HomeMy WebLinkAbout20112402.tiff RESOLUTION
RE: APPROVE GRANT CLOSEOUT SUMMARY FOR VARIOUS WORKFORCE INVESTMENT
ACT PROGRAMS AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Grant Closeout Summary for Various
Workforce Investment Act Programs from the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Human
Services, Division of Employment Services, to the Colorado Department of Labor and Employment,
and
WHEREAS,after review, the Board deems it advisable to approve said closeout summary, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Grant Closeout Summary for Various Workforce Investment Act
Programs from the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Division of
Employment Services, to the Colorado Department of Labor and Employment, be, and hereby is,
approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said closeout summary.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 12th day of September, A.D., 2011.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: i�w"� �� l� —r •te ti s ± Liefcam -‘-
" arb kmeye , Chair
Weld County Clerk to the Board t
� Sean P., ( sway, Pro-Tem
BY: put erk •L
Deputy/lerk to the Board
IN F. Garcia
APP D A M: ,sod i
dr
David E./Lori
Jvtorne y lfa
Douglhs Rademac er
44
Date of signature: //2O///
Onc a ( xsavc - CP- N5O 2011-2402
13 l l . a1- 11 HR0082
MEMORANDUM
1861 - 2011
DATE: September 6, 2011
WELD CEO NTY
TO: Barbara Kirkmeyer, Chair, Board of Co missioners
FROM: Judy A. Griego, Director, Human Serve e Dep m rs�ent+
SUBJECT: Weld County Department of Human Services' Workforce
Investment Act (WIA) Grant Closeout Summary
Enclosed for Board approval is the Workforce Investment Act (WIA) Grant Closeout Summary.
This Closeout Summary was reviewed under Pass-Around Memorandum dated September 1,
2011, and approved for placement on the Board's Agenda.
The WIA Grant Closeout 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 of July I, 2010 to
June 30, 2011. Revenues and expenses are reconciled and grant obligations are released for those
projects that are fully expended by the Division of Employment Services.
If you have any questions, give me a call at extension 6510.
2011-2402
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) 352-1551 ext. 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 # FSCI23#
PY 08 ARRA-Adult $157,705.00 1488 8NA01 P, 8NAD2P,
8ND02P, 8NFE3P,
8NA02P, 8NO02P
PY 08 ARRA-Dislocated Worker $382,443.00 1490 8NADIP, 8ND01P,
8NAD3P, 8ND03P
PY 08 ARRA-Wagner Peyser $201,729.00 1491 8NWR01
PY 09/FY 10 WIA Adult $426,912.00 1557 9NAOIF,9NO01F.
9NAD2F,9ND02F,
9NFE1P
PY 09 WIA Youth $463,436.00 1558 9NAY1P, 9NYOIP
PY 09/FY 10 WIA Dislocated Worker $242,532.00 1559 9NAD1F, 9ND0IF
PY 09 Wagner Peyser $266,835.00 1560 9NW01
FY 10 DVOP $ 8,852.00 1561 9NV01
PY 07 On-Line Education and Training Grant $ 12,992.75 1612 7No01
PY 08 ARRA 25% Enhanced Dislocated Worker $ 95,139.00 1651 8NFE I P
PY 09 TANF Hire Colorado $378,308.00 1663 9NH01
FY 09 TAA Funds $ 23,310.00 1675 8Na01 F
PY 09 WIA 10% Statewide Activities $149,219.73 1686 9DSK1P,9DSP1F,
9YSJ 1 P, 9YSY 1 P,
9DSSIF,9YSSIP
PY 09 WP 10% Summer Job Hunt $ 30,000.00 1708 9NJ01
FY 10 Wagner Peyser $694,076.55 1763 ONW01
PY 10 Summer Job Hunt Marketing $ 1,000.00 1839 OYSJ1P
PY 09 WP 10% Performance Incentive $105,888.00 1909 9Nc01
Total $3,640,378.03
SO7/-ayv02-
Each Program Year(PY)and funding stream listed above will have the following forms completed:
Form Attachment I and Attachment H:
• Grant Recipient's Release (Attachment I: page 1 of 6)
• Contract Closeout Tax Certification (Attachment I: page 2 of 6)
• Schedule of Unclaimed Checks(Attachment I: page 3 of 6)
• Grant Recipient's Assignment of Refunds, Rebates, and Credits(Attachment I: page 4 of 6)
• Sub-recipient Certification of Physical Inventory(Attachment I: page 5 of 6)
• Physical Inventory List(Attachment I: page 6 of 6)
• Grant Closeout Reconciliation Worksheet(Attachment H)
I certify to the best of my knowledge and belief the following financial data reported in this
closeout packet is correctly stated.
By: � c f < <�€P 1 2011
it-CH cal Elected Offi ial Date
Chair, Board of County Commissioners or
Authorized Signature
Barbara Kirkmeyer
OS O(/-e;11/Oa .
Attachment I
Page 1 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S RELEASE
Grant Recipient's Name: Employment Services of Weld County
Address: PO Box 1805, Greeley, Co. 80632
Release Date: 08/31/2011
Pursuant to the terms of Contract/Grant Agreement Number KAA 00008 , including the Expenditure
Authorizations (EAs) awarded under said Contract/Grant Agreement, as VAX/FCS123 number(s): 1488/8NA01P
1488/8NAD2P , 1488/8ND02P , 1488/8NFE3P , 1488/8NA02P , 1488/8NO02P , 1490/8NAD1P , 1490/8ND01P
1490/8NAD3P , 1490/8ND03P , 1491/8NWR01 , 1557/9NA01F , 1557/9NO01F , 1557/9NAD2F , 1557/9ND02F
1557/9NFE1P , 1558/9NAY1P , 1558/9NY01P , 1559/9NAD1F , 1559/9ND01F , 1560/9NW01 , 1561/9NV01
1612/7No01 , 1651/8NFE1P , 1663/9NH01 , 1675/8Na01F , 1686/9DSK1P , 1686/9DSP1F , 1686/9YSJ1P
1686/9YSY1P , 1686/9DSS1F , 1686/9YSS1P , 1708/9NJ01 , 1763/ONW01 , 1839/OYSJ1P , 1909/9Nc01
and in consideration of the sum of Total amount paid of and payable of
NONE ($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 , 2011
By % &i--
Authorize Signature/
Title Chair, Weld County Board of Commissioners
Barbara Kirkmeyer SEP 1 2 7011
Revised: 6/1/06 Attachment 1-1 RecRelease2011.xis
o?o//-.20;,1_
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) : 1488/8NA01 P , 1488/8NAD2P , 1488/8ND02P ,
1488/8NFE3P , 1488/8NA02P , 1488/8NO02P , 1490/8NAD1P , 1490/8ND01P ,
1490/8NAD3P , 1490/8ND03P , 1491/8NWR01 , 1557/9NAO1F , 1557/9NO01F ,
1557/9NAD2F , 1557/9ND02F , 1557/9NFE1P , 1558/9NAY1P , 1558/9NYO1P ,
1559/9NAD1F 1559/9ND01F 1560/9NW01 , 1561/9NV01 1612/7No01 ,
1651/8NFE1P , 1663/9NH01 , 1675/8Na01F , 1686/9DSK1P , 1686/9DSP1F ,
1686/9YSJ1P , 1686/9YSY1P , 1686/9DSS1F , 1686/9YSS1P , 1708/9NJ01 ,
1763/ONW01 , 1839/OYSJ1P , 1909/9Nc01 .
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: P.O. 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 , 20 1.
/Y— Authoriz Signatur
Title Chair, Weld County Board of Commissioners
Barbara Kirkmeyer CEP 1 2 2011
Revised: 6/1/06 2011Attachl-2ContCloseTaxCert.xlsx
aO/1-a1/0
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: 8/31/11
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 , 2011.
n /
Authori a Signature
Title Chair, Weld County Board of Commissioners
Barbara Kirktheyer SEP 1 2 2011
Revised: 6/1/06 Attachment I-3UnclaimedChecks2011 (2).xls
,2Q//- .21/0Z
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: P.O. Box 1805 No: KAA 00008
City and State: Greeley, 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) : 1488/8NA01P , 1488/8NAD2P , 1488/8ND02P ,
1488/8NFE3P , 1488/8NA02P , 1488/8NO02P , 1490/8NAD1P , 1490/8ND01P ,
1490/8NAD3P , 1490/8ND03P , 1491/8NWR01 , 1557/9NAO1F , 1557/9NO01F ,
1557/9NAD2F , 1557/9ND02F , 1557/9NFE1P , 1558/9NAY1P , 1558/9NYO1P ,
1559/9NAD1F , 1559/9ND01F , 1560/9NW01 1561/9NV01 1612/7No01
1651/8NFE1P , 1663/9NH01 , 1675/8Na01F , 1686/9DSK1P , 1686/9DSP1F
1686/9YSJ1P , 1686/9YSY1P , 1686/9DSS1F , 1686/9YSS1P , 1708/9NJ01 ,
1763/ONW01 , 1839/OYSJ1P , 1909/9Nc01 .
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 U day of £f {,Ca.L/ 2011
r(13 Authorized ignature
Title Division Head of Employment Services
Revised: 6/1/06 2011Attachl-4AssignRefRebCredits.xlsx
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:
El 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.
Subrecipient Director's Siglralure Date
Revised. 6/1/06 Attachment 1-5 Certification of Physical Inventoryxls
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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: 06/30/11
CDLE PIER VAX#: NA
1. CUMULATIVE PROGRAM INCOME CASH REPORTED ON CASH REQUEST THRU QUARTER END DATE:
FCS123 AMOUNT
NET(Undisbursed) LINE ITEM NONE
2. BUDGET ALLOCATION:
COST CATEGORY/BUDGET Total Disbursed Prog Income Net(Undisbursed)
LINE ITEM(S)-FCS123# 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.
//�Q �� $ 3Uo1J//
�A orized Signature Date
See instructions for completing this form on the next page.
Revised'. 6/1/01 Attachment E-Program Income Expense Report201 I.xlsx
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 Employ Svcs of Weld County Stand In/Leveraged Costs for the Period: 07/01/10 to 06/30/11
CDLE Assigned VAX SICRF#: None
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 ;mitts Expender Total
GRANT NAME: WIA Adult
PY or FY Current PY10 0.00
Prior PY09 0.00
Year Before Prior PY08 0.00
GRANT NAME: WIA Dislocated Workers
PY or FY Current PY10 0.00
Prior PY09 0.00
Year Before Prior PY08 0.00
GRANT NAME: WIA Youth
PY or FY Current PYI0 0.00
Prior PY09 0.00
Year Before Prior PY08 0.00
GRANT NAME: WIA 1O%Statewide Actv.
PY or FY Current PY10 DO NOT.ENTER 0.00
Prior 08 D0MOENTER 0.00
Year Before Prior 07 DO NOT ENTRE 0.00
GRANT NAME: WIA 25%Enh. DW
PY or FY Current PY10 0.00
Prior PY09 0.00
Year Before Prior PY08 0.00
GRANT NAME: WIA 25%Innovaty Proj.
PY or FY Current PY10 DO NOT ENTCF.! . 0.00
Prior PY09 DO NOT ENTER 0.00
Year Before Prior PY08 DO NOT ENTER 0.00
GRANT NAME: WIA ARRA NEG Grant
11 DoNurENTER 0.00
I0 DO NOT ENTER 0.00
09 DO NOT ENrER 0.00
GRANT NAM E:ARRA SESP Green Jobs RANT
10 0.00
09 0.00
08 0.00
CERTIFICATION:
I certify to the best of my k ledge and belief the above reported information is accurate and complete of the period reported.
uthorized Signature Date
Revised: 2/28/10 Attach F-SICRP201 I 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 Employ Svcs of Weld County Stand In/Leveraged Costs for the Period: 07/01/10 to 06/30/11
'DLE Assigned VAX SICR#: None
Program COST CATEGORY(IES /BUDGET LINE ITEM(S)
'iscal Ve Stand-In Stand in Leveraged Leveraged Other Federal
GRANTS of Funds dministratior Program Cash Match In-Kind ,unds Expend el Total
GRANT NAME: Wagner Peyser
DO NOT ENTER 0.00
DO NO TENTER 0.00
DONOT ENTER (>' 0.00
GRAN I NAME: WP 10%P1
PYl0 0.00
PY09 0.00
PY08 0.00
GRANT NAME: WP 10%SJH
DONOI ENTER..a 0.00
DONDE ENTER ? 0.00
DPNOT ENTER 0.00
GRANT NAME: Vets DVOP
DONOI ENTER 0.00
DONOT ENTER 0.00
DO NOT ENTER 0.00
GRANT NAME: Vets LVER
_ DO NOT ENTER.. 0.00
IDQNPT ENTER 0.00
DONOtENTER 0.00
GRANT NAME:UI Reemployme
DO NOT ENTER 0.00
DO NOYENTER. 0.00
no NOT ENTER 0.00
GRANT NAME:STATE P.1. Gri
10 0.00
11 0.00
12 0.00
CERTIFICATION:
I certify t the best o my knowledge and belief the above reported information is accurate and complete of the
A thorized Signatu Date
See instructions for completing this form on the next page.
Revised: 2/28/10 Attach F-SICRF201 1.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)# 1488
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#6NAOIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 21,322.00
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.) 21,322.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1488 *)t_,, � p -
I. Total Expenses+Accruals Previously Reported(Through Last Month) 21,322.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.11.3.) 21,322.00
ADMINISTRATIVE EXPENSE(ER) Vax# ) #;,_ g
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
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) t
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 21,322.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 21,322.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED � '`iti:fric:AtiftW
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)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total P1 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.) 21,322.00
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/NOH
'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. q
Datea72 gn/
,/6 E/.3O%W��
Authorized Signatur 4d-f-E Date
Sce instructions'far completing this form on the next page.
Revised'. 6/1/06 2o11AtiachHCloseneconWS14e8A.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)# 1488
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8ND02P #I r'
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 79,634.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date 0.1.-41.2=1.3.) 79,634.00
H. PROGRAM EXPENSE REPORT(ER) Vax# 1488
I. Total Expenses+Accruals Previously Reported(Through Last Month) 79,634.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2:11.3.) 79,634.00
ADMINISTRATIVE EXPENSE(ER) Fax# I `-'*,, ".P
4. Total Expenses+Accruals Previously Reported(Through Last Month) PCS/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 Fax# "°
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(111.1.+Ill.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) lig r„ " .. .3
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 79,634.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 79,634.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOH
V. CASH REQUEST PROGRAM INCOME CASH REPORTED ,"
I. Total PI Cash Previously Reported on CR (Last CR/4 I
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=P/[Z.rpenaes) 0. .
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(V I.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Fax# `'
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 79,634.00
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/NOD
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�
Preparer's Signature Co) ���333���333 w J Date 1a71 t
Authorized Signa[}tf --z—t-- I Date �� ���
See instructions'for completing this form on the next page
Revised 6/1/06 2011AttachHCloseReconWS1486Cxls
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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)# 1488
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NAD2P r sa :4;
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 821.06
2. Current Program and Admin Cash Needs (CR 0 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+1.2:1.3.) 821.06
II. PROGRAM EXPENSE REPORT(ER) Fax k 1488 n,r,
I. total Expenses+Accruals Previously Reported(Through Last Month) 821.06
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11a:11.3.) 821.06
ADMINISTRATIVE EXPENSE(ER) Fax 4 's, it
4. Total Expenses+Accruals Previously Reported(Through Last Month) ECS123#
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 Fax# ititIP.I
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) yr
1. FINAL CR Contract to Date(1.3.) If not, explain on the Remark below 821.06
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 821.06
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L)/NOLL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED si• . ""
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 Pl Cash Request=P/Expenses) (9
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 Fax 4 ;',+
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+ 116.+111.3.) 821.06
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) 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. l
Preparer's Signature �lL. e ' —V Date #7,/
Authorized Signatur
-6 Date OW/
See instructions for completing this than on the next page.
Revised. 6/1/06 201lAttachHCloseReconWS1488B xis
Attachment II
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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)# 1488
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NFE3P E£an:. -,� ).
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 48,799.94
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.) 48.799.94
II. PROGRAM EXPENSE REPORT(ER) Vax# 1488 $# 1 "
I. Total Expenses+Accruals Previously Reported(Through Last Month) 48,799.94
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1 +11.2=11.3.) 48,799.94
ADMINISTRATIVE EXPENSE(ER) LdkrC"
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# Sti
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(fhrough End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.1-111.2.=111.3.) 0.00
IV. RECONCILIATION Cash Request=Expensed
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 48,799.94
2. FINAL Expenses Through End of Contract(II.3.+II 6.+II1.3.) 48.799.94
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES HI/NOL I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED I5;
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 Pl cash Request Pt Expensee) it �
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.I -V1.2.=VL3.) (Refund * Extend 1 0.00
VII. MATCH RECONCILIATION Fax# ee. l
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I I.3.+116.+111.3.) 48,799.94
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) YESL i/NOLJ
The Program Income Expenss/e RReepp�Iort and Cash Request can only be extended through the availability of the Award and/or Federal funding periotl
Remo k: •W
Preparer's Signature / Date / (�/
rs ii, vvv
Authorized SignaWc- a" 7 Date /Z/i .
See instructions for completing this form on the next page.
Revised'. 811106 2o11AttachHcioseeeconW51488D 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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)it 1488
CONTRACT or EA START DATE 04/01/11 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NAO2P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 1 397.90
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.) 397.90
II. PROGRAM EXPENSE REPORT(ER) vax# 1488 ( pi?l< stx' ;
I. Total Expenses+Accruals Previously Reported(Through Last Month) 397.90
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+I1.2.11.3.) 397.90,
ADMINISTRATIVE EXPENSE(ER) Vax# fib l; 'ai,
4. Total Expenses+Accruals Previously Reported(Through Last Month) ECS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.I1.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT vax# k=in,
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) rit t,
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 397.90
2. FINAL Expenses'Through End of Contract(11.3.+116+111.3.) 397.90
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L 1/NOH
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR/I 1
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 (l'1 Cash Hennes)=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.=V1.3.) (Refund * Extend 1 0.00
VII. MATCH RECONCILIATION Vax# aaa
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses"Through End of Contract(I I.3.+116+111.3.) 397.90
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VIL3.) 0.00
5. Total Match Reported(VII I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESI_I/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 //// /) ppppp__,�
Preparer's Signature G1 //� ,,4 74-/• Date )(0
Authorized Sign, of Date
�`-"���
Sec instructions for completing this form on the next page.
Revised. 6/1/06 2011 AIIachHCloseReconWS1488E 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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-Adult
Greeley, CO 80632 VAX ERF(VERF)# 1488
CONTRACT or EA START DATE 04/01/11 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NO02P _ ,
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 6,335 00
2. Current Program and Admin Cash Needs (CR# 1504 ,Column F) 395.10
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+1.2:1.3.) 6,730.10
II. PROGRAM EXPENSE REPORT(ER) Fax 4 1488 sr
I. Total Expenses+Accruals Previously Reported(Through Last Month) 6,730.10
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date 01.1.+11.2.=11.3.) 6,730.10
ADMINISTRATIVE EXPENSE(ER) Fax# IV r ,r
4. Total Expenses+Accruals Previously Reported(Through Last Month) PCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+II.5.=11.6.) 0.00
HL 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(III.I.+111.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) )' r
I. FINAL CR Contract to Date(1.3.) If not, explain on the Remark below 6,730.10
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 6,730.10
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/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.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Fax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6+111.3.) 6,730.10
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(VI1.4.)?(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
l/
Preparer's Signature a 1`t/. 4 Date %O
Authorized Signatur;'
- ( Date v����
See instructions for completing this form on the next page.
Reseed. 611/06 2011AtlachHCloseReconWS1488F.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-DW
Greeley, CO 80632 VAX ERF(VERF)# 1490
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NAD1P Wei ,.I slit:1
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 32,784.98
2. Current Program and Admin Cash Needs (CR 4 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+1.2.1.3.) 32,784.98
IL PROGRAM EXPENSE REPORT(ER) Vax# 1490 7 t'iRF . :
I. Total Expenses+Accruals Previously Reported(Through Last Month) 32,784.98
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=l1.3) 32,784.98
ADMINISTRATIVE EXPENSE(ER) Vax# rika,
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(11.4.4 II.5=11.6.) 0.00
HL PROGRAM INCOME(PI) EXPENSE REPORT Vax# ii '‘ Pr a:f
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 -
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 32,784.98
2. FINAL Expenses Through End of Contract(11.3.+II6+II1.3.) 32,784.98
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) _ YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED c. d '`'
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 P1 Cash Reque t=PI Expenses) ' 1
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 4 I 'itiV.Y °':
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.-411 3 ) 32,784.98
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/NOH
•The Program Income Expense Repoli and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark a CIL Preparer's Signature Date 3/47A
Authorized Signatur - /�A Date 7/`S�4J/il
L-----
Revised 6/1/06 2011AtiachHCloseReconWS1490A.xis
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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-DW
Greeley, CO 80632 VAX ERF(VERF)# 1490
CONTRACT or EA START DATE 03/06/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8ND01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 1 321,146.02
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.) _ 321,146.02
IL PROGRAM EXPENSE REPORT(ER) Vax# 1490 B
I. Total Expenses+Accruals Previously Reported(Through Last Month) 321,146.02
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+1I.2.II.3.) 321,146.02
ADMINISTRATIVE EXPENSE(ER) Fax 4 `i ti
4. Total Expenses+Accruals Previously Reported(Through Last Month) FC'S123#
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 4
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) C'''
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 321,146.02
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 321,146.02
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOH
V. CASH REQUEST PROGRAM INCOME CASH REPORTED 1
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) 41 `.
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# ri&u Pl " £ „
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+I16.+111.3.) 321,146.02
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(VI1.4.)?(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 0 _ #(-7?— Date
Authorized Signat GyAreh / Date ri7A
�
41
See instructions for completing this form on the next page.
Revised' 60/06 2011 AItachHCloseReconWS1490B.els
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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-DW
Greeley, CO 80632 VAX ERF(VERF)11 1490
CONTRACT or EA START DATE 03/06/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NAD3P •, i °'II
�+ gSn
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 1,036.23
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.) 1,036 23
II. PROGRAM EXPENSE REPORT(ER) Vax# 1490 Ma Si
I. Total Expenses+Accruals Previously Reported(Through Last Month) 1,036.23
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1 ±11.2=11.3.) 1,036.23
ADMINISTRATIVE EXPENSE(ER) Fax# Ai 1:.1
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
Ill. PROGRAM INCOME(PI)EXPENSE REPORT Vax# , edify,«
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) `)p '
I. FINAL CR Contract to Date(1.3.) If not, explain on the Remark below 1,036.23
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 1,036.23
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 _ a
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VL RECONCILIATION (PI Cash Request=PI Expenses) '"t .,
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# 'e.
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 1,036.23
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(VI1.4.)?(Check Box) YESH/NOH
*The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
:::er's
o Date Signature ,/ r
��s���
Authorized Signs r ,...---.7.-4"T r Date
Sec instructions for completing this form on the next page.
Revised'. 6/1/06 2011AtiachHCloseReconWS1490C.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-DW
Greeley, CO 80632 VAX ERF(VERF)# 1490
CONTRACT or EA START DATE 04/01/11 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS12311 8ND03P 6 a n. r
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 15,962.55
2. Current Program and Admin Cash Needs (CR# 1504 ,Column F) 11,513.22
3. FINAL Program and Admin Cash Needs Contract to Date(L 1.+1.2.1.3.) 27.475.77
II. PROGRAM EXPENSE REPORT(ER) Fax# 1490 ilA _ }a
I. Total Expenses+Accruals Previously Reported(Through Last Month) 27,475.77
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+II.2=l1.3.) 27.475.77
ADMINISTRATIVE EXPENSE(ER) Fax# ,_Tl
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(II.4.+11.5.IL6.) 0.00
IIL 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(III.1.+III.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) g
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 27,475.77
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 27,475.77
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES IJ/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
VL RECONCILIATION Pl 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 Fax# *a `'u i
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+II6.+111.3.) 27,475.77
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V 11.2 x VII 3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(V11.4.)?(Check Box) YESLi/NOH
The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period
Remark: p�'Qg��
Preparer's Signature , di * Date 6%O
Authorized Sig tur :>. Date S�o�/
Sec instruct'Otis for completing this Turin on the'text page.
Revised: 6/1/06 2011 AltachHCloseReconW51490D 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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA-WP
Greeley, CO 80632 VAX ERF(VERF)# 1491
CONTRACT or EA START DATE 03/06/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NWRO1
I. 'Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 201,729.00
2. Current Program and Admin Cash Needs (CR t1 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+1.2.-1.3.) 201,729.00
IL PROGRAM EXPENSE REPORT(ER) Vox# 1491 ipS .,. #_
I. Total Expenses+Accruals Previously Reported(Through Last Month) 201,729.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+I1.2.11.3.) 201,729.00
ADMINISTRATIVE EXPENSE(ER) Vex# 4fe sfx ` i
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+1L5:II.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vex# t #
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1+III.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 201,729.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 201,729.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/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=PI Expenses) ae,
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.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vex# t1,
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116+111.3.) 201,729.00
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) YESH/NOH
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark.
Preparer's Signature I/n/)I C (Cr Date �07 l�
Authorized Signatuf' Date l Yr/
See instructions for completing this form on the next page.
Revised: 6/1/06 2011AttachhCloseReconWS1491.xis
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 FY 09/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NAO1F f'
I. Total Program and Admin Cash Needs Previously Reported (Last CR 11 1407 ) 28,382.00
2. Current Program and Admin Cash Needs (CR t/ ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+1.2.=1.3.) 28,382.00
II. PROGRAM EXPENSE REPORT(ER) Vax 11 1557 ;11.1V 1,,i {
I. Total Expenses+Accruals Previously Reported(Through Last Month) 28,382.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+11.2:11.3.) 28,382.00
ADMINISTRATIVE EXPENSE(ER) Vax# q# ,.
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(I1.4.+11.5.=11.6.) 0.00
III, PROGRAM INCOME(PI) EXPENSE REPORT Vax# 7
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) it, 1 '
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 28,382.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 28,382.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED ' :#
I. Total PI Cash Previously Reported on CR (Last CR# 1
2. Current Program Income Cash(I hrough 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) fin
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(V1.1 -V1.2.=VI 3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax# f ri
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+116.+111.3.) 28,382.00
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/NOLI
The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period.
Remark:
q
Preparer's Signature f j Date %` ��
Authorized Signat Date (We/
See instructions(or completing this Ibnn on the next page.
Revised'. 6/1/06 2011AItachHCloseReconWS1557A.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/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NO01F 70 AP» ,
I. Total Program and Admin Cash Needs Previously Reported (Last CR 4 1407 ) 255,443.00
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.) 255,443 00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1557 11,1. x a LC I. Total Expenses+Accruals Previously Reported(Through Last Month) 255,443.000O 2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+11.2.=11.3.) 255,443.00
ADMINISTRATIVE EXPENSE(ER) Vax# a:, ' a
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(II.4.+11.5.=II.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax 8
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 255,443.00
2. FINAL Expenses Through End of Contract(11.3.+ 116+III.3.) 255,443.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NO H
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR 4 )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(VI.+V.2=V.3.) 0.00
VI. RECONCILIATION P/Ca.c/t RegtreN=PI Espensen) tl
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(V1.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax# `dti etTIP4..
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+ 116.+111.3.) 255,443.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V 1I.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOH
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 Qs s / Date //
Authorized Signatur _Z-y€2 Date V/3%j
Sec instructions for completing this form on the next page.
Revised 6/1/06 2011AttachHCloseReconWSt 5576.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/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS#123 9NAD2F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 6,063.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.4-1.2.=1.3.) 6,063.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1557 j)M, A
1. Total Expenses+Accruals Previously Reported(Through Last Month) 6,063.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.11.3.) 6,063.00
ADMINISTRATIVE EXPENSE(ER) Vax# a '? ?
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
IIL PROGRAM INCOME(PI) EXPENSE REPORT Vax# f :".
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.-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 6,063.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 6,063.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L /NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED gigt7
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 Pt Cash Request=P/Rxpen.vesJ ff .•.,,
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(VLI -VI.2.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax# .0 r
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+ 116.+111.3.) 6,063.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(V II.I.)>or=to Match Expenditure Requirement(V 11.4.)?(Check Box) YESLi/NOEL
`The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period.
Remark:
Preparer's Signature 1`/ i 2. ( Date %Z
Authorized Signatur,, Date Vs/;--
Sec in strut lions for completing this form on the next page.
Revised 6/1/06 2011AttachHCloseReconWS1557C.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 Adult
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9ND02F 1`
I. Total Program and Admin Cash Needs Previously Reported (Last CR 4 1407 1 54,569.00
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.) 54,569.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1557 L $ 11
I. Total Expenses+Accruals Previously Reported(Through Last Month) 54,569.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+11.2.II.3.) 54,569.00
ADMINISTRATIVE EXPENSE(ER) Fax# A
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(II.4.+II.5=11.6.) 0.00
III PROGRAM INCOME(PI)EXPENSE REPORT Fax# NM ''' ,'
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)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 54,569.00
2. FINAL Expenses Through End of Contract(11.3.+II 6+111.3.) 54,569.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YESH/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED :. a
I. Total PI Cash Previously Reported on CR (Last CR 4 )
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.1 -VI.2.=VI.3.) (Refund * Extend I 0.00
VIL MATCH RECONCILIATION Fax 4 i liglitriViti.
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 54,569.00
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(V11.4.)?(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.
::er's
Date Signature 1/n ry i// � /T/��/Q�1 I',
Authorized Signatur/— ,4„y ( �/ U Date ysd/�/
See instructions for completing this form on the next page.
Revised 6/1/06 2011AttachHCloseReconWs1551D xis
Attachment H
Page 1 oft
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
Greeley, CO 80632 VAX ERF(VERF)/4 1557
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NFE1P !I s�
I. Total Program and Admin Cash Needs Previously Reported (Last CR 4 1407 ) 82,455.00
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.) 82,455.00
IL PROGRAM EXPENSE REPORT(ER) Vax 4 1557 Ga
I. Total Expenses+Accruals Previously Reported(Through Last Month) 82,455.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2:11.3.) 82,455.00
ADMINISTRATIVE EXPENSE(ER) Vax# VP .. ?�
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+11.5.II.6.) 0.00
III PROGRAM INCOME(PI) EXPENSE REPORT Vax#
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
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 82,455.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 82,455.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOL I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED ..� .r fu
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 (P1 Cush Request—P7 Expenses) l,., 'IL
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 -VL2.=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.) 82,455.00
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/NOLL
'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 , alit Date IA7/1(
Authorized Signat Date V?,c1/4,
Sec instructions for completing this form on the next page.
Revised: 6/1/06 2011AtiachHCloseReconWS1557E xls
Attachment II
Page I of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SURRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1558
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NAY1P ibis ,t
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 46,344.00
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.) 46,344.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1558 9
I. Total Expenses+Accruals Previously Reported(Through Last Month) 46,344.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11 3.) 46,344.00
ADMINISTRATIVE EXPENSE(ER)
Vax# !3 iI.
4. Total Expenses+Accruals Previously Reported(Through Last Month) ECS123#
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'I'hrough End Date of Contract(III.I.+ 111.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) Iii, I "lc
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 46,344.00
2. FINAL Expenses Through End of Contract(II 3.+II 6.+111.3.) 46,344.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/NOLL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED u65 t,ti
I. Total PI Cash Previously Reported on CR (Last CR/4 )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column CO
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VL RECONCILIATION (P/Cash Request—P/E.penses) `' -.
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.) 46,344.00
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/NOLL
'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 CN[,{' Date W
Authorized Signatur �: 66 Date �lll��%
See Instnmtions for completing this tbrm on the next page.
Revised'. 6/1/06 2011AttachHCloseReconWS1558A.xis
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 WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1558
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NYO1P (¢fll .._ #nU
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 417,092.00
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.) 417,092.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1558
I. Total Expenses+Accruals Previously Reported(Through Last Month) 417,092.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+112,=11.3.) 417,092.00
ADMINISTRATIVE EXPENSE(ER) Vax# t :Itii:
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(II.4,+11.5:IL6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax
M.
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1+111.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) s x54
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 417,092.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 417,092.00
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 (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 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.) 417,092.00
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/NOLl
The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period.
Remark: ,(n/Preparer's Signature h'61 ir Date 3QT�)
Authorized Signatu � Date e373441
Sec instructions for completing Ibis form on the next page.
Revised. 6/1/06 2011AttachHCloseReconvlS1558B.xis
Attachment H
/'age 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
Greeley, CO 80632 VAX ERF(VERF)# 1559
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NAD1F s
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 1 17,899.53
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.) 17,899.53
IL PROGRAM EXPENSE REPORT(ER) Vax# 1559 -t),
I. Total Expenses+Accruals Previously Reported(Through Last Month) 17,899.53
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1 +11.2=11.3.) 17.899..533
ADMINISTRATIVE EXPENSE(ER)
Vax# ." %i -. .k"
4. Total Expenses+Accruals Previously Reported(Through Last Month) ECS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I I.4+IL5.11.6.) 0.00
IIL PROGRAM INCOME(PI)EXPENSE REPORT Vax# Mk l
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) +`5'
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 17,899.53
2. FINAL Expenses Through End of Contract(11.3.+116+111.3.) 17,899.53
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOL]
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR# 1
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=P/Expenses) aI a'^,
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# .'_ I
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 17,899.53
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) 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 Date 7Z l
/
Authorized Signatur ! Lx Date y20/,
See instructions for completing this form on the next page.
Revised'. 6/1/06 2011AltachHCloseReconWS1559A xls
Attachment H
Page l 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
Greeley, CO 80632 VAX ERF(VERF)# 1559
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1407 FCS123#9NDO1F I m
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 224,632.47
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.) 224,632.47
II. PROGRAM EXPENSE REPORT(ER) vox# 1559
I. Total Expenses+Accruals Previously Reported(Through Last Month) 224,632.47
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+11.2.=11.3.) 224,632.47
ADMINISTRATIVE EXPENSE(ER) Fax# i9xe' r
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT var# rf't .
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(II I.I,+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 224,632.47
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 224,632.47
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ld/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 4 ,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) r !4I
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II I.3.) 0.00
3. Total PI Cash Balance(VI.I -V1.2.=V I.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Ft-aft }.,
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 224,632.47
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII 1.3>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOH
"The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark.
Preparers-Signature e4 ,°i _ ttrt Date 7 �///7
Authorized Signatur �,.y.C2'r / Date 11�/?e
Sec instructions for completing this form on the next page.
Reviser. 6/1/06 2011AtIachHCloseReconWS1559B.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 Wagner Peyser
Greeley, CO 80632 VAX ERF(VERF)# 1560
CONTRACT or EA START DATE 07/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS123#9NWa1 "rx,
I. "total Program and Admin Cash Needs Previously Reported (Last CR# 1847 > 266,835.00
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.) 266,835.00
IL PROGRAM EXPENSE REPORT(ER) vax# 1560 r' ' pl
I. Total Expenses+Accruals Previously Reported(Through Last Month) 266,835.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2:11.3.) 266,835.00
ADMINISTRATIVE EXPENSE(ER) vax# ' 9 I.
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.+11.5:11.6.) 0.00
IlL PROGRAM INCOME(PL)EXPENSE REPORT Vax# Nuttp
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) D&
I. FINAL CR Contract to Date(I.3.) If not, explain on the Remark below 266,835.00
2. FINAL Expenses Through End of Contract(11.3.+11 6.+111.3.) 266,835.00
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 I $:
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses) i 4 }
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 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax# "?4,?+'
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 266,835.00
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(VIl.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 .t Date 00f
/��
Authorized Signatur 2A---50L it2 Date ��`-��1�//
See instructions for completing this form on the nest page.
Revised 6/1/06 2011AttechHCloseReconWS1560xls
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 DVOP
Greeley, CO 80632 VAX ERF(VERF)# 1561
CONTRACT or EA START DATE 10/01/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAXCRa 1407 FCS123#s vvot Utli
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 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) Fax# 1561 w
I. 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(II.I+11.2.11.3.) 8,852.00
ADMINISTRATIVE EXPENSE(ER) Vax 0 T J
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=II.6.) 0.00
HL PROGRAM INCOME(PI) EXPENSE REPORT Fax# I '
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
/V. RECONCILIATION (Cash Request=Expense) u'`x_, v"
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 8,852.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 8,852.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED s
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) fft
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.=V I.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Fax# a
I. 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(V11.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>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: Q�J�V
Preparer's Signature Date % (//
Authorized Signatu % Date �� ) /
See instructions for completing this form on the next page.
Revised'. 6/1/06 2611AItachHcloseReconWS1561 xls
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 07
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT OLET Grant
Greeley, CO 80632 VAX ERF(VERF)# 1612
CONTRACT or EA START DATE 08/01/09 END DATE 12/31/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#7No01 Ii't,.p, )
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 12,992.75
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.) 12,992.75
IL PROGRAM EXPENSE REPORT(ER) Vax# 1612 `tr, '°a
1. Total Expenses+Accruals Previously Reported(Through Last Month) 12,992.75
2. Current Expenses+Accruals(through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 12,992.75
ADMINISTRATIVE EXPENSE(ER) Vex# $ nj),.,
4. Total Expenses+Accruals Previously Reported(Through Last Month) PCS/23#
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 Vax# f ' F
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.r III 2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) ., 'a a. 1
I. FINAL CR Contract to Date(1.3.) I/not,explain on the Remark below 12,992.75
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 12,99275
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'
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR P ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (Pt Cash Request=PI Erpenses)
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# itl,.
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3 ) 12.992.75
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/NOH
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/ �x
A ift Date �z C ��
Preparer's Signature ��//��,f ,
Authorized Signatuy l9!rz'�"� ( Date V&A"
Sec instructions tor completing this form oil the next page.
Revised'. 6/1/06 2011 AitachHCloseReconWS1612.xis
Attachment El
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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ARRA 25% Enh DW
Greeley, CO 80632 VAX ERF(VERF)# 1651
CONTRACT or EA START DATE 10/01/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE rri�gg
L CASH REQUEST(CR) VAX CR#1504 FCS123#8NFE1P Orr' rtp(
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1504 ) 95,139.00
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.) 95,139.00
II. PROGRAM EXPENSE REPORT(ER) Fax# 1651
I. Total Expenses+Accruals Previously Reported(Through Last Month) 95,139.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=l1.3) 95,139.00
ADMINISTRATIVE EXPENSE(ER)
Fax#
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 Fax# 'III ") „1
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+II1.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) It I.
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 95,139.00
2. FINAL Expenses Through End of Contract(11.3.+116+II1.3.) 95,139.00
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 C)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses) t#
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(V I.1 -VI 2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Fax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+ 116+111.3.) 95,139.00
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(VI1.4.)?(Check Box) YESL/1/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:
Preparer's Signature del Date /O�(
Authorized Signatur. L Date 3/firs
Sec instructions tar completing this torn on the next page.
Revised: 6/1/06 2011AttachHCloseReconWS1651.xIs
Attachment H
Page 1 oft
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 TANF HIRE CO
Greeley, CO 80632 VAX ERF(VERF)# 1663
CONTRACT or EA START DATE 11/09/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NH01 VI ,A}tgg 1
I. Total Program and Admin Cash Needs Previously Reported (Last CR 4 1407 ) 378,308.00
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.) 378,308.00
IL PROGRAM EXPENSE REPORT(ER) Vax 4 1663 iiiit
I. Total Expenses+Accruals Previously Reported(Through Last Month) 378,308.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1 +11.2=11.3.) 378,308.00
ADMINISTRATIVE EXPENSE(ER)
Vax 4 NJ, I .fik.,ill
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(111.1+ II1.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) tat..i t
'.,-
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 378,308.00
2. FINAL Expenses Through End of Contract(11.3.+II 6+111.3.) 378,308.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOIJ
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 4 ,column G)
3. FINAL Program Income Cash Contract to Date(V I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cush Request=PI Expenses) Ims
'
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 a ? $ ." lL'
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 378,308.00
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/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. /9�
Preparer's Signature lI l /n ? Date (p2.0Authorized Signatur .. �-Y� Date
See instructions for completing this form on the next page.
Revised 6/1/06 2011AttachHCloseReconWS1663.xis
Attachment II
Page I 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 TAA Funds
Greeley, CO 80632 VAX ERF(VERF)# 1675
CONTRACT or EA START DATE 11/02/09 END DATE 09/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#8Na01F gs w- lyt i.
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 23,310.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+12.-1.3.) 23,310.00
IL PROGRAM EXPENSE REPORT(ER) Fax# 1675gg '
I. Total Expenses+Accruals Previously Reported(Through Last Month) 23,310.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 23,310.00
ADMINISTRATIVE EXPENSE(ER) Vax# fine n°I
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.=II.6.) 0.00
IlL PROGRAM INCOME(PI) EXPENSE REPORT Vax# 4
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.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) s .maasaaat'
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 23,310.00
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 23,310.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Li VNOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED Wi I.
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=P/Expenses) a 1 - i<.a}.
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 1 0.00
f
VII. MATCH RECONCILIATION Vax# }� � :
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.1 1II.3.) 23,310.00
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/NOH
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
j'�7411
Authorized SignatuK— Date pay,
See instructions for completing this form on the next page.
Revised'. 6/1/06 2011 AltechHCloseReconWS1675.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 Marketing
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 11/02/09 END DATE 12/31/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9DSKIP i E HI
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 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:I.3.) 25,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1686 .t„ rta ae,
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(11.1.+11.2.11.3.) 25,000.00
ADMINISTRATIVE EXPENSE(ER) Vax# I ha G,
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(11.4+11.5=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax# z. 3## . I
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) ' f " ,
4
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 25,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 25,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED €; s,I
I. Total PI Cash Previously Reported on CR (Last CR# 1
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, .
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# ( `c
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 25,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VI1.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOH
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 e K`7 Date /
Authorized Signatur - 12�i%2.--t Date Vre7.
See instructions for completing this form on the ncxI page.
Revised'. 6/1/06 2011AttachHCloseReconWS1686A.xls
Attachment II
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 WIA 10% SW PI
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 12/31/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9DSP1F lfr. U J '''M1
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 59,089.00
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.) 59,089.00
IL PROGRAM EXPENSE REPORT(ER) Fax 4 1686 j$ M' a:.-
I. Total Expenses+Accruals Previously Reported(Through Last Month) 59,089.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 59,089.00
ADMINISTRATIVE EXPENSE(ER) Fax# of *kt A ILI '
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
III. PROGRAM INCOME(PI)EXPENSE REPORT Fax 4 r+;trs
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) gim G'r.. ." ,
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 59,089.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 59,089.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLl
V. CASH REQUEST PROGRAM INCOME CASH REPORTED id! to '",
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=Pt Expenses) ; Iti Vr'
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 -V1.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Fax 4 I
I. FINAL Match Reported"Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+ 116+111.3.) 59,089.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VI1.2 x V II.3.) 0.00
5. Total Match Reported(V11.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESL'1/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: G-ti7--
Preparer's SignatureC` fre( Date OI
Authorized Signaturp�
�3O/
Date
L/
Sec instructions for completing this form on the next page.
Revised. 6/1/06 2011AaachHCloseReconWS1686B xls
Attachment H
Pagel 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 SJH
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 08/31/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9YSJ1P "
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 3,500.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+1.2=I.3.) 3,500.00
a�II. PROGRAM EXPENSE REPORT(ER) Vex# 1686 I##f; TIO• "M
I. Total Expenses+Accruals Previously Reported(Through Last Month) 3,500.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.-11.3.) 3,500.00
ADMINISTRATIVE EXPENSE(ER) Vex# 01 g
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+II.5.II.6.) 0.00
HL PROGRAM INCOME(PI) EXPENSE REPORT Vax# '`a g: a(l
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) 1 3ii,V
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 3,500.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 3,500.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L /NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED 1"W.it tint°. #'
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) s. 4
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 Vex#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+116+III.3.) 3,500.00
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/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: Ceoi
ppPreparer's Signature ,a 0_ Date �ZL�/
Authorized Signatu`' ��'%' .- Date �31�.
See instructions for completing this form on the next page.
Revised'. 6/1/06 2011AttachHCloseReconWS1686C.xis
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 SJH Marketing
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 06/30/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAXCR#1407 FCSt23#9YSJ1P rii'', °
5
I. Total Program and Admin Cash Needs Previously Reported (Last CR 4 1407 ) 1,000.00
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.) 1,000 00
IL PROGRAM EXPENSE REPORT(ER) Fax 4 1686 l; {
I. Total Expenses+Accruals Previously Reported(Through Last Month) 1,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(lI.l.+11.2.--11 3.) 1,000.00
ADMINISTRATIVE EXPENSE(ER) Fax 4
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
!IL PROGRAM INCOME(P1)EXPENSE REPORT Fax 4
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 9 n �'
(Cash Request=Expense) '
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 1,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 1,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Li/NOLL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED v.�
I. Total PI Cash Previously Reported on CR (Last CR# 1
2. Current Program Income Cash(Through End Date of Contract) (CR 4 ,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
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 Fax# ski
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111 3.) 1,000.00
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/NOH
'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�
Preparer's Signature /t Date Sr'/
Authorized Signatur . % L Date g�`3/ %.
Sec instructions for completing this form on the next page.
Revised 6/1/06 2011 AItachHCioseReconWS16860 xis
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 Youth Incentive
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1407 FCS123#9YSY1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 ) 10,317.76
2. Current Program and Admin Cash Needs (CR# 1407 ,Column F) 312.97
3. FINAL Program and Admin Cash Needs Contract to Date(l.1.+1.2=1.3.) 10,630.73
H, PROGRAM EXPENSE REPORT(ER) Fax# 1686 a 6
I. Total Expenses+Accruals Previously Reported(Through Last Month) 10,630.73
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+II.2.-11.3.) 10,630.73
ADMINISTRATIVE EXPENSE(ER) Vax# iiiiJ1 .: . '1 '
4. Total Expenses 4 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 Fax# j ;1 il:nt 4,":111.711g7
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.+111.1=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) p #I
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 10,630.73
2. FINAL Expenses Through End of Contract(11.3.+116+III.3.) 10,630.73
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES IJ/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED s
I. Total PI Cash Previously Reported on CR (Last CR# 1
2. Current Program Income Cash(Through End Date of Contract) (CR/4 ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V 2=V.3.) 0.00
VI. RECONCILIATION Pf Cash Request=P/F_xpenaes)
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
VII. MATCH RECONCILIATION Fax# +lip 7
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+111.3.) 10,630.73
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 I/NOH
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark' Date 8/10/Ljz/! �
Preparer's Signature (lir r ( -7,2
over i
Authorized Signatur . Date //
Sec Instructions for completing this'form on the next page.
Revised 6/1/06 2011AltachHCloseReconWS1686E.xis
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 FY 10 SECTRS
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS123#9DSSIF , - f
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 20,695.77
2. Current Program and Admin Cash Needs (CR 4 1847 ,Column F) 15,376.53
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+I.2.1.3.) 36,072.30
IL PROGRAM EXPENSE REPORT(ER) Vax 4 1686
I. Total Expenses+Accruals Previously Reported(Through Last Month) 36,072.30
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+11.2.11.3.) 36,072.30
ADMINISTRATIVE EXPENSE(ER) Fax 4 illt
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.I I.6.) 0.00
III. PROGRAM INCOME(PI) EXPENSE REPORT Vax 4
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.+lll.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 36,072.30
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 36,072.30
3. CR to Date=Expense reported Through End Date of Contract'?(Check Appropriate Box) YES IA/NOI]
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(V I.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vox# ( C,
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 36,072.30
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(VI1.4.)?(Check Box) YES[+]/NOH
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 Rt�/
Preparer's Signature � __ll.. Date �(�
Authorized Signattir'� Ql-`.a
, Date s14/,
See instructions for completing this form on the next page.
Revised 6/1/06 2011At(achHCloseReconWS1686F.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 PROJ
Greeley, CO 80632 VAX ERF(VERF)# 1686
CONTRACT or EA START DATE 12/01/09 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#9YSSIP ie
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 0.00
2. Current Program and Admin Cash Needs (CR# 1847 ,Column F) 13,927.70
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.-1.3) 13,927.70
II. PROGRAM EXPENSE REPORT(ER) Vax# 1686 I W
I. Total Expenses+Accruals Previously Reported(Through Last Month) 13,927.70
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+11.2:11.3.) 13,927.70
ADMINISTRATIVE EXPENSE(ER) Fax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) N'CS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+IL5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Fax# x
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) ;
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 13,927.70
2. FINAL Expenses Through End of Contract(11.3.+11 6.+111.3.) 13,927.70
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOH
V. CASH REQUEST PROGRAM INCOME CASH REPORTED lil ..
I. Total PI Cash Previously Reported on CR (Last CR# I
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.i V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Reques/—PI Expenses) w 1
r. 4
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 -VI.2.=VI.3.)
(Refund * Extend ) 0.00
VII. MATCH RECONCILIATION vox# ',
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 13,927.70
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) YESH/NOLJ
*The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period.
Remark. a
Preparer's Signature t, � Date �2 01,
Authorized Signatuy-4- �� (7 Date �`?�J/i
Sec instructions for completing this loon on the next page.
Revised 611106 2011AttachHCloseReconwsl666G xIs
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% SJH
Greeley, CO 80632 VAX ERE(VERF)# 1708
CONTRACT or EA START DATE 01/04/10 END DATE 08/31/10
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1407 FCS123#9NJ01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1407 1 30,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.41.2.=1.3.) 30,000.00
IL PROGRAM EXPENSE REPORT(ER) Vat# 1708 1''f
I. Total Expenses+Accruals Previously Reported(Through Last Month) 30,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+II.2.=11.3.) 30,000.00
ADMINISTRATIVE EXPENSE(ER) Vex# tir
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.—II.6.) 0.00
III. PROGRAM INCOME(PI) EXPENSE REPORT Fax# f
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.=IIL3.) 0.00
/V. RECONCILIATION (Cash Request=Expense) kg
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 30,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6+111.3.) 30,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Hl/NOL I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR# 1
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 Pl Cash Regnell=Pl Expenver) 'op; a
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.1 -VI.2.=VI.3.) (Refund * Extend I 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.) 30,000.00
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) YESL'L/NOLJ
'The Program Income Expense Report and Cash Request can only be extended through the availability o/the Award and/or Federal funding period
Remark'
q /f
2/
gnah
Preparer's Signature r 7 • Date '
/ �P‘2100.Authorized SOr-
iy l '� Date
See instructions for completing this form on the next page.
Revised 6/1/06 2011AttachHeloseReconWSl708.sIs
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 Wagner Peyser
Greeley, CO 80632 VAX ERF(VERF)# 1763
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCCS123#ONW01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 694,076.55
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.) 694,076.55
IL PROGRAM EXPENSE REPORT(ER) Fax# 1763 4 `3
I. Total Expenses+Accruals Previously Reported(Through Last Month) 694,076.55
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2:11.3.) 694,076.55
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 Vex# II .t
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.+IIl.2:111.3.) 0.00
/V. RECONCILIATION (Cash Request=Expense) ( gh1''
1. FINAL CR Contract to Datc(1.3.) If not,explain on the Remark below 694,076.55
2. FINAL Expenses Through End of Contract(I1.3.+116+111.3.) 694,076.55
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# 1
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=P/Expenses) t
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 Vex# Ill;" F'P
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+ 116.+III.3.) 694,076.55
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(VI1.4.)?(Check Box) YESL)/NOLJ
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federa/funding period.
Remark:
Preparer's Signature @ /^'
✓ x IL WWW/, Date
(��
Authorized Signatur ,--- Date �?
v
See instructions for completing this form on the next page.
Revised 6/1/06 2011AtlachHCloseReconwsl 763.xIs
Attachment H
Pagel 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 Marketing
Greeley, CO 80632 VAX ERF(VERF)# 1839
CONTRACT or EA START DATE 07/01/10 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123#OYSJIP v
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 1,000.00
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.) 1,000.00
IL PROGRAM EXPENSE REPORT(ER) Fax# 1839 l
I. Total Expenses+Accruals Previously Reported(Through Last Month) 1,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2:11.3.) 1,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) ECS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.II.6.) 0.00
IIL PROGRAM INCOME(PI)EXPENSE REPORT Fax# )t; t }..(
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:III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) let . iI z
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 1,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 1,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES W/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED i x,
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/Lash Reytmsr=Pt E penses) i k i::. , %'
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 Fax# °iis
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 1,000.00
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) YESIW/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' 8�
Preparer's Signature �1)' 6 Date l���//'r'0(
L �`t- Date 1/3��/
Authorized Signat r J/
See instructions for completing this form on the next page.
Revised 6/1/06 2011AttachHCloseReconWS1839.xIs
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% PI
Greeley, CO 80632 VAX ERF(VERF)# 1909
CONTRACT or EA START DATE 09/01/10 END DATE 06/30/11
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 FCS123tt 9Nco1 1,
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 105,888.00
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.) 105,888.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1909 E} '• ,
I. Total Expenses+Accruals Previously Reported(Through Last Month) 105,888.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.4-11.2=11.3.) 105,888.00
ADMINISTRATIVE EXPENSE(ER) Vax# ,a;,
4. Total Expenses+ Accruals Previously Reported(Through Last Month) P'CS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+II.5.II.6.) 0.00
III. PROGRAM INCOME(PI) EXPENSE REPORT Vax#
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.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) _ ' .
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 105,888.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 105,888.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ld/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED ..,29::;71
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 Pl Cash Rer nest=P/Ex ensee art
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# ),{,?` 'p
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 105,888.00
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.)7(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 0 t� /lr Date �� O
Authorized Signatur Cy--r ///�
Date �%%
Sec instructions for completing this form on the next page.
Revised'. 6l1/66 zol lAtIachHCioseREConWSt909.xis
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