERF(VERF)# 1764
CONTRACT or EA START DATE 10/01/10 END DATE 09/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#ONV0I
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 8,852.00
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.) 8,852.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1764
1. Total Expenses+Accruals Previously Reported(Through Last Month) 8,852.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 8,852.00
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(II.4+11.5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vex# _
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=III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 8,852.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+III.3.) 8,852.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLJ
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 (P/Cash Request=P7 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(11.3.+116.+111.3.) 8,852.00
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) YESIJ/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: y
Preparer's Signature f �.(,CiJ C Date /���// %J Z..r/
Authorized Signatur / 7 / �G Date Y7/Z.Z
`/
See instructions for completing this form on the next page.
Revised: 6/1/06 2012AttachHCloseRec1764.xls
Attachment H
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WP 10% Spec Pop
Greeley, CO 80632 VAX ERF(VERF)# 1778
CONTRACT or EA START DATE 05/20/10 END DATE 09/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NE01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 24,720.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(LI+1.2=L3.) 24,720.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1778
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(11.1 +11.2=11.3.) 24,720.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+II.5.=11.6.) 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(III./+IIl.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) II not, explain on the Remark below 24,720.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 24,720.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.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(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.+111.3.) 24,720.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/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 q®� Q�
Preparer's Signature / G g411— Date / 25Z—
Authorized Signatur/ Date %7j2—
Sec instructions for completing this form on the next page.
Revised'. 6/1/06 2012AltachHCloseRec1778.xis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT TAA
Greeley, CO 80632 VAX ERF(VERF)# 1786
CONTRACT or EA START DATE 05/03/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CRF#1847 FCS123#9Na03F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 14,111.00
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.) 14,1 1 1.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1786
I. Total Expenses+Accruals Previously Reported(Through Last Month) 14,1 1 1.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date 01.1.+11.2.-11.3.) 14,111.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.-11.6.) 0.00
III 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.+111.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 14,1 1 1.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 14,111.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L' /NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. 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(11.3.+116+111.3.) 14,11 1.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/NOW
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark. U/, l/ 8/�
Preparer's Signature /1 / / • Date /,-"91/ L-��
Authorized Signatgr' ✓�rKAL Date �O'%/6--
See instructions for completing this form on the next page.
Revised 60/06 2012AttachHCloseRec1766.xts
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Outreach
Greeley, CO 80632 VAX ERF(VERF)# 1839
CONTRACT or EA START DATE 01/10/11 END DATE 12/31/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#OOSK1F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 25,000.00
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.) 25,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1 839
I. Total Expenses+Accruals Previously Reported(Through Last Month) 25,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2=11.3.) 25,000.00
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(11.4.+11.5.=11.6.) 0.00
III. 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(IIl.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 25,000.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 25,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/NOL
•
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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 (P/Cash Request=P1 Expenses)
I. 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#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116+111.3.) 25,000.00
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 LJ/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: /J
`/t7x�Lfv_� Date
Preparer's Signature ,4,1� / q
Authorized Signat 'r� Date 87U`//Z2
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AItachHCloseRec1839A.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA 10%SW Act
Greeley, CO 80632 VAX ERF(VERF)# 1839
CONTRACT or EA START DATE 07/01/10 END DATE 12/31/11
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAX CR#1847 FCS123#QYSPIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 41,972.00
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.) 41,972.00.
IL PROGRAM EXPENSE REPORT(ER) Vax# 1839
I. Total Expenses+Accruals Previously Reported(Through Last Month) 41,972.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2:11.3.) 41,972.00
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(11.4+II.5:11.6.) 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(III.1+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 41,972.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+1113.) 41,972.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'I/NOLJ
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 (P/Cash Request=P/Expenses)
I. 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.] -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(11.3.+116+111.3.) 41,972.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(Vll.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLI/NOLI
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding penod
Remark: �.�c/,�.�
Preparer's Signature - _- r i '/l.r Date
Authorized Signayur � ��� Date
Sec instructions for completing this form on the next page.
Revised: 6/1/06 2012AttachHCloseRec18398.xis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT SJH
Greeley, CO 80632 VAX ERF(VERF)# 1839
CONTRACT or EA START DATE 01/10/2011 END DATE 08/31/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#OYSJIP MIMIMIIIIM
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 7,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2=I.3.) 7,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1839
I. Total Expenses+Accruals Previously Reported(Through Last Month) 7,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.-11.3.) 7,000.00
ADMINISTRATIVE EXPENSE(ER) Elwell
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.-M.5.=11.6.) 0.00
IIL 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(HI M+IIL2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 7,000.00
2. FINAL Expenses Through End of Contract(11.3.+11 6.+111.3.) 7,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=PI Expenses) IIIIINIMINI
I. 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.I -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(11.3.+116.+III.3.) 7,000.00
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) YESH/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 c- et Date q/2 Li���///G
Authorized Signatur _ Z¢ ,.: Date 11�
See instructions for completing this form on the next page.
Revised 6/1/06 2012AttachHCloseRec1B39C.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10/FY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA DW UI
Greeley, CO 80632 VAX ERF(VERF)# 1883
CONTRACT or EA START DATE 09/15/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS1123#ONFU2F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 33,613.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.=1.3.) 33,613.00
II. PROGRAM EXPENSE REPORT(ER) Vex# 1883
1. Total Expenses+Accruals Previously Reported(Through Last Month) 30,252.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2=11.3.) 30,252.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1883
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# OAFU2F 3,361.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+17.5.=11.6.) 3,361.00
IlL PROGRAM INCOME(PI)EXPENSE REPORT Vex#
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.I+I1I.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 33,613.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 33,613.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Li' /NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total P1 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(11.3.+116+III.3.) 33,613.00
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) 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 .,6 Wa c Date Yr-2-
.Authorized Signatur / /�z�ZL'?� rte/ Date
See instructions for completing this form on the next page.
Revised'. 6O/06 2012AttachHCloseRec1683A.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10/FY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA 25%EDW
Greeley, CO 80632 VAX ERF(VERF)# 1883
CONTRACT or EA START DATE 09/01/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FC5123#ONFEIF OIIIIMIIIIIIMN
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 28,996.00
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.) 28,996.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1883
I. Total Expenses+Accruals Previously Reported(Through Last Month) 26,097.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1+11.2.II.3.) 26,097.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1883
4, Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# OAFEIF 2,899.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.-11.6.) 2,899.00
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(III.1.+111.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) II not,explain on the Remark below 28,996.00
2. FINAL Expenses Through End of Contract(I1.3.+II 6,+III.3.) 28,996.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LUNOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED E
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=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(11I.3.) 0.00
3. Total P1 Cash Balance(VI.1 -V I.2.=V I.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.4111.3.) 28,996.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/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:
U � z
Preparer's Signature G �//�, �� Date
Authorized Signatur -x4GLY V-�"� Date ?/
See instructions for completing this form on the next page. V-4
Revised' 6/1/06 2012AttachHCloseRec1883B.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 09
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA NEG
Greeley, CO 80632 VAX ERF(VERF)# 1903
CONTRACT or EA START DATE 10/1/10 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9NK01 IIIIIIIIIIMMI
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 64,840.00
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.) 64,840.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1903
1. Total Expenses+Accruals Previously Reported(Through Last Month) 61,598.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2=11.3.) 61,598.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1903
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 9AN01 3,242.00
5. Current Expenses+Accruals(Through End Date of Award)
6, FINAL Administrative Expenses Contract to Date(11.4+II.5=II.6.) 3,242.00
III. 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(Ill.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 64,840.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 64,840.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'I/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=PI Expenses)
I. 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.I -V1.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax It
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 64,840.00
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(VIL4.)?(Check Box) MESH/NOIJ
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
� /J� /�/yy��c—__
Preparer's Signature „tie/./1,,, - V Date % - Z:141,.&17„,/,
Authorized Signatur - J,a�"�.4C / Date �
See instructions for completing this form on the next page.
Revised. 6/1/06 2012AttachHCloseRec1903.xIs
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WP 10%SJH
Greeley, CO 80632 VAX ERF(VERF)# 1924
CONTRACT or EA START DATE 01/10/11 END DATE 08/31/11
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS123#ONJ01
I, Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 32,000.00
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.) 32,000.00
II. PROGRAM EXPENSE REPORT(ER) Vex# 1924
I. Total Expenses+Accruals Previously Reported(Through Last Month) 32,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2=II.3.) 32,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS723#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+11.5.=II.6.) 0.00
III. 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.+I11.2=111.3.) 0.00..
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 32,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 32,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L'I/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=P/Expenses)
I. 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.I -V1.2.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 32,000.00
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) YESH/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 Li"; x Date
Authorized Signatur ,�%j>-�='�`�� .-L � Date //2�
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AttachHeloseRec1924 xis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult Admin
Greeley, CO 80632 VAX ERF(VERF)# 1966
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#1NA01P IIMIIIIIIIIIIIII
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3,417.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(11+1.2.-1.3.) _... 3,417.00
IL PROGRAM EXPENSE REPORT(ER) Vax#
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(111+11.2.-11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1966
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23# I AO01 P 3,417.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.-01.5.-11.6.) 3,41.7.00
HL PROGRAM INCOME(P1)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(II1.1+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 3,417.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 3,417.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NO LJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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
VL RECONCILIATION (PI Cash Request=PI Expenses) IMINISIII
I. 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.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 3,417.00
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) YESW/NOD
The Program Income Expense Report and�^ .
:::er's
Signature lark
Date / -#2.-
Authorized Signatur - 2 1 . ��) Date e, /%o
See instructions for completing this form on the next page.
Revised: 6/1/66 2012AttachHCloseRec1966Axis
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1966
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#1NO01P allINNIMI
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 30,757.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+1.2=I.3.) 30,757.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1966
I. Total Expenses+Accruals Previously Reported(Through Last Month) 30,757.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+11.2.=11.3.) 30,757.00
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(II.4.+II.5.-11.6.) 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(III. .+111.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 30,757.00
2. FINAL Expenses Through End of Contract(11.3.+II 6+111.3.) 30,757.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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=PI Expenses) IIIIIIIIIIIIIIIII
I. 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.I -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(11.3.+116+III.3.) 30,757.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(V II.4.)?(Check Box) YESLI/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: //�O/�
Preparer's Signature � e D4-{ S, l Date max^'/ —YL'Z•
Authorized Signatur .__"mil r� ,--�- ..> Date �����
i
See instructions for completing this form on the next page.
Revised 6/1/06 2012AttachHCloseRec1966B.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult Admin
Greeley, CO 80632 VAX ERF(VERF)# 1966
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#1NAD2P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3,959.00
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.) 3,959.00
IL PROGRAM EXPENSE REPORT(ER) Vax#
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.+II.2=11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 1966
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# IAD02P 3,959.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+I1.5.=B.6.) 3,959.00
IIL 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(III.I+111.2.=III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) '•
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 3,959.00
2. FINAL Expenses Through End of Contract(I1.3.+11 6+111.3.) 3,959.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. 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.=V I.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+111.3.) 3,959.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/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 1 . . / r C� ✓ Date
Authorized Signatur, "CJ �ZL L Date
See instructions for completing this form on the next page.
Revised'. 6/1/06 2012AttachHCloseRec1966C.xls
Attachment H
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1966
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#1NO02P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 35,639.00
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.) 35,639.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1966
I. Total Expenses+Accruals Previously Reported(Through Last Month) 35,639.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2.=11.3.) 35,639 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 01.4.+11.5.=11.6.) 0.00
7lL 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.+II1.2:II1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) " 3
I. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 35,639.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+11I.3.) 35,639.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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.1.+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(111.3,) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (Refund « Extend ) 0.00
VIL MATCH RECONCILIATION Vac#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+111.3.) 35,639.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) _ YESH/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 r, a / Date
Authorized Signatur Date
Sec instructions for completing this form on the next page.
Revised'. 6/1/06 2012AttachHCloseRec1966D.xis
Attachment II
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 12
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1966
CONTRACT or EA START DATE 07/01/11 END DATE 06/30/13
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR41847 FCS123#1NO01F IIIIIIIIIIIIIIIIII
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 1 371,502.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.=1.3.) 371,502.00.
IL PROGRAM EXPENSE REPORT(ER) Vax# 1966
I. Total Expenses+Accruals Previously Reported(Through Last Month) 371,502.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=113.) 371,502.00
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(11.4.+II.5.=II.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(III.I+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 371,502.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 371,502.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L' /NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED G
I. Total PI Cash Previously Reported on CR (Last CR it )
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
VL RECONCILIATION (PI Cash Request=PI Expenses) IIIIIIIIIIBIIIIIIIIIIIE
I. 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.I -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+111.3.) 371,502.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VI1.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLJ/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: Orly'Preparer's Signature tt Date % ZL
Authorized Signatur Date g-77�
i i
See instructions for completing this form on the next page.
Revised: 6/1/06 2012AaachHCloseRec1966E.xls
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11/FY 12 25%
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA DW UI
Greeley, CO 80632 VAX ERF(VERF)# 2109
CONTRACT or EA START DATE 12/01/11 END DATE 06/30/12
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS123#1NRUIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 10,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+1.2.=1.3.) 10,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 2109
I. Total Expenses+Accruals Previously Reported(Through Last Month) 10,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=11.3.) 10,000.00
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(I1.4.+11.5.=1I.6.) 0.00
IIL 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.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 10,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6+III.3.) 10,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ld/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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
VL RECONCILIATION (P1 Cash Request=PI Expenses)
I. 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.I -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(11.3.+116.+111.3.) 10,000.00
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(V11.4.)?(Check Box) YESW/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 .6g2 !7,2
01-70r- Date
72-1?A_
Authorized Signatur `t-47T Date 9//71
See instructions for completing this form on the next page.
Revised: 6/1/06 2012AttachHCloseRec2109.xts
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