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Witness Prot. Reimbursement Application aolci -30c131 Victim Witness Protection Program Reimbursement Application Rule Reference 11N-1.004 and I1N--1.0052 F.A.0 Florida Department of Law Enforcement State Financial Assistance Chapter 11N-1.004(3) requires in part `...Requesting agencies shall retain documentation supporting expenditures from the Account and make these available during the annual evaluation and audit of the trust fund." The box below will be completed by FDLE: The Florida Department of Law Enforcement(herein referred to as FDLE)may award state financial assistance in the amount of _ to the -_(Requesting Agency,herein referred to as Recipient)on (Date)as follows: To be completed by requesting agency: ❑ Violent Crime Investigations. Catalog of State Financial Assistance 4 71.004,Appropriation Category# 109701, Violent Crime Investigative Emergencies ❑ Drug Controi/Money Laundering Investigations -Matching Funds, Catalog of State Financial Assistance*71.005 Appropriation Category#109701, Violent Crime Investigative Emergencies Ell Victim or Witness Assistance, Catalog of State Financia'Assistance#71.006,Appropriation Category#040000, Expenses The administration of the resources awarded by the FDLE to the Recipient may be subject to audits and/or monitoring by the FDLE as described below: MONITORING In addition to reviews of audits conducted in accordance with Section 215.97, F.S., monitoring procedures may include, but not be limited to, on-site visits by the FDLE staff and/or other procedures. By accepting the award, the Recipient agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the FDLE. In the event the FDLE determines that a limited scope audit of the Recipient is appropriate, the Recipient agrees to comply with any additional instructions provided by the FDLE staff to the Recipient regarding such audit. The Recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by Florida's Chief Financial Officer or Auditor General. AUDIT As a non-state entity defined by Section 215.97(2)(m), Florida Statutes, the Recipient may be subject to audit requirements as provided below In the event that the Recipient expends a total amount of all state financial assistance equal to or in excess of$500,030 in any fiscal year of the Recipient,the Recipient must have a State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes, applicable rules of the Executive Office of the Governor and the Department of Financial Services, and Chapter 10.550 (local governmental entities), Rules of the Auditor General. In determining the state financial assistance expended in its fiscal year, the Recipient shall consider all sources of state financial assistance, including state financial assistance received from the FDLE, other state agencies, and other non-state entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a non-state entity for Federal program matching requirements. In connection with the audit requirements, the Recipient shall ensure that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2)(e), Florida Statutes,and Chapter 10.550(local governmental entities), Rules of the Auditor General. If the Recipient expends less than $500,000 in state financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the Recipient expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the non-state entity's resources (i.e., the cost of such an audit must be paid from the Recipient's resources obtained from other than State entities). Information to help facilitate the Recipient's compliance with the requirements may be found at the following web sites: • Auditor General-htto:The w.state fi a =,,dgen/paves/localgovt.htm • Department of Financial Services(Chief Financial Officer)-https:t/apps.fidfs.com/fsaa/ Violent Crime Investigative Emergency& Form FDLEr1FS-006 Revised 01/30/07 Reimbursement Funding Request 1 oft I0l11111111011101111111111411l1I1011I'«tl1111111I11X11 11111 1111111111111101111 11111111111111111111 JIlIIJIJIJjJJI PAGE NO. 1 { STATE OF FLORIDA VOUCHER SCHEDULE DATE 10/01/2018 t 5411 AMC',VOIAChir Nes I OLO 710000 D90-0016-0730 f DEPARTMENT DEPARTMENT OF LAW ENFORCEMENT ? 002630 snE DEPARTMENT OF LAW ENFORCEMENT OBJECT TRANS �t TRANS CODE CODE CODE VENDOR ID NUMBER I --- INVOICE( ) - OR EMPLOYEE ID PAYEE ( OBJECT ARRANT AMOUNT I AMOUNT as 4J CITY •F MIAMI BEACH CITY OF MIAMI BEACH POLICE 7510 10589.31 F596000573024 MIAMI-DADE POLICE DEPARTMENT 10589.31 7510 14421.70 14421.70 J � { 111 � TOTAL TOTAL ACCOUNT NAME: OPERATING TRUST FUND LAW ENF-IN CONTRACTED SERVICES ACCOUNT CODE: 71202510016-7180010000-10077700 25011.01+ t � I I hereby certify that the above transactions are in accordance For state CFO Use Only I with the Florida Statutes and all applicable laws and rules of ( f2,�� the State of Florida. Time In LJ' '`� Ckadtge otteta4 APPROVED: Audited By TITLE: ? i Agency Victim Witness Protection Program Reimbursement Application Rtde Refaier a II L9 H and 11N-1.905.FA C NOTICE OF EXEMPTION FROM AUDIT If the Recipient expends less than$500,000 in all state financial assistance in its fiscal year and is exempt from the audit requirements, the Recipient's Chief Financial Officer or designee shall provide written notice of exemption to the FDLE. The notice of exemption from audit shall include the Recipient's fiscal year, name of the state financial assistance award from the FDLE, catalog of state financial assistance number, amount of the award, and statement that the Recipient is exempt from the audit requirements for its fiscal year due to the threshold requirements for an audit. The notice of exemption from audit shall be submitted by March 1 following the end of the Recipients fiscal year to the: Florida Department of Law Enforcement Investigations&Forensic Science P. O. Box 1489 Tallahassee, Florida 32302 REPORT SUBMISSION If a copy of the financial reporting packages required by this agreement is already submitted by or on behalf of the Recipient to FDLE because of federal single audit requirements,another audit reporting package does not need to be submitted. Recipients,who do not already submit to FDLE a copy of the financial reporting packages required by this agreement,should send an audit report directly to each of the following: Florida Department of Law Enforcement Investigations&Forensic Sciences Program Office P. O. Box 1489 Tallahassee, Florida 32302 Auditor General's Office Room 401, Pepper Building 111 West Madison Street Tallahassee, Florida 32399-1450 Any reports, management letter, or other information required to be submitted to the FDLE pursuant to this agreement shall be submitted timely in accordance with Florida Statutes, and Chapter 10.550, Rules of the Auditor General. 'Mien submitting financial reporting packages to the FDLE for audits done in accordance with Chapter 10.550, Rules of the Auditor General,the Recipient should indicate the date that the reporting package was delivered to the Recipient in correspondence accompanying the reporting package. RECORD RETENTION The Recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of five years from the date the audit report is issued, and shall allow the FDLE or its designee, Florida's Chief Financial Officer or Auditor General access to such records upon request. The Recipient shall ensure that audit working papers are made available to the FDLE or its designee, Florida's Chief Financial Officer or Auditor General upon request for a period of five years from the date the audit report is issued, unless extended in writing by the FDLE. SIGNATURES Please sign •- • t-2 d' ee ent with the terms: Do ICICU - G tet ct eif5(2.01g •f Agency Head Print/Type Title&Name( gency Head) Dat / 411-C SG1 $.--(Cta CI 414 t(t5k- PaAA 1M-f (PrliCIC Signature of Chief Financial Officer or Designee Print/Type Title&Name (Chief Financial Officer/Designee) Date QI 5 J 2-E'l Violent Crime Investigative Emergency& Form FDLE/IFS-006 Revised 01/30/07 Reimbursement Funding Request 2 of 2