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Checklist <br />FDR Requirements for A&E Consultant Indirect Cost Rate <br />• Requirements for total contract amount equal to or greater than $1,000,000. <br />• Prime and all sub-consultant(s) with estimated contract costs of $500,000 and above must provide the <br />documents marked below based on their applicable category. <br />Instructions <br />• LPAs are required to complete this form and include all applicable required documents upon submission. <br />• For financial document packages received between July 1 through December 31, the previous years ICR <br />is the one that must be submitted. <br />• ICR Acceptance ID #: This is an identification number issued by Caltrans upon review and acceptance of <br />consultant's ICR(s) schedule for a specific fiscal year. The Caltrans ID# ICR FYE must agree with the <br />period when this form and financial documents are submitted as described above. If any consultant <br />already has an accepted ID # for the applicable period then include that number on the schedule on <br />page 1. For those consultants no additional documentation needs to be submitted at this time. <br />Please Note: Items on this checklist may not be all inclusive. IOAI reserves the right to request additional <br />documents as deemed necessary. <br />Type of Financial CATEGORY 1: <br />CATEGORY 2: CATEGORY 3: CATEGORY 4: <br />Documents and Consultants with <br />Consultants Requesting Consultants with CPA Consultants with <br />Information for ICR FYE Cognizant Approval <br />Safe Harbor Rate Audited ICR Reports Participation Amount of <br />Proposed Letter for ICR FYE <br />$500K or Greater and <br />Proposed <br />No CPA Report <br />Paycheck Protection Program ❑ ❑ ❑ ❑ <br />(PPP) Loan Questionnaire <br />Certification of Indirect Costs <br />and Financial Management ✓❑ ❑ ❑ ✓❑ <br />System Form <br />CPAAudited ICR Report and <br />Schedule (Prime Consultant ❑ ❑ ❑ ❑ <br />must have a CPAAudited ICR <br />Schedule) <br />ICR Schedule with FAR <br />References for Disallowed ❑ ❑ El El <br />(a) <br />Cognizant Approval Letter for ❑ ❑ ❑ ❑ <br />the ICR FYE proposed <br />AASHTO Internal Control <br />Questionnaire Appendix B ❑ ❑ ❑�❑ <br />Safe Harbor Rate: Consultant <br />Certification of Eligibility of ❑ ❑ ❑ ❑ <br />Contract Costs and Financial <br />Management System <br />(a) See Table R_1 of the AAgHT() Ai Ait (:i 6Ha fnr A lictin9 of rnmmnn i inalln niahlc rnctc <br />City Council 20 — 47 7/18/2023 <br />Financial Document RLIView Request Form - Independent Office of Audits and Investigations - Revised 9/2022 2 <br />