Appendix
A
EPA
Administrative
Capability
Questionnaire*

The
Environmental
Protection
Agency
(
EPA)
uses
the
standards
set
forth
in
the
Code
of
Federal
Regulations,
Title
40,
Part
30,

Subpart
C
to
assess
the
adequacy
of
administrative
management
systems.
The
standards
can
be
found
on
EPA's
website
at:

http://
www.
epa.
gov/
ogd/
grants/
regulations.
htm.
If
your
organization
is
being
recommended
for
an
EPA
grant,
and
your
organizational
policies
and
procedures
do
not
fully
cover
the
areas
outlined
in
this
document,
revised
or
new
policies
may
be
necessary
to
comply
with
Federal
financial
management
standards.

Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

Financial
Position
and
Cash
Management
1.
Cash
Requirements.
The
procedures
must
explain
how
the
organization
will
minimize
the
time
elapsing
between
the
transfer
of
funds
and
disbursement
of
funds.

2.
Budgeted
and
Actual
Expenditures.
Procedures
must
outline
requirements
for
comparing
actual
to
budgeted
expenditures.
Comparisons
are
usually
performed
at
the
close
of
each
month,
detailing
cumulative
incurred
costs
to
date
for
each
budgeted
line
item.
Significant
variances
must
be
reviewed
to
ensure
actual
costs
do
not
exceed
budgeted
amounts
for
the
grant
period.
Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

3.
Annual
Audits.
If
applicable,
procedures
must
detail
requirements
for
an
annual
audit,
to
be
performed
in
accordance
with
OMB
Circular
A­
133,

Audits
of
States,
Local
Governments,
and
Non­
Profit
Organizations.
A
non­
Federal
audit
is
required
if,
during
the
fiscal
year,
an
organization
expends
a
total
of
$
300,000
($
500,000
for
fiscal
years
ending
after
December
31,
2003).

Accounting
System
1.
General.
Policies
must
include
a
description
of
the
accounting
system,

including
cash
receipts,
disbursement
journals,
and
general
ledger.
A
double­
entry
accounting
system
capable
of
identifying
expenditures
to
the
Federal
grant
must
be
maintained,
together
with
a
chart
of
accounts.

2.
Indirect
Costs.
Policies
must
describe
any
existing
or
planned
indirect
cost
rates
(
if
applicable).
The
policy
must
disclose
the
type
of
rate
or
rates
used,
as
well
as
the
content
of
pooled
expenses
and
the
type
of
allocation
base
used
to
allocate
costs.
If
all
costs
are
charged
direct,
the
accounting
system
must
adequately
track
and
consistently
apply
costs
to
cost
objectives.

Internal
Controls.
Internal
controls
are
necessary
for
ensuring
the
efficiency
and
effectiveness
of
operations,
for
safeguarding
assets,
and
for
ensuring
the
reliability
of
financial
reporting.
Some
areas
to
be
covered
include
the
following:
Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

a.
Cash
Receipts.
Procedures
must
provide
for
adequate
separation
of
duties
for
receipt
and
deposit
of
funds.
The
individual
who
opens
the
mail
and
receives
checks
must
not
be
the
same
person
who
makes
the
bank
deposits.
Policies
must
include
procedures
for
logging
incoming
mail
and
reconciling
with
bank
deposits.

b.
Bank
Reconciliations.
Procedures
must
provide
for
monthly
bank
reconciliations.
The
person
performing
the
bank
reconciliation
must
be
different
than
the
person
depositing
the
checks.

c.
Cash
Disbursements.
Procedures
must
provide
for
maintaining
copies
of
supporting
documentation
for
disbursements,
for
controlling
blank
checks,

and
for
approving
disbursements.
Policies
must
outline
the
number
of
required
signatures
on
checks,
as
well
as
signatory
authority
designations.

Significant
disbursements
(
over
$
1,000)
normally
require
more
than
one
signature.

d.
Credit
Cards.
Policies
must
describe
internal
procedures
used
to
control
the
use
of
organizational
credit
cards.
Procedures
must
be
established
to
control
access
to
credit
cards
and
prohibit
personal
expenditures.
Policies
must
also
require
prior
approval
of
expenditures,
documentation
of
amounts
charged,
and
limit
the
amount
and
type
of
expenses
that
can
be
incurred.
Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

Written
policies
and
procedures
must
provide
guidelines
for
personnel
travel,
procurement,
property
control,
and
the
use
of
consultants.

e.
Personnel.
A
Personnel
Manual
must
include
written
procedures
for
general
employment,
such
as
hiring,
dismissal,
hours
of
work,
employee
benefits,
and
available
paid
absences.
Both
the
amount
and
type
of
paid
absence,
as
well
as
work
requirements
for
earning
paid
leave
must
be
detailed.

f.
Timekeeping.
Written
procedures
for
time
and
attendance
must
include
identification
of
time
worked
on
specific
projects
(
job
cost
system),
as
well
as
paid
time
off,
employee
signatures
certifying
to
the
accuracy
of
the
time
sheet,
and
supervisory
signature
approving
time
charges.

g.
Travel.
Procedures
must
ensure
that
travel
expenses
are
both
necessary
and
reasonable.
Policies
must
document
management
control
over
travel
expenses,
dollar
limitations
for
mileage,
meals
and
lodging,
approval
by
supervisor
prior
to
travel,
approval
of
travel
vouchers,
and
documentation
required
for
payment.
Airfare
must
be
limited
to
coach
fare,
and
car
rental
must
be
limited
to
compact
or
mid­
sized
automobiles
(
exceptions
must
be
justified).
Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

h.
Procurement.
Policies
must
document
review
and
approval
procedures
for
both
small
and
large
dollar
purchases.
Policies
must
identify
dollar
limitations,
documentation
procedures
(
such
as
the
use
of
purchase
requisition
and
purchase
order
forms),
and
the
procedures
used
to
ensure
cost
reasonableness
(
competitive
bidding,
price
analysis,
etc.)
and
affirmative
steps
to
be
taken
to
ensure
opportunities
are
available
to
small
and
disadvantaged
business
enterprises.

i.
Property
Control.
Property
management
procedures
must
establish
the
basis
for
accountability
for
all
equipment.
Property
records
must
include
a
description
of
cost,
purchase
date,
source
of
funding,
location
and
condition.
In
addition,
the
procedures
must
define
the
frequency
of
the
physical
inventory,
which
must
be
done
no
less
frequently
than
every
two
years;
the
requirement
that
all
property
owned
by
the
Government
must
be
tagged;
and
a
control
system
to
ensure
adequate
safeguards
to
prevent
loss
or
theft.

j.
Consultants
and
Subcontracts.
Procedures
must
document:
the
nature
and
scope
of
services
that
may
be
outsourced;
a
requirement
to
evaluate
inhouse
before
obtaining
external
assistance;
the
required
selection
process;

and
a
requirement
for
ensuring
the
reasonableness
of
cost.
Instructions:
Check
the
appropriate
box
to
the
right
for
each
item.
If
your
organization
does
not
have
written
policies/
procedures
that
meet
the
requirement
described
under
this
column,
check
(

)
the
box
under
the
"
No"
column.
If
your
organization
does
have
written
policies/
procedures
that
meet
the
requirement,
check
the
box
under
the
"
Yes"
column
and
provide
a
paper
or
electronic
copy
of
policies/
procedures,
an
A­
133
audit
report,
or
other
evidence
that
your
administrative
systems
meet
the
following
standards.
If
your
organization
is
currently
developing
policies/
procedures,
provide
the
expected
date
of
completion
and
attach
any
explanations
necessary.
No
Yes
(
policy/
procedure
or
other
supporting
document
is
being
submitted
with
this
checklist)
Under
development
(
provide
date
of
completion
­
attach
explanation
if
necessary)

k.
Conflict
of
Interest.
Policy
guidelines
must
be
established
to
avoid
and
prevent
conflict
of
interest
situations;
policies
must
reflect
State
and
local
laws,
and
must
cover
financial
interests,
gifts,
gratuities,
favors,
nepotism,

and
other
areas
such
as
political
participation
and
bribery.

l.
Drug
Free
Workplace
Policy.
The
requirements
of
the
Drug
Free
Workplace
Act
must
be
included
in
established
policies.

Submit
questionnaire
with
documentation
at
least
60
days
prior
to
your
proposed
project
start
date
by
email
to
xxx@
EPA.
gov,

or
by
fax
to
(
202)
xxx­
xxxx,
or
by
mail
to
the
following
address:

US
Environmental
Protection
Agency
(
EPA)

xxxxxxxxxxxxx
Attn:
xxxxxxxxxxxx
Applicant's
Authorized
Representative:

Name
Title
Signature
*
If
the
signed
document
is
submitted
by
email,
it
must
be
submitted
in
a
computer
file
format,
such
as
Portable
Document
Format
(
PDF)
developed
by
Adobe
Systems,
Inc.,
that
allows
authors
to
exchange
documents
among
different
computer
systems,
while
preserving
the
documents'
typography
and
page
layout.
