Sf 271 Form – Fill Out and Use This PDF

Item

E n t r y

1Mark the appropriate box. If the request is final, the amounts billed should represent the final cost of the project.

2Show whether amounts are computed on an accrued expenditure or cash disbursement basis.

6Enter the Employer Identification Number (EIN) assigned b y the U . S . Internal R e v e n u e Service or F I C E (institution) code if requested by the Federal agency.

7This s p a c e is reserved for a n account number or other identifying number that may be assigned by the recipient.

11 T h e purpose of vertical columns (a) through (c) is to provide s p a c e for separate cost breakdowns when a large project h a s b e e n planned a n d budgeted b y program, function or activity. If additional columns a r e needed, u s e a s m a n y additional forms a s n e e d e d a n d indicate p a g e number in s p a c e provided in upper right; however, the summary totals of all programs, functions, or activities should b e shown in the "total" column o n the first p a g e . All amounts are reported on a cumulative basis.

11 a Enter amounts expended for such items a s travel, legal fees, rental of vehicles a n d a n y other administrative expenses . Include the amount of interest expense when authorized b y program legislation. Also show the amount of interest expense on a separate sheet.

11b Enter amounts pertaining to the work of locating a n d designing, making surveys a n d m a p s , sinking test holes, and all other work required prior to actual construction.

1 1 c Enter all amounts directly associated with the acquisition of land, existing structures and related right-of-way.

11d Enter basic fees for services of architectural engineers.

1 1 e Enter other architectural engineering services. D o not include any amounts shown on line d.

11f Enter inspection and audit fees of construction and related programs.

11g Enter all amounts associated with the development of land where the primary purpose of the grant is land improvement. T h e amount pertaining to land development normally associated with major construction should b e excluded from this category and entered on line k.

11h Enter the dollar amounts used to provide relocation advisory assistance a n d net costs of replacement housing (last resort). D o not include amounts needed for relocation administrative expenses; these amounts should be included in amounts shown on line a.

11i Enter the amount of relocation payments m a d e b y the recipient to displaced persons, farms, business concerns, and nonprofit organizations.

Item

E n t r y

11j Enter gross salaries a n d w a g e s of employees of the recipient a n d payments to third party contractors directly e n g a g e d in performing demolition or removal of structures from developed land . All proceeds from the s a l e of s a l v a g e or the removal of structures should b e credited to this account; thereby reflecting net amounts if required by the Federal agency.

1 1 k Enter those amounts associated with the actual construction of, addition to, or restoration of a facility. Also, include in this category, the amounts for project improvements such a s sewers, streets, landscaping, a n d lighting.

11l Enter amounts for all equipment, both fixed a n d movable, exclusive of equipment u s e d for construction. F o r example, permanently attached laboratory tables, built-in audio visual systems, movable desks, chairs, and laboratory equipment.

1 1 m Enter the amounts of all items not specifically mentioned above .

11n Enter the total cumulative amount to d a t e which should be the sum of lines a through m.

11o Enter the total amount of program income applied to the grant or contract agreement except income included o n line j. Identify o n a separate sheet of paper the sources and types of the income.

11p Enter the net cumulative amount to date which should be the amount shown on line n minus the amount on line o.

11q Enter the Federal share of the amount shown on line p.

11r Enter the amount of rehabilitation grant payments m a d e to individuals when program legislation provides 100 percent payment by the Federal agency.

11t Enter the total amount of F e d e r a l payments previously requested, if this form is u s e d for requesting reimbursement.

11u Enter the amount now being requested for reimbursement. This amount should b e the difference between the amounts shown o n lines s a n d t. If different, explain on a separate sheet.

1 2 a T o b e completed b y the official recipient official who is responsible for the operation of the program. T h e d a t e should b e the actual d a t e the form is submitted to the Federal agency .

12b T o b e completed b y the official representative who is certifying to the percent of project completion a s provided for in the terms of the grant or agreement.