Form RUS Form 219 RUS Form 219 Inventory of Work Orders

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Overview

Instructions
Data Input
Form 219
Minor Constr. Form 219
Optional Special Equip. Summary
Optional Transformer Conv. Cost

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Sheet 1: Instructions

									Version 13, 10/21/02
		INSTRUCTIONS FOR USE OF AUTOMATED FORM 219
	Effective August 6, 1999, RUS published in the Federal Register a change to 7 CFR 1710.
	This change eliminates the traditional accounting and engineering classification of "Ordinary
	Replacement". This 219 implements this change by eliminating the "Original Cost" column.
	The aforementioned change combines the classifications of "System Improvements" and "Ordinary
	Replacements" into a single category which will be referred to as "Replacement of Plant"
	Never use the master form for data input. Save the original form for continued use and always
	enter data on a copy of the original. The original can also be saved as a template to avoid
	accidental use of the master.
1	All input for a standard form 219 (no minor construction) should be completed on the Data Input tab.
2	All input for a minor construction form 219 should be completed on the Minor Constr. Form 219 tab.
Predominant Cost
	When accounting for retirement or removal costs associated with new construction, the predominant cost
	method should be used. For example, if incidental to the construction of a new service, a structure in the
	existing line had to be changed or removed and the new construction is the costliest part of the
	project, the project would be classified as new construction. Conversly, if the costliest part was the removal
	or replacement, the project would be classified as a system improvement.
			Standard Work Order 219 Data Input
1	The Data Input sheet includes one additional column "Code Cat." or Code Category that is not normally
	found on a normal 219. This form requires input in this column in order to sort and subtotal your projects
	by code category. You may enter work orders in any order that you wish but you must include a Code
	Category such as 300 or 100, etc. The form will sort and subtotal your work orders according to the Code
	Category that you provide for each work order. For example: If the first work order is project code 235,
	you would insert Code Category 200 in column "A", Code Cat. If the next work order was a code 101, you
	would enter code 100 in column "A"; and so on.
2	Column "C", Year - Enter the year as a 4 digit entry; for example 1999 or 2000.
3	When you have completed entering all work orders that will be included on the subject Form 219,
	review each work order to assure that there are no error messages in the "Loan Funds"
	box. If a "ERROR-reduce CIAC" message appears, you should reduce Contributions In Aid of
	Construction to a level that will produce $0.00 Loan Funds. See Bulletin 1767B-2, paragraph 8.6.7.10.1.
4	When you have completed entering and reviewing all work orders that will be included on the subject
	Form 219, press the Sort button. This will sort all the work orders by Code Category.
5	The next step will create the Form 219 according to the data entered and sorted on the Data Input sheet.
	Press the Create 219 button. If asked whether you want to replace the contents of destination cells - Press
	YES. This action will subtotal the data by Code Category and copy the information to the blank Form 219
	that is located on the first tab. This action will also create the Summary By Budget Number that is
	located in the bottom left corner of the Form 219.
	DO NOT PRESS THE "CREATE 219" BUTTON MORE THAN ONCE WITHOUT FIRST PRESSING
	THE "CLEAR 219" BUTTON.
6	If you are satisfied that the Form 219 is correct and no changes are required, go to Printing the Form 219
	section below. If corrections are needed, go to the Editing the Form 219 section below.
				Editing the Form 219
1	It is very important that you follow these directions in order to successfully edit and create a new Form
	219 with the corrected data.
2	DO NOT MAKE ANY CHANGES ON THE FORM 219.
3	Go to the Data Input tab and press the Clear Subtotals button. This action will remove the subtotals that
	were previous created.
4	Now press the Clear Form 219 button. This action will remove the data from the
	Form 219 located under the first tab.
5	You may now edit existing data or enter additional data. If you need to enter new work orders, you
	may enter them at the bottom of the current list of sorted work orders and press the Sort button again.
6	Now go back to Steps 2, 3 and 4 under Standard Work Order 219 Data Input above.
				Printing the Form 219
1	Your almost Home!!! You have entered all the work orders that you need or will fit on the Form 219,
	corrected all the erroneous information that was obviously provided by others and verified the output
	on the actual Form 219 that is located on the first tab. You are now ready to print the final Form 219.
2	This is the easy part. First select the Form 219 tab. Now print this page by selecting the Print Icon or
	selecting Print Command under the File drop down box. That's all there is to it.
3	Don't forget to save your work.
				Creating a Minor Construction Form 219
1	In this case, you will actually enter the information directly on the Minor Construction Form 219.
	It is located above the "Minor Constr. Form 219" tab.
2	The only difference between this form and any other standard or hard copy of a Form 219 is the fact that
	an area has been provided below the section for dollar amounts for you to enter the required Description
	of Construction. In addition, the form will automatically total amounts entered in columns 4 through 9 into
	column 10 (do not overwrite the formulas in column 10) and will subtotal all work order totals and create the
	Summary by Budget Items total in the bottom left corner of the form. One additional difference is the
	required Environmental Certification that is provided just above the Borrower Certification.
3	Once you have entered all data required, print the form by selecting the Print Icon or the Print Command
	located under the File drop down box.
4	Don’t forget to save your work.
				Creating a Special Equipment Summary
				and/or Transformer Conversion Cost Sheet
1	As with the Minor Construction Form 219, this form is created by entering data directly onto the form. The
	form is located above the "Special Equip. Summary" tab.
2	This form works in conjunction with the Transformer Conversion Costs sheet that is located immediately
	following this form. Transformer conversion costs, if any, are first entered on the Transformer Conv.
	Cost sheet. These costs are summarized for you and totals provided at the bottom of the form for your
	use on the Special Equipment Summary form.
3	Data for both forms is entered in the same manner as you would on a standard, hard copy, form (see RUS
	Bulletin 1767B-2 for details relating to each column.
4	To print either form, go to the form to be printed and press the Print Icon or select the Print Command
	located under the File drop down box.
5	Don't forget to save your work.

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Sheet 2: Data Input

DATA INPUT SHEET
Inventory Number
Month Ending
System Designation
Name of Borrower
Manager						Date
Board Officer						Date
Inspection Performed By
Firm
License Number
	740-C		WORK ORDER		Budget Item No.	GROSS FUNDS REQUIRED		DEDUCTIONS
	CODE					Cost Of	Cost Of	SALVAGE RELATING TO		Contributions	LOAN FUNDS
Code	Code No.	Year				Construction:	Removal:	Improvements	Retirements	in Aid of	SUBJECT
Cat.			Construc-	Retire-			Improvements	or	Without	Construction	TO ADVANCE
			tion	ment			or	Replacements	Replacement	and Previous	BY RUS
							Replacements			Advances
		YYYY	(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)
								DO NOT OVERWRITE FORMULAS IN COL. 9
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.											This column is calculated automatically with formulas included in each cell. Do not enter data in this column. This column will calculate automatically if a "Code Cat." is entered in Cokumn "A".

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Sheet 3: Form 219

	USDA-RUS						No funds involved may be requisitioned unless a				FORM APPROVED
	INVENTORY OF WORK ORDERS						completed application Form 219 has been received				OMB No. 0572-0015
							(7 U.S.C. 901 et seq.)				Exp: mm/dd/yyyy
							1. INVENTORY NO.		2. MONTH ENDING
							3. SYSTEM DESIGNATION
	Instructions - Prepare 2 copies of this form. Forward 1 copy to the
	Rural Utilities Service, USDA-RD, Washington DC 20250. Copy 2 is for your records.						4. NAME OF BORROWER
	For detailed instructions see RUS Bulletin 1767B-2
	740-C		WORK ORDER		Budget Item No.	GROSS FUNDS REQUIRED		DEDUCTIONS
	CODE					Cost Of	Cost Of	SALVAGE RELATING TO		Contributions	LOAN FUNDS
	Code No.	Year				Construction:	Removal:	Improvements	Retirements	in Aid of	SUBJECT
			Construc-	Retire-			Improvements	or	Without	Construction	TO ADVANCE
			tion	ment			or	Replacements	Replacement	and Previous	BY RUS
							Replacements			Advances
			(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.	Do Not Enter data on this form. Use the Data Input Sheet to enter required information
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
User Input: Enter W/O's in random order. Before Creating Form 219, press the Sort button. Do Not enter Minor projects on this form.
Grand Total											0.00
	SUMMARY BY BUDGET NUMBER			BORROWER CERTIFICATION - We certify that the costs of construction shown are the actual costs and are reflected in the general
	Bud.	cat.	Total	accounting records. We further certify that funds represented by advances requested have been expended in accordance with the
	Grand Total		$0.00	purposes of the loan, the provisions of the loan contract and mortgage, and RUS bulletins and the Code of Federal Regulations
				relative to the advance of funds for work order purposes. We recognize that statements contained herein concern a matter within the
				jurisdiction of an agency of the United States and the making of a false, fictitious or fraudulent statement may render the maker subject
				to prosecution under Title 18, United States Code Section 1001.
				DATE				SIGNATURE (Manager)
				DATE				SIGNATURE (Board Approval)
				ENGINEERING CERTIFICATION - I hereby certify that sufficient inspection has been made of the construction reported by this
				inventory to give me reasonable assurance that the construction complies with applicable specifications and standards and meets
				appropriate code requirements as to strength and safety. This certification is in accordance with acceptable engineering practice.
				INSPECTION PERFORMED BY				FIRM
				LICENSE NUMBER				SIGNATURE OF LICENSED ENGINEER
	RUS Form 219 (Rev.10-02)			version 13, 10/21/02
	A federalAccording to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection displays a currently it displays a valid OMB cControl nNumber.The valid OMB cControl nNumber for this information collection is 0572-0015. Public reporting for this The time required to complete this information collection of information is estimated to be approximately average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in this form is required (7 U.S.C. 901 et. Seq, as amended). Rural Development has no plans to publish information collected under the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of information, inlcuding suggestions for reducing this burden to: Information Collection Clearance Officer, Rural Development Innovation Center, Regulations Management Diviison at ICRMTRequest@usda.gov.

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Sheet 4: Minor Constr. Form 219

USDA-RUS						No funds involved may be requisitioned unless a				FORM APPROVED
INVENTORY OF WORK ORDERS						completed application Form 219 has been received				OMB No. 0572-0015
						(7 U.S.C. 901 et seq.)				Exp: mm/dd/yyyy
						1. INVENTORY NO.		2. MONTH ENDING
						3. SYSTEM DESIGNATION
Instructions - Prepare 2 copies of this form. Forward 1 copy to the
Rural Utilities Service, USDA-RD, Washington DC 20250. Copy 2 is for your records.						4. NAME OF BORROWER
For detailed instructions see RUS Bulletin 1767B-2
740-C		WORK ORDER		Budget Item No.	GROSS FUNDS REQUIRED		DEDUCTIONS
CODE					Cost Of	Cost Of	SALVAGE RELATING TO		Contributions	LOAN FUNDS
Code No.	Year				Construction:	Removal:	Improvements	Retirements	in Aid of	SUBJECT
		Construc-	Retire-			Improvements	or	Without	Construction	TO ADVANCE
		tion	ment			or	Replacements	Replacement	and Previous	BY RUS
						Replacements			Advances
		(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
										In order for this function to calculate, you must enter a code number in column "A".
Subtotal					0.00	0.00	0.00	0.00	0.00	0.00
Work OrderNo.						Description of Construction
SUMMARY BY BUDGET ITEMS			ENVIRONMENTAL CERTIFICATION - FOR MINOR PROJECT 219 ONLY
			1		We certify that construction reported on the above listed work orders (except certification "2" below), is a categorical exclusion
Item	740-C				of a type described in 7 CFR 1794.31 (b) which normally does not require preparation of a Borrower's Environmental Report.
No.	Code	Amount	2		We certify that construction reported on work orders					above, is a categorical
					exclusion of a type that normally requires a Borrower's Environmental Report which is attached.
1		$0.00	DATE				SIGNATURE (Manager)
			BORROWER CERTIFICATION - We certify that the costs of construction shown are the actual costs and are reflected in the general
			accounting records. We further certify that funds represented by advances requested have been expended in accordance with the
			purposes of the loan, the provisions of the loan contract and mortgage, and RUS bulletins and the Code of Federal Regulations
			relative to the advance of funds for work order purposes. We recognize that statements contained herein concern a matter within the
			jurisdiction of an agency of the United States and the making of a false, fictitious or fraudulent statement may render the maker subject
			to prosecution under Title 18, United States Code Section 1001.
			DATE				SIGNATURE (Manager)
			DATE				SIGNATURE (Board Approval)
			ENGINEERING CERTIFICATION - I hereby certify that sufficient inspection has been made of the construction reported by this
			inventory to give me reasonable assurance that the construction complies with applicable specifications and standards and meets
			appropriate code requirements as to strength and safety. This certification is in accordance with acceptable engineering practice.
			INSPECTION PERFORMED BY				FIRM
Total		$0.00
			LICENSE NUMBER				SIGNATURE OF LICENSED ENGINEER
RUS Form 219 (Rev. 10-02)			version 13, 10/21/02
A federalAccording to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection displays a currently it displays a valid OMB cControl nNumber.The valid OMB cControl nNumber for this information collection is 0572-0015. Public reporting for this The time required to complete this information collection of information is estimated to be approximately average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in this form is required (7 U.S.C. 901 et. Seq, as amended). Rural Development has no plans to publish information collected under the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of information, inlcuding suggestions for reducing this burden to: Information Collection Clearance Officer, Rural Development Innovation Center, Regulations Management Diviison at ICRMTRequest@usda.gov.

---

Sheet 5: Optional Special Equip. Summary

Optional form

CODE 600

SUMMARY OF SPECIAL EQUIPMENT COSTS

Date

Reference

Transformer

Salvage Value

Conversion

of Old

Invoice

Labor

Costs

Estimated

Loan Funds

Transformers

Quan-

Size

Manufacturer

Type

Cost and

and

(from Col.10

Cost of

Subject to

(from Col. 6

Total Cost

ity

Freight

Other

Trans. Conv.

Installation

Advance

Trans. Conv.

Capitalized

Costs

Costs

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

Account 370, Meters - Meter Sockets, Current and Potential Transformers

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

TOTALS

$0.00

$0.00

$0.00

$0.00

$0.00

Account 368, Line Transformers - Voltage Regulators

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

TOTALS

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Account 365, Overhead Conductors and Devices - Oil Circuit Reclosers and Sectionalizers

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

In order for this function to calculate, you must enter an amount in column 5. Any amount including $0.00.

TOTALS

$0.00

$0.00

$0.00

$0.00

$0.00

MONTHLY GRAND TOTAL LOAN FUNDS SUBJECT TO ADVANCE

$0.00

BORROWER CERTIFICATION

I certify that the costs of construction shown are the actual costs and are reflected in the general accounting records. We further certify that funds represented

by advances requested have been expensed in accordance with the purposes of the loan, the provisions of the loan contract and mortgage, and RUS bulletins

and the Code of Federal Regulations relative to the advance of funds for work order purposes.

Manager's Signature

Date

V 13, 10/21/02

---

Sheet 6: Optional Transformer Conv. Cost

Optional Form

TRANSFORMER CONVERSION COSTS

DATE

REFERENCE

TOTAL

TOTAL COST

CONVERTED

Size in KVA

Retired Transformers

CONVERSION

OF CONVERTED

UNIT COST

ORIGINAL

RETIREMENT

INVOICE COST

OTHER

COST -

TRANSFORMERS

COL. 11 /

QUANTITY

OLD

NEW

TYPE

INSTALLED

SALVAGE

LOSS - COL.

OF CONVERSION

CONVERSION

COL. 8 +

COL. 6 +

COL. 1

COST

5 - COL. 6

AND FREIGHT

COSTS

COL. 9

COL. 10

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

In order for this function to calculate, you must enter a quantity in column 1. The quantity can be any positive number but cannot be "0".

In order for this function to calculate, you must enter an amount in column 8. Any positive number including "0"

CREDIT ACCT. 368, DEBIT ACCT. 106.8

$0.00

DEBIT ACCT. 107.3, CREDIT ACCT. 108.8

$0.00

DEBIT ACCT. 108.6, CREDIT ACCT. 108.8

$0.00

TOTAL INVOICE PRICE, DEBIT ACCT. 107.3

$0.00

TOTAL OTHER COST, DEBIT ACCT. 107.3

$0.00

TOTAL CONVERSION COST

$0.00

GRAND TOTAL

$0.00

V 13, 10/21/02