HomeMy WebLinkAbout20152735.tiff RESOLUTION
RE: APPROVE GRANT CLOSEOUT FOR VARIOUS WORKFORCE INVESTMENT ACT
(WIA) 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 for Various Workforce
Investment Act Programs between the County of Weld, State of Colorado, by and through the
Board of County Commissioners of Weld County, on behalf of the Department of Human
Services, Employment Services of Weld County, and the Colorado Department of Labor and
Employment, for all programs that have Expenditure Authorizations ending during the period of
July 1, 2014, and June 30, 2015, with further terms and conditions being as stated in said grant
closeout, and
WHEREAS, after review, the Board deems it advisable to approve said grant closeout, 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 for Various Workforce Investment Act Program
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, Employment
Services of Weld County, and 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 grant closeout.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 17th day of August A.D., 2015.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST:, / EXCUSED
Barbara Kirkmeyer, Chair
Weld County Clerk to the Board
Mike Freeman, Pro-Tem
BY: A �. 1 l.t. L• t. :..�'�!��'►` �--
De• t Clerk to the Bo- d �� 1 ®♦ �C
`; n P •nwa
R
APPROVED AS TO FORM: 1161L •
Al l�,/�/
O().,e;0R
. ozad
ounty Attorney `"<<�� XCUSED
C)/
/� Steve Moreno
Date of signature: !!
2015-2735
kiskenT: + 9/II HR0086
MEMORANDUM
DATE: July 31,2015
i�,�.1861 i
TO: Board of County Commissioners—Pass-Around
FR: Judy A.Griego,Director, Human Services
N T Y RE: Department of Human Services'2014-2015 Workforce
Investment Act(WIA)Grant Closeout for the Colorado
Department of Labor and Employment(CDLE)
Please review and indicate if you would like a work session prior to placing this item on the
Board's agenda.
Request Board Approval of the Departments' 2014-2015 Workforce Investment Act
(WIA)Grant Closeout for the Colorado Department of Labor and Employment(CDLE).
The WIA Grant Closeout packet is required by the Year-End Contract Closeout Procedures of
CDLE and in accordance with their Policy Guidance Letter#06-12-FI for all programs that
have Expenditure Authorizations ending during the period July I,2014 to June 30,2015.
Revenues and expenses are reconciled and grant obligations are released for those projects that
are fully expended by the Division of Employment Services.
I do not recommend a Work Session. I recommend approval of this Closeout.
Approve Request
BOCC Agenda Work Session
Sean Conway
Steve Moreno
Barbara Kirkmeyer
Mike Freeman
Julie Cozad
2015-2735
Pass-Around Memorandum; July 31, 2015 Page 1
Attachment K
Colorado Department of Labor and Employment
Grant Closeout Signature Page
Workforce Region: Employment Services of Weld County
Address: P. O. Box 1805, Greeley, Colorado 80632
Director: Linda Perez Phone Number: (970)352-1551ext 6750
Fiscal Manager: Leonard Bottorff Phone Number: (970)352-1551 ext 6537
L. Master Grant/Contract Agreement Number: 14KAA 54599
CLOSEOUT SUMMARY
This closeout packet signature page includes the following contracts:
Program Funding Stream Amount Vax# Line Item
Year FSC123#
PY 11 WIA HIB $ 120,475.57 2155 1NHO2, 1AHC02
FY 13 25% Discretionary UI Pilot $ 95,000.00 2310 2NRU 1 F
PY 13 WIA Adult $ 292,235.00 2361 3NAOIF, 3AO01F
3NAD2F, 3AD02F
3NAD3F, 3AD03F
3ND02F, 3ND03F
3ND04F
PY 13 WIA Youth $ 687,164.00 2362 3NAY1P,P, 3AY01 P
3NY01 P, 3NYO2P
PY 13 WIA Dislocated Worker $ 244,619.00 2363 3NAD1P, 3AD01P
3NAD1F, 3AD01F
3ND01P,P, 3ND01 F
3ND05F
PY 13 Wagner Peyser $ 593,155.00 2364 3NW01, 3NW02
FY 13 TAA Case Management $ 30,082.00 2389 2Na01F
FY 14 DVOP $ 14,000.00 2408 3NV01
PY 13 Disaster NEG $ 520,595.00 2414 3NAK1 P, 3AKO1P
3AK02P, 3NPK1P
PY 13 WIA 25% Enhanced Dislocated Worker $ 33,213.00 2422 3NAF2P, 3AFE1P
3NFE2P
PY 13 Wagner Peyser 10% Summer Job Hunt $ 40,000.00 2431 3NJ01
PY 14 WIA Adult $ 526,400.00 2492 4NAO1P, 4AO01P
4NAD2P, 4AD02P
4NO01 P, 4ND02P
4NO01 F
PY 14 WIA Dislocated Worker $ 39,104.00 2494 4NAD1P, 4ADO1P
4ND01 P
PY 14 ESF $ 421,715.00 2496 4Ns01
FY 14 TAA Case Management $ 9,160.00 2497 3Na01 F
PY 13 Wagner Peyser 10% MSFW $ 30,226.00 2498 3NE01
PY 14 Disaster NEG $ 5,534.00 2541 4NAK1 P, 4AK01 P
2014-2015
Total $ 3,702,677.57
Each Program Year(PY)and funding stream listed above will have the following forms completed:
Form Attachment I and Attachment H:
• Grant Recipient's Release(Attachment I: page 1 of 6)
• Contract Closeout Tax Certification(Attachment I: page 2 of 6)
• Schedule of Unclaimed Checks(Attachment I: page 3 of 6)
• Grant Recipient's Assignment of Refunds, Rebates, and Credits(Attachment I: page 4 of 6)
• Sub-recipient Certification of Physical Inventory(Attachment I: page 5 of 6)
• Physical Inventory List(Attachment I: page 6 of 6)
• Grant Closeout Reconciliation Worksheet(Attachment H)
I certibi to the best of my knowledge and belief the following financial data reported in this
closeout packet is correctly stated.
By: 1\.c+ .ILQ�:�-��
AUG 1 7 2015
Local Elected Official Date
Chair, Board of County Commissioners or
Authorized Signature
020/5- X7&5 0)
2014-2015
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 11
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT H 1 B
Greeley,CO 80632 VAX ERF(VERF)# 2155
CONTRACT or EA START DATE 02/15/12 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 FCS123#1NH02
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) I20.47 57
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+L2.=L3.) 120.475.57
II. PROGRAM EXPENSE REPORT(ER) Vax# 2155
I. Total Expenses+Accruals Previously Reported(Through Last Month) 11(063.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=II.3.) 110. 6 3.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2155
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 1 AHCO2 # 9,612.57
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+II.5.=II.6.) 0.617.57
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+.+II1.2.=1I1.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 120,475.57
2. FINAL Expenses Through End of Contract(II.3.+II 6.+111.3.) 120,475.57
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES S f I/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (P1 Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vex# �
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+II1.3.) 120,475.57
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/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 Signaturei� Date ,/?1///-
/
Authorized Signaturi Date 7/��/ )�
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2155.xlsx
mik
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT 25%Discretionary UI Pilot
Greeley,CO 80632 VAX ERF(VERF)#2310
CONTRACT or EA START DATE 06/01/13 END DATE 03/31/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 2NRUIF
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 9s.(N10.00
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.) `)-000.00
II. PROGRAM EXPENSE REPORT(ER) var# 2310
1. 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.1.+II.2.=IL3.) 9�-001.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# r 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=11.6.) 11.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(111.1.+1I1.2.=111.3.) u.o0
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 95,000.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 95,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NO'
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=P1 Expenses)
1. 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.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+II6.+III.3.) 95,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH a/NO L.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:
Preparer's Signature `ii -.1' 7 Date-7/21'i 1
S
Authorized Signatur Date 7/2 4 111
See instructions for completing this form on the next page.
Revised 6/1/06 2015AttachHCloseRec2310.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley,CO 80632 VAX ERF(VERF)#2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR)
VAX CR#1847 3NAO1F
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 51,467.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=1.3.) 51,467.00
IL PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month) 0.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2=11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2361
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AO01F 0 51,-467.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=1I.6.) 51,46751(1
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.l.+III.2=I1I.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 51,467.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+III.3.) 51,467.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES IJ/NOU
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) _ 0.0(1
VI. RECONCILIATION (P1 Cash Request=P1 Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(I11.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax# 74
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+I16.+III3.) 51,467.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) .3.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOU 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:
Preparer's Signature s�G°G Date 7/Z4/A.—
Authorized Signatur Date 7/, // F
See instructions for completing this form on the next page.
Revised 6/1/06 2015AttachHCloseRec2361.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)# 2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NAD2F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 10,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+I.2.=1.3.) 10,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax#
L Total Expenses+Accruals Previously Reported(Through Last Month) 0.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=II.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2361
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AD02F # 10,000.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=11.6.) 10,000.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax# ��•�
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 10,000.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+III.3.) 10,000.00
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#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0.00
VL RECONCILIATION (P1 Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) - (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 10,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NOH
*The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature Date /z.t/ /-C—
Authorized Signatu v • Date 7/ 4//11.-
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2361B visa
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley,CO 80632 VAX ERF(VERF)# 2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NAD3F
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 6.(m.,#)
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2=I.3.) (,)37.00
/I. PROGRAM EXPENSE REPORT(ER) Vax#
I. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+II.2.=11.3.) 0.0(1
ADMINISTRATIVE EXPENSE(ER) Vax# 2361
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AD03F # (037.90
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+II.5.=I1.6.) 0.037.90
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+IIl.2.=1I1.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 6,037.90
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+1I1.3.) 6,037.90
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/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# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) II-uo
2. Less Program Income Expenses Through Contract End Date(III.3.) (ou
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 1111f1
VIL MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+1I1.3.) 6,037.90
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 H/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 J� Date 7l ',s
Authorized Signatur#01,
�� Date 7/`7//r
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2361 F.xlsx
i
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)#2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3ND02F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 90.000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=I.3.) 90MU.titl
II. PROGRAM EXPENSE REPORT(ER) Vax# 2361
1. Total Expenses+Accruals Previously Reported(Through Last Month) U.000 00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.i-11.1=11.3.) 99.000.U0
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.=Il.6.) 0.110
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(1H.1.+III.2.=III.3.) 0 00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 9U,000 00
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+III.3.) 90,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES -./NO L-
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=P1 Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(11I.3.) 0.0U
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+1I1.3.) 90,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VI1.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES J/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 /Alibi-
-
Authorized Signatur �� Date
7/9-4/
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2361 C.xlsx
i
Attachment H
Page 1 of I
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)# 2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NDO3F
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) o>.`o'.I i)
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.) 'x.,.06'.I 0
II. PROGRAM EXPENSE REPORT(ER) Vax# 2361
1. Total Expenses+Accruals Previously Reported(Through Last Month) q?.Oh'.I I)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+I1.2.=II.3.) 93,962.10
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#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(1II.1.+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 93,962.10
2. FINAL Expenses Through End of Contract(11.3.+H 6.+111.3.) 93,962.10
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.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(I11.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
t MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+I16.+III.3.) 93,962.10
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 l_4_1/NOL':
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature �� Date 7/2'x/c
Authorized Signatur Date 7/24/ /
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2361D.xlsx
•
Attachment H
Page 1 of
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)#2361
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NDO4F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) a!!. !,,.uu
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.)
II. PROGRAM EXPENSE REPORT(ER) Vax# 2361
1. Total Expenses+Accruals Previously Reported(Through Last Month) tU.?os!tl!
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.I.+1I.2.=II.3.) 40,
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# ri
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#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL P1 Expenses Through End Date of Contract(III.1.+III.2.=[I1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 40,768 UU
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 40,768.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L✓i/NN1OL!
V CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=P1 Expenses) '
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(1I1.3.) 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(11.3.+II6.+III.3.) 40,768.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES /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 „.2 . Date 744111�
Authorized Signatur -CC i � Date 7/7/41f
tiC�
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2361 E,xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT YOUTH
Greeley,CO 80632 VAX ERF(VERF)#2362
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX GR#1847 3NAv1P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 08.7 16.00
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.) 68,716.00
II. PROGRAM EXPENSE REPORT(ER) Vax#
I. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+I1.2.=11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2362
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AY0 I P # 65.7 16.011
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5:II.6.) 0 .7 16.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.I.+III.2.=1I1.3.) 0.00
/V. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 68,716.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+II1.3.) 68,716.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NO
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR if
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.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+1I6.+III.3.) 68,716.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VIM.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES[A/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 Date fiAl I�S�
Authorized Signatur Date 7/Z4
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2362A.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT YOUTH
Greeley, CO 80632 VAX ERF(VERF)#2362
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NY01 P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 185,534 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.) 185,534.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2362 s - �
1. Total Expenses+Accruals Previously Reported(Through Last Month) 185,534.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(H.1.+II.2.=II.3.) 185,53-1.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# to 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5=IL6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1,+III.2.=III.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 185,534.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 185,534.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NO L
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (P1 Cash Request=P1 Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(1II.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+I16.+III.3.) 185,534.00
3, Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES i.. )/NO(• ..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:
Preparer's Signature �' ' Date'77? iii
Authorized Signatur ( Date 7A(///r
See instructions for completing this form on the next page.
Revised 6/1/06 2015AttachHCloseRec2362B.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT YOUTH
Greeley, CO 80632 VAX ERF(VERF)#2362
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NY02P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) -1A2,914.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=1.3.) 432,914.00
/I. PROGRAM EXPENSE REPORT(ER) Vax# 2362
I. Total Expenses+Accruals Previously Reported(Through Last Month) 432,9 14.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+II.2.=11.3.) 432,914.0x)
ADMINISTRATIVE EXPENSE(ER) Vax# ti
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSl23# # 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=II.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
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.+II1.2.=III.3.) 0.00
I V. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 432,914.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 432,914.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ls/NOH
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. 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)
1. 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.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+I16.+111.3.) 432,914.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES /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 1/Ill Id
Authorized Signatqr Date 7/2-4 1,I
See instructions for completing this form on the next page.
Revised 6/1/06 2015AttachHCloseRec2362C.xlsx
Attachment H
Page 1 Ol-2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley,CO 80632 VAX ERF(VERF)# 2363
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAX CR#1847 3NADIP
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 4,749.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=1.3.) 4,749.00
IL PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month) 0.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=II.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2363
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AD0 1 P # 4,749.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.=II.6.) 4,749.00
III PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+111.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense) -.
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 4,749.00
2. FINAL Expenses Through End of Contract(11.3.+11 6.+III.3.) 4,749.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/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.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.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+111.3.) 4,749.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES L/NC'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: _
Preparer's Signature ;.1i Date7/vi,/.j
Authorized Signatur C—L,---Z--k Date 7 24/(-C-
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2363.xlsx
Attachment H
Page 1ofI
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley, CO 80632 VAX ERF(VERF)#2363
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NADIF
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 12.106 I o
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=I.3.) 1_,I U6.I U
II. PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month) 0.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+II.2.=II.3.) U.U0
ADMINISTRATIVE EXPENSE(ER) Vax# 2363
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AD01 F # 12,1(16.I()
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5:11.6.) 12,106.10
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax# �. >>
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.I.+I11.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 12,106.10
2. FINAL Expenses Through End of Contract(11.3.+II 6.+11J.3.) 12,106.10
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NO'
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 11 01)
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(1II.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend I 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 12,106.10
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 E1.)
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 ! 't/(t
Authorized Signatur ��� Date 7/3-4(1"
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2363E.xlsx
Attachment H
Page 1c 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley,CO 80632 VAX ERF(VERF)#2363
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NDO I P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 42,749.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=I.3.) 42,749.00
IL PROGRAM EXPENSE REPORT(ER) vax# 2363 _ . m..
1. Total Expenses+Accruals Previously Reported(Through Last Month) 42,749.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+II.2.=II.3.) 42,749.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# 4 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(H.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.+II1.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 42,749.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 42,749.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) 1"h:S _!/NO
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=PI Expenses) £
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+116.+111.3.) 42,749.00
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) YES L/NOLJ
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark'
Preparer's Signature _Date 7/24/(/S�
Authorized Signatu Date 71 24I/
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2363B.xlsx
r
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley, CO 80632 VAX ERF(VERF)# 2363
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3No01F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 144,244 00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=I.3.) 144,'4400
_
II. PROGRAM EXPENSE REPORT(ER) Vax# 2363
1. Total Expenses+Accruals Previously Reported(Through Last Month) 144,244 00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+11.2.=11.3.) 144,244.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# # 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(1I.4+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(I11.1.+1[1.2.=11I.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 144,244.90
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 144,244.90
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LINOLJ
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 O)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (P1 Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+116.+111.3.) 144,244.90
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES td/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 j� _Date 7/7 I) C
Authorized Signature
c r< Date 7/ t(Ii 1
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2363C.xlsx
1
Attachment II
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley,CO 80632 VAX ERF(VERF)#2363
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NDOSF
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 40.770.00
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.) 40,770.00
I/. PROGRAM EXPENSE REPORTER) Vax# 2363
1. Total Expenses+Accruals Previously Reported(Through Last Month) 40,770.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=II.3.) 40,770.00
ADMINISTRATIVE EXPENSE(ER) Vax# -
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# # 0.00
5. Current Expenses+Accruals(Through End Date of Award) _
6. FINAL Administrative Expenses Contract to Date(II.4.+I1.5.=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(Ill.l.+III.2.=111.3.) 0.00
/V RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 40,770.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 40,770.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES UMOLi
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=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.1-VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+III.3.) 40,770.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES /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 „04--17' Date 7/7"Y /IA
Authorized Signatu /..e'>✓.c Date 7/(/I _
See instructions for completing this form on the next page.
Revised. 6/1/06 2015Attach HCIoseRec2363Dxlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Wagner Peyser
Greeley,CO 80632 VAX ERF(VERF)#2364
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 SNWOI
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 512,357.0o
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=I.3.) 5 12,357.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 2364
I. Total Expenses+Accruals Previously Reported(Through Last Month) 512,357.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+II.2.=II.3.) 5 12.357.00
ADMINISTRATIVE EXPENSE(ER) vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# #
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+II.5.=11.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract) •
3. TOTAL PI Expenses Through End Date of Contract(III.I+I1I.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense) ,
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 512,357.00
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+1I1.3.) 512,357.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES LI/NO I
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# ) _
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(I11.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+II6.+III.3.) 512,357.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESIJ/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 #4" Date 7/1A-1'i(
7/ r/1
Authorized Signatur ^-e-�a Date /
See instructions for completing this form on the next page.
Revised: 611106 2015AttachHCloseRec2364xisx.xlsx
Attachment H
Page 1 of I
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Wagner Peyser
Greeley,CO 80632 VAX ERF(VERF)#2364
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
/. CASH REQUEST(CR) VAX CR#1847 3NW02
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 80,798.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=I.3.) 80,798.u0
II PROGRAM EXPENSE REPORT(ER) Vax# 2364
I. Total Expenses+Accruals Previously Reported(Through Last Month) m).7,-) .0o
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+II.2.=II.3.) 80.708.00
ADMINISTRATIVE EXPENSE(ER) vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# ii
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(I11.1.+II1.2.=III.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) if not,explain on the Remark below 80,798.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+III.3.) 80,798.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /N0I
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 (PI Cash Request=PI Expenses) '" 71.
ai
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 80,798.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES!__.J/NO I....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:
::::::::::
"4 Date Date 7/) l/ I
r�
See instructions for completing this form on the next page.
Revised: 611/06 2015AttachHCloseRec23646.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT TAA Case Mgmnt
Greeley, CO 80632 VAX ERF(VERF)# 2389
CONTRACT or EA START DATE 07/01/13 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAX CR#1847 2Na01F +
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 30,082.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2.=L3.) 30,082.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2389 4 ,A
I. Total Expenses+Accruals Previously Reported(Through Last Month) 30,082.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+II.2.=II.3.) 30,082.00
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.=1I.6.) 0.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(II1.1.+'11.2.=I1I.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 30,082.00
2. FINAL Expenses Through End of Contract(11.3.+11 6.+III.3.) 30,082.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOJ
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(i)
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(I11.3.) 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(I1.3.+116.+111.3.) 30,082.00
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 period.
Remark:
Preparer's Signature „Atemil/ Date 7/ 4///c/
Authorized Signatur Date 7A(//13
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2389.xlsx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT DVOP
Greeley,CO 80632 VAX ERF(VERF)#2408
CONTRACT or EA START DATE 10/07/13 END DATE 09/30/14
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NV01 __
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 14,000.o{I
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.) I-t.00O-oo
II. PROGRAM EXPENSE REPORT(ER) Vax# 2408
1. Total Expenses+Accruals Previously Reported(Through Last Month) 1-i,oiii).on
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+I1.2.=II.3.) H-H.{liuuu uO
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.+I1.5.=II.6.) ).Uo
IIL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+1II.2.=I1I.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 14,000.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+III.3.) 14,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES UrNOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VL RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+III.3.) 14,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x V1I.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESIJ/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: J/
Preparer's Signature Date /I NO N
Authorized Signatur (/ Date 7/ 4/1
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2408xisx.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Disaster NEG
Greeley, CO 80632 VAX ERF(VERF)#2414
CONTRACT or EA START DATE 10/07/13 END DATE 09/30/15
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAXCR#1847 3NAK1P �.
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 34,500.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+L2.=1.3.) 34,500.00
IL PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.I.+1I.2.=11.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2414
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 3AK0I P # 31,754.00
3AK02P # 2,746.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.-11.6.) 34,500.00
III PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+III.2.=111.3.) 0.00
/V. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 34,500.00
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+III.3.) 34,500.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES IJ/NO U
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) -0,
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax# 5
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+116.+III.3.) 34,500.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLJ/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 %' Date 7/ qlAuthorized Sign ur Date 7/2
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2414xIsx.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Disaster NEG
Greeley, CO 80632 VAX ERF(VERF)# 2414
CONTRACT or EA START DATE 10/07/13 END DATE 09/30/15
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 3NPK1 P ,
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 486,095.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.=1.3.) -1S6,00 00
II. PROGRAM EXPENSE REPORT(ER) Vax# 2414
I. Total Expenses+Accruals Previously Reported(Through Last Month) 486,095.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=11.3.) 486.095.00
ADMINISTRATIVE EXPENSE(ER) Vax# e' e
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.=1I.6.) 0.00
III. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+III.2.=11I.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 486,095.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+111.3.) 486,095.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOU
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. 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=P/Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
• 2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=V1.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+II6.+III.3.) 486,095.00
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/NOL
'The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark.
Preparer's Signature %'��' 1� Date '2#91
Authorized Signat Date 7/ /r 1
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2414Bxlsx.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA 25%ENHANCED DW
Greeley, CO 80632 VAX ERF(VERF)#2422
CONTRACT or EA START DATE 10/10/13 END DATE 06/30/15
• PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NAF2P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3,321,00
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.) ;..12 I l lu
II. PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=11.3.) 0 00
ADMINISTRATIVE EXPENSE(ER) Vax# 2422
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# 3AFE1P # 3,32110^
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=II.6.) 3,"1211)0
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(II1.1.+111.2.=1I1.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 3,321.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+III.3.) 3,321.00-
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES Ld i/NO U
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
I. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(I1I.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+II6.+III.3.) 3,321.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES[?.l/NO L....
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature Date 7/J
f
Authorized Signatur Date 7/ 2'1 f/
See instructions for completing this form on the next page.
Revised 6/1/06 2015AttachHCloseRec2422A.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WIA 25%ENHANCED DW
Greeley, CO 80632 VAX ERF(VERF)#2422
CONTRACT or EA START DATE 10/10/13 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NFE2P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 29,892.00
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.) 29,892.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2422
I. Total Expenses+Accruals Previously Reported(Through Last Month) 29,892.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+11.2.=I1.3.) 29,892.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSI23# # 0.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+11.5.=I1.6.) 0.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+.+III.2.'111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 29,892.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 29,892.00
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 (PI Cash Request=PI Expenses)
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+III.3.) 29,892.00
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/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 _Date 7 ;7/If
� fff
Authorized Signatur Date 7/7 slCf S
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2422B.xlsx
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 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WP 10% SJH
Greeley, CO 80632 VAX ERF(VERF)# 2431
CONTRACT or EA START DATE 02/01/14 END DATE 12/31/14
PROGRAM INCOME START DATE END DATE
I CASH REQUEST(CR) VAX CR#1847 3NJ01 _
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 40,000.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+1.2.=I.3.) 40,000.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 2431 r------r-x
1. Total Expenses+Accruals Previously Reported(Through Last Month) 40,000.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+II.2.=1I.3.) 40,000.00
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(II.4.+I1.5.=1I.6.) 0.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+III.2.=II1.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 40,000.00
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+III.3.) 40,000.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES d/NOUJ
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.)
VI RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II1.3.) 0.00
3. Total P1 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(I1.3.+II6.+I1I.3.) 40,000.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.).)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESH/NO Ll
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature ,0" Date 7/z1t/h c
Authorized Signatu ��� Date 7/'"7"/(i i
fffFFF✓ ��
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2431xIsx.xlsx
Attachment H
Page 1of1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)#2492
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4NAO1P
L Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3,802.0(1
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+I.2=L3.) c,02 o
II. PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+1I.2.=II.3.) 0.00
ADMINISTRATIVE EXPENSE(ER) Vax# 2492
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 4AO0I P # 1,m(2 00
5, Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=IL6.) 3802.00
PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+IIL2.=111.3.) 0.00
I V. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 3,802.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+III.3.) 3,802.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOL
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=P1 Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(11I.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+116.+III.3.) 3,802.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES ILI/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:
Preparer's Signature Date 2/71r
Authorized Signatur Date (S
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2492C.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)# 2492
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4NAD2P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3,910.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+1.2.=1.3.) 3,910.00
II, PROGRAM EXPENSE REPORT(ER) vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(I1.1.+II.2.=II.3.) 0.00
. .............. . _ ...
ADMINISTRATIVE EXPENSE(ER) Vax# 2492
4. Total Expenses+Accruals Previously Reported(Through Last Month) F'CS123# 4AD02P # 3,910.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=II.6.) 3,910.00
III PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(II1.1.+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 3,910.00
2. FINAL Expenses Through End of Contract(I1.3.+II 6.+I1I.3.) 3,910.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NO LI
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(I11.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+II6.+III.3.) 3,910.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESL:_l/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. �r q�,
Preparer's Signature Date 7/`7//.1
Authorized Signatur Date 7 PlfC
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2492Dxlsx.xlsx
,
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 14 -
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)# 2492
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 4NO0I P ` % as
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 34,227.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=I.3.) _ 3.4.227.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2492
1. Total Expenses+Accruals Previously Reported(Through Last Month) 34,227.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=II.3.) 34,227.00
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
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+111.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) : .
1. FINAL CR Contract to Date(I.3.) If not,explain on the Remark below 34,227.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 34,227.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NO Li
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(111.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII. MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(1I.3.+I16.±111.3.) 34,227.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YESLI/NOL
The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark: ��r
Preparer's Signature Date 7/>�01)r-
Authorized Signatur Date 7 0 ci01/
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2492A.xlsx
i
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)#2492
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 4ND02P
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 35,193.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.l.+L2.=I.3.) 35,193.00
H. PROGRAM EXPENSE REPORT(ER) Vox# 2492 ,i.:-.4„:',.-1.,'
I. Total Expenses+Accruals Previously Reported(Through Last Month) 3-5,193.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.I+11.2.=IL3.) 35,193.00
ADMINISTRATIVE EXPENSE(ER) Vax 4A- <
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.+IL5.=11.6.) 0 00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax# - h
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+01.2.=111.3.) 0 00
IV. RECONCILIATION (Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 35,193.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+III.3.) 35,193.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/1OLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0 00
VI RECONCILIATION (P1 Cash Request=PI Expenses)
4
I. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(III.3.) 0 00
3. Total PI Cash Balance(VI.1 -VL2.=VI.3.) (Refund * Extend 1 0.00
VII MATCH RECONCILIATION yax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+116.+111.3.) 35,193.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES H/NO!....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:
Preparer's Signature ` -t:V _Date .2L0 i�
Authorized Signatur ; �� Date // 712-7k
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCioseRec2492B.xtsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Adult
Greeley, CO 80632 VAX ERF(VERF)#2492
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4NO01F
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 43 ,13U.05
2. Current Program and Admin Cash Needs (CR# 1847 ,Column F) 11,117.95
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=I.3.) 449,268.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2492
1. Total Expenses+Accruals Previously Reported(Through Last Month) 438,150.05
2. Current Expenses+Accruals(Through End Date of Award) 11,1 17.95
3. FINAL Program Expenses Contract to Date(11.1.+II.2.=II.3.) 449,268.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(11.4.+II.5.=II.6.) 0.00
HI. PROGRAM INCOME(PI)EXPENSE REPORT Vax#
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(111.1.+I11.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 449,268.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 449,268.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES /NO
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (P1 Cash Request=P/Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(II1.3.) 0.00
3. Total PI Cash Balance(VI.I -VI.2.=VI.3.) (Refund * Extend
0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+II6.+II1.3.) 449,268.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES /NOi
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Pre arer's Si nature S�
Date
Authorized Signatur Date 7/27 J/
See instructions for completing this form on the next page.
Revised: 6/1/06 2015AttachHCloseRec2492ExIsx.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley, CO 80632 VAX ERF(VERF)#2494
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4NADIP
1. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 3.011 0.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(1.I.+1.2.=1.3.) 3,910 00
II. PROGRAM EXPENSE REPORT(ER) Vax#
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(11.1.+II.2.=II.3.) 0 00
ADMINISTRATIVE EXPENSE(ER) Vax# 2494
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 4AD0 I P # 3,910 00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+II.5.=I1.6.) -3.010 00
HL PROGRAM INCOME(PI)EXPENSE REPORT Vax#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.I.+.+III.2.=1I1.3.) 0 10
IV RECONCILIATION (Cash Request=Expense) ,
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 3,910.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 3,910.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES U/NOU
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.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(1II.3.) 0 00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax# '",-,
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+11I.3) 3,910.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES ±1/NO C_
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 0175)r-cooK
, Date '7/"%r jS----
Authorized Signat /P-----1"--9
Date /---Vb
See instructions for completing this form on the next page.
Revised: 6/1/06
2015AttachHCloseRec2494.xlsx
inimmimannums
Attachment H
Page 1ofl
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Dislocated Worker
Greeley, CO 80632 VAX ERF(VERF)#2494
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4ND01P
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 i 35,104 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.) 35,194,00
H. PROGRAM EXPENSE REPORT(ER) vax# 2494a
I. Total Expenses+Accruals Previously Reported(Through Last Month) 35,194.00
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(1I.1.+II.2.=II.3.) 35,194.00
ADMINISTRATIVE EXPENSE(ER) vex#
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
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.+1II.2.=111.3.) 0.00
IV RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 35,194.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+III.3.) 35,194.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) 1 ES;JINO L_
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR#
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI RECONCILIATION (PI Cash Request=P1 Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(11L3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION vax#
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(I1.3.+116.+111.3.) 35,194.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES /NOI
*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
Preparer's Signature iS�� /' Date l/l' i./
r �Authorized Signatur Date 7/2 //,r
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2494B.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT ESF
Greeley, CO 80632 VAX ERF(VERF)# 2496
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 4Ns01
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 362,633.76
2. Current Program and Admin Cash Needs (CR# 1847 ,Column F) 59,081.24
3. FINAL Program and Admin Cash Needs Contract to Date(I.I.+I.2.=I.3.) 421,715.00
II. PROGRAM EXPENSE REPORT(ER) Vax# 2496
I. Total Expenses+Accruals Previously Reported(Through Last Month) 362,633.76
2. Current Expenses+Accruals(Through End Date of Award) 59,081.24
3. FINAL Program Expenses Contract to Date(II.I.+1I.2.=II.3.) 421,715.00
ADMINISTRATIVE EXPENSE(ER) Vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# #
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(I1.4.+[1.5.=11.6.) 0.00
III PROGRAM INCOME(PI)EXPENSE REPORT Vox#
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.1.+[11.2.=111.3.) 0.00
IV. RECONCILIATION (Cash Request=Expense) 4
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 421,715.00
2. FINAL Expenses Through End of Contract(II.3.+II 6.+[II.3.) 421,715.00
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 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(1II.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VII MATCH RECONCILIATION Vax#
1. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract([1.3.+[I6.+II1.3.) 421,715.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0,00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES I_J/NO L_!
•The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period
Remark:
Preparer's Signature s�� _Date 7/ikf
Authorized Signatur ��
��� Date 772-Y/f�'
See instructions for completing this form on the next page. J
Revised' 6/1/0S
2015Attach HCIoseRec2496.xlsx
Attachment H
Page I of I
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS FY14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT TAA Case Management
Greeley, CO 80632 VAX ERF(VERF)#2497
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/16
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3Na01F
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 5,552.08
2. Current Program and Admin Cash Needs (CR# 1847 ,Column F) 3,607.92
3. FINAL Program and Admin Cash Needs Contract to Date(1.1.+1.2.=I.3.) 9,160.00
IL PROGRAM EXPENSE REPORT(ER) Vax# 2497
I. Total Expenses+Accruals Previously Reported(Through Last Month) 5,552.08
2. Current Expenses+Accruals(Through End Date of Award) 3,607.92
3. FINAL Program Expenses Contract to Date(I1.1.+11.2.=II.3.) 9,160.00
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(1I.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 PI Expenses Through End Date of Contract(111.l.+111.2.=111.3.) 0.00
I V. RECONCILIATION (Cash Request=Expense)
1. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below 9,160.00
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 9,160.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L/NOLI
V. CASH REQUEST PROGRAM INCOME CASH REPORTED allailling
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.1.+V.2=V.3.) 0.00
VI. RECONCILIATION (PI Cash Request=PI Expenses)
I. 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(11.3.+116.+III.3.) 9,160.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES IS-1/NO[....1
'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 7/7O/S�
Authorized Signatur f/ , i Date
See instructions for completing this form on the next page.
Revised. 6/1/06 2015AttachHCloseRec2497.xlsx
Attachment H
Page 1 of 1
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 13
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT WP 10% MSFW
Greeley, CO 80632 VAX ERF(VERF)#2498
CONTRACT or EA START DATE 07/01/14 END DATE 06/30/15
PROGRAM INCOME START DATE END DATE
I. CASH REQUEST(CR) VAX CR#1847 3NE01 �
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) "23,517.3"1
2. Current Program and Admin Cash Needs (CR# 1847 ,Column F) 6,708.69
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+I.2.=I.3.) 30,226.00
IL PROGRAM EXPENSE REPORT(ER) vax# 2498 ' ,
I. Total Expenses+Accruals Previously Reported(Through Last Month)
23,517.31
2. Current Expenses+Accruals(Through End Date of Award) 6,708.69
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=11.3.) 30,226.00
ADMINISTRATIVE EXPENSE(ER) vax#
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCSJ23#
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+11.5.=11.6.)
III PROGRAM INCOME(PI)EXPENSE REPORT 0 00
vax# :- :' t
I. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(M.1.+111.2.=111.3.)
IV. RECONCILIATION u..OU
.
(Cash Request=Expense)
I. FINAL CR Contract to Date(1.3.) If not,explain on the Remark below
2. FINAL Expenses Through End of Contract(11.3.+II 6.+111.3.) 30,226.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) 30,226.00
NoI
YES L� OI L
V. CASH REQUEST PROGRAM INCOME CASH REPORTED
alialinal
I. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR#
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) column G)
0.00
VI RECONCILIATION
(PI Cash Request=P/Expenses)
1. FINAL Program Income Cash(V.3.)
2. Less Program Income Expenses Through Contract End Date(11I.3.) 0.00
3. Total PI Cash Balance(V1.1 -VI.2.=VI.3.) (Refund * Extend 0.00
0.00
VII MATCH RECONCILIATION
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(11.3.+116.+111.3.) 30,226.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VIl.3.)
5. Total Match Reported(VII.I.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box 0.00
)*The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal YES(-/l/NO{funding period.
Remark:
1 /Preparer's SignaturedoWilY
Date 7/7J1L--
Authorized Signatu Date � ! r _.
See instructions for completing this form on the next page.
Revised 6/1/06
2015AttachHC IoseRec2498.x(sx
Attachment H
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT/EA CLOSEOUT RECONCILIATION WORKSHEET
SUBRECIPIENT Employment Services of Weld County YEAR OF FUNDS PY 14
ADDRESS PO Box 1805 TITLE/PROGRAM/PROJECT Disaster NEG
Greeley, CO 80632 VAX ERF(VERF)# 2541
CONTRACT or EA START DATE 07/01/14 END DATE 09/30/15
PROGRAM INCOME START DATE END DATE
L CASH REQUEST(CR) VAX CR#1847 4NAKIP
I. Total Program and Admin Cash Needs Previously Reported (Last CR# 1847 ) 5,534.00
2. Current Program and Admin Cash Needs (CR# ,Column F)
3. FINAL Program and Admin Cash Needs Contract to Date(I.1.+1.2.=L3.) s,5 34 00
IL PROGRAM EXPENSE REPORT(ER) vax# ,
1. Total Expenses+Accruals Previously Reported(Through Last Month)
2. Current Expenses+Accruals(Through End Date of Award)
3. FINAL Program Expenses Contract to Date(II.1.+II.2.=11.3.) 0 00
ADMINISTRATIVE EXPENSE(ER) Vax# 2541 �-
4. Total Expenses+Accruals Previously Reported(Through Last Month) FCS123# 4AK01 P # 5,534.00
5. Current Expenses+Accruals(Through End Date of Award)
6. FINAL Administrative Expenses Contract to Date(II.4.+II.5.=II.6.) 5,534.00
HI PROGRAM INCOME(PI)EXPENSE REPORT Vax# _•
1. Total Program Income Expenses Reported(Last Quarter)
2. Current Program Income Expenses(Through End Date of Contract)
3. TOTAL PI Expenses Through End Date of Contract(III.l.+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 5,534.00
2. FINAL Expenses Through End of Contract(1I.3.+II 6.+III.3.) 5,534.00
3. CR to Date=Expense reported Through End Date of Contract?(Check Appropriate Box) YES L7/NOLI
V CASH REQUEST PROGRAM INCOME CASH REPORTED
1. Total PI Cash Previously Reported on CR (Last CR# )
2. Current Program Income Cash(Through End Date of Contract) (CR# ,column G)
3. FINAL Program Income Cash Contract to Date(V.I.+V.2=V.3.) 0 00
VI RECONCILIATION (PI Cash Request=PI Expenses)
1. FINAL Program Income Cash(V.3.) 0.00
2. Less Program Income Expenses Through Contract End Date(1II.3.) 0.00
3. Total PI Cash Balance(VI.1 -VI.2.=VI.3.) (Refund * Extend ) 0.00
VIL MATCH RECONCILIATION Vax# -
I. FINAL Match Reported Through End of Contract
2. FINAL Expenses Through End of Contract(II.3.+II6.+III.3.) 5,534.00
3. Match Percentage of Expenditure Contractual Requirement
4. Match Expenditure Requirement(VII.2 x VII.3.) 0.00
5. Total Match Reported(VII.1.)>or=to Match Expenditure Requirement(VII.4.)?(Check Box) YES Li/NOLI*The Program Income Expense Report and Cash Request can only be extended through the availability of the Award and/or Federal funding period.
Remark:
Preparer's Signature _6 //V----7, Date 7 /j
_
Authorized Si r
Date 7/ [ l}
See instructions for completing this form on the next page.
Revised 6/1/06
2015Attach HC lose R ec2541.x lsx
r
Attachment I
Page 1 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S RELEASE
Grant Recipient's Name: Employment Services of Weld County
Address: PO Box 1805, Greeley, CO 80632
Release Date:
Pursuant to the terms of Contract/Grant Agreement Number 14 KAA 54599 , including the Expenditure
Authorizations (EAs) awarded under said Contract/Grant Agreement, as VAX/FCS123 number(s): 2155/1NH02 ,
2155/1AHC02 , 2310/2NRU1F , 2361/3NAO1F , 2361/3AO01F , 2361/3NAD2F , 2361/3AD02F , 2361/3NAD3F ,
2361/3AD03F 2361/3ND02F , 2361/3ND03F , 2361/3ND04F , 2362/3NAY1P , 2362/3AY01P , 2362/3NY01P ,
2362/3NY02P , 2363/3NAD1P , 2363/3AD01P , 2363/3NAD1F , 2363/3AD01F , 2363/3ND01P , 2363/3ND01F ,
2363/3ND05F , 2364/3NW01 , 2364/3NW02 , 2389/2Na01F , 2408/3NV01 , 2414/3NAK1 P , 2414/3AK01P ,
2414/3AK02P , 2414/3NPK1P , 2422/3NAF2P , 2422/3AFE1P , 2422/3NFE2P , 2431/3NJ01 , 2492/4NAO1P ,
2492/4AO01 P 2492/4NAD2P 2492/4AD02P 2492/4NO01 P 2492/4ND02P 249214NO01 F 2494/4NAD1 P
2494/4AD01 P 2494/4ND01 P 2496/4Ns01 2497/3Na01 F 2498/3NE01 2541/4NAK1 P 2541/4AK01 P
and in consideration of the sum of Total amount paid of $3,702,677.57 and payable of
NONE ($of Unclaimed Checks Total) under the said Contract to
(Contractor's Name and Address)
hereafter called the Grant Recipient or to its assignees, if any, the Grant Recipient, upon payment of the said sum by the
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT, hereinafter called CDLE, does remise, release, and
discharge CDLE, its officers, agents, and employees, of and from all liabilities, obligations, claims, and demands
whatsoever under or arising from said Contract/Grant Agreement except:
1. Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible of exact
statement by the Grant Recipient, as follows(if none, so state):
VAX/ Invoice Expected
FCS123 Date Invoice Line Cost Payment
Number (If Known) Vendor or P.O.# Item Category Amount Amount
NONE
2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Grant
Recipient to third parties arising out of the performance of the said contract, which are not known to the
Grant Recipient on the date of the execution of this release and of which the Grant Recipient gives notice in
writing to the CDLE within the period specified in the said Contract/Grant Agreement.
3. Claims after closeout, for costs which results from the liability to pay Unemployment Insurance costs under
a reimbursement system or to settle orker's Compensation claims.
This release has been executed this / 7 day of August, 2015
By 11\4aAM
Authorized Signature
Pro—Tem, Mike Freeman
Title , Weld County Board of Commissioners
c)2b/5 2735 )
Attach 1-1Gran RecRelForm2015.xlsx
Attachment I
Page 2 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
CONTRACT CLOSEOUT TAX CERTIFICATION
In the performance of Contract/Grant Agreement Number 14KAA 54599 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified
as VAX/FCS123 number(s) : 2155/1NH02 , 2155/1AHC02 , 2310/2NRU1F ,
2361/3NAO1F , 2361/3AO01F , 2361/3NAD2F , 2361/3AD02F , 2361/3NAD3F ,
2361/3AD03F , 2361/3ND02F , 2361/3ND03F , 2361/3ND04F , 2362/3NAY1P ,
2362/3AY01P , 2362/3NY01P , 2362/3NY02P , 2363/3NAD1P , 2363/3AD01P ,
2363/3NAD1F , 2363/3AD01F , 2363/3ND01P , 2363/3ND01F , 2363/3ND05F ,
2364/3NW01 , 2364/3NW02 , 2389/2Na01F , 2408/3NV01 , 2414/3NAK1P ,
2414/3AK01P , 2414/3AK02P , 2414/3NPK1P , 2422/3NAF2P , 2422/3AFE1P ,
2422/3NFE2P , 2431/3NJ01 , 2492/4NAO1P , 2492/4AO01 P , 2492/4NAD2P ,
2492/4AD02P 2492/4NO01 P , 2492/4ND02P , 2492/4NO01 F , 2494/4NAD1P ,
2494/4AD01P 2494/4ND01P , 2496/4Ns01 , 2497/3Na01 F , 2498/3NE01 ,
2541/4NAK1P 2541/4AK01P ,
I certify that I have complied with requirements of the law and the Colorado Department of
Labor and Employment, regarding the obtaining of employer identification/account numbers;
collection, payment, deposit, and reporting of federal, state, and local taxes; and the provision
of W-2 forms to employees/enrollees who are not now my employees. For present
employees/enrollees (formerly employed under the contract), W-2 forms will be furnished as
specified in Circular E. Employer's Tax Guide.
Grant Recipient Name: Employment Services of Weld County
Grant Recipient Address: PO Box 1805
Greeley, CO 80632
Grant Recipient Employer: Weld County Dept of Human Services
Employer's Identification Number: 84-6000813
I rk'.
This certification has been executed this / / day of August 2015
By
Authorized Signature
Pro—Tem, Mike Freeman
Title Weld County Board of Commissioners
o20/•S-4 7 6 )
Attach I-2ContractCloseoutTaxCert2015.xIsx
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: 14KAA 54599
Release Date:
VAX/FSC123 Check Check Payee's Last Known
Number Number Payee Amount Address
NONE
Total Amount Unclaimed
This schedule has been executed this /7
day of August 2015
By ,c
Authorized Signature
Pro-Tem, Mike Freeman
Title Weld County Board of Commissioners
4 . a735C0)
Attach 1-3 ScheduleofUnclaimedChecks 2015.xlsx
Attachment I
Page 4 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
GRANT RECIPIENT'S ASSIGNMENT OF REFUNDS, REBATES, AND CREDITS
Grant Recipient's Name: Emp Svcs of Weld County Contract/Grant Agreement
Street Address: PO Box 1805 No: 14KAA 54599
City and State: Greeley, CO 80632
Pursuant to the terms of Contract/Grant Agreement Number 14KAA 54599 , including the
Expenditure Authorizations (EAs) awarded under said Contract/Grant Agreement, identified as
VAX/FCS123 number(s) : 2155/1NH02 , 2155/1AHC02 2310/2NRU1F ,
2361/3NAO1F , 2361/3AO01F , 2361/3NAD2F , 2361/3AD02F , 2361/3NAD3F ,
2361/3AD03F , 2361/3ND02F , 2361/3ND03F , 2361/3ND04F , 2362/3NAY1P ,
2362/3AY01P , 2362/3NY01P , 2362/3NY02P , 2363/3NAD1P , 2363/3AD01 P ,
2363/3NAD1F , 2363/3AD01F , 2363/3ND01P , 2363/3ND01F , 2363/3ND05F ,
2364/3NW01 , 2364/3NW02 , 2389/2Na01F , 2408/3NV01 , 2414/3NAK1 P ,
2414/3AK01P , 2414/3AK02P , 2414/3NPK1P , 2422/3NAF2P , 2422/3AFE1P ,
2422/3NFE2P , 2431/3NJ01 , 2492/4NAO1P , 2492/4AO01 P , 2492/4NAD2P ,
2492/4AD02P , 2492/4NO01 P , 2492/4ND02P , 2492/4NO01 F , 2494/4NAD1P ,
2494/4AD01P , 2494/4ND01P , 2496/4Ns01 , 2497/3Na01F , 2498/3NE01 ,
2541/4NAK1P , 2541/4AK01P ,
and in consideration of the reimbursement of costs and payment of fee, as provided in the said
Contract/Grant Agreement and any assignment thereunder, the Grant Recipient's Name and Address
(hereinafter called the Grant Recipient) does hereby:
1. Assign, transfer, set over and release to the Colorado Department of Labor
and Employment (hereinafter called CDLE), all right, title and interest to all
refunds, rebates credits or other amounts (including any interest thereon)
arising out of the performance of the said contract/grant agreement, together
with all the rights of action accrued on which may hereafter accrue
thereunder.
2. Agree to take whatever action may be necessary to effect prompt collection of
as such refunds, rebates, credits or other amounts (including any interest
thereon due or which may become due, and to forward promptly to CDLE.
3. Agree to cooperate fully with CDLE as to any claim or suit in connection with
such refunds, rebates, credits or other amounts due (including an interest
thereon): execute any protest, pleading, application, power of attorney or
other papers in connection therewith; and to permit CDLE to represent it at an
hearing, trial or other proceeding arising out of such claim or suit.
This assignment has been executed this / 70
9day of August 2015
By �t
Authorized Signature
Title Division Head of Employment Services
Attach I-4RefRebCredits2015.xlsx
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Attachment E
Page 1 of 2
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
PROGRAM INCOME EXPENSE REPORT FROM (PIERF)
SUBRECIPIENT: Employment Services of Weld County Calendar Qrtr End Date: 06/30/15
CDLE PIER VAX#: NA
1. CUMULATIVE PROGRAM INCOME CASH REPORTED ON CASH REQUEST THRU QUARTER END DATE:
VAV EXP REPORT FCS123 AMOUNT
NUMBER
NET (Undisbursed) LINE ITEM NONE
2. BUDGET ALLOCATION:
COST CATEGORY/BUDGET Total Disbursed Prog Income Net(Undisbursed)
LINE ITEM(S)-FCS123#on Expense Report Program Income (Expended) Program Income
VAX# FCS#: NONE 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
VAX# FCS#: 0.00
Total(total net must equal amount on Pa 0.00 0.00 0.00
CERTIFICATION:
I certify to the best of my knowledge and belief the above reported information is accurate and
complete for the period reported.
ut orized Signature to
See instructions for completing this form on the next page.
Revised: 6/1/01 Attach E-Prog Inc Exp 2015.xlsx
Attachment I
Page 5 of 6
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
SUBRECIPIENT CERTIFICATION OF PHYSICAL INVENTORY
Subrecipient Name: Emp Svcs of Weld County Contact Person: Linda Archibeque
Address: PO Box 1805 Phone Number: 970-352-1551 ext 6662
Greeley, CO 80632
I hereby certify that all property/equipment previously purchased with or transferred from the
Comprehensive Employment and Training Act (CETA) or the Job Training Partnership Act (JTPA)
program to the Workforce Investment Act (WIA) programs or purchased under any Colorado
Department of Labor and Employment (CDLE) federally funded grant or transferred with the
CDLE's approval is included in the attached listing for the above-noted subrecipient.
The attached listing has been verified by a physical inventory. Changes/revisions are:
❑ Noted O Not Applicable
I certify that this property is being used for purposes that it was originally purchased for and will be
repaired or replaced by my insurance if damaged, lost, or stolen.
I certify that all property/equipment previously purchased with or transferred from the CETA or the
JTPA programs to WIA program or purchased under a CDLE federally funded grant or transferred
with the CDLE's approval with a fair market value (FMV), established by our existing local
procedures, of$5,000 or more, has been identified.
I further certify that the proceeds of all property/equipment previously purchased with or transferred
from the CETA or JTPA program to the WIA program, with a FMV of $5,000 or more, will be
returned to CDLE, in order to return the proceeds to the U.S. Department of Labor.
e6Mto is
Subrecipient Directors Si ture
D
Revised: 6/1/06 Attach I-5CertofPhysInv2015.xIsx
Attachment F
Page 1 of 3
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
STAND-IN COST REPORT FORM (SICRF)
AND LEVERAGED RESOURCES REPORT FORM
Subrecipient Emp Svcs of Weld County Stand In/Leveraged Costs from 7/1/14 to 6/30/15
Name: CDLE Assigned VAX SICRF#:
Program COST CATEGORY(IES)/BUDGET LINE ITEM(S)
Year Stand-In Stand-In Leveraged Leveraged Other Federal
GRANTS of Funds Administration Program Cash Match In-Kind unds Expendec Total
GRANT NAME: WIA Adult
PY or FY Current PY14 1,064.00 16,754.00 17,818.00
Prior PY13 982.00 15,466.00 16,448.00
Year Before Prior PY12 0.00
GRANT NAME: WIA Dislocated Workers
PY or FY Current PY14 862.00 13,578.00 14,440.00
Prior PY13 706.00 11,108.00 11,814.00
Year Before Prior PY12 0.00
GRANT NAME: WIA Youth
PY or FY Current PY14 1,156.00 20,457.00 21,613.00
Prior PY13 1,299.00 18,207.00 19,506.00
Year Before Prior PY12 0.00
GRANT NAME: WIA 10%Statewide Actv.
PY or FY Current PY 14 oo NOT HNIER 0.00
Prior PY13 DO NO!ENTER 0.00
Year Before Prior PY12 DO NOT ENTER 0.00
GRANT NAME: WIA 25%Enh.DW
PY or FY Current PY14 98.00 1,543.00 1,641.00
Prior PY13 80.00 1,263.00 1,343.00
Year Before Prior PY12 _ 0.00
GRANT NAME: FED EUC
PY or FY Current PY14 DU No l[N,1 R 0.00
Prior PY13 uo No, ,z 0.00 0.00
Year Before Prior PY12 DODO]I-N I H) 0.00
GRANT NAME: WIA NEG
PY or FY Current PY14 64.00 1,012.00 1,076.00
Prior PY13 174.00 2,735.00 2,909.00
Year Before Prior PY12 0.00
GRANT NAME: WP 10%MSF
PY or FY Current PY14 DO NOT EN Ilk 1,965.00 1,965.00
Prior PY13 00NO1(\II 1,012.00 1,012.00
Year Before Prior PY12 001)01 Y.No R 0.00
CERTIFICATION:
I certify to the best of my wledge and belief the above reported information is accurate and complete of the period reported.
uthorized Signature Date
Revised: 2/28/10 Attach F-SICR2015.xlsx
Attachment F
Page 2 of 3
COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT
EMPLOYMENT AND TRAINING PROGRAMS
STAND-IN COST REPORT FORM (SICRF)
AND LEVERAGED RESOURCES REPORT FORM
Subrecipient Emp Svcs of Weld County Stand In/Leveraged Costs from 7/1/14 to 6/30/15
'DLE Assigned VAX SICR#:
Program/ COST CATEGORY(IES)BUDGET LINE ITEM(S)
iscal Yea Stand-In Stand_in Leveraged Leveraged Other Federa
GRANTS of Funds dministratior Program Cash Match In-Kind unds Expend Total
GRANT NAME:H-1B Tech Skills Training
PY or FY Current PY14 24.00 373.00 397.00
Prior PY13 5.00 82.00 87.00
Year Before Prior PY12 0.00
rTrANT NAME: Wagner Peyser
PY or FY Current PY14 DO NOE ENTER 38,123.00 38,123.00
Prior PY13 Do NM INIER 26,492.00 26,492.00
Year Before Prior PY12 Do NO I NILE 0.00
GRANT NAME: WP 10%SJK
PY or FY Current PY14 DO NOT EN I I k 2,003.00 2,003.00
Prior PY13 D0NOIENTER 3,005.00 3,005.00
Year Before Prior PY12 DoNOIINJI.R 0.00
GRANT NAME: Vets DVOP
DO NO I!Nil R 0.00
I)))NOI tEN II I) 0.00
1)0 NTI INIIR 0.00
GRANT NAME: Vets LVER
DO NOT ENTER 0.00
DO NOT ENTER 0.00
DO NOT ENTER 0.00
GRANT NAME:UI Reemployme
DON)))ENDER 0.00
DO NOT f!NTEIt. 0.00
DON)))ENI ER 0.00
GRANT NAME:WP-ESF
PY or FY Current PY14 D0 N0T IN,ER 11,549.00 11,549.00
Prior PY13 DONO tN„tR 20,531.00 20,531.00
Year Before Prior PY12 DO NOT I NFER 0.00
CERTIFICATION:
I certify to the best of knowledge and belief the above reported information is accurate and complete of the period
uthorized Signature Date
See instructions for completing this form on the next page.
Revised: 2/28/10 Attach F-SICR2015.xlsx
CONTRACT ID162, CDLE 2014-2015 GRANT CLOSEOUT
ATTEST. daJ ' BOARD OF COUNTY COMMISSIONERS
Weld Co-n y lerk to the Boa d WELD COUNTY, COLORADO
BY: i4�. ' • `.s _°i=.�"�� �� -c --�
Deputy Clergy to the me; -/J Mike Freeman, Pro-Tem
AUG 1 7 2015
APPROVED AS TO FUN t e1 =' =4 f APPROVED AS TO SU TANCE:
Contf+
`'� ��/rf, r►. � Elected Office or Depart ent d
APP ED AS TO FORM: IU/t1
RP( Director of General Services
County Attorney
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