fiscal affairs department...(716) 945-1790 x3082 d. email address [email protected] e. date report...
TRANSCRIPT
The Seneca Nation of Indians FISCAL AFFAIRS DEPARTMENT
PO Box 231 Salamanca New York 14779 Phone (716)945-1790
December 19 2017
Mr Terrence Parks Acting Chief Office of Indian Energy amp Economic Development Division of Workforce Development Office of Indian Services 1846 C Street MS-4520-MIB Washington DC 20240
Dear Mr Parks
Enclosed you will find Signed SF425s for the following Contracts
Tribal 477 Al4AV00104 Tribal 477 Al7AV00137
Should you require any additional information please feel free to contact Christine Shattuck at (716)-945-1790 ext 3098 or myself at (716)945-1790 ext 3082 or at
TheresaHercsniorg
Thank You
~de~ Theresa Herc Grants amp Contracts Budget Officer Seneca Nation of Indians
RECE ED xc Director File -42814 42817
DEC 2 6 2017
Bureau of Indian Affairs Ottice of lndi Services
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency (To report multiple grants use FFR Attachment)
A14AV00104
3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779
Page of
1
I
4a DUNS Number 4b EIN 5 Recipient Account Number or Identifying 6 Report Type 7 Basis of Accounting Number (To report multiple grants use FFR D Quarterly Ocash Attachment) D Semi-Annual 0Accrual
074038266 16-0786768 0Annual 42814 0Final
8 ProjectGrant Period (Month Day Year) 9 Reporting Period End Date (Month Day Year)
From 1012012 ITo 91302017 9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple arant reportina) Federal Cash (To report multiple arants also use FFR Attachment)
1
pages
a Cash Receipts $1 72201167 b Cash Disbursements $ 172201167 c Cash on Hand line a minus b) $ -
(Use lines d-o for single grant reportina) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 172201167 e Federal share of expenditures $ 1722011 67 f Federal share of unliquidated obligations $000 g Total Federal share (sum of lines e and f) $ 1722 011 67
bull h Unobligated balance of Federal funds (line d minus g) $0DO Recipient Share
i Total recipient share required $000 i Recipient share of expenditures $000
k Remaining recipient share to be provided (line i minus j) $000 Program Income
I Total Federal program income earned $000 m Proqram income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended proqram income line I minus line m or linen) $000
11 a Type b Rate c Period I Period To d Base e Amount Charged f Federal Share Indirect From Expense
a Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (U S Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
b Signature of Authori~fi9 ~
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
e Date Report Submitted (Month Day Year)
I Z -1- 7 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-0061 Expiration Date 103120 11
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
I Tribeffribal Organization
Seneca Nation of Indians
2 Other Identifying Number Assigned by DOI
Al4AVOOJ04
3 Mailing Address (Provide complete mailing address)
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original 0 Revised
5 Final Report for Plan Period
bull Yes QNo
6 Annual Report Period
From 100 12016 To 09302017
(MonthDayYear) (MonthDayYear)
7 Plan Period Covered by this Report
From 101 2012 To 09302017 (MonthDayYear) (MonthDayYear)
8 Transactions
a Total Funds Available
middot b Cash Assistance Expenditures
c Child Care Services Expenditures
d Education Employment Training and Supportive Services Expenditures
i TANF Purposes 3 and 4 (non-add)
ii Other TANF Assistance (non-add)
e Program Operations Expenditures
i Child Care Quality Improvement (non-add)
f AdministrationIndirect Cost Expenditures
g Total Federal Expenditures (Sum of lines b through f)
h Total Unexpended Funds
Column I Previously Reported
$ 17220 1167
$ -$ -
$ 16844290
$ -
$ -
$ 75785635
$ -
$ 36995480
$ 129625405
$ 425 75762
Column ll Column III
This Annual Report CumulativeTotal
Period
$ - $ 172201167
$ - $ -
$ - $ -
$ 14005123 $ 30849413
$ - $ -
$ - $ -
$ 28288846 $ 104074481
$ - $ -
$ 28 1793 $ 37277273
$ 42575762 $ 172201167
$ (42575762) $ -
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicab le statutory requirements and with those directly applicable regulatory requirements which have not been waived
a Signature ofT~b~ ~ b Type Name and Title c Date Report Submitted
Todd Gates Seneca Nation President 2 -S-7 d Questions regarding this report - Contact (Type ame Title Phone and Email Address)
Theresa Herc Grants Budget Compliance Officer (716)945 -1 790 X3082 theresahercsniorg
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency To report multiple grants use FFR Attachment)
A17AV00137
Page of
1 1
I pages 3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779 4a DUNS Number
074038266
4b EIN
16-0786768
5 Recipient Account Number or Identifying Number (To report multiple grants use FFR Attachment)
42817
6 Report Type
0 Quarterly 0 Semi-Annual 0 Annual 0Final
7 Basis of Accounting
Ocash 0 Accrual
8 ProjectGrant Period (Month Day Year)
From 1012016 To 9302019 9 Reporting Period End Date (Month Day Year)
9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple grant reporting) Federal Cash To report multiple arants also use FFR Attachment)
a Cash Receipts $16251819 b Cash Disbursements $ 24040342 c Cash on Hand line a minus b) $ (7788523)
I (Use lines d-o for single grant reporting) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 600901 19 e Federal share of expenditures $ 24040342 f Federal share of unliquidated obligations $1102191
g Total Federal share (sum of lines e and f) $ 25142533 h )nobl igated balance ofFederal funds lined minus a) $34947586
Recipient Share i Total recipient share required $000 j Recipient share of expenditures $0 00 k Remaining recipient share to be provided (line i minus j) $000
Program Income I Total Federal program income earned $000 m Program income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended program income line I minus line m or linen) $000
11 Indirect Expense
a Type b Rate c Period From
Period To d Base e Amount Charged f Federal Share
g Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (US Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
b Signature of Authorized7W--- e Date Report Submitted (Month Day Year)
I 2 I --17 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-006 1 Expiration Date 10312011
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
1 Triberfribal Organization
Seneca Nation of Indians
3 Mailing Address (Provide complete mailing address)
2 Other Identifying Number Assigned by DOI
Al7AVOOI37
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original
6 Annual Report Period
0 Revised
5 Final Report for Plan Period
0 Yes No
7 Plan Period Covered by this Report
From I 00 120 16 To 093020 17
(MonthDayYear) (MonthDayYear) From I 001 20 16 To 9302019
(MonthDayYear) (MonthDayYear)
8 Transactions Column I
Previously Reported
Column 11 This Annual Report
Period
Column Ill CumulativeTotal
a Total Funds Available $ - $ 60090119 $ 60090119
b Cash Assistance Expenditures $ - $ - $
c Chi ld Care Services Expenditures $ - $ - $ -
d Education Employment Training and Supportive Services $ - $ 4200444 $ 4200444
Expenditures
$ -i TANF Purposes 3 and 4 (non-add) $ - $ -
$ - $ -ii Other TANF Assistance (non-add) $ -
$ -e Program Operations Expenditures $ - $ -
$ - $ 11517062 i Child Care Quality Improvement (non-add) $ 11517062
$ - $ 8322836 f AdministrationIndirect Cost Expenditures $ 8322836
$ 24040342 $ - $ 24040342 g Total Federal Expenditures (Sum of lines b through f)
$ 36049777 $ - $ 36049777 h Total Unexpended Funds
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory
req uirements which have not been waived
a Signature of Tribal 07 A---b Type Name and Title C Date Report sritted
Todd Gates Seneca ation President Z_- -7 d Questions regarding this report- Contact (Type Name Title Phone and Email Address)
Theresa A Herc Grants Budget Compliance Officer (716)945-1790 X3082 theresahercsniorg
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency (To report multiple grants use FFR Attachment)
A14AV00104
3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779
Page of
1
I
4a DUNS Number 4b EIN 5 Recipient Account Number or Identifying 6 Report Type 7 Basis of Accounting Number (To report multiple grants use FFR D Quarterly Ocash Attachment) D Semi-Annual 0Accrual
074038266 16-0786768 0Annual 42814 0Final
8 ProjectGrant Period (Month Day Year) 9 Reporting Period End Date (Month Day Year)
From 1012012 ITo 91302017 9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple arant reportina) Federal Cash (To report multiple arants also use FFR Attachment)
1
pages
a Cash Receipts $1 72201167 b Cash Disbursements $ 172201167 c Cash on Hand line a minus b) $ -
(Use lines d-o for single grant reportina) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 172201167 e Federal share of expenditures $ 1722011 67 f Federal share of unliquidated obligations $000 g Total Federal share (sum of lines e and f) $ 1722 011 67
bull h Unobligated balance of Federal funds (line d minus g) $0DO Recipient Share
i Total recipient share required $000 i Recipient share of expenditures $000
k Remaining recipient share to be provided (line i minus j) $000 Program Income
I Total Federal program income earned $000 m Proqram income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended proqram income line I minus line m or linen) $000
11 a Type b Rate c Period I Period To d Base e Amount Charged f Federal Share Indirect From Expense
a Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (U S Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
b Signature of Authori~fi9 ~
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
e Date Report Submitted (Month Day Year)
I Z -1- 7 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-0061 Expiration Date 103120 11
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
I Tribeffribal Organization
Seneca Nation of Indians
2 Other Identifying Number Assigned by DOI
Al4AVOOJ04
3 Mailing Address (Provide complete mailing address)
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original 0 Revised
5 Final Report for Plan Period
bull Yes QNo
6 Annual Report Period
From 100 12016 To 09302017
(MonthDayYear) (MonthDayYear)
7 Plan Period Covered by this Report
From 101 2012 To 09302017 (MonthDayYear) (MonthDayYear)
8 Transactions
a Total Funds Available
middot b Cash Assistance Expenditures
c Child Care Services Expenditures
d Education Employment Training and Supportive Services Expenditures
i TANF Purposes 3 and 4 (non-add)
ii Other TANF Assistance (non-add)
e Program Operations Expenditures
i Child Care Quality Improvement (non-add)
f AdministrationIndirect Cost Expenditures
g Total Federal Expenditures (Sum of lines b through f)
h Total Unexpended Funds
Column I Previously Reported
$ 17220 1167
$ -$ -
$ 16844290
$ -
$ -
$ 75785635
$ -
$ 36995480
$ 129625405
$ 425 75762
Column ll Column III
This Annual Report CumulativeTotal
Period
$ - $ 172201167
$ - $ -
$ - $ -
$ 14005123 $ 30849413
$ - $ -
$ - $ -
$ 28288846 $ 104074481
$ - $ -
$ 28 1793 $ 37277273
$ 42575762 $ 172201167
$ (42575762) $ -
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicab le statutory requirements and with those directly applicable regulatory requirements which have not been waived
a Signature ofT~b~ ~ b Type Name and Title c Date Report Submitted
Todd Gates Seneca Nation President 2 -S-7 d Questions regarding this report - Contact (Type ame Title Phone and Email Address)
Theresa Herc Grants Budget Compliance Officer (716)945 -1 790 X3082 theresahercsniorg
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency To report multiple grants use FFR Attachment)
A17AV00137
Page of
1 1
I pages 3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779 4a DUNS Number
074038266
4b EIN
16-0786768
5 Recipient Account Number or Identifying Number (To report multiple grants use FFR Attachment)
42817
6 Report Type
0 Quarterly 0 Semi-Annual 0 Annual 0Final
7 Basis of Accounting
Ocash 0 Accrual
8 ProjectGrant Period (Month Day Year)
From 1012016 To 9302019 9 Reporting Period End Date (Month Day Year)
9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple grant reporting) Federal Cash To report multiple arants also use FFR Attachment)
a Cash Receipts $16251819 b Cash Disbursements $ 24040342 c Cash on Hand line a minus b) $ (7788523)
I (Use lines d-o for single grant reporting) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 600901 19 e Federal share of expenditures $ 24040342 f Federal share of unliquidated obligations $1102191
g Total Federal share (sum of lines e and f) $ 25142533 h )nobl igated balance ofFederal funds lined minus a) $34947586
Recipient Share i Total recipient share required $000 j Recipient share of expenditures $0 00 k Remaining recipient share to be provided (line i minus j) $000
Program Income I Total Federal program income earned $000 m Program income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended program income line I minus line m or linen) $000
11 Indirect Expense
a Type b Rate c Period From
Period To d Base e Amount Charged f Federal Share
g Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (US Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
b Signature of Authorized7W--- e Date Report Submitted (Month Day Year)
I 2 I --17 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-006 1 Expiration Date 10312011
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
1 Triberfribal Organization
Seneca Nation of Indians
3 Mailing Address (Provide complete mailing address)
2 Other Identifying Number Assigned by DOI
Al7AVOOI37
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original
6 Annual Report Period
0 Revised
5 Final Report for Plan Period
0 Yes No
7 Plan Period Covered by this Report
From I 00 120 16 To 093020 17
(MonthDayYear) (MonthDayYear) From I 001 20 16 To 9302019
(MonthDayYear) (MonthDayYear)
8 Transactions Column I
Previously Reported
Column 11 This Annual Report
Period
Column Ill CumulativeTotal
a Total Funds Available $ - $ 60090119 $ 60090119
b Cash Assistance Expenditures $ - $ - $
c Chi ld Care Services Expenditures $ - $ - $ -
d Education Employment Training and Supportive Services $ - $ 4200444 $ 4200444
Expenditures
$ -i TANF Purposes 3 and 4 (non-add) $ - $ -
$ - $ -ii Other TANF Assistance (non-add) $ -
$ -e Program Operations Expenditures $ - $ -
$ - $ 11517062 i Child Care Quality Improvement (non-add) $ 11517062
$ - $ 8322836 f AdministrationIndirect Cost Expenditures $ 8322836
$ 24040342 $ - $ 24040342 g Total Federal Expenditures (Sum of lines b through f)
$ 36049777 $ - $ 36049777 h Total Unexpended Funds
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory
req uirements which have not been waived
a Signature of Tribal 07 A---b Type Name and Title C Date Report sritted
Todd Gates Seneca ation President Z_- -7 d Questions regarding this report- Contact (Type Name Title Phone and Email Address)
Theresa A Herc Grants Budget Compliance Officer (716)945-1790 X3082 theresahercsniorg
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
I Tribeffribal Organization
Seneca Nation of Indians
2 Other Identifying Number Assigned by DOI
Al4AVOOJ04
3 Mailing Address (Provide complete mailing address)
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original 0 Revised
5 Final Report for Plan Period
bull Yes QNo
6 Annual Report Period
From 100 12016 To 09302017
(MonthDayYear) (MonthDayYear)
7 Plan Period Covered by this Report
From 101 2012 To 09302017 (MonthDayYear) (MonthDayYear)
8 Transactions
a Total Funds Available
middot b Cash Assistance Expenditures
c Child Care Services Expenditures
d Education Employment Training and Supportive Services Expenditures
i TANF Purposes 3 and 4 (non-add)
ii Other TANF Assistance (non-add)
e Program Operations Expenditures
i Child Care Quality Improvement (non-add)
f AdministrationIndirect Cost Expenditures
g Total Federal Expenditures (Sum of lines b through f)
h Total Unexpended Funds
Column I Previously Reported
$ 17220 1167
$ -$ -
$ 16844290
$ -
$ -
$ 75785635
$ -
$ 36995480
$ 129625405
$ 425 75762
Column ll Column III
This Annual Report CumulativeTotal
Period
$ - $ 172201167
$ - $ -
$ - $ -
$ 14005123 $ 30849413
$ - $ -
$ - $ -
$ 28288846 $ 104074481
$ - $ -
$ 28 1793 $ 37277273
$ 42575762 $ 172201167
$ (42575762) $ -
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicab le statutory requirements and with those directly applicable regulatory requirements which have not been waived
a Signature ofT~b~ ~ b Type Name and Title c Date Report Submitted
Todd Gates Seneca Nation President 2 -S-7 d Questions regarding this report - Contact (Type ame Title Phone and Email Address)
Theresa Herc Grants Budget Compliance Officer (716)945 -1 790 X3082 theresahercsniorg
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency To report multiple grants use FFR Attachment)
A17AV00137
Page of
1 1
I pages 3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779 4a DUNS Number
074038266
4b EIN
16-0786768
5 Recipient Account Number or Identifying Number (To report multiple grants use FFR Attachment)
42817
6 Report Type
0 Quarterly 0 Semi-Annual 0 Annual 0Final
7 Basis of Accounting
Ocash 0 Accrual
8 ProjectGrant Period (Month Day Year)
From 1012016 To 9302019 9 Reporting Period End Date (Month Day Year)
9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple grant reporting) Federal Cash To report multiple arants also use FFR Attachment)
a Cash Receipts $16251819 b Cash Disbursements $ 24040342 c Cash on Hand line a minus b) $ (7788523)
I (Use lines d-o for single grant reporting) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 600901 19 e Federal share of expenditures $ 24040342 f Federal share of unliquidated obligations $1102191
g Total Federal share (sum of lines e and f) $ 25142533 h )nobl igated balance ofFederal funds lined minus a) $34947586
Recipient Share i Total recipient share required $000 j Recipient share of expenditures $0 00 k Remaining recipient share to be provided (line i minus j) $000
Program Income I Total Federal program income earned $000 m Program income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended program income line I minus line m or linen) $000
11 Indirect Expense
a Type b Rate c Period From
Period To d Base e Amount Charged f Federal Share
g Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (US Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
b Signature of Authorized7W--- e Date Report Submitted (Month Day Year)
I 2 I --17 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-006 1 Expiration Date 10312011
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
1 Triberfribal Organization
Seneca Nation of Indians
3 Mailing Address (Provide complete mailing address)
2 Other Identifying Number Assigned by DOI
Al7AVOOI37
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original
6 Annual Report Period
0 Revised
5 Final Report for Plan Period
0 Yes No
7 Plan Period Covered by this Report
From I 00 120 16 To 093020 17
(MonthDayYear) (MonthDayYear) From I 001 20 16 To 9302019
(MonthDayYear) (MonthDayYear)
8 Transactions Column I
Previously Reported
Column 11 This Annual Report
Period
Column Ill CumulativeTotal
a Total Funds Available $ - $ 60090119 $ 60090119
b Cash Assistance Expenditures $ - $ - $
c Chi ld Care Services Expenditures $ - $ - $ -
d Education Employment Training and Supportive Services $ - $ 4200444 $ 4200444
Expenditures
$ -i TANF Purposes 3 and 4 (non-add) $ - $ -
$ - $ -ii Other TANF Assistance (non-add) $ -
$ -e Program Operations Expenditures $ - $ -
$ - $ 11517062 i Child Care Quality Improvement (non-add) $ 11517062
$ - $ 8322836 f AdministrationIndirect Cost Expenditures $ 8322836
$ 24040342 $ - $ 24040342 g Total Federal Expenditures (Sum of lines b through f)
$ 36049777 $ - $ 36049777 h Total Unexpended Funds
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory
req uirements which have not been waived
a Signature of Tribal 07 A---b Type Name and Title C Date Report sritted
Todd Gates Seneca ation President Z_- -7 d Questions regarding this report- Contact (Type Name Title Phone and Email Address)
Theresa A Herc Grants Budget Compliance Officer (716)945-1790 X3082 theresahercsniorg
FEDERAL FINANCIAL REPORT (Follow form instructions)
1 Federal Agency and Organizational Element to Which Report is Submitted
BIA
2 Federal Grant or Other Identifying Number Assigned by Federal Agency To report multiple grants use FFR Attachment)
A17AV00137
Page of
1 1
I pages 3 Recipient Organization (Name and complete address including Zip code)
Seneca Nation of Indians PO Box 231
Salamanca NY 14779 4a DUNS Number
074038266
4b EIN
16-0786768
5 Recipient Account Number or Identifying Number (To report multiple grants use FFR Attachment)
42817
6 Report Type
0 Quarterly 0 Semi-Annual 0 Annual 0Final
7 Basis of Accounting
Ocash 0 Accrual
8 ProjectGrant Period (Month Day Year)
From 1012016 To 9302019 9 Reporting Period End Date (Month Day Year)
9302017 10 Transactions Cumulative
(Use lines a-c for single or multiple grant reporting) Federal Cash To report multiple arants also use FFR Attachment)
a Cash Receipts $16251819 b Cash Disbursements $ 24040342 c Cash on Hand line a minus b) $ (7788523)
I (Use lines d-o for single grant reporting) Federal Expenditures and Unobligated Balance
d Total Federal funds authorized $ 600901 19 e Federal share of expenditures $ 24040342 f Federal share of unliquidated obligations $1102191
g Total Federal share (sum of lines e and f) $ 25142533 h )nobl igated balance ofFederal funds lined minus a) $34947586
Recipient Share i Total recipient share required $000 j Recipient share of expenditures $0 00 k Remaining recipient share to be provided (line i minus j) $000
Program Income I Total Federal program income earned $000 m Program income expended in accordance with the deduction alternative $000 n Program income expended in accordance with the addition alternative $000 o Unexpended program income line I minus line m or linen) $000
11 Indirect Expense
a Type b Rate c Period From
Period To d Base e Amount Charged f Federal Share
g Totals 0 0 0 12 Remarks Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation
13 Certification By signing this report I certify to the best of my knowledge and belief that the report is true complete and accurate and the expenditures disbursements and cash receipts are for the purposes and intent set forth in the award documents I am aware that any false fictitious or fraudulent information may subject me to criminal civil or administrative penalties (US Code Title 18 Section 1001)
a Typed or Printed Name and Title of Authorized Certifying Official
Todd Gates Seneca Nation President
c Telephone (Area code number and extension)
(716) 945-1790 X3082
d Email Address
Todd Gatessniorg
b Signature of Authorized7W--- e Date Report Submitted (Month Day Year)
I 2 I --17 14 Agency use only
Standard Form 425 - Revised 6282010 0MB Approval Number 0348-006 1 Expiration Date 10312011
Paperwork Burden Statement According to the Paperwork Reduction Act as amended no persons are required to respond to a collection of information unless it displays a valid 0MB Control Number The valid 0MB control number for this information collection is 0348-0061 Public reporting burden for this collection of information is estimated to average 15 hours per response including time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to the Office of Management and Budget Paperwork Reduction Project (0348-0061 ) Washington DC 20503
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
1 Triberfribal Organization
Seneca Nation of Indians
3 Mailing Address (Provide complete mailing address)
2 Other Identifying Number Assigned by DOI
Al7AVOOI37
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original
6 Annual Report Period
0 Revised
5 Final Report for Plan Period
0 Yes No
7 Plan Period Covered by this Report
From I 00 120 16 To 093020 17
(MonthDayYear) (MonthDayYear) From I 001 20 16 To 9302019
(MonthDayYear) (MonthDayYear)
8 Transactions Column I
Previously Reported
Column 11 This Annual Report
Period
Column Ill CumulativeTotal
a Total Funds Available $ - $ 60090119 $ 60090119
b Cash Assistance Expenditures $ - $ - $
c Chi ld Care Services Expenditures $ - $ - $ -
d Education Employment Training and Supportive Services $ - $ 4200444 $ 4200444
Expenditures
$ -i TANF Purposes 3 and 4 (non-add) $ - $ -
$ - $ -ii Other TANF Assistance (non-add) $ -
$ -e Program Operations Expenditures $ - $ -
$ - $ 11517062 i Child Care Quality Improvement (non-add) $ 11517062
$ - $ 8322836 f AdministrationIndirect Cost Expenditures $ 8322836
$ 24040342 $ - $ 24040342 g Total Federal Expenditures (Sum of lines b through f)
$ 36049777 $ - $ 36049777 h Total Unexpended Funds
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory
req uirements which have not been waived
a Signature of Tribal 07 A---b Type Name and Title C Date Report sritted
Todd Gates Seneca ation President Z_- -7 d Questions regarding this report- Contact (Type Name Title Phone and Email Address)
Theresa A Herc Grants Budget Compliance Officer (716)945-1790 X3082 theresahercsniorg
0MB Control No 1076-0135 Expiration Date 02282018
US Department of the Interior Public Law 102-477
Annual Financial Expenditure Report (Version 2)
1 Triberfribal Organization
Seneca Nation of Indians
3 Mailing Address (Provide complete mailing address)
2 Other Identifying Number Assigned by DOI
Al7AVOOI37
PO Box 231 Salamanca NY 14779
4 Submission (Mark One)
bull Original
6 Annual Report Period
0 Revised
5 Final Report for Plan Period
0 Yes No
7 Plan Period Covered by this Report
From I 00 120 16 To 093020 17
(MonthDayYear) (MonthDayYear) From I 001 20 16 To 9302019
(MonthDayYear) (MonthDayYear)
8 Transactions Column I
Previously Reported
Column 11 This Annual Report
Period
Column Ill CumulativeTotal
a Total Funds Available $ - $ 60090119 $ 60090119
b Cash Assistance Expenditures $ - $ - $
c Chi ld Care Services Expenditures $ - $ - $ -
d Education Employment Training and Supportive Services $ - $ 4200444 $ 4200444
Expenditures
$ -i TANF Purposes 3 and 4 (non-add) $ - $ -
$ - $ -ii Other TANF Assistance (non-add) $ -
$ -e Program Operations Expenditures $ - $ -
$ - $ 11517062 i Child Care Quality Improvement (non-add) $ 11517062
$ - $ 8322836 f AdministrationIndirect Cost Expenditures $ 8322836
$ 24040342 $ - $ 24040342 g Total Federal Expenditures (Sum of lines b through f)
$ 36049777 $ - $ 36049777 h Total Unexpended Funds
9 Certification This is to certify that the information reported on all parts of this form is accurate and true to the best ofmy knowledge and belief and that the tribe has complied with all directly applicable statutory requirements and with those directly applicable regulatory
req uirements which have not been waived
a Signature of Tribal 07 A---b Type Name and Title C Date Report sritted
Todd Gates Seneca ation President Z_- -7 d Questions regarding this report- Contact (Type Name Title Phone and Email Address)
Theresa A Herc Grants Budget Compliance Officer (716)945-1790 X3082 theresahercsniorg