<p> ODOT Supplemental Accounting System Questionnaire (SASQ)</p><p>THIS VERSION WAS DESIGNED TO BE COMPLETED ELECTRONICALLY. THE FIELDS WILL EXPAND, AS REQUIRED, TO ACCOMMODATE THE LENGTH OF YOUR RESPONSES. Instructions: The following SASQ must be completed and submitted annually to the Ohio Department of Transportation (ODOT) Office Audits. If your company performs any works on contracts that provide for payment using the Actual Costs Plus a Net Fee (cost-plus) method, then you also will be required to complete all sections of the AASHTO Internal Control Questionnaire for Consulting Engineers (AASHTO Guide Appendix B), available at— http://www.dot.state.oh.us/Divisions/Finance/Auditing/Pages/Consultants.aspx. Submittal Method: The required documents listed above must be submitted either electronically or via email to [email protected], or via fax to (614) 887-4010. The documents should be submitted in Microsoft Excel, Microsoft Word, or Adobe PDF format when possible. (ODOT encourages the use of email for submissions. Please do not submit documents in hard copy format through the U.S. Mail or any commercial carrier.) Note: Documents submitted in compressed (.zip) format must be renamed to another file extension, such as .doc. The ODOT email system automatically deletes files with .zip extensions.</p><p>Due Date: Documents must be submitted/updated annually, no later than six months after the close of your company’s fiscal year. Accordingly, the documents are due by July 1 for calendar-year companies. Request for Extension: ODOT will grant an extension to the due date for any company that has made a timely submittal to its cognizant audit agency and is awaiting issuance of a cognizant letter of concurrence. Requests for extension must be in writing, on company letterhead, and submitted either electronically via email to [email protected], or via fax to (614) 887-4010.</p><p>Contacts: Please address all questions or comments to— Ohio Department of Transportation Office of Audits 1980 West Broad Street, 4th Floor Primary Contact: Backup: Scot P. Gormley, Audit Manager Jana O. Cassidy, Audit Administrator Phone: (614) 644-0384 Phone: (614) 644-7892 Email: [email protected] Email: [email protected] Before contacting the staff of ODOT’s Office of Audits, please read the Frequently Asked Questions document available at: http://www.dot.state.oh.us/Divisions/Finance/Auditing/Pages/Consultants.aspx.</p><p>Note Regarding Engineering Prequalification: The staff of the ODOT Office of Consultant Services make all determinations regarding engineering prequalification. Consultants are responsible for renewing engineering prequalification every two years, and this process is independent of cost submissions made to the ODOT Office of Audits. For details regarding prequalification requirements, see http://www.dot.state.oh.us/Divisions/ProdMgt/Consultant/Pages/default.aspx. SUPPLEMENTAL ACCOUNTING SYSTEM QUESTIONNAIRE (SASQ) Ohio Department of Transportation (ODOT) Section I. General Information Company Name: For Year Ended:</p><p>A. Company Revenues </p><p>Business Activity During Period: As a Prime Consultant As a Subconsultant Total Revenues from ODOT Projects $ $ $ </p><p>Revenues Other Customers $ $ $ </p><p>Total Company Gross Revenue $ $ $ </p><p>A/E related - Percentage of Total Revenue Last Fiscal Year Applicable to all Government Contracts %</p><p>Nature of Revenue Transportation Architecture Geotechnical Private/Commercial (A/E related - list percentage) % % % %</p><p>B. Contracting Status: Limited versus Unlimited For contracts funded by State or Federal sources, is your company either: (a) currently a party to any contract providing for payment under the Actual Costs Plus a Net Fee (cost-plus) method,1 or (b) do you anticipate entering into any of these agreements in the current year?</p><p>Yes: UNLIMITED . Please complete and submit: (1) the remaining sections of this SASQ, (2) all sections of the AASHTO ICQ for Consulting Engineers,2 (3) the Management Representation and Certification for Unlimited Contracting Status in Section IV of this SASQ, and (4) all documents listed on page 2 of this SASQ. </p><p>No: LIMITED . Please complete the following (submit this page along with the following): (1) Section A of the AASHTO ICQ for Consulting Engineers.2 (2) How does your company ensure that costs billed to government projects are not incurred prior to proper authorization?</p><p>(3) Management Representation and Certification for Limited Contracting Status: I hereby certify and agree that the company only shall enter into lump-sum or unit-cost agreements. If, at any future date, the company enters into any cost-plus contract with ODOT or other governmental entities, then the company will be required to establish a cost- accounting system compliant with Part 31 of the Federal Acquisition Regulation (48 CFR Part 31) and establish an overhead rate for use in billings to said contracts. The ODOT Office Audits has sole discretion over the review and approval of overhead rates. </p><p>(Typed or Printed Name) (Title)</p><p>(Date Completed) (Official Signature)</p><p>(Telephone Number, including Area Code) (Email Address)</p><p>1 Note: To be eligible to perform work on cost-plus contracts, your firm must qualify for unlimited contracting status. 2 See AASHTO Guide, Appendix B, at http://www.dot.state.oh.us/Divisions/Finance/Auditing/Pages/Consultants.aspx.</p><p>Version 1.4 (Last revised July 9, 2010) Page SASQ-1 SUPPLEMENTAL ACCOUNTING SYSTEM QUESTIONNAIRE (SASQ) Ohio Department of Transportation (ODOT) Section II. Required Supporting Documents Note: If you marked “yes” in Section I.B, then the following documents, if applicable, must be completed and submitted in your ODOT application package. 1. These items are required from all firms:  The AASHTO ICQ for Consulting Engineers (AASHTO ICQ).  FAR Part 31 Overhead Audit Report for most recent fiscal year, including audited(*) Statement of Direct Labor, Fringe Benefits, and General Overhead (Overhead Schedule) and related reconciliation to the financial statements. (*)Note: ODOT also accepts unaudited overhead schedules; however, if an independent CPA has performed an audit of the overhead schedule, then the audited schedule must be submitted. Check here if the Overhead Schedule was not audited:  Cognizant audit report or cognizant letter of concurrence from the cognizant Government agency (if applicable). Check here if not applicable: 2. The remaining items are required only if your firm has not received a cognizant letter of concurrence (or cognizant audit) from the cognizant Government agency:  The following standard attachments listed on the AASHTO ICQ: (a) Post-closing trial balance and financial statements (balance sheet, income statement, and statement of cash flows) for the most recent fiscal year. (b) Current chart of accounts that ties to financial statements and overhead schedule. (c) Independent Auditor’s Report on financial statements and accompanying management letter (if applicable). Check here if not applicable: (d) Sample timesheet. (e) The company’s policies for vacation and sick leave. (f) The company’s bonus policy.  Supplemental documentation to support the reasonableness of Executive Compensation. This requires either: (a) an analysis of Executive Compensation performed in accordance with Chapter 7 of the AASHTO Audit & Accounting Guide, or (b) a schedule demonstrating compliance with the Compensation Matrix shown in Appendix A of ODOT Circular No. 2.  A copy/example of a completed job-cost record for an active project.  If your company rents/leases facilities from a related party, then prepare and submit either Cost of Ownership Template 6.1 or 6.2, as applicable, from ODOT Contract Audit Circular No. 6–Rental Cost of Facilities. Include relevant excerpts from the property owner’s tax return (i.e., Form 1040 Schedule E, Partnership Form 1065, C corporation Form 1120, or S corporation Form 1120S), or another similar document, to support your computations. Check here if not applicable (no common control): </p><p>The ODOT Contract Audit Circulars referenced above are available at: http://www.dot.state.oh.us/Divisions/Finance/Auditing/Pages/Consultants.aspx</p><p>Submittal Method: The required documents listed above must be submitted either electronically via email to [email protected] (include company name in the email subject line), or via fax to (614) 887- 4010. The documents should be submitted in Microsoft Excel, Microsoft Word, or Adobe PDF format when possible. Note: Documents submitted in compressed (.zip) format must be renamed to another file extension, such as .doc. The ODOT firewall system automatically deletes files with .zip extensions.</p><p>Due Date: Documents must be submitted/updated annually, no later than six months after the close of your company’s fiscal year. Accordingly, the documents are due by July 1 for calendar-year companies (see note on cover page regarding requests for extension to due date).</p><p>Version 1.4 (Last revised July 9, 2010) Page SASQ-2 SUPPLEMENTAL ACCOUNTING SYSTEM QUESTIONNAIRE (SASQ) Ohio Department of Transportation (ODOT) Point of Contact: Please address all questions or comments to Scot Gormley at (614) 644-0384 or [email protected]</p><p>Version 1.4 (Last revised July 9, 2010) Page SASQ-3 SUPPLEMENTAL ACCOUNTING SYSTEM QUESTIONNAIRE (SASQ) Ohio Department of Transportation (ODOT) Section III. Detailed Financial Information B. Cost Allocation and Billing</p><p>1. What method does your company use to charge labor to individual jobs? Actual Pay Rate Standard Cost Rate Other. Please explain: </p><p>2. Does your company rent or lease property from any related party? (See ODOT Circular 6–Common Control of Rental Facilities or Leased Equipment.) No Yes </p><p>. If “yes,” have the rental costs been adjusted to the owner’s actual costs?</p><p>No Yes N/A </p><p>. If “yes,” what basis was used to determine actual cost? (E.g., the owner’s tax return, less interest expense, plus cost of money). </p><p>(To demonstrate compliance, please complete and attach a copy of Template 6.1 or 6.2 from ODOT Circular No. 6, as applicable. Include relevant excerpts from the property owner’s tax return, or another similar document, to support your computations.)</p><p>3. How do time sheets identify work performed outside an agreement’s original scope of services?</p><p>4. How does your company ensure that costs are not billed to government projects prior to proper authorization?</p><p>5. How are timesheet coding errors detected and corrected?</p><p>6. Are billings to ODOT prepared from, or reconciled to, reports generated from your firm's job-cost system? Yes No. Please explain: </p><p>7. Describe any manual procedures that occur outside of the automated accounting system to prepare billing packages.</p><p>Version 1.4 (Last revised July 9, 2010) Page SASQ-4 SUPPLEMENTAL ACCOUNTING SYSTEM QUESTIONNAIRE (SASQ) Ohio Department of Transportation (ODOT) Section IV. Management Representation and Certification for Unlimited Contracting Status</p><p>Note: Please complete the following only if you answered “yes” in Section I.</p><p>Company Name: For Year Ended:</p><p>This ODOT Supplemental Accounting System Questionnaire (SASQ) is for the year ended as specified above and includes information regarding the financial records, and underlying transactions, of the your company. ODOT will use the information from the SASQ, in combination with your responses to the AASHTO Internal Control Questionnaire (ICQ) for Consulting Engineers (Appendix B of the AASHTO Uniform Audit and Accounting Guide), to determine your company’s compliance with the applicable cost accounting standards and related laws, regulations, and policies.</p><p>I, the undersigned, attest that the Statement of Direct Labor, Fringe Benefits and General Overhead (Overhead Schedule) and all related notes and supporting schedules were prepared in compliance with Part 31 of the Federal Acquisition Regulation (48 CFR 31) and guidance provided in the current edition of the AASHTO Uniform Audit and Accounting Guide. We have disclosed all known, material transactions or events affecting the company’s ownership, organization, and indirect cost rates. I recognize that the information is submitted for the purpose of allowing the Ohio Department of Transportation to administer contract(s) with the above-named company. By affixing my signature below, I attest that the financial information and other assertions submitted on the overhead schedule, the AASHTO ICQ, and this SASQ are true, accurate, and complete.</p><p>(Company Name) (For Year Ended)</p><p>(Typed or Printed Name) (Title) (Date Completed)</p><p>(Official Signature) (Telephone Number, including Area Code) (Email Address)</p><p>Note: The representations made on this SASQ are the responsibility of the company’s management. Accordingly, ODOT does not accept SASQs prepared and/or certified by external CPA firms.</p><p>Version 1.4 (Last revised July 9, 2010) Page SASQ-5</p>