HomeMy WebLinkAbout20102042.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 8th day of September, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
E ELD COUNTY, COLORADO�
•u!. fJ t
4- :lf_las 'ademac -r, Chair
- '
Weld County Clerk to the Bo 1 v ,ss
V € {',/i �� USED
a, '_:
` T . ,c � :rbara Kirkmeyer, Pro-Tem
4U/1}-4q,� 12 Dep y lerk to tote Board -
- Se
an P.677
APPR AST M:
r
ounty Attorney \\� CA.- )
l Davi Long A
Date of signature: 9I ho
\ 0yiox gnu * ko I-45'U CC ' f-15 2010-2042
y/$iID 9 -Ji-/O HR0081
MEMORANDUM
. b
frDATE: September 2, 2010
W IlD
TO: Douglas Rademacher, Chair, Board of County Conjmisne
l FROM: Judy A. Griego, Director, Human Services partm /
COLORADO RE: Weld County Department of Human Services Workforce
Investment Act Grant Closeout Summary
Enclosed for Board approval is the Department's Workforce Investment Act Grant Closeout
Summary. This Summary was presented at the Board's August 30, 2010, Work Session.
The Workforce Investment Act Grant Closeout packet is required by the Year-End Contract
Closeout Procedures of the Colorado Department of Labor and in accordance with their Policy
Guidance Letter#06-12-Fi for all programs that have Expenditure Authorizations ending during
the period July 1, 2009 through June 30, 2010. 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, please give me a call at extension 6510.
2010-2042
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 # FSC123#
PY 08 WIA 10% Statewide Activities $147,569.60 1236, 8YSJIP, 8OSK1F,
1272 8DSP IF, 8YSY1P,
8YSY3P, 8YSY2P,
7DSX1P, 7DSXIF
FY 07 WIRED Initiative $386,555.02 1277, 6NTo1F, 6NT02F,
1698 6NT02P, 7NT0I P
PY 08 WIA Adult $443,293.00 1351, 8NAO1F,9NAOIP,
1557 9NO0IP, 9NAD2P,
9ND02P, 8NO01F
PY 08 WIA Adult: ARRA $191,899.00 1488 8NO01P
PY 08 WIA Youth $582,978.00 1352 8NY01, 8NAY1P
PY 08 WIA Youth: ARRA $634,959.00 1489 8NAYI P, 8NYOIP
PY 08 WIA Dislocated Worker $299,195.00 1353, 8NADIF, 8NDO1F,
1559 9NADIP, 9NDOIP
PY 08 25% Enhanced Dislocated Worker $31,371.00 1356 8NFE1F
PY 08 DVOP $7,008.00 1355 8NV01
PY 08 Wagner Peyser 10% Summer Job Hunt $30,000.00 1419 8NJ01
PY 09 Wagner Peyser $765,199.73 1560 9NW01
PY 08 Wagner Peyser: ARRA $121,037.00 1491 8NWW01
PY 08 DPN: Salary $27,000.00 1599 8PPWC1
Total $3,668,064.35
Each Program Year(PY) and funding stream listed above will have the following forms completed:
Form Attachment I and Attachment H:
• Grant Recipient's Release(Attachment I: page I of 6)
• Contract Closeout Tax Certification (Attachment I: page 2 of 6)
• Schedule of Unclaimed Checks (Attachment I: page 3 of 6)
• Grant Recipient's Assignment of Refunds, Rebates, and Credits(Attachment I: page 4 of 6)
• Sub-recipient Certification of Physical Inventory(Attachment I: page 5 of 6)
• Physical Inventory List(Attachment I: page 6 of 6)
• Grant Closeout Reconciliation Worksheet(Attachment H)
I certify to the best of my knowledge and belief the following financial data reported in this
closeout packet is correctly stated
By: c \i ,SEP 0 8 2010
Local actno edO icial Date
Chair, Board of County Commissioners or
Authorized Signature
Attachment I
Page 1 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S RELEASE
Grant Recipient's Name: Employment Services of Weld County
Address: P.O. Box 1805, Greeley, CO 80632
Release Date: August 27, 2010
Pursuant to the terms of Contract/Grant Agreement Number , including the Expenditure
Authorizations (EAs) awarded under said Contract/Grant Agreement, as VAX/FCS123 number(s): 1236/8YSJ1P ,
1236/8OSK1F , 1236/8DSP1F , 1236/8YSY1P , 1236/8YSY3P , 1236/8YSY2P , 1272/7DSX1P , 1272/7DSX1F ,
1277/6NT01F , 1277/6NT02F , 1277/6NTO2P , 1698/7NT01P , 1351/8NAO1F , 1557/9NAO1P , 1557/9NO01P ,
1557/9NAD2P , 1557/9ND02P , 1488/8NO01P , 1352/8NY01 , 1352/8NAY1P , 1489/8NAY1P , 1489/8NY01P ,
1353/8NAD1F , 1353/8ND01F , 1559/9NAD1P , 1559/9ND01P , 1356/8NFE1F , 1355/8NV01 , 1419/8NJ01 ,
1560/9NW01 , 1491/8NWW01 , 1599/8PPWC1 , 1351/8NO01F
and in consideration of the sum of Total amount paid of and payable of
NONE ($ of Unclaimed Checks Total) under the said Contract to
Employment Services of Weld County, P.O. Box 1805, Greeley, CO 80632 (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
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.
aThis release has been executed this 8 day of o.e7')/e/Ylder , 2010 .
BY 40 VV WFk
Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 2010Atlachl-GrantRecRelForm.xls
Attachment I
Page 2 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
CONTRACT CLOSEOUT TAX CERTIFICATION
In the performance of Contract/Grant Agreement Number KAA 00008 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified
as VAX/FCS123 number(s) : 1236/8YSJ1 P , 1236/8OSK1 F , 1236/8DSP1F ,
1236/8YSY1P , 1236/8YSY3P , 1236/8YSY2P , 1272/7DSX1P , 1272/7DSX1F ,
1277/6NT01F , 1277/6NT02F , 1277/6NT02P , 1698/7NT01P , 1351/8NAO1F ,
1557/9NAO1P , 1557/9NO01 P , 1557/9NAD2P , 1557/9ND02P , 1488/8NO01 P ,
1352/8NY01 , 1352/8NAY1P , 1489/8NAY1P , 1489/8NY01P , 1353/8NAD1F ,
1353/8ND01F , 1559/9NAD1P , 1559/9ND01P , 1356/8NFE1F , 1355/8NV01 ,
1419/8NJ01 , 1560/9NW01 , 1491/8NWW01 , 1599/8PPWC1 , 1351/8NO01F
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
rL
This certification has been executed this f day of tillihkd', 2010.
By ovL R cQoorn Ww
( /Authorized Signature
Title Chair, Weld County Board of Commissioners
Revised: 6/1/06 2010Attachl-2ContCloseTaxCert.xls
Attachment I
Page 3 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
SCHEDULE OF UNCLAIMED CHECKS
Grant Recipient Name: Employment Services of Weld County
Contract/Grant Agreement Number: KAA 0008
Release Date: 8/31/10
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 2010
By' px)p(q) RO( YVIL
l Authorizeee��� Signature
Title Chair, Weld Co. Board of Co. Commissioners
Revised: 6/1/06 2010Attachl-3Schedule UnclaimChecks.xls
Attachment I
Page 4of6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S ASSIGNMENT OF REFUNDS, REBATES, AND CREDITS
'it 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) : 1236/8YSJ1P , 1236/8OSK1F , 1236/8DSP1F ,
1236/8YSY1P , 1236/8YSY3P , 1236/8YSY2P , 1272/7DSX1P , 1272/7DSX1F ,
1277/6NT01F , 1277/6NT02F , 1277/6NT02P , 1698/7NT01P , 1351/8NAO1 F ,
1557/9NAO1P , 1557/9NO01P , 1557/9NAD2P , 1557/9ND02P , 1488/8NO01P ,
1352/8NY01 , 1352/8NAY1P , 1489/8NAY1P , 1489/8NYO1P , 1353/8NAD1F ,
1353/8NDO1F , 1559/9NAD1P , 1559/9ND01P , 1356/8NFE1F , 1355/8NV01
1419/8NJ01 , 1560/9NW01 , 1491/8NWW01 , 1599/8PPWC1 , 1351/8NO01F .
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 eiC day of C-�,Gzf7p 2010
Authorized Sig e
Title Director of Employment Services
Revised: 6/1/06 2010Attachl-4AssignRefRebCredits.xls
Attachment I
Page 5 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
SUBRECIPIENT CERTIFICATION OF PHYSICAL INVENTORY
Subrecipient Name: Emp Svcs of Weld County Contact Person: Dennis Bogott
Address: PO Box 1805 Phone Number: 970-352-1551 ext 6662
Greeley, CO 80632
I hereby certify that all property/equipment previously purchased with or transferred from the
Comprehensive Employment and Training Act (CETA) or the Job Training Partnership Act (JTPA)
program to the Workforce Investment Act (WIA) programs or purchased under any Colorado
Department of Labor and Employment (CDLE) federally funded grant or transferred with the
CDLE's approval is included in the attached listing for the above-noted subrecipient.
The attached listing has been verified by a physical inventory. Changes/revisions are:
❑ Noted ❑ 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.Ffr/ e
Subrecipient Director' Signature ate
Revised: 6/1/06 2010Attachl-5CertPhyslnv.xls
Attachment E
Page 1 of 4
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
PROGRAM INCOME EXPENSE REPORT FROM (PIERF)
SUBRECIPIENT: Calendar Qrtr End Date: 06/30/10
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(Undisbu
LINE ITEM(S)-FCSt23# Program Income (Expended) Program Incol
VAX# FCS#: NONE
VAX# FCS#:
VAX# FCS#:
VAX# FCS#:
VAX# FCS#:
VAX# FCS#:
Total(total net must equal amount on Pa 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 re orted.
Cthor' ed Signature Date
See instructions for completing this form on the next page.
Revised'. 6/1/01
?01 0AnachE-ProglncExpRepl.xls
Attachment F
Page 1 of 3
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
STAND-IN COST REPORT FORM (SICRF)
AND LEVERAGED RESOURCES REPORT FORM
Subrecipient Employ Svcs of weld County Stand In/Leveraged Costs for Period: 07/01/09 to 06/30/10
CDLE Assigned VAX SICRF#: NONE
Program COST CATEGORY(IES /BUDGET LINE ITEM(S)
Year Stand-In Stand-In Leveraged Leveraged Other Federal
g S
GRANTS of Funds Administration Program Cash Match In-Kind unds Expender Total
GRANT NAME: WIA Adult
PY or FY Current 09 0.00
Prior 08 0.00
Year Before Prior 07 0.00
GRANT NAME: WIA Dislocated Workers
PY or FY Current 09 0.00
Prior 08 0.00
Year Before Prior 07 0.00
GRANT NAME: WIA Youth
PY or FY Current 09 0.00
Prior 08 0.00
Year Before Prior 07 0.00
GRANT NAME: WIA 10%Statewide Acty
PY or FY Current 09 zs t. 0.00
Prior 08 .M hi 0.00
Year Before Prior 07 w,, 0.00
GRANT NAME: WIA 25%Enh. DW
PY or FY Current 09 0.00
Prior 08 0.00
Year Before Prior 07 0.00
GRANT NAME: WIA 25%lnnovaty Proj.
PY or FY Current 09 Tis„. +Cc 0.00
Prior 08 ' m!�" 0.00
Year Before Prior 07 "". "- e+ _.., r': 0.00
GRANT NAME: WIA NER Grant
0.00
0.00
txNoreetrr�grk'..:.: 0.00
GRANT NAME:DPN Grant
09 0.00
08 0.00
07 0.00
CERTIFICATION:
I certify to to be�y k ledge and belief the above reported information is accurate and complete of the period reported.
Authorized Signature D e
Revised: 2/28/10 2010AttachF-StandlnCostRept.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 Period: 07/01/09 to 06/30/10
CDLE Assigned SICR#: NONE
Program COST CATEGORY(IES /BUDGET LINE ITEM(S)
'iscal Ye al Stand-In Stand_in Leveraged Leveraged Other Federal
GRANTS of Funds dministratior Program Cash Match In-Kind unds Expend Total
GRAN 1`NAME: Wagner Peyser
T , 0.00
€ l tlthec 0.00
0.00
GRANT NAME: WIRED(;RANI'
07 0.00
06 0.00
05 0.00
GRANT NAME: WP 10%SJH
0.00
0.00
0.00
GRANT NAME: Vets DVOP
0.00
a Fk; 0.00
trif 0.00
GRANT NAME: Vets LVER
At" 22 21 0.00
0.00
rarfow 0.00
GRANT NAME: UI Reemployme
ypr 0.00
0.00
Is 0.00
GRANT NAME:GREEN JOB
10 0.00
11 0.00
12 0.00
CERTIFICATION:
I certify to the best of my knowledge and belief the above reported information is accurate and complete of the
_71D
Authorized Signature
See instructions for completing this form on the next page.
Revised: 2/28/10 20I0Attachr-StandlnCostRept.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #SYSJIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 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.=I.3.) 1,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1236
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(IL I.+11.2.=11.3.) 1,000.00
ADMINISTRATIVE EXPENSE(ER) Vex#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSl23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.=II.6.) 0.00
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+IIL2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not.explain on the Remark below 1,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+BI.3.) 1,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(I1I.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund ' Extend ) 0.00
VIL MATCH RECONCILIATION Vat#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+I16.+111.3.) 1,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) 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: rJ
Preparer's Signature /,, " /N/, Date AJ
Authorized Sign fir 6l-t- C Date 3/20
See instructions for completing this form on the next page.
Revised. 6/1/06 2010Attach H-GranlCloseReconWS 1236C.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 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8Y8J1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 3,500.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2:1.3.) 3,500.00
IL PROGRAM EXPENSE REPORT(ER) Var# 1236
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) 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 01.4.+11.5=-11.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.I.+III.2:III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) Ir 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 LUNOLJ
V CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -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.) 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(VIII.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES./NO■
•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
///'/ - fir✓
Authorized Signatur j/lij/'—a:( y Date
See instructions for completing this form on the next page.
Revised 6/1/06 2010Attach H-GrantCloseReconWS1236D.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 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #808KIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 25,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2:1.3.) 25,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1236
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#
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 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.=II1.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 25,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+II1.3.) 25,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=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.+II6.+1113 J 25,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESfd/NOTJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding pedod.
Remark.
Preparer's Signature i%!/. ter Date
Authorized Signgtur li/�7 /' Date X-927,C3
See instructions for completing this form on the next page.
Revised. 6/1/06 2oloAttaca H-GranteloseReconWS1236B.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 10% Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #aDSPIF
. Total Program and Admin Cash Needs Previously Reported (Last CR# 1 41,595.00
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.) 41,595.00
II. PROGRAM EXPENSE REPORT(ER) Vex# 1236
I. Total Expenses+Accruals Previously Reported(Through Last Month) 41,595.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1L 1+IL2:IL3.) 41,595.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.-11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(I11.1.+111.2=II1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not explain on the Remark below 41,595.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 41,595.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VL RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116+111.3.) 41,595.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VlI.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOLL
•The Pm gram 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 Ili;
fit Date
Authorized Signat &I/Y'YA MI6/ Date �C
See instructions for completing this form on the next page.
Revised 6/1/06 2010Ahach H-GranteloseReconWS1236A 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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #8YSYIP
1. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 43,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(l.1.+1.2:L3.) 43,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1236
I. Total Expenses+Accruals Previously Reported(Through Last Month) 43,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+II.2:IL3.) 43,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1+111.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) I/not,explain on the Remark below 43,000.00
2. FINAL Expenses Through End of Contract(11.3.+❑6.+111.3.) 43,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Pi/NOLL
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(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.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(II.3.+116.+III.3.) 43,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) 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'
%0 Preparer's Signature Date
Authorized Signatu1 Date
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Attach H-GrantCloseReconWS 1236E.xts
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT 10%Statewide Act
Greeley,CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #BYSYJP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 16,140.60
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.) 16,140.60
IL PROGRAM EXPENSE REPORT(ER) Vax# 1236
I. Total Expenses+Accruals Previously Reported(Through Last Month) 16,140.60
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2.=11.3.) 16,140.60
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=11.6.) 0.00
IlL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(III.I.+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) ,
1. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 16,140.60
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 16,140.60
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.! -VI.2.=VL3.) (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.) 16,140.60
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLJ/NOLJ
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark'
Preparer's Signature {7•/ . Date
Authorized Signatu(C % 1/ Date 070
See instructions for completing this form on the next page.
Revised 6/1/06 2010Anach H-GrantCloseReconWS1236F.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 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1236
CONTRACT or EA START DATE 11/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
CASH REQUEST(CR) CR #BYSY2P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1 1,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1+12.=1.3.) 1,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax 4 1236
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(II.I.+II.2.11.3.) 1,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=I1.6.) 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(1111.+III2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) I/not,explain on the Remark below 1,000.00
2. FINAL Expenses Through End of Contract(11.3.+ II 6.+1II.3.) 1,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=P1 Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(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.) 1,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VIl.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLI/NOT]
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 UM. � !- et2r Date �6.7//
4.
Authorized Signal ta.-Y Date
See instructions for completing this form on the next page.
Revised. 6/1/06 2010A11ach H-GrantCloseReconWS1236G.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 10%Statewide Act
Greeley, CO 80632 VAX ERE(VERF)/4 1272
CONTRACT or EA START DATE 01/04/08 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #7DSX1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1 4,334.00
2. Current Program and Admin Cash Needs (CR/I ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=1.3.) 4,334.00
It PROGRAM EXPENSE REPORT(ER) Pax# 1272
I. Total Expenses+Accruals Previously Reported(Through Last Month) 4,334.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I,+11.2.11.3.) 4,334.00
ADMINISTRATIVE EXPENSE(ER) Paz#
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
HE 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 MIL L++Ill.2:111.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 4,334.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 4,334.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLl
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total P1 Cash Previously Reported on CR (Last CR# 1
2. Current Program Income Cash(Through End Date of Contract) (CR ft ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI RECONCILIATION (P1 Cash Request=P1 Expenses) alinallill
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 -V1.2.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Pax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 4,334.00
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/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 4�,�� (� / %- Gam(// .Date ��Z7
•
Authorized Signatuy' ye..r / (' , Date • 3N,)/�/
l.)
C-----
//l
See instructions for completing this form on the next page.
Revised 6/1/06 2010Attach H-GrantCoseReconWS1272A.ds
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 10%Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1272
CONTRACT or EA START DATE 01/04/08 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #7DSXIP alliel
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 6,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+I.2.=I.3.) 6,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1272
I. Total Expenses+Accruals Previously Reported(Through Last Month) 6,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(Il.l+11.2.-11.3.) 6,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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(II.4.+II.5=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax# allaillal
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)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 6,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 6,000.00
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=PI Expenses) lialiMill
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+[II.3.) 6,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(V II.1.)>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: ,e/,
Preparer's Signature c /, 4-'r Date 07/.../
�AAuthorized Signatur _� A Date C/
See instructions for completing this form on the next page.
Revise&. 6/1/06 2010Attach H-GrantCloseReconWS1272B.xls
Attachment H
Page 1 of2
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 10% Statewide Act
Greeley, CO 80632 VAX ERF(VERF)# 1272
CONTRACT or EA START DATE 01/04/08 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #7DSX1F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 6,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date 0.1.+I.2.-1.3.) 6,000.00
II. PROGRAM EXPENSE REPORT(ER) Fax ft 1272
I. Total Expenses+Accruals Previously Reported(Through Last Month) 6,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(IL 1.+11.2.=II.3.) 6,000.00
ADMINISTRATIVE EXPENSE(ER) Fax#
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 Vex#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1+III.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 6,000.00
2. FINAL Expenses Through End of Contract(11.3.+ II 6.-011.3.) 6,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED •
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
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#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 6,000.00
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) YESL/NO Li
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature tor z O4— Date /5713
Authorized Signat Date jC/
See instructions for completing this fomi on the next page.
Revised 6/1/06 2010Attach H-GrantcloseReconWS1272G.cls
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 07
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIRED Initiative
Greeley, CO 80632 VAX ERF(VERF)# 1277
CONTRACT or EA START DATE 05/08/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #6NTOIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 2,796.83
2. Current Program and Admin Cash Needs (CR 4 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+I.2.I.3.) 2,796.83
a PROGRAM EXPENSE REPORT(ER) vex 4 1277
I. Total Expenses+Accruals Previously Reported(Through Last Month) 34,833.59
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=1I.3.) 34,833.59
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=11.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vex#
I. Total Program Income Expenses Reported(Last Quarter)2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.'.+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 2,796.83
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 34,833.59
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Li/NOW
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VL RECONCILIATION (P/Cash Request=PI Expenses)
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 RECONCILIA HON Vex#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+1113.) 34,833.59
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(VII.4.)?(Check Box) YESLH/NOL I
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark:The remaining revenue
required to fund this program came from PO KAA 20080789 effective May 8,2008-June 30,2008.
Preparer's Signature IlM.{. — �%Date J1/4
Authorized Signatu� Date Ygii.[)
See instructions for completing this form on the next page.
Revised'. 6/1/06 2010Attach H-GrantCloseReconWS1277C.xls
Attachment If
Page I oft
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 07
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIRED Initiative
Greeley, CO 80632 VAX ERF(VERF)# 1277
CONTRACT or EA START DATE 05/08/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #6NT02F
1. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 25,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2:1.3.) 25,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1277
I. l'otal Expenses+Accruals Previously Reported(Through Last Month) 25,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+1I.2.=11.3.) 25,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+11.5.II.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+lll.2.=III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.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 Ld/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 (P1 Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total P1 Cash Balance(VI.I -VI.2.=VI.3.) (Refund r Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 25,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) 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 Date �%/�
Authorized Signatur/ r Date Q/` -7//fi
See instructions for completing this form on the next page. .J
Revised: 6/1/06 2010Attach H-GrantcloseReconWS 1277A.xis
Attachment I-I
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 07
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIRED Initiative
Greeley,CO 80632 VAX ERF(VERF)# 1277
CONTRACT or EA START DATE 05/08/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #6NTO2P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 274,1 18.22
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.) 274,1 18.22
IL PROGRAM EXPENSE REPORT(ER) Vax# 1277
I. Total Expenses+Accruals Previously Reported(Through Last Month) 274,648.41
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 274,648.41
ADMINISTRATIVE EXPENSE(ER) Vax#
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.+II.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.+III.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 274,1 18.22
2. FINAL Expenses Through End of Contract(II.3.+❑6.+111.3.) 274,648.41
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Li/NOW
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)
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.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract 01.3.+116.+111.3.) 274,648.41
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:The remaining revenue re uired to fund this pro ram came f PO KAA 20080789 effective May 8,2008-June 3O2008. �J
Preparers ritO ( �Q Signature Date
Authorized Signatur � Date
w
See instructions for completing this form on the next page.
Revised: 6/1/06 2oloAttaeh H-GrantCloseReconWS12llB.%Is
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 07
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIRED ITAs
Greeley, CO 80632 VAX ERF(VERF)# 1698
CONTRACT or EA START DATE 12/01/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #7NT01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 49,806.38
2. Current Program and Admin Cash Needs (CR 4 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=1.3.) 49,806.38
IL PROGRAM EXPENSE REPORT(ER) Vax# 1698
I. Total Expenses+Accruals Previously Reported(Through Last Month) 49,806.38
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.! +B.2.=11.3.) 49,806.38
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSl23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=11.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(Ill.1+III.2:II1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 49,806.38
2, FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 49,806.38
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L I/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. "hotal 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(III.3.) 0.00
3. Total PI Cash Balance(VI.I -V1.2.=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.) 49,806.38
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLJ/NOLJ
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark: 7�j��
Preparer's Signature Date —�"'
Authorized Signatur �Jy�Cs( ,.e Date (/�7C., /lJ
See instructions for completing this form on the next page.
Revised'. 6/1/06 2010Aaach H-GrantcloseneconWS1698 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 WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1351
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NAOIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 35,966.00
2. Current Program and Adm in Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2=1.3.) 35,966.00
IL PROGRAM EXPENSE REPORT(ER) Vac ft 1351
I. Total Expenses+Accruals Previously Reported(Through Last Month) 35,966.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1+11.2.=11.3.) 35,966.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4+11.5.11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vac#
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.❑1.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 35,966.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 35,966.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NOL I
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 (P1 Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.! -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+Itt3.) 35 966.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.!.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES L'I/NO LI
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark: �/�"J _.
Preparer's Signature � ° Date 12r
Authorized Signatur f*zs4 Date ��
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Attach H-GrantCloseReconWS1351A.xis
Attachment Fl
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 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #9NAo1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 5,961.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.13.) 5,961.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1557
I. Total Expenses+Accruals Previously Reported(Through Last Month) 5,961.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+I1.2.II.3.) 5,961.00
ADMINISTRATIVE EXPENSE(ER) Vax#
•
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.+II.5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(IIL I.+III.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 5,961.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 5,961.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total P1 Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax it I
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+D1.3.) 5,961.00
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/NOEL
'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 n Ice xar Date >>:7,
Authorized Signatur Date rw?Od
See instructions for completing this form on the next page.
Revised 6/1/06 2010Attach H-GrantCloseReconWS1557A.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 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #9NO01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 53,651.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I+1.2.1.3.) 53,651.00
H PROGRAM EXPENSE REPORT(ER) Vax# 1557
I. Total Expenses+Accruals Previously Reported(Through Last Month) 53,651.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1+11.2.=11.3.) 53,651.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+11.5.-11.6.) 0.00
III PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1+111.2:111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) I/not,explain on the Remark below 53,651.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 53,651.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOD
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund • Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3. +116.+111.3.) 53,651.00
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) YESU/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.' r/
Preparer's Signature i p ' _ ,,///�� Date
f�
Authorized Signatpf � l/Y Yom'"'( Date ?7,--.C)9:467
See instructions for completing this/form on the next page.
Revised'. 6/1/06 2010Attach H-GrantcloseReconWS155]B.xis
Attachment II
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 09/FY 10
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1557
CONTRACT or EA START DATE 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #9NAD2P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 2,401.00
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.) 2,401.00
IL PROGRAM EXPENSE REPORT(ER) vax# 1557
I. Total Expenses+Accruals Previously Reported(Through Last Month) 2,401.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.II.3.) 2,401.00
ADMINISTRATIVE EXPENSE(ER) Vax it
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(1L4.+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(III.I+111.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) henot,explain on the Remark below 2,401.00
2. FINAL Expenses Through End of Contract(11.3. +II 6+III.3.) 2,401.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOH
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=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
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(IL3.+116.+111.3.) 2,401.00
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) YESL I/NOI-J
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark: t(//) Q�
Preparer's Signature 4- - er— Date %4A/��
Authorized Signat Date
See instructions for completing this form on the next page. l/
Revised. 6/1/06 2010Attach H-GrantCloseReconWS 1557O xls
Attachment It
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 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR It 9ND02P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 21,612.00
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.) 21,612.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1557
I. Total Expenses+Accruals Previously Reported(Through Last Month) 21,612.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2.❑.3.) 21,612.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+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.+IIl.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense) L V
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 21,612.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 21,612.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOLI
V CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI RECONCILIATION (P1 Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (Refund ` Extend ) 0.00
VIL MATCH RECONCILIATION Vax ti
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3. +II6.+111.3.) 21,612.00
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 G g:1),
Date EE:;≤Oy/
Authorized Signatus�..vv ---e) Date // / je "
See instructions for completing this form on the next page
Revised'. 6/1/06 201oAaach H-GrantCloseReconWS1557D xis
Attachment II
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Adult
Greeley, CO 80632 VAX ERF(VERF)# 1351
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NO01F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 323,702.00
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.) 323,702.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1351
I. Total Expenses+Accruals Previously Reported(Through Last Month) 323,702.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2.=11.3.) 323,702.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS723#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+II.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.+IIL2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 323,702.00
2. FINAL Expenses Through End of Contract(II 3.+II 6+111.3.) 323,702.00
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
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VL2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II 3.+II6+111.3.) 323,702.00
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) YESL /NOLJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding penod
Remark.' P77/1).
Date Preparer's Signature r.-?,;("2/
Authorized Signatur L/ .c _ Date
See instructions for completing this form on the next page.
2010Atlach H-GrantCloseReconW51351 a.xis
Revised 6/1/06
Attachment H
Page I oft
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(VERY)# 1488
CONTRACT or EA START DATE 03/06/2009 END DATE 09/30/2010
PROGRAM INCOME START DATE END DATE
CASH REQUEST(CR) CR #8NO01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 191,899.00
2. Current Program and Admin Cash Needs (CR It ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=1.3.) 191,899.00
IL PROGRAM EXPENSE REPORT(ER) Vat# 1488
I. Total Expenses+Accruals Previously Reported(Through Last Month) 191,899.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+11.2.=11.3.) 191,899.00
ADMINISTRATIVE EXPENSE(ER) Vat#
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
III. PROGRAM INCOME(PI) EXPENSE REPORT Vex#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(III.L+[11.2:111.3.) 0.00
IV. RECONCILIATION ((Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) II not,explain on the Remark below 191,899.00
2. FINAL Expenses Through End of Contract(11.3.+ II 6+1113.) 191,899.00
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#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -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.) 191,899.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLJ/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.' ��j �J
Preparer's Signature k�� (eft-- Date %< <�
Authorized Signatur 6 (c.t"'�"( Dateyes5kv0/6/
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Atlactl H.crantCloseReconWSl4e8 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 WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1352
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NY01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 457,276.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.4 I.2.=1.3.) 457,276.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 1352
I. Total Expenses+Accruals Previously Reported(Through Last Month) 457,276.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+II.2.=II.3.) 457,276.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(IL4,+IL5.—IL6.) 0.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+III.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 457,276.00
2. FINAL Expenses Through End of Contract(11.3.+11 6.+111.3.) 457,276.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLJ
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -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(I1.3.+II6.+III.3.) 457,276.00
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(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.
Remark.' ,�(
Preparer's Signature Date %/7
r� Date Vic--?9/--/0Authorized Signatur�
See instructions for completing this form on the next page.
Revised 611/06 2010Anach H-GranteloseReconWS1352B 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 WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1352
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I- CASH REQUEST(CR) CR #8NY01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 97,404.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+L2.=1.3.) 97,404.00
1L PROGRAM EXPENSE REPORT(ER) vax# 1352
I. 'Total Expenses+Accruals Previously Reported(Through Last Month) 97,404.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2.❑.3.) 97,404.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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(II.4.+11.5.=11.6.) 0.00
ILL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+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 97,404.00
2. FINAL Expenses Through End of Contract(11.3. +II 6.4-111.3.) 97,404.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total P1 Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI. -VI.2.=V1.3.) (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.+116.1111.3.) 97,404.00
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/NOL1
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding penbd
:::er's
`I Signature o 1- %
Date 7 7,100
Authorized Signatur - - Date C� SpA/
See instructions for completing this form on the next page.
Revised'. 6/1/06 2010Attach H-GrantCloseReconWsl]52C.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 WIA Youth
Greeley, CO 80632 VAX ERF(VERF)# 1352
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NAYIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# I 28,298.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+I.2.=1.3.) 28,298.00
IL PROGRAM EXPENSE REPORT(ER) Fax# 1352
I. Total Expenses+Accruals Previously Reported(Through Last Month) 28,298.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=II.3.) 28,298.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+II.5=II.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.1+IIl.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 28,298.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 28,298.00
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
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(III.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.+ II6.+111.3.) 28,298.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESIJ/NOLJ
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark: ((''''))
��
Preparer's Signature /�/ e Date �,// /J!////��S
Authorized Signal //yj-14 Date O ��/ V
See instructions for completing this form on the next page.
Revise+ 6/1/06 2010Attach H-GrantCloseReconWS1352A.is
Attachment II
Page I oft
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-Youth
Greeley, CO 80632 VAX ERF(VERF)# 1489
CONTRACT or EA START DATE 03/06/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #BNAYIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 22,154.88
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+12,=13.) 22,154.88
II, PROGRAM EXPENSE REPORT(ER) Vax# 1489
I. Total Expenses+Accruals Previously Reported(Through Last Month) 22,154.88
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2:I1.3.) 22,154.88
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSl23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+IL5.=11.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+162:111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 22,154.88
2. FINAL Expenses Through End of Contract(11.3. +116.+111.3.) 22,154.88
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LJ/NOLI
V CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=P1 Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(V I.I -VI.2.=V I.3.) (Refund r Extend ) _ 0.00
VII MATCH RECONCILIATION Vax
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+IIL3.) 22,154.88
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) _ YESU/NUJ
*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 lai` �,,�//�/1
Authorized Signat ( Date Y�/ "
See instructions for completing this form on the next page.
Revised'. 611/06 2010Attach H.GrantCloseReconWS1469A.KIs
Attachment It
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-Youth
Greeley, CO 80632 VAX ERF(VERF)# 1489
CONTRACT or EA START DATE 03/06/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
/. CASH REQUEST(CR) CR #8NY01P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 381,943.88
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.) 381,943.88
IL PROGRAM EXPENSE REPORT(ER) Vax# 1489
I. Total Expenses+Accruals Previously Reported(Through Last Month) 381,943.88
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(IL 1+11.2.=11.3.) 381,943.88
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI2J#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4+11.5:11.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(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 381,943.88
2. FINAL Expenses Through End of Contract(11.3.+II 6+II1.3.) 381,943.88
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOL I
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 (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 -V1.2.=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.+❑6,+111.3.) 381,943.88
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VI1.2 x V11.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VI1.4.)?(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: rer
Preparer's Signature . 4r Date er(27�0
Authorized Signat T
Date / o
See instructions for completing this form on the next page.
Revised 6/1/06 2010Attach H-GrantCtoseReconWS1469B 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-Youth
Greeley, CO 80632 VAX ERF(VERF)# 1489
CONTRACT or EA START DATE 03/06/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) CR #8NYOIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 230,860.24
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.) 230,860.24
IL PROGRAM EXPENSE REPORT(ER) Fax# 1489
I. Total Expenses+Accruals Previously Reported(Through Last Month) 230,860.24
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2=I1.3.) 230,860.24
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.II.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
L 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.+lII.2=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) j. ..
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 230,860.24
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 230,860.24
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=P1 Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II1.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIAHON Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 230,860.24
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) 'YES Li MOLT
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark: C„...ii, '- �i A
Preparer's Signature � �W Date / /'OAuthorized Sign, �� VVV""" Date y�cd
See instructions for completing this form on the next page.
Revised. 6/1/06 2010Attach H-GrantcloseReconW81489C.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 08
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA Disloc Worker
Greeley, CO 80632 VAX ERE(VERF)# 1353
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
CASH REQUEST(CR) CR #8NAD1F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 20,314.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+L2.=1.3.) 20,314.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1353
I. Total Expenses+Accruals Previously Reported(Through Last Month) 20,314.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II 1.+II 2=II3.) 20,314.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=II.6.) 0.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.L+IIl.2.=[II.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 20,314.00
2. FINAL Expenses Through End of Contract(11.3. +II 6.+111.3.) 20,314.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LH/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.] -VI.2.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+❑6,+I1I.3.) 20,314.00
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/NOT
•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 Datefrit
C)Authorized Signat Date �
See instructions for completing this form on the next page.
Revised. 6/1/06 2010Attach H-GrantCloseReconWS1353A 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 WIA Disloc Worker
Greeley, CO 80632 VAX ERF(VERF)# 1353
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #ENDOW
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 182,829.00
2. Current Program and Admin Cash Needs (CR 4 ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=1.3.) 182,829.00
H. PROGRAM EXPENSE REPORT(ER) Fax# 1353
I. Total Expenses+Accruals Previously Reported(Through Last Month) 182,829.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+B.2.=11.3.) 182,829.00
ADMINISTRATIVE EXPENSE(ER) Far#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.--11.6.) 0.00
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.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 182,829.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 182,829.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
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) 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 Fax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses through End of Contract(11.3.+116.+111.3.) 182,829.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESU/NOU
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding paned
Remark
� Z�Preparer's Signature d -- ! Date P/
Authorized Signatyr /may // Y Date
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Atlach H-GranlcloseReconW51353e 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 Disloc Worker
Greeley, CO 80632 VAX ERF(VERF)# 1559
CONTRACT or EA START DATE 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #9NAD1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 9,605.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+I.2.=1.3.) 9,605.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1559
I. Total Expenses Accruals Previously Reported(Through Last Month) 9,605.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 9,605.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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(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(III.I+III 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 9,605.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 9,605.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LVNOLJ
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 (P1 Cush Request=P/Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.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.) 9,605.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESW/NOLJ
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature Date CA..-/ Z��
Authorized Signatuy" „ cy Date b 3Q
See instructions for completing this fort on the next page-
Revised 6/1/06 201oAttach H-GrantCloseReconWs1559Axis
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 Disloc Worker
Greeley, CO 80632 VAX ERF(VERF)# 1559
CONTRACT or EA START DATE 07/01/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR)
CR #9ND01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR/4 ) 86,447.00
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.) 86,447.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1559
I. Total Expenses+Accruals Previously Reported(Through Last Month) 86,447.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=11.3.) 86,447.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+IL5.=11.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax# ,
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1+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 86,447.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 86,447.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI RECONCILIATION (P/Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (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.) 86,447.00
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) YESL/NOU
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark:
Preparer's Signature (M Y . Date 7O
Authorized Signat OeCC Date
See instructions for completing this form on the next page.
Revised: 6/1/06 20IDAttach H-GrantcleseReconWSl 5596.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 25%Enh Dis Work
Greeley, CO 80632 VAX ERF(VERF)# 1356
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
CASH REQUEST(CR) CR #8NFEIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 28,234.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2:1.3.) 28,234.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1356
I. Total Expenses+Accruals Previously Reported(Through Last Month) 28,234.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 28,234.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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(II.4.+11.5:11.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax# ({'
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+1,1.2.III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) tt ;
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 28,234.00
2. FINAL Expenses Through End of Contract(11.3.+ II 6.+111.3.) 28,234.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOH
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.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.] -V I.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(I1.3-+116.+111.3.) 28,234.00
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/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 j r Date ��
Authorized Signatur Date ///��y/�Q
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Ahach H-GrantCloseReconWS t 356B 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 25% Enh Dis Work
Greeley, CO 80632 VAX ERF(VERF)# 1356
CONTRACT or EA START DATE 07/01/2008 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NFEIF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# I 3,137.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.L+L2.1.3.) 3,137.00
IL PROGRAM EXPENSE REPORT(ER) Pax# 1356
I. Total Expenses+Accruals Previously Reported(Through Last Month) 3,137.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=11.3.) 3,137.00
ADMINISTRATIVE EXPENSE(ER) Vax II
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+11.5.=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(III.I.+❑1.2:III.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 3,137.00
2. FINAL Expenses Through End of Contract(II.3. +II 6.+111.3.) 3,137.00
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#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.I -VI 2.=VI.3.) (Refund * Extend I 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+111.3.) 3,137.00
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:
Preparer's Signature 41 � AZT Date % [yA)
_71Authorized Signal ; Date 7/30(/
See instructions for completing this form on the next page.
Revised: 6/1/D6 2010Attach H-GrantCloseReconWS1356A.xis
Attachment H
Page I oft
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 DVOP
Greeley, CO 80632 VAX ERF(V ERF)# 1355
CONTRACT or EA START DATE 10/01/2008 END DATE 09/30/2009
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8NV0l
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 7,008.00
2. Current Program and Adm in Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=1.3.) 7,008.00
H. PROGRAM EXPENSE REPORT(ER) Vax# 1355
I. Total Expenses+Accruals Previously Reported(Through Last Month) 7,008.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+11.2.=11.3.) 7,008.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.=11.6.) 0.00
Ill PROGRAM INCOME(PI)EXPENSE REPORT Vax#
L 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+lII.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 7,008.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 7,008.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L' /NOL I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total P1 Cash Balance(VI.! -VI.2.=VI.].) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vex#
I. FINAL Match Reported Through End of Contract
2, FINAL Expenses Through End of Contract(11.3.+II6.+111.3.) 7,008.00
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(V[l.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:
Preparer's Signature bel (/"(.( Date %`QL9
Authorized Sign Date �nl��/`�y//4',/ e
See instructions for completing this form on the next page. //!
Revised. 5/1/06 2010Attach H-GrantCloseReconWs1355.xis
Atracnment n
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 WP 10%SJH
Greeley, CO 80632 VAX ERF(VERF)# 1419
CONTRACT or EA START DATE 01/20/2009 END DATE 08/31/2009
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR #BNJOI
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 30,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+1.2:1.3.) 30,000.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1419
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(11.1.+11.2.=I1.3.) 30,000.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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(II.4.+11.5.II.6.) 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+III.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 30,000.00
2. FINAL Expenses Through End of Contract(II.3.+II 6+111.3.) 30,000.00
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#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -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.) 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.!.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESL-0/NOLI
'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
Signature /0 �w�VVVV Date �zt
Authorized Signatu
�yY�f Date �JY/
See instructions for completing this form on the next page.
Revised 6/1106 2010Attach H-GrantCloseReconWS1419 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 07/01/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) CR it 9NW01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 765,199.73
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.) 765,199.73
IL PROGRAM EXPENSE REPORT(ER) Vax# 1 560
I. Total Expenses+Accruals Previously Reported(Through Last Month) 765,199.73
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+11.2.=11.3.) 765,199.73
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS/23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=11.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(PIA.+111.2.111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 765,199.73
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 765,199.73
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI. RECONCILIATION (P/Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION vax#
I. FINAL Match Reported Through End of Contract
2, FINAL Expenses Through End of Contract(II.3. + 116.+61.3.) 765,199.73
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(VI1.4.)?(Check Box) YESLI/NOLI
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark
/
( / $T/o
Preparers Signature 1� . Date /
Authorized Signat .7��Lc Date �J9 7. O
See instructions for completing this Conn on the next page.
Revised'. 611/06 2010Attach H-GrantCloseReconWS1560.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-WP
Greeley, CO 80632 VAX ERF(VERF)# 1491
CONTRACT or EA START DATE 03/06/2009 END DATE 06/30/2011
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #BNWWo1
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 121,037.00
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.) 121,037.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 1491
I. Total Expenses+Accruals Previously Reported(Through Last Month) 121,037.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I.+11.2.=11.3.) 121,037.00
ADMINISTRATIVE EXPENSE(ER) Vax#
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.=l1.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III./+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) II not,explain on the Remark below 121,037.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+III.3.) 121,037.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ltl/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(4 ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VI RECONCILIATION (P/Cash Request=P/Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (Refund * Extend ) __ 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+❑6.+tll.3.) 121,037.00
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/NOL
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark:
Preparer's Signature r 6:: ar Date j� l
Authorized Signatur Date �3O�'/
See instructions for completing this form on the next page.
Revised: 6/1/06 2010Atlach H-GrantCloseReconWs1491.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 DPN -Salary
Greeley, CO 80632 VAX ERF(VERF)# 1599
CONTRACT or EA START DATE 07/01/2009 END DATE 06/30/2010
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) CR #8PPWC1
I. Total Program and Admin Cash Needs Previously Reported (Last CR# ) 27,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1_+1.2.1.3.) 27,000.00
H PROGRAM EXPENSE REPORT(ER) vax# 1599
I. Total Expenses+Accruals Previously Reported(Through Last Month) 27,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.11.3.) 27,000.00
ADMINISTRATIVE EXPENSE(ER) Vex#
4. Total Expenses 1-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+11.5:11.6,) _ 0.00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+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 27,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 27,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES H/NOL
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VL RECONCILIATION (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=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.) 27,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(V11.2 x VI1.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(V11.4.)?(Check Box) YESLJ/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 l/ lArPreparer's Signature / Date
Authorized Signatur L%��—"� //jcX-� Date /Y,/e-)
See instructions for completing this form on the next page.
Revised 6/1/06 2010Attach H-GrantetoseReconWSl599.els
Hello