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HomeMy WebLinkAbout2017 Exemption of AuditNAME OF GOVERNMENT ADDRESS CONTACT PERSON PHONE EMAIL FAX SHORT FORM Wheat Ridge Housing Authority 7500 West 29th Avenue Wheat Ridge, CO 80033 Ken Johnstone (303) 235-2846 235-2857 For the Year Ended 12/31117 or fiscal year ended: I certify that I am skilled in governmental accounting and that the information in the application is complete and accurate, to the best of my knowledge. NAME: Wendy Swanhorst TITLE Partner FIRM NAME (if applicable) Hinkle & Company, PC ADDRESS 5950 S. Willow Drive, Suite 302, Greenwood Village, CO 80111 PHONE 303 796-1000 DATE PREPARED (Must be prepared prior to 2/26/2017 Board approval) d \ kS c 'P r" Please indicate whether the following financial information is GOVERNMENTAL PROPRIETARY (MODIFIED ACCRUAL BASIS) (CASH OR BUDGETARY BASIS) recorded using Governmental or Proprietary fund types ❑ 3 2-1 2-2 2-3 2-4 2-5 2-6 2-7 2-8 2-9 2-10 2-11 2-12 2-13 2-14 2-15 2-16 2-17 2-18 2-19 2-20 2-21 2-22 2-23 2-24 3-1 3-2 3-3 3-4 3-5 3-6 3-7 3-8 3-9 3-10 3-11 3-12 3-13 3-14 3-15 3-16 3-17 3-18 3-19 3-20 3-21 3-22 3-23 3-24 3-25 3-26 REVENUE: All revenues for all funds must be reflected in this section, including proceeds from the sale of the government's land, building, and equipment, and proceeds from debt or lease transactions. Financial information will not include fund equity information. Taxes: Property Specific ownership Sales and use Other (specify): Licenses and permits Intergovernmental: Grants Conservation Trust Funds (Lottery) Highway Users Tax Funds (HUTF) Other (specify): Charges for services Fines and forfeits Special assessments Investment income Charges for utility services Debt proceeds Lease proceeds Developer Advances received Proceeds from sale of capital assets Fire and police pension Donations Other (specify): (should agree with line 4-4, column 2) (should agree with line 4-4) EXPENDITURES: All expenditures for all funds must be reflected in this section, including the purchase of capital assets and principal and interest oavments on long-term debt. Financial information will not include fund equity information. Administrative Salaries Payroll taxes Contract services Employee benefits Insurance Accounting and legal fees Repair and maintenance Supplies Utilities and telephone Fire/Police Streets and highways Public health Culture and recreation Utility operations Capital outlay Debt service principal Debt service interest Repayment of Developer Advance Principal Repayment of Developer Advance Interest Contribution to pension plan Contribution to Fire & Police Pension Assoc. Other (specify): (should agree with Part 4) (should agree with line 4-4) (should agree to line 7 (should agree to line 7 4 3 4-1 Does the entity have outstanding debt? If Yes, please attach a copy of the entity's Debt Repayment Schedule. 4-2 Is the debt repayment schedule attached? If no MUST ex Iain: ❑ ❑ 4-5 Does the entity have any authorized, but unissued, debt? L Please complete the following debt schedule, if (please only include principal amounts)(enter all positive numbers) applicable: amount as Outstanding at Issued during enndd oof f prior year' year Retired during C year Date the debt was authorized: 4-6 Does the entity intend to issue debt within the next calendar year? ❑ If yes: How much? $ - 4-5 Does the entity have any authorized, but unissued, debt? L If yes: How much? $ - Date the debt was authorized: 4-6 Does the entity intend to issue debt within the next calendar year? ❑ If yes: How much? $ - 4-7 Does the entity have debt that has been refinanced that it is still responsible for? ❑ If yes: What is the amount outstanding? $ - 4-8 Does the entity have any lease agreements? ❑ If yes: What is being leased? What is the original date of the lease? Number of years of lease? Is the lease subject to annual appropriation? ❑ What are the annual lease payments? $ 4-9 Does the entity have a certified Mill Levy? ❑ If yes: Please provide the following mills levied for the year reported (do not report $ amounts): Bond Redemption General/Other TOTAL U R1 D D El 7 5-4 Are the entity's Investments legal in accordance with Section 24-75-601, ❑ ❑ 121 et. seq., C.R.S.? 5-5 Are the entity's deposits in an eligible (Public Deposit Protection Act) ❑ ❑ public depository (Section 11-10.5-101, et seq. C.R.S.)? 5 6-1 Does the entity have capital assets? ❑ El 6-2 Has the entity performed an annual inventory of capital assets in accordance with ❑ ❑ Section 29-1-506, C.R.S.,? If no, MUST explain: F_ 6-3 1 1 Balance - Additions (Must the following capital assets table: . beginning of the be included in year* Part 3) DeletionsComplete Year -End Balance Land $ - $ - $ - $ - Buildings $ - $ - $ - $ - Machinery and equipment $ - $ - $ - $ - Furniture and fixtures $ - $ - $ - $ - Construction In Progress (CIP) $ - $ - $ - $ - Other (explain): $ - $ - $ - $ _ Accumulated Depreciation $ - $ $ - (Please enter a negative, or credit, balance) $ _ spacePlease use this • provide 'must tie to prior year ending balance any explanations or comments: 7-2 Does the entity have a volunteer firemen's pension Ian? If yes: Who administers the plan? Indicate the contributions from: Tax (property, SO, sales, etc.): $ - State contribution amount: $ - Other (gifts, donations, etc.): $ - • $ - What is the monthly benefit paid for 20 years of service per retiree as of $ - Jan 1? ❑ Q 8-1 Did the entity file a budget with the Department of Local Affairs for the ❑ ❑ ❑ current year in accordance with Section 29-1-113 C.R.S.? If no, MUST explain: 8-2 Did the entity pass an appropriations resolution, in accordance with D ❑ ❑ Section 29-1-108 C.R.S.? If no, MUST explain: If yes: Please indicate the amount appropriated for each fund for the year reported: General Fund $ 8,900 11 9-1 Is the entity in compliance with all the provisions of TABOR [State Constitution, 21 ❑ Article X, Section 20(5)]? Note: An election to exempt the government from the spending limitations of TABOR does not exempt the government from the 3 percent emergency reserve requirement. All governments should determine if they meet this requirement of TABOR. MUST explain: 10-1 Is this application for a newly formed governmental entity? ❑ 21 If yes: Date of formation: 10-2 Has the entity changed its name in the past or current year? ❑ El If yes: Please list the NEW name & PRIOR name: 10-3 Is the entity a metropolitan district? ❑ D Please indicate what services the entity provides: 10-4 Does the entity have an agreement with another government to provide services? D ❑ If yes: List the name of the other governmental entity and the services provided: The City of Wheat Ridge provides administrative services. 10-5 Has the district filed a Title 32, Article 1 Special District Notice of Inactive Status during the year? [Applicable to Title 32 special districts only, pursuant to Sections 32- ❑ 2 1-103 (9.3) and 32-1-104 3 C.R.S. If yes: Date Filed: 7 12-1 If you plan to submit this form electronically, have you read the new Electronic ❑ ❑ Signature Policy? Office of the State Auditor — Local Government Division - Exemption Form Electronic Signatures Policy and Procedure Policy - Requirements The Office of the State Auditor Local Government Audit Division may accept an electronic submission of an application for exemption from audit that includes governing board signatures obtained through a program such as Docusign or Echosign. Required elements and safeguards are as follows: • The preparer of the application is responsible for obtaining board signatures that comply with the requirement in Section 29-1-604 (3), C.R.S., that states the application shall be personally reviewed, approved, and signed by a majority of the members of the governing body. • The application must be accompanied by the signature history document created by the electronic signature software. The signature history document must show when the document was created and when the document was emailed to the various parties, and include the dates the individual board members signed the document. The signature history must also show the individuals' email addresses and IP address. • Office of the State Auditor staff will not coordinate obtaining signatures. The application for exemption from audit form created by our office includes a section for governing body approval. Local governing boards note their approval and submit the application through one of the following three methods: 1) Submit the application in hard copy via the US Mail including original signatures. 2) Submit the application electronically via email and either, a. Include a copy of an adopted resolution that documents formal approval by the Board, or b. Include electronic signatures obtained through a software program such as Docusign or Echosign in accordance with the requirements noted above. 0 RESOLUTION/ORDINANCE FOR EXEMPTION FROM AUDIT (Pursuant to Section 29-1-604, C.R.S.) A RESOLUTION/ORDINANCE APPROVING AN EXEMPTION FROM AUDIT FGR. FISCAL YEAR 20XX FOR THE (name of government), STATE OF COLORADO. WHEREAS, the (governing body) of (name of government) wishes to claim exemption from t.i,- audit requirements of Section 29-1-603, C.R.S.; and WHEREAS, Section 29-1-604, C.R.S., states that any local government where m, ither revrnu:;s nor expenditures exceed seven hundred and fifty thousand dollars may, with the approval of the State Auurto., be exempt from the provision of Section 29-1-603, C.R.S.; and [Choose 1 or 2 below, -.7hichever is arplicable] (1)WHEREAS, neither revenue nor expenditures for (n:: me of gavernment) exceeded $100,000 for Fiscal Year 20XX; and WHEREAS, an application for exemption frc, - ?udit for (name of gevemment) has been prepared by (name of individual), a person skilled in govemmemal r,'ouniinq, and OR (2)WHEREAS, neither revenues :tor expenditures for.1name of government) exceeded $750,000 for Fiscal Year 20XX; and WHEREAS, an application for exemption f: ori audit for (name of government) has been prepared by (name of individual or firm), ar uuicpendent accountant with knowledge of governmental accounting; and WHEREAS, said appiication for :,�,:mptiot. from audit has been completed in accordance with regulations, issued by the State Auditor. NOW THEREFORE, be it resobco/o.dained by the (governing body) of the (name of government) that the application for exemption from audit for (name of government) for the Fiscal Year ended 20XX, has been personally reviewed and is hereby approved by a majority of the (governing body) of the (name of government); that those members of the (governing body) have signified their approval by signing below; and that this resolution shall be attached to, and shall become a part of, the application for exemption from audit of the (name of government) for the fiscal year ended , 20XX. ADOPTED THIS _ day of , A.D. 20XX. 10 ivlayurirreSIuent/%-nairman, etc. ATTEST: Town Clerk, Secretary, etc. Type or Print Names of Members of Governing Body Date Tern, Exja� 5 SL-gature 11 , attest I am a duly elected or appointed board member, and that I have personally reviewed and approve this application for Chad Harr exemption from audit. Signed Date: My term Expires: March 2019 Board Member's Name � I Ln''I•f'967 attest I am a duly elected or appointed board member, and that Utave perso 11 revi wed and approve this application for Thomas Abbott exemption f dit. Z"Signed_ Date: My term Expires: March 2022 I ,.lCiR%ems ��?o/l2t�Sml7 attest I am a duly elected or appointed board member, and that I have personally reviewed and approve this application for Janice Thompson exempt' rom audit. Signed— Date: J My term Expires: March 2020 oar ernWs Name1 1 '� n, f^ i -Z y rc�j, attest I am a duly elected or appointed board member, and that I have pe ally review d and approve this application for Tim Fitzgerald exemption fro Signed Date: My term Expires: 6ty Council Representative Board Member's Name1 attest I am a duly elected or appointed board member, and that I have personally reviewed and approve this application for exemption from audit. Signed Date: My term Expires: 1 _ , attest I am a duly elected or appointed board member, and that I have personally reviewed and approve this application for exemption from audit. Signed Date: My term Expires: I _ , attest I am a duly elected or appointed board member, and that I have personally reviewed and approve this application for exemption from audit. Signed Date: My term Expires: 9 SHORT FORM Under the Local Government Audit Law (Section 29-1-601, et seq., C.R.S.) any local government may apply for an exemption from audit if neither revenues nor expenditures exceed $750,000 in the year. To qualify for exemption from audit, a local government must complete an Application for Exemption from Audit EACH YEAR and submit it to the Office of the State Auditor (OSA). Any preparer of an Application for Exemption from Audit -SHORT FORM must be a person skilled in governmental accounting. Approval for an exemption from audit iwgranted only upon the review by the OSA. ALL APPLICATIONS MUST BE FILED WITH THE OSA WITHIN 3 MONTHS AFTER THE ACCOUNTING YEAR-END. FOR EXAMPLE, APPLICATIONS MUST BE RECEIVED BY THE OSA ON OR BEFORE MARCH 31 FOR GOVERNMENTS WITH A DECEMBER 31 YEAR-END. GOVERNMENTAL ACTIVITY SHOULD BE REPORTED ON THE MODIFIED ACCRUAL BASIS PROPRIETARY ACTIVITY SHOULD BE REPORTED ON A BUDGETARY BASIS PRIOR YEAR FORMS ARE OBSOLETE AND WILL NOT BE FOR YOUR REFERENCE, COLORADO REVISED STATUTES ACCEPTED. CAN BE FOUND AT: APPLICATIONS SUBMITTED ON FORMS OTHER THAN THOSE http://www.lexisnexis.com/hottopics/Colorado/ PRESCRIBED BY THE OSA WILL NOT BE ACCEPTED. APPLICATIONS MUST BE FULLY AND ACCURATELY COMPLETED. ❑ Has the preparer signed the application? ❑ Has the entity corrected all Prior Year Deficiencies as communicated by the OSA? ❑ Has the application been PERSONALLY reviewed and approved by the governing body? ❑ Did you include any relevant explanations for unusual items in the appropriate spaces at the end of each section? ❑ Will this application be submitted via Fax or Email? ❑ If yes, have you read and understand the new Electronic Signature Policy? See new policy -> here --or-- ❑ If yes, have you included a resolution? ❑ Does the resolution state that the governing body PERSONALLY reviewed and approved the resolution in an open public meeting? ❑ Has the resolution been signed by a MAJORITY of the governing body? (See sample resolution.) ❑ Will this application be submitted via a mail service? (e.g. US Post Office, FedEx, UPS, courier.) ❑ If yes, does the application include ORIGINAL INK SIGNATURES from the MAJORITY of the governing body? FILING METHODS IMPORTANT! All Applications for Exemption from Audit are subject to review and approval by the Office of the State Auditor. Governmental Activity should be reported on the Modified Accrual Basis Proprietary Activity should be reported on the Cash or Budgetary Basis Failure to file an application or denial of the request could cause the local government to lose its exemption from audit for that year and the ensuing year. In that event, AN AUDIT SHALL BE REQUIRED.