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'PSNMBTUVQEBUFE The University of Vermont ^WKE^KZ WZK:d D/E/^dZ d/KE Subrecipient Commitment & Audit Certification Form Complete this form when submitting a proposal to UVM It provides a checklist of documents and certifications required by sponsors, as well as an area for the authorized institutional representative to sign Complete and accurate information facilitates quicker processing of a subaward /Ĩ LJŽƵ ĂƌĞ ƌĞŐŝƐƚĞƌĞĚ ŝŶ ƚŚĞ &W džƉĂŶĚĞĚ ůĞĂƌŝŶŐŚŽƵƐĞ LJŽƵ ĐĂŶ ĞŝƚŚĞƌ ĐŽŵƉůĞƚĞ ƚŚŝƐ ƚŽƉ ƐĞĐƚŝŽŶ͕ ^ĞĐƚŝŽŶ ĂŶĚ  Žƌ ƐƵďŵŝƚ ĂŶ ĂƵƚŚŽƌŝnjĞĚ ƐŝŐŶĞĚ ĚŽĐƵŵĞŶƚ ŝŶĐůƵĚŝŶŐ ƚŚĞ ƐĂŵĞ͘ ŚƚƚƉ͗ͬͬƐŝƚĞƐ͘ŶĂƚŝŽŶĂůĂĐĂĚĞŵŝĞƐ͘ŽƌŐͬW' ͬĨĚƉͬW' ͺϭϳϭϱϮϬ hsD͛^ WͬW/͗ Arne Bomblies hsD͛^ WZKWK^ > η͗ 30373 ^hZ/W/Ed͛^ >' > E D͗ Z^^͗ /dz͗ ^d d͗ /E͗ W ZEd hE^ EŽ͗ hE^ EŽ͗ /W нϰ͗ WZK:d d/d>͗ ^hZ/W/Ed͛^ WͬW/͗ WZ/K K& WZ&KZD E͗ ^d Zd͗ E͗ dKd > &hE^ ZYh^d͗ K^d ^, Z KDD/dDEd͗ ^d/KE ͗ WZKWK^ > KhDEd^ dŚĞ ĨŽůůŽǁŝŶŐ ĚŽĐƵŵĞŶƚƐ ĂƌĞ ŝŶĐůƵĚĞĚ ŝŶ ŽƵƌ ƐƵďĂǁĂƌĚ ƉƌŽƉŽƐĂů ƐƵďŵŝƐƐŝŽŶ ĂŶĚ ĐŽǀĞƌĞĚ ďLJ ƚŚĞ ĐĞƌƚŝĨŝĐĂƚŝŽŶƐ ďĞůŽǁ͗ ✔ ✔ ✔ ^d dDEd K& tKZ< ;ƌĞƋƵŝƌĞĚͿ h'd Θ :h^d/&/ dKE ;ƌĞƋƵŝƌĞĚͿ /K ^ŝŶŬ͗ tĞƌĞ ƚŚĞƌĞ ĂŶLJ ĨŝŶĚŝŶŐƐ ŝŶ ƚŚĞ ŵŽƐƚ ƌĞĐĞŶƚ ƐŝŶŐůĞ ĂƵĚŝƚ ƌĞůĂƚĞĚ ƚŽ hsD ŝƐƐƵĞĚ ƐƵďĂǁĂƌĚƐ ƚŽ LJŽƵƌ ŝŶƐƚŝƚƵƚŝŽŶ͍ zĞƐ EŽ (/f “yes”, please note the applicable page(s) in the audit report and ƉƌŽǀŝĚĞ Ăn update on the status of the corrective action ďĞůŽǁ.) /Ĩ ƚŚĞ ƐƵďƌĞĐŝƉŝĞŶƚ ĚŝĚ ŶŽƚ ƵŶĚĞƌŐŽ Ă ƐŝŶŐůĞ ĂƵĚŝƚ͕ ƉƌŽǀŝĚĞ ĞdžƉůĂŶĂƚŝŽŶ ǁŚLJ ƚŚĞ ƐŝŶŐůĞ ĂƵĚŝƚ ǁĂƐ ŶŽƚ ƉĞƌĨŽƌŵĞĚ ;Ğ͘Ő͘ ďĞůŽǁ ƚŚƌĞƐŚŽůĚ͕ ĨŽƌͲƉƌŽĨŝƚ ĐŽŵƉĂŶLJ͕ ĞƚĐ͘Ϳ ĂŶĚ ĂƚƚĂĐŚ ƚŚĞ ŵŽƐƚ ƌĞĐĞŶƚůLJ ĐŽŵƉůĞƚĞĚ ĨŝƐĐĂů LJĞĂƌ ĂƵĚŝƚ ƌĞƉŽƌƚ ŝŶĐůƵĚŝŶŐ ŝŶĚĞƉĞŶĚĞŶƚ ĂƵĚŝƚŽƌ͛Ɛ ůĞƚƚĞƌ͕ ŵĂŶĂŐĞŵĞŶƚƐ ĐŽƌƌĞĐƚŝǀĞ ĂĐƚŝŽŶ ŽŶ ĂŶLJ ĨŝŶĚŝŶŐƐ ĂŶĚ ĂŶƐǁĞƌ ƚŚĞ ĨŝŶĂŶĐŝĂů ƐƚĂƚƵƐ ƋƵĞƐƚŝŽŶƐ͘ The University of Vermont 10 Financial Status Questions: (Only required if subrecipient does not receive an annual ƐŝŶŐůĞ audit.) džƉůĂŝŶƐ LJŽƵƌ ŝŶƐƚŝƚƵƚŝŽŶ͛Ɛ ƉƌŽĐĞƐƐĞƐ ĂŶĚ ƉƌŽĐĞĚƵƌĞƐ ƚŽ ĞŶƐƵƌĞ ĐŽŵƉůŝĂŶĐĞ ǁŝƚŚ ĂƉƉůŝĐĂďůĞ ĨĞĚĞƌĂů ŐƵŝĚĞůŝŶĞƐ͕ ďƵƚ ŶŽƚ ůŝŵŝƚĞĚ ƚŽ͕ ƚŚĞ ĨŽůůŽǁŝŶŐ͗ (Attach additional pages as needed.) ĨŝŶĂŶĐŝĂů ŵĂŶĂŐĞŵĞŶƚ ƐLJƐƚĞŵ ƚŚĂƚ ƉƌŽǀŝĚĞƐ ƌĞĐŽƌĚƐ ƚŚĂƚ ĐĂŶ ŝĚĞŶƚŝĨLJ ƚŚĞ ƐŽƵƌĐĞ ĂŶĚ ĂƉƉůŝĐĂƚŝŽŶ ŽĨ ĨƵŶĚƐ ĨŽƌ ĂǁĂƌĚ ƐƵƉƉŽƌƚĞĚ ĂĐƚŝǀŝƚŝĞƐ ŝŶĐůƵĚŝŶŐ ĐŽƐƚͲƐŚĂƌŝŶŐ ;ŝĨ ĂƉƉůŝĐĂďůĞͿ ŽŶƚƌŽůƐ ƚŽ ƉƌĞǀĞŶƚ ĞdžƉĞŶĚŝƚƵƌĞƐ ŝŶ ĞdžĐĞƐƐ ŽĨ ĂƉƉƌŽǀĞĚ ďƵĚŐĞƚ ĂŵŽƵŶƚƐ WƵƌĐŚĂƐŝŶŐͬWƌŽĐƵƌĞŵĞŶƚ ƉŽůŝĐLJ ĐƌĞĂƚŝŶŐ ƐƚĂŶĚĂƌĚƐ ŝŶ ƚŚĞ ƉƌŽĐƵƌĞŵĞŶƚ ŽĨ ƐƵƉƉůŝĞƐ ĂŶĚ ŽƚŚĞƌ ĞdžƉĂŶĚĂďůĞ ƉƌŽƉĞƌƚLJ͕ ĞƋƵŝƉŵĞŶƚ͕ ƌĞĂů ƉƌŽƉĞƌƚLJ ĂŶĚ ŽƚŚĞƌ ƐĞƌǀŝĐĞƐ ǁŝƚŚ ĨĞĚĞƌĂů ĨƵŶĚƐ Ŷ ŝŶǀĞŶƚŽƌLJŝŶŐ ƐLJƐƚĞŵ ĨŽƌ ĞƋƵŝƉŵĞŶƚ ŝŶĐůƵĚŝŶŐ ĚĂƚĂ ĨŽƌ ĨĞĚĞƌĂů ŐŽǀĞƌŶŵĞŶƚ ƉƌŽƉĞƌƚLJ ƚŚĂƚ ŝĚĞŶƚŝĨŝĞƐ ƉƵƌĐŚĂƐĞ ĚĂƚĞ͕ ĐŽƐƚ͕ ǀĞŶĚŽƌ͕ ĚĞƐĐƌŝƉƚŝŽŶ͕ ƐĞƌŝĂů ŶƵŵďĞƌ͕ ůŽĐĂƚŝŽŶƐ ĂŶĚ ƵůƚŝŵĂƚĞ ĚŝƐƉŽƐŝƚŝŽŶ ZĞĐŽƌĚ ƌĞƚĞŶƚŝŽŶ ĨŽƌ Ă ƉĞƌŝŽĚ ŽĨ ƚŚƌĞĞ LJĞĂƌƐ ĨŽůůŽǁŝŶŐ ƚŚĞ ƐƵďŵŝƐƐŝŽŶ ŽĨ ƚŚĞ ĨŝŶĂů ĨŝŶĂŶĐŝĂů ĂŶĚ ƉƌŽŐƌĂŵŵĂƚŝĐ ƌĞƉŽƌƚƐ ƚŽ ƚŚĞ WƌŝŵĞ ZĞĐŝƉŝĞŶƚ tŚĂƚ ŝŶƚĞƌŶĂů ĐŽŶƚƌŽůƐ ĚŽĞƐ LJŽƵƌ ŝŶƐƚŝƚƵƚŝŽŶ ŚĂǀĞ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ Ăůů hsD ƐƵďͲĂǁĂƌĚ ƌĞůĂƚĞĚ ĞdžƉĞŶƐĞƐ ĂƌĞ ĂůůŽǁĂďůĞ ǁŝƚŚŝŶ ƚŚĞ ŽƐƚ WƌŝŶĐŝƉůĞƐ ŽĨ ĂƉƉůŝĐĂďůĞ &ĞĚĞƌĂů ŐƵŝĚĞůŝŶĞƐ͍ dŚŝƐ ŝŶĐůƵĚĞƐ ďƵƚ ŝƐ ŶŽƚ ůŝŵŝƚĞĚ ƚŽ ĞĨĨŽƌƚ ƌĞƉŽƌƚŝŶŐ ĂŶĚ ƚŝŵĞ ŵĂŶĂŐĞŵĞŶƚ ĂŶĚ ĂƉƉƌŽƉƌŝĂƚĞ ƚƌĂǀĞů ƉŽůŝĐŝĞƐ ĂŶĚ ƉƌŽĐĞĚƵƌĞƐ͘ ^d/KE ͗ KDDEd^ The University of Vermont ^d/KE ͗ hd,KZ/ ^/'E dhZ APPROVED FOR SUBRECIPIENT: dŚĞ ŝŶĨŽƌŵĂƚŝŽŶ͕ ĐĞƌƚŝĨŝĐĂƚŝŽŶƐ ĂŶĚ ƌĞƉƌĞƐĞŶƚĂƚŝŽŶƐ ĂďŽǀĞ ŚĂǀĞ ďĞĞŶ ƌĞĂĚ͕ ƐŝŐŶĞĚ ĂŶĚ ŵĂĚĞ ďLJ ĂŶ ĂƵƚŚŽƌŝnjĞĚ ŽĨĨŝĐŝĂů ŽĨ ƚŚĞ ƐƵďƌĞĐŝƉŝĞŶƚ ŶĂŵĞĚ ŚĞƌĞŝŶ͘ dŚĞ ĂƉƉƌŽƉƌŝĂƚĞ ƉƌŽŐƌĂŵŵĂƚŝĐ ĂŶĚ ĂĚŵŝŶŝƐƚƌĂƚŝǀĞ ƉĞƌƐŽŶŶĞů ŝŶǀŽůǀĞĚ ŝŶ ƚŚŝƐ ĂƉƉůŝĐĂƚŝŽŶ ĂƌĞ ĂǁĂƌĞ ŽĨ ĂŐĞŶĐLJ ƉŽůŝĐLJ ŝŶ ƌĞŐĂƌĚ ƚŽ ƐƵďĂǁĂƌĚƐ ĂŶĚ ĂƌĞ ƉƌĞƉĂƌĞĚ ƚŽ ĞƐƚĂďůŝƐŚ ƚŚĞ ŶĞĐĞƐƐĂƌLJ ŝŶƚĞƌͲŝŶƐƚŝƚƵƚŝŽŶĂů ĂŐƌĞĞŵĞŶƚƐ ĐŽŶƐŝƐƚĞŶƚ ǁŝƚŚ ƚŚŽƐĞ ƉŽůŝĐŝĞƐ ƐŚŽƵůĚ ĂŶ ĂǁĂƌĚ ďĞ ŵĂĚĞ͘ ŶLJ ǁŽƌŬ ďĞŐƵŶ ĂŶĚͬŽƌ ĞdžƉĞŶƐĞƐ ŝŶĐƵƌƌĞĚ ƉƌŝŽƌ ƚŽ ĞdžĞĐƵƚŝŽŶ ŽĨ Ă ƐƵďĂǁĂƌĚ ĂŐƌĞĞŵĞŶƚ ĂƌĞ Ăƚ ƚŚĞ ƐƵďƌĞĐŝƉŝĞŶƚΖƐ ŽǁŶ ƌŝƐŬ͘ ^ŝŐŶĂƚƵƌĞ ŽĨ ^ƵďƌĞĐŝƉŝĞŶƚΖƐ ƵƚŚŽƌŝnjĞĚ KĨĨŝĐŝĂů ĂƚĞ EĂŵĞ ĂŶĚ dŝƚůĞ ŽĨ ƵƚŚŽƌŝnjĞĚ KĨĨŝĐŝĂů͗ WŚŽŶĞ͗ ŵĂŝů͗ ^d/KE ͗ Zs/^/KE^ This section is only to be completed to update information previously provided on the commitment form 11 Audit: ,ĂƐ ĂŶLJ ŽĨ ƚŚĞ ŝŶĨŽƌŵĂƚŝŽŶ ƉƌŽǀŝĚĞĚ ŝŶ ŝƚĞŵ ϵ ;ĂďŽǀĞͿ ĐŚĂŶŐĞĚ ƐŝŶĐĞ ƚŚĞ ŝŶŝƚŝĂů ĐĞƌƚŝĨŝĐĂƚŝŽŶ͍ zĞƐ 12 Additional Changes Žƌ ĐŽŵŵĞŶƚƐ ƐŝŶĐĞ ƚŚĞ ŝŶŝƚŝĂů ĐĞƌƚŝĨŝĐĂƚŝŽŶ ^ŝŐŶĂƚƵƌĞ ŽĨ ^ƵďƌĞĐŝƉŝĞŶƚΖƐ ƵƚŚŽƌŝnjĞĚ KĨĨŝĐŝĂů ĂƚĞ EŽ

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