Sub-Recipient Profile_Updated 07082021.xlsx

Version: 2021.07.15

Template Name: Sub-Recipient Profile

Instructions to Reporter: - Do not change the cell formatting - Do not reformat the template - All data should be as text - Do not publish the "Field ID" row (Treasury Internal Use Only)

Field ID

DUNS__c

DUNS_4__c

EIN__c

Recipient_Type__c

Name

POC_Email_Address__c

Address__c

Address_2__c

Address_3__c

City__c

State__c

Zip__c

Zip_4__c

Registered_in_Sam_gov__c

Federal_Funds_80_or_More_of_Revenue__c

Derives_25_Million_or_More_from_Federal__c

Total_Compensation_for_Officers_Public__c

Officer_Name__c

Officer_Total_Comp__c

Officer_2_Name__c

Officer_2_Total_Comp__c

Officer_3_Name__c

Officer_3_Total_Comp__c

Officer_4_Name__c

Officer_4_Total_Comp__c

Officer_5_Name__c

Officer_5_Total_Comp__c

Label

Sub-recipient DUNS

Sub-recipient DUNS (+4)

Sub-Recipient TIN

Subrecipient Type

Sub-Recipient Name

POC Email Address

Address Line 1

Address Line 2

Address Line 3

City Name

State Code

Zip5

Zip4

Sub-recipient SAM.gov Registration

In its preceding fiscal year, did recipient receive 80% or more of its annual gross revenue from federal funds?

In the preceding fiscal year, did recipient receive $25 million or more of its annual gross revenue from federal funds?

Is the "total compensation" for the organization's five highest paid officers publicly listed or otherwise listed in SAM.gov?

Executive Name (1)

Total Compensation Executive (1)

Executive Name (2)

Total Compensation Executive (2)

Executive Name (3)

Total Compensation Executive (3)

Executive Name (4)

Total Compensation Executive (4)

Executive Name (5)

Total Compensation Executive (5)

Required or Optional

Required

Optional

Required

Required

Required

Required

Required

Optional

Optional

Required

Required

Required

Required

Required

Required

Required

Required

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Required (If you answered No to previous question)

Help Text

The DUNS unique identification number for the Sub-Recipient Organization of the Recipient's ERA funds. Format XXXXXXXXX, 9 numeric characters.

A 4-character suffix that may be assigned by a business concern and appended to its DUNS. Format XXXX, 5 numeric characters.

The Sub-Recipient's Internal Revenue Service (IRS) Taxpayer Identification Number. Format XXXXXXXXX, 9 numeric characters.

A collection of indicators of different types of Sub-Recipient types that receive ERA funds. Valid responses: "Tenant", "Landlord or Owner" , "Utility / Home Energy Service Provider", "Other Housing Services", "Eligible Expenses Provider".

The name of the Sub-Recipient. Max character 80.

The email address of the primary point-of-contact for the sub-recipient. Must be valid Email format.

First line of the Sub-Recipient's address. (255 Character max)

Second line of the Sub-Recipient's address. (255 Character max)

Third line of the Sub-Recipient's address. (255 Character max)

Name of the city in which the Sub-Recipient is located. (100 Character Max)

United States Postal Service (USPS) two-letter abbreviation for the state or territory in which the Sub-Recipient is located. Valid Response: (AL, AK, AS, AZ, AR, CA, CO, CT, DE, DC, FM, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MH, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, MP, OH, OK, OR, PW, PA, PR, RI, SC, SD, TN, TX, UT, VT, VI, VA, WA, WV, WI, WY)

United States ZIP code (five digits) associated with the Sub-Recipient's address. Format XXXXX, 5 numeric characters.

Zip Plus4 (four digits) identifying where the predominant performance of the subaward will be accomplished. Format XXXX, 4 numeric characters.

Confirmation that the Sub-Recipient is registered in SAM.gov. Must select Yes or No.

Confirmation that the proportion of the Sub-Recipient's federal funding-to-total annual gross revenue for the preceding fiscal year is at least 80%. Must select Yes or No.

Confirmation that the Sub-Recipient's total annual gross revenue from federal funding across all programs for the preceding fiscal year is greater than $25 million. Must select Yes or No.

Confirmation that qualifying Sub-Recipient's publicly identify their top five highest compensated executives or have it listed in their SAM.gov profile, if No please enter the names and compensation for the 5 highest officers. Must select Yes or No.

The legal name belonging to one of the five highest paid executives, officers, or employees of the Sub-Recipient.

The Total Compensation, as defined in 2 CFR part 170.330, earned by the five highest paid executives, officers, or employees of the Sub-Recipient. DO NOT include a "$" sign when entering compensation.

The legal name belonging to one of the five highest paid executives, officers, or employees of the Sub-Recipient.

The Total Compensation, as defined in 2 CFR part 170.330, earned by the five highest paid executives, officers, or employees of the Sub-Recipient. DO NOT include a "$" sign when entering compensation.

The legal name belonging to one of the five highest paid executives, officers, or employees of the Sub-Recipient.

The Total Compensation, as defined in 2 CFR part 170.330, earned by the five highest paid executives, officers, or employees of the Sub-Recipient. DO NOT include a "$" sign when entering compensation.

The legal name belonging to one of the five highest paid executives, officers, or employees of the Sub-Recipient.

The Total Compensation, as defined in 2 CFR part 170.330, earned by the five highest paid executives, officers, or employees of the Sub-Recipient. DO NOT include a "$" sign when entering compensation.

The legal name belonging to one of the five highest paid executives, officers, or employees of the Sub-Recipient.

The Total Compensation, as defined in 2 CFR part 170.330, earned by the five highest paid executives, officers, or employees of the Sub-Recipient. DO NOT include a "$" sign when entering compensation.