Form FRA F 251 FRA F 251 Applicant Financial Capability Questionnaire

OMB Clearance No. 2130-0615
Expiration Date: 01/31/2024

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failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB
Control Number. The OMB Control Number for this information collection is 2130-0615. Public reporting for this collection of information is estimated to be approximately 2 hours
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including suggestions for reducing this burden to: Information Collection Clearance Officer (RAD-20), Federal Railroad Administration, 1200 New Jersey Avenue, Washington, DC.
20590.

Federal Railroad Administration
APPLICANT FINANCIAL CAPABILITY QUESTIONNAIRE
SECTION A: PURPOSE
Federal agencies are required to review and evaluate the potential risks posed by applicants prior to awarding Federal funds (2 C.F.R. § 200.205). The
Federal Railroad Administration (FRA) considers a variety of factors and information in completing this risk assessment. FRA’s evaluation may include
the following: financial capability and/or stability of the applicant organization; quality of the organization’s management and financial systems; history of
past performance; and results of audits and/or reports.
Completion of this form is intended to assist FRA in evaluating the financial capability of the applicant organization. This form is to be completed by organizations
applying for FRA programs that 1) have not previously completed this form or 2) have not had a current/active award with FRA within the last three years.

SECTION B: ORGANIZATION INFORMATION
1.

NAME OF ORGANIZATION:

2.

NAME AND TITLE OF AUTHORIZED REPRESENTATIVE (individual who will accept the grant on behalf of your organization):

3.

YEAR ORGANIZATION WAS FOUNDED/INCORPORATED:

4.

EMPLOYER IDENTIFICATION NUMBER (EIN):

5.

DUNS NUMBER/ UNIQUE ENTITY IDENTIFIER:

6. PRIMARY ADDRESS OF THE ORGANIZATION:

7. DOES THE ORGANIZATION HAVE A CURRENT
ORGANIZATIONAL CHART?
YES

8.

HAS YOUR ORGANIZATION RECEIVED FEDERAL
ASSISTANCE FUNDS IN THE LAST 2 YEARS?

YES

NO

NO

IF YES, PLEASE PROVIDE A COPY
9. TOTAL OPERATING BUDGET IN THE PREVIOUS FISCAL
YEAR:
$

SECTION C: ACCOUNTING SYSTEM
1.

HAS ANY GOVERNMENT AGENCY RENDERED AN OFFICIAL WRITTEN OPINION CONCERNING
THE ADEQUACY OF THE ACCOUNTING SYSTEM FOR THE COLLECTION, IDENTIFICATION
AND ALLOCATION OF COSTS UNDER FEDERAL CONTRACTS/GRANTS?

1a. IF YES, PROVIDE NAME, AND ADDRESS OF AGENCY PERFORMING REVIEW:

FRA F 36 (02/20)

YES

NO

1b. ATTACH A COPY OF THE LATEST REVIEW AND ANY SUBSEQUENT
CORRESPONDENCE, CLEARANCE DOCUMENTS, ETC.

Office of the Chief Financial Officer

2.

WHICH OF THE FOLLOWING BEST DESCRIBES THE ORGANIZATION’S ACCOUNTING SYSTEM?
MANUAL

3.

COMBINATION

IS THE ORGANIZATION’S FINANCIAL MANAGEMENT PERFORMED IN-HOUSE (BY EMPLOYED STAFF) OR OUTSOURCED WITH CONTRACTED
INDIVIDUALS?
IN-HOUSE

4.

AUTOMATED

OUTSOURCED/CONTRACTED

COMBINATION

DOES THE ORGANIZATION ANTICIPATE ANY SIGNIFICANT CHANGES TO ACCOUNTING SYSTEM IN THE NEXT 12 MONTHS?

YES

NO

IF YES, PLEASE EXPLAIN:

5.

DOES THE APPLICANT HAVE EFFECTIVE INTERNAL CONTROLS IN PLACE TO ENSURE THAT FEDERAL FUNDS ARE USED SOLEY FOR
AUTHORIZED PURPOSES?
YES
NO

6.

DOES THE ORGANIZATION HAVE WRITTEN GRANTS MANAGEMENT POLICIES AND PROCEDURES FOR THE FOLLOWING:
6a. ACCOUNTING/FINANCIAL?

YES

NO

6b. PROCUREMENT?

YES

NO

6c. PROPERTY MANAGEMENT?

YES

NO

6d. PERSONNEL?

YES

NO

6e. TRAVEL?

YES

NO

7.

DOES THE ORGANIZATION MAINTAIN TIMESHEETS (OR TIME AND ACTIVITY REPORTS) FOR EMPLOYEES THAT TRACK ACTUAL EFFORT BY PROJECT
COST OR OBJECTIVE?
YES
NO

8.

DOES THE ORGANIZATION HAVE A CURRENT AND APPROVED INDIRECT COST RATE?

9.

DOES THE ACCOUNTING/FINANCIAL SYSTEM INCLUDE CONTROLS TO PREVENT INCURRING OBLIGATIO NS IN EXCESS OF:
9a TOTAL FUNDS AVAILABLE FOR A GRANT?

YES

YES

NO

NO

9b TOTAL FUNDS AVAILABLE FOR A BUDGET COST CATEGORY (e.g. Personnel, Fringe Benefits, etc.)

YES

10. ARE THE INDIVIDUALS RESPONSIBLE FOR ADMINISTERING GRANT FUNDS FAMILIAR
WITH THE CURRENT REGULATIONS AND GUIDELINES ON ADMINISTRATION, COST
PRINCIPLES AND AUDIT REQUIREMENTS FOR FEDERAL GRANTS (INCLUDING 2 C.F.R. 200)?

NO

YES

NO

SECTION D: HISTORY OF PERFORMANCE
1. HAS THE ORGANIZATION EVER HAD A FEDERAL AWARD SUSPENDED OR TERMINATED FOR NON-COMPLIANCE?

YES

NO

YES

NO

YES

NO

YES

NO

SECTION E: FINANCIAL STATEMENTS
1. DID THE ORGANIZATION HAVE A FINANCIAL STATEMENT AUDIT IN ITS MOST RECENT FISCAL YEAR?
1a. WHEN IS THE ORGANIZATION'S FISCAL YEAR END?
2. IF THE ORGANIZATION HAD AN AUDIT IN ITS MOST RECENT FISCAL YEAR, IS THE REPORT AVAILABLE PUBLICLY?
IF YES, PLEASE PROVIDE LOCATION: (e.g. FEDERAL AUDIT CLEARINGHOUSE OR WEBSITE)

IF NO, PLEASE PROVIDE A COPY.
3. DID YOUR ORGANIZATION EXPEND $750,000 OR MORE IN FEDERAL FUNDS IN THE MOST RECENT COMPLETED
FISCAL YEAR?

FRA F 36 (02/20)

Office of the Chief Financial Officer

SECTION F: ADDITIONAL INFORMATION
1.

USE THIS SPACE FOR ANY ADDITIONAL INFORMATION (INDICATE SECTION AND ITEM NUMBERS IF A CONTINUATION). IF NEEDED, PLEASE ADD
ADDITIONAL PAGE(S) AS REQUIRED.

SECTION G: APPLICANT CERTIFICATION
I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE.” (THE INDIVIDUAL CERTIFYING THIS FORM
SHOULD BE FAMILIAR WITH THE ORGANIZATION’S MANAGEMENT AND FINANCIAL SYSTEMS.)
1. NAME OF THE CERTIFYING OFFICIAL

1a. SIGNATURE

FRA F 36 (02/20)

1b DATE

1c. TITLE

Office of the Chief Financial Officer