JTPA AGREEMENT CLOSEOUT PACKAGE

Instructions:

"To"	The agency to which the awardee is responsible for reporting
"From"	The awardee's name and address
"Agreement Number"	The numerical identification of your agreement
"Agreement Period"	The span of time during which the agreement was authorized to operate
"Check One"	Identifies the program's source of funding (i.e., II-A/Adult, II-B/Summer, II-C/Youth, and III-EDWAA)
"Submitted"	The awardee must indicate those forms which are being filed with the package
"Received"	Not for awardee use
"Date of Execution"	The date on which the form is being signed
"Authorized Signature"	Must be the individual who has entered into the agreement on behalf of the awardee

To:	______________________________ ______________________________ ______________________________
From:	______________________________ ______________________________ ______________________________
Agreement Number:	______________________________
Agreement Period:	______________________________

As authorized representative of the awardee organization noted above, I have taken actions related to the closeout of the above referenced agreement and am enclosing the required documents as follows:

Financial records must be retained for three years from the date of your final Financial Closeout Package.

Unresolved issues (which may include but are not limited to audit findings, litigation, and bankruptcy) would necessitate a longer retention period. The three-year clock would be adjusted after resolution of the issue and/or submission of a revised closeout package.

Authorized representatives of the U.S. Department of Labor and the awarding agency shall have timely and reasonable access to any pertinent books, documents, papers, or other records of the awardee in order to make audits, examinations, excerpts, and transcripts.

I certify that, to the best of my knowledge, the information contained on this form, and on all other closeout forms and documents for the agreement indicated above, is correct and complete.

"Date Funds Requested"	The date on which the cash requests were signed
"Date Funds Received"	The date on which receipt of the funds were deposited/recorded
"Amount"	The amount of the funds received
"Total"	Total of all funds received for the agreement period. Show here and on Line 1 of the Financial Reconciliation Worksheet.

List each receipt of funds individually.

Date Funds Requested	Date Check Received	Amount











		Total

Instructions:

"Line Item"	List all line items as negotiated in the agreement.
"Agreement Section"	Show budgeted amounts by line item as shown in your agreement. Show actual expenditures against the budgeted line items. Show accrued expenditures against the budgeted line items. Total should be the sum of actual and accrued expenditures by line item.
"Match Section"	List by line items budgeted costs for match as indicated in your agreement. List by line item actual costs incurred that are being used as match.
"Stand-In Section"	All items listed must be eligible JTPA expenditures. List allowable costs that could have been charged against the agreement but were paid with NON-FEDERAL funds. List by line item costs incurred above and beyond costs reported in the "Agreement Section" and "Match Section" incurred during the operation of the negotiated agreement.
"Total Administration"	Must be the sum of the line items listed above.
Total "Agreement Budget"	Must equal the amounts as negotiated.
Total "Agreement Actual"	Must be the sum of the line items listed above.
Total "Agreement Accrued"	Must be the sum of the line items listed above.
Total "Agreement Total"	Must equal total expenditures (actual plus accrued). Show here and on Line 2 of the Financial Reconciliation Worksheet.
Total "Match Budget"	Must equal total match costs as shown in the negotiated agreement.
Total "Match Actual"	Must reflect a sum equal to the awardee's percentage of match required. Show here and on Line 7 of the Financial Reconciliation Worksheet.
Total "Stand-In"	The sum of all items listed in this column. Show here and on Line 8 of the Financial Reconciliation Worksheet.

This chart is a sample for the Administration cost category. A similar chart could be used for each cost category, if appropriate, and for closeout costs and WIA transition expenditures.

Administration Costs

Line Item Agreement Match Stand-In

Budget Actual Accrued Total Budget Actual Actual

Instructions:

Line 1, "Cash Received"	Enter total amount of funds received.
Line 2, "Reportable Expenditures"	Enter total expended funds, by cost category, for line items as negotiated in the agreement. Add the cost categories and enter the sum in the "Total" column.
Line 3, "Cash on Hand"	Subtract Line 2 from Line 1. If Line 1 is greater than Line 2, the balance in the "Total" column must be returned when submitting this report.
Line 4, "Program Income"	Enter total funds received from program income (see definitions).
Line 5, "Program Income Expenditures"	Enter total funds expended against funds received (reported on Line 4), by cost category, for eligible grant costs. Add the three cost categories and enter the sum in the "Total" column. Program income is subject to administrative cost limitations in 20 CFR 627.445 and cost classification in 20 CFR 627.440.
Line 6, "Balance of Program Income"	Subtract Line 5 from Line 4. If Line 4 is greater than Line 5, the balance in the "Total" column must be returned with the agreement closeout or be retained for further operation of a negotiated agreement.
Line 7, "Matching Funds"	Enter total funds expended as matching costs.
Line 8, "Eligible Stand-In Costs"	Enter total funds expended, by cost category, for funds that could be used as Stand-In costs (see definitions). These costs must be eligible expenditures for the negotiated grant agreement. Add the cost categories and enter the sum in the "Total" column.
Line 9, "Obligational Authority"	Enter total budget negotiated in the agreement by cost category. Add the cost categories and enter the sum in the "Total" column.
Line 10, "Unused Obligational Authority"	Subtract Line 2 from Line 9. Add the cost categories and enter the sum in the "Total" column.
Line 11, "% of Obligational Authority Expended"	Divide Line 2 by Line 9, and enter percentage, by cost category and for total.

COST CLASSIFICATION	ADMINISTRATION	DIRECT TRAINING	TRAINING RELATED	TOTAL
1. Cash Received
2. Reportable Expenditures
3. Cash on Hand (Line 2 less Line 1)
4. Program Income
5. Program Income Expenditures
6. Balance of Program Income (Line 5 less Line 4)
7. Matching Funds
8. Eligible Stand-In Costs
9. Obligational Authority
10. Unused Obligational Authority (Line 9 less Line 2)
11. % of Obligational Authority Expended (Line 2/Line 9)

Note: Information in shaded areas is not required.
Note: In some States, cost category information may not be required or may be limited to two cost categories.

"Execution Date"	The date on which the form is being signed
"Authorized Signature"	Must be the individual who entered into the agreementon behalf of the awardee

Pursuant to the terms of Agreement #_____________, and in consideration of the expended and accrued sum of $________, of which $_________ is the amount paid and $__________ is the amount to be paid under the said agreement _________________ hereinafter called the awardee or to its assignees, if any, the awardee upon payment of the said ____________ sum by _______________________________ hereinafter called the awarding entity does release and discharge the awarding entity its officer, agents, and employees, of and from all liabilities, obligations, claims, and demands whatsoever under or arising from the said agreement except:

1. Unpaid bills in stated amounts, or in estimated amounts where the exact amounts are not available, by the awardee, as follows:

Invoice Date (if known)	Vendor	Invoice or P.O. #	Line Item	Cost Category	Amount	Expected Payment Date

2. Claims after closeout for costs which result from liabilities under the JTPA program will not be paid after December 31, 2000, including unemployment insurance costs and workers' compensation claims.

"Total Allotment"	Amount expended under terms of the grant agreement
"Execution Date"	The date on which the form is being signed
"Authorized Signature"	Must be the individual who entered into the agreement on behalf of the awardee

Pursuant to the terms of Subgrant No. _____________________ and for the total allotment of ________________________ and in consideration of the reimbursement of costs and payment of fee, as provided in the said agreement and any assignment thereunder, the
__________________________________ (hereby called by the subrecipient), does hereby:
(Subrecipient's Name)

Assign, transfer, set over, and release to the
________________________ all right, title, and interest thereon, arising out of the performance of
(State agency name)
the said subgrant together with all the rights of action accrued or which hereafter accrue thereunder.

Agree to take whatever action may be necessary to effect prompt collection of all such refunds, rates, credits, or other amounts (including interest thereon), due or which become due, and to forward promptly checks made payable to the
_________________________________ for any proceeds so collected.
(State agency)

Agree to cooperate fully with __________________ (State Agency) as to any claims or suit in connection with such refunds, rebates, credits, or other amounts due (including any interest thereon); to execute any protest, pleading, application, power of attorney, or other papers in connection therewith; and to permit the State to represent it at any hearing, trial, or other proceeding arising out of such claim or suit.

IN WITNESS WHEREOF, this assignment has been executed this ____________ day of ______________, _____________.

__________________________________
Subrecipient
By________________________________
Title______________________________

Instructions:
Enter the complete entity name, agreement number, and date in the spaces provided at the top of the form.
Check appropriate box to indicate funds negotiated were to be used for the acquisition of property.

"Item A"	If no funds negotiated were used for the acquisition of property, no further information is required.
"Item B"	If funds negotiated were for the acquisition of property, for each item acquired, enter the following information: a. Item #: Enter property items in numerical sequence, i.e., 1, 2, 3, etc. b. Identification #: Enter an identification number such as the stock number, manufacturer's serial number, property tag number, or otheridentifying number. c. Description: Describe the property, e.g.., Dell PC 486. d. Location: If different from the address stated above, enter the location of the property. e. Date of Acquisition: Date on which the entity assumed responsibility for the property. f. Condition Code: Enter the condition code (see "Condition Codes") that corresponds to the condition of the property. g. Unit: Enter the unit, e.g.., "ea" for each, "dz" for dozen, "st" for set, etc. h. Quantity: Enter the number of units acquired. i. Unit Acquisition Cost, Total Cost: Enter JTPA and non-JTPA share of the acquisition cost of each item. The sum of the two should be reflected in Total Cost. Total Cost must equal the total cost of the property.
"Item C"	Check if a new grant has been approved and indicate the agreement number issued.
"Item D"	If no new agreement is awarded, above listed property must be returned to the awarding entity.

Unit Acquisition Cost
Item #	Identification #	Description	Location	Acquisition Date	Condition Code	Unit	Quantity	JTPA	Non-JTPA	Total Cost

1. Unused-Good	Unused property that is usable without repairs and is identical or interchangeable with new items from normal supply sources.
2. Unused-Fair	Unused property that is usable without repairs, but is deteriorated or damaged to the extent that the utility is somewhat impaired.
3. Unused-Poor	Unused property that is usable without repairs, but is considerably deteriorated or damaged. Enough utility remains to classify the property as better than salvage.
4. Used-Good	Used property that is usable without repairs, and most of its useful life remains.
5. Used-Fair	Used property that is usable without repairs, but somewhat worn or deteriorated and may soon require repairs.
6. Used-Poor	Used property that may be used without repairs, but is considerably worn or deteriorated to the degree that remaining utility is limited or major repairs will soon be required.
7. Repairs Required-Good	Required repairs are minor and should not exceed 15 percent of original acquisition cost.
8. Repairs Required-Poor	Required repairs are considerable and are estimated to range from 16 to 40 percent of original acquisition cost.
9. Repairs Required-Poor	Required repairs are major because property is badly damaged, worn, or deteriorated, and are estimated to range from 41 to 65 percent of original acquisition cost.
X Salvage	Property has some value in excess of its basic material content, but repair or rehabilitation to use for the originally intended purpose is clearly impractical. Repair for any use would exceed 65 percent of the original acquisition cost.
S Scrap	Material that has no value except for its basic material content.

Instructions:

"Name of Awardee"	The agency who has received JTPA funds for the operation of a funded program
"Address"	The physical location of the agency
"Employer's State Identification Number"	The numerical identification issued by the State which is used to recognize the agency for tax liability

In the performance of agreement # ___________, I certify that I have complied with requirements of the law and the State JTPA Administration, State of _____________, 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 award, W-2 forms will be furnished as specified in Circular E, Employers' Tax Guide.

Submitted	Received	Documents
		Detailed Statement of Receipts
		Detailed Statement of Expenditures
		Financial Reconciliation Worksheet
		Awardee's Release (with signature)
		Assignment of Refunds, Rebates, and Credits
		Property Inventory
		Tax Certification
		Other (List)

Job Training Partnership Act (JTPA) Financial Closeout:
Technical Assistance Guide (TAG)

Appendix C
JTPA AGREEMENT CLOSEOUT PACKAGE

Line Item	Agreement				Match		Stand-In
Line Item	Budget	Actual	Accrued	Total	Budget	Actual	Actual

Job Training Partnership Act (JTPA) Financial Closeout: Technical Assistance Guide (TAG)

Appendix CJTPA AGREEMENT CLOSEOUT PACKAGE

Job Training Partnership Act (JTPA) Financial Closeout:
Technical Assistance Guide (TAG)

Appendix C
JTPA AGREEMENT CLOSEOUT PACKAGE