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FLORIDA SINGLE AUDIT ACT STATE PROJECT DETERMINATION CHECKLIST <br /> Part C-State Project Determination <br /> Based on your analysis above and discussions with appropriate agency personnel,state your <br /> conclusion regarding the state program. <br /> Name of State Program N/A <br /> Enter X"to indicate the State Project Determination. All signatures are required. <br /> A State Project Not a State Project <br /> Completed By(Program Personnel) — — <br /> Name Alison Parker Phone 850-717-1239 <br /> Title <br /> Deputy General Counsel Email Alison.Parker@myflorid <br /> alicense.com <br /> . ....... ... ............... <br /> Signature l C% 9-0As2_, Date (� id j <br /> Budget Office Review <br /> (Applies only to Questions I through 4 in Part A—State Program Resources.) <br /> Reviewer Lynn Smith Phone 850-717-1541 <br /> Title: Planning and Budget Administrator Email f'7'„h ' <br /> Signature✓_. Date4/ u+MS�.c7lr <br /> ZO <br /> Finance and At ting Review <br /> (Applies only to Questions 3 and 4 in Part B—State Program Evaluation.) <br /> Reviewer Phone <br /> Title: Email <br /> Signature Date <br /> Office of Inspector General Receipt <br /> Receiver Lynne Winston Phone 850-363-4829 <br /> Title Inspector General Email tom* "©'m1 <br /> Signature soi.va Date -//a <br /> It R e tib4) .a _tole. ao,(/4)_ <br /> For questions regarding Mt evaluation of a state program or if it has been determined that the state program is a <br /> state project and has not been assigned a CSFA number,contact your FSAA state agency liaison or the Department <br /> of Financial Services,Bureau of Auditing,at FSAA ih FloridaCFO.com or(850)413-3060. <br /> Email completed forms to the FSAA Coordinator at the Department of Financial Services, Bureau of Auditing <br /> (FSAA@MyFloridaCFO.com). <br /> Note: Rule Chapter 691-5,Florida Administrative Code(F.A.C),State Financial Assistance,incorporates this form as well <br /> as the regulations cited therein by reference in Rule 691-5.005,F.A.C. Rule 691-5.001,F.A.C,incorporates 2 CFR Part 200, <br /> Uniform Administrative Requirements,Cost Principle.,and Audit Requirements for Federal Awards,including Subpart F- <br /> Audit Requirements,2018 Edition,and its related Appendix Xl,Compliance Supplement,April2017 and April 2018. The <br /> form and regulations can be accessed via the Department of Financial Services'website at https://apps.ffdfs.comffsaal. <br /> DFS-A2-PD Page-3- <br /> Rev. 11/18 <br /> Rule 69I-5.005,F.A.C. <br />