Employee Business Procedures Manual

2016 - 2017

Jean Ann McCarthy, Director of Finance

Smithville Independent School District Employee Business Procedures Manual

Introduction

This handbook is designed to provide information about Smithville Independent School District’s business office procedures. You should read, understand, and comply will all provisions of the handbook. It describes many of your responsibilities as an employee.

No employee handbook can anticipate every circumstance or question about policy. As SISD continues to grow and change, the need may arise and the District reserves the right to supplement or revise any policy or portion of this handbook as it deems appropriate.

The purpose of this handbook is to provide an explanation of the business office procedures of the District. The policy manual is the legal authority for all District policy. Smithville ISD has elected the two-year grace period to implement the new EDGAR procurement policies and procedures. The new procurement requirements will go in effect July 1, 2017. Beginning with the 2015-2016 school year, all TEA administered grant awards include a supplement to the Notice of Grant Award (NOGA supplement) specifying which federal regulations apply to the grant. In regards to the procurement guidelines, since Smithville ISD has elected to take the grace period, the procurement shall be in accordance with OMB Circular A-133.

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The Budget

Every spring, each campus and department prepares a budget for the upcoming year. All projected expenditures should be included in the spending plan. All of the submitted budgets are combined at the Business Office. These combined budget plans are reviewed by the Director of Finance and Superintendent, and then presented to the Board of Trustees for final approval.

A budget amendment/adjustment is needed when funds in a specific line item in the budget are not sufficient to allow a necessary expense. A budget amendment/adjustment must be completed and signed by the principal or department Director and then submitted to the Director of Finance.

A budget adjustment is necessary: To move funds within the same function

A budget amendment is necessary: To move funds from one function to another function If prior adjustments between object categories exceed 25 percent of the

total budget and the adjustment is to a federal or state fund, unless otherwise stated in the grant award

Budget amendments must receive Board approval prior to expending funds.

Monthly organization budget reports are distributed to each campus Principal or department Director for review after the Business Office closes each month. If an employee has questions when reconciling the monthly report to the campus/department records/books, contact the Director of Finance in the Business Office.

Budget Terms

Fund How and when the expenditure is financed

Governmental fund types for Texas school districts consist of four governmental fund groups (General, Special Revenue, Capital Projects and Debt Service) that account for the acquisition, use and balances of expendable financial resources and related liabilities as required by law or rule.

The General Fund is the District’s principal fund, accounting for the majority of current operating expenditures. Recorded in the General Fund are transactions encompassing the approved current operating budget, related revenues, expenditures, assets, liabilities, and fund balance. Financial transactions of the

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District are recorded in detail in the general ledger by objects and functions within projects and programs. This fund has often been described as an operation or current fund and includes revenues from ad valorem local maintenance tax, state funding, and other sources such as investment earnings.

The Special Revenue Fund accounts for all designated-purpose monies received in the form of federal, state, or local grants. These grants, referred to as projects, are awarded to the Smithville Independent School District for the purpose of accomplishing specified education tasks; therefore, revenues and expenditures are recorded by project or similar groups of projects related by funding to accomplish the purpose of accounting for each grant.

The Debt Service Fund is used to account for the District’s annual long-term debt repayment of principal and interest.

The Construction Fund must be used to account for projects financed by the proceeds from bond issues or for other capital projects otherwise legally mandated to be so accounted for.

Function How the funds are used

Function 11 – Instruction This function is used for activities dealing directly with classroom instruction.

Function 12 – Instruction Resources and Media Services This function is used primarily for libraries for preparing, maintaining, and distributing resources and media used to support instruction.

Function 13 – Curriculum and Instructional Staff Development This function is used for activities related directly to and exclusively for in-service training and other staff development involving instructional or instructional related personnel.

Function 21 – Instructional Leadership This function is used to account for district-wide activities which have as their purpose managing, directing, and supervising the instructional program, and improving the quality of instruction and the curriculum.

Function 23 – School Leadership This function is used for activities which have as their purpose directing, managing, and supervising a school campus. (Principals’ office)

Function 31 – Guidance, Counseling, and Evaluation Services This function is used for activities which have as their purpose assessing and testing pupils’ abilities, aptitudes, and interests, counseling pupils with respect to career and educational opportunities, and helping them establish realistic goals.

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It also includes psychological services, identification of individual characteristics, testing, and counseling (educational and occupational).

Function 32 – Social Work Services This function is used for activities related to promoting and improving school attendance, including the promotion of positive student and parent attitudes toward attendance.

Function 33 – Health Services This function is used for activities related to providing physical health services to students. It includes the cost of medical, dental, and nursing services.

Function 34 – Pupil Transportation This function is used for activities related to transporting students to and from school.

Function 35 – Food Services This function is used for food service operation expenditures including the cost of food, labor and other expenses necessary to provide food to students and staff.

Function 36 – Co-Curricular/extracurricular Activities This function is used for activities which are student and curricular related, but which are not necessary to the regular instructional services. Included are such activities as athletics, student organizations, and special interest activities.

Function 41 – General Administration This function is used for expenditures that are for purposes of managing or governing the school district as an overall entity. It includes such areas as the board of directors, superintendent’s office, personnel and support services, business office, tax administration, and other general administrative services.

Function 51 – Plant Maintenance and Operation This function is used for those activities concerned with keeping the physical plant open, comfortable, and safe for use, and keeping the grounds, building, and equipment in effective working condition and state of repair, and insured.

Function 52 – Security and Monitoring This function is used for expenditures for campus police and security necessary to keep student and staff surroundings safe. Function 53 – Data Processing This function includes all activities associated with the administrative operational use of computers. Services such as student scheduling, grade reporting, student attendance, personnel and payroll processing, and finance processing are included in this function. It does not include instructional computing.

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Function 61 – Community Services This function is used for expenditures for services or activities relating to the whole community or some segment of the community. The parent/community liaison coordinator will encourage more active parent involvement in the district.

Function 71 – Debt Service This function covers bond principal and interest, and principal and interest on lease purchases.

Function 81 – Facilities Acquisition and Construction This function includes activities concerned with the acquisition of land and buildings, the remodeling and construction of buildings and additions to buildings, initial installation or extension of service systems and other built-in equipment, and improvement to sites.

Function 93 – Payments to Fiscal Agents/Member Districts of Shared Service Arrangements This function is used for expenditures that are for payments from a member district to a fiscal agent of a shared service arrangement, or payments from a fiscal agent to a member district of a shared services arrangement.

Object What is to be purchased

6100 Payroll Cost – Expenditures for the gross salaries and benefits costs for employee services. Among the items included in benefits costs are social security, teacher retirement, group health & life insurance and workers’ compensation insurance.

6200 Professional and Contracted Services – Expenditures for services rendered to the school system by firms, individuals, or other organizations, which are independent of the system. Included are utility costs, audit and legal services, education service center services, rentals and contracted maintenance and repair services.

6300 Supplies and Materials – All expenditures for consumable supplies and materials

6400 Other Operating Expenses – Expenditures for expenses other than payroll, professional & contracted services, materials & supplies, debt service, and capital equipment necessary to the operation of the school system. Included are travel, insurance (except employee health, life, and accident), election expenses, fees, dues, and awards.

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6500 Debt Service – Principal and interest on all borrowings, including bonded debt.

6600 Capital Outlay – Expenditures for all capital assets including land, buildings and equipment.

Organization Identifies the location making the expenditure

The Organization Code is an identification number for each campus/department. For example, the Organization Code for Brown Primary is 102.

Program Intent Designates major educational program area

11 – Basic Educational Services The costs incurred to provide the basic services for education/instruction to students in PK-12. Basic educational services include the costs to evaluate, place, and provide educational services to students in honors, college preparatory and advanced placement courses.

21 – Gifted and Talented The costs incurred to assess students for program placement and provide instructional services (which are guided by the state plan) beyond the basic educational program and that are designed to meet the needs of students in gifted and talented programs.

22 – Career and Technology Career and Technology refers to those programs, approved by the Texas Education Agency, that are designated to prepare pupils for gainful employment, advanced technical training, or homemaking. This may include apprenticeship or job training activities.

23 – Services to Students with Disabilities (Special Education) Special education refers to programs, approved by the Texas Education Agency, that are designated for pupils with special needs incorporating distinctive techniques, materials, and arrangements suited to their learning needs. 24 – Accelerated Education Accelerated education refers to programs that provide special assistance to at-risk pupils by increasing the amount and quality of instructional time.

25 – Bilingual Education and Special Language Programs The costs incurred to evaluate, place and provide educational and/or other services that are intended to make the students proficient in the English language, primary language literacy, composition and academic language related

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to required courses. These services include the bilingual basic program of instruction and special assistance to increase cognitive academic language proficiencies in English.

26 – Non-disciplinary Alternative Education Programs (AEP Services) The cost incurred to provide services to students who are separated from the regular classroom to a non-disciplinary alternative education program and are at risk of dropping out of school.

28 – Disciplinary Alternative Education Program (DAEP Basic Services) All costs incurred to provide the base line program (non-supplemental) services to students who are separated from the regular classroom to a disciplinary alternative education program.

30 – State Compensatory Education The costs incurred to supplement federal grant awards for use on Title I, Part A school-wide campuses with at least 40% educationally disadvantaged students.

31 – High School Allotment All costs incurred to prepare students to go on to higher education, encourage students to take advanced academic course work, increase the rigor of academic course work, align secondary and postsecondary curriculum and support promising high school completion and success initiatives in grades 6 through 12.

32 – Prekindergarten (Pre-K) The costs incurred for prekindergarten programs designed to develop skills necessary for success in the regular public school curriculum, including language, mathematics, and social skills.

91 – Athletics and Related Activities The costs incurred to provide for participation in competitive athletic activities such as football, basketball, golf, swimming, wrestling, gymnastics, baseball, tennis, track, volleyball, etc. This includes costs associated with coaching as well as sponsors for drill team, cheerleaders, pep squad or any other organized activity to support athletics. However, this does not include band.

99 – Undistributed All charges which are not readily distributed to program intent codes are classified here. Program intent code 99 may be used when recording substitute teachers and on-behalf teacher retirement payments in all function codes. This code may be used for costs not clearly attributable to a specific program intent.

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Purchasing

The overall mission of purchasing is to use available fiscal resources to obtain the maximum product or service for the resources expended.

All purchases of state and educational entities are required to be encumbered. The districts use requisitions/purchase orders to fulfill this requirement. Requisitions will be entered at the campus level into TxEIS and electronically submitted to the Business Office. Before submitting to the campus secretary for entry, a requisition must:

Be properly completed, dated, and signed. Special attention should be given to the following:

o Vendor – Include the complete name of the company, complete address with zip code, and telephone number. If the purchase order will be sent to the attention of a specific person, the attention line should be the second line in the address.

o Ship To – Central Administration (901 NE 6th Street) o Reference – In this section, include the name of the person to

whom the order will be delivered after being received by Central Administration.

o Budget Code – Insert the complete budget number code that is in the budget for the items being ordered. This code may not be changed at a later date unless initialed by the campus principal/director. The invoice will be paid from this code.

o Encumbrance Amount – Total the amount of the purchase order charged to the specific budget code here.

o If more than one budget code is being used on a purchase order, indicate the items to be charged to each budget code and the encumbrance amount for each different budget code.

o Budget codes from different fiscal years cannot be on the same purchase order.

Be used for all expenses incurred, general operating funds and activity funds, by the district for goods and services in which the total amount of the purchase will exceed $50.

Include actual amount if known. If not, an estimated amount must be included.

Be issued to approved vendors only, with the exception of sole source vendors.

Identify the vendor source (i.e., Region 2, PACE Purchasing Cooperative, TIPS/TAPS Purchasing Cooperative, TCPN, Buy Board, HCED Choice Partners Cooperative, Sole Source, RFP # 2013-001, three quotes, etc.).

Include ten percent (10%) for freight/shipping/handling charges in the total amount of the purchase order unless the amount is known or the vendor does not charge freight/shipping/handling. If using more than one budget

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code, divide the freight/shipping/handling charges among the budget codes.

All purchase orders that exceed $10,000 will require additional authorization through the Superintendent’s office.

The only exceptions to requisitions/purchase orders are travel, necessary prepayments, stipends/substitutes, and emergencies.

Submit all completed requisitions to the campus secretary or appropriate department head for entry into the TxEIS system and for transmittal to principal and business office for approval. Important: The goal of the Business Office is to provide a 48-hour turnaround time on requisition approvals. Please allow a longer turnaround time on requisitions at the beginning of the month due to closing.

Competitive Purchasing Laws – All district contracts (except for the purchase of vehicle fuel) valued at $50,000 or more during each 12-month period shall be competitively purchased. Formal quotes must be taken on purchases or lease-purchases of property (defined as related classes or types of items) reasonably anticipated being $10,000 or more during each 12-month period. In other words, bids, proposals, or quotes must be taken for contracted services, supplies, and inventory items/capital outlay when more than $10,000 will be spent within a 12-month period. Changes in the price of goods and services are not negotiable in the competitive bidding process. Smithville ISD utilizes competitive proposal procedures when possible where other procurement procedures are not required according to state or federal rules, laws or regulations, in order to stimulate competitive prices for services.

Bids –The competitive bidding process requires that bids be evaluated and awards made based solely upon bid specifications, best value, terms and conditions contained in the request for bids document, and according to the bid prices offered by vendors and pertinent factors that may affect contract performance. These formal quotes shall be advertised through the newspaper once a week for two weeks. Bids proposals may be opened after 10 days from the last advertisement. Bids or proposals are analyzed and presented to the district Board of Trustees at its monthly meeting. Any or all bids may be rejected if there is a sound documented reason.

Important: All specs must be submitted to the Director of Finance. The Director of Finance will submit information to the newspaper and vendors. All bids, proposals, or quotes from outside sources will be sent to the attention of the Director of Finance for a formal opening. Once bids are opened, the Director of Finance will send the information to departments/campuses for analysis. When completed by the departments/campuses, the original forms along with the bid or proposal tabulation sheet must be submitted to the business office.

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The only exceptions to competitive purchasing through bids or proposals are when we are purchasing from another governmental entity in Texas or other agencies that have already bid groups of items. These agencies include the Texas Building and Procurement Commission (State Purchasing), Region II Cooperative Purchasing, Region IV TCPN Cooperative, TCI (Texas Correctional Industries), HCED Choice Partners Cooperative, TIPS-TAPS Purchasing Cooperative, and Region 20 PACE Cooperative Purchasing. The other exception to cooperative purchasing is the purchase of items or services that are available only through a sole source vendor where there are no other vendors that sell these items or services. Indicate in the bottom portion of the description section of the requisition which approved bid qualifies the vendor. The campus secretary will enter the vendor source into TxEIS before submitting to the Business Office.

The district has contracted or agreed with other local governments to purchase goods and services reasonably for the installation, operation, or maintenance of the goods. Requirements for inter-local contracts include: authorization by the governing board of each party to the contract, a statement of purpose, terms, rights, and duties of the contracting parties, and specification that each party paying for the performance of governmental functions or services must make those payments from current revenues available to the paying party. For every procurement action over $150,000, Smithville ISD will perform a cost or price analysis, which includes contract modifications.

Any purchase, if not using a vendor through the purchasing coop, you must provide three quotes or a sole source affidavit. When purchasing from sole source vendors, a sole source letter or affidavit from the vendor must be attached to the requisition prior to submitting to the Business Office. Please mail/FAX the two-page Confirmation of Sole Source Compliance by Vendor to the sole source vendor for completion. The Confirmation of Sole Source Compliance by Vendor must be renewed annually on September 1. Noncompetitive Proposals – are only appropriate when the item is only available from a single source, there is a public emergency that will not permit delay, the Federal awarding agency or pass-through expressly authorizes noncompetitive proposals in response to a written request from Smithville ISD or after soliciting a number of sources, competition is determined inadequate.

Vendor Payment Schedule – Paperwork authorizing purchase order payments received by the 2nd, 3rd and 4th Friday of the month will be processed for payment the following Thursday provided the original purchase order, vendor’s invoice and the signed gold copy of the purchase order have all been received. Every attempt will be made to meet these deadlines.

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Closing Purchase Orders – SISD purchase orders include a “no back-order clause.” If information is received that all/part of the merchandise ordered is not available, make note on the gold copy and forward to Accounts Payable to process payment and close the purchase order.

Receiving Merchandise – When a purchase order is approved, a gold copy is generated and sent to the originator. This gold copy should be used to check in the order and verify that all items have been received. Payment cannot be made until the Business Office receives a signed gold copy of the purchase order.

Vendor Performance – Evaluating the performance of approved vendors is critical. When non-conforming products or services are received by an approved vendor, the Vendor Performance Report Form must be completed. Upon completion by the requestor the Vendor Performance Report form is submitted to the business office for the official complaint to be recorded on the Approved Vendor Spreadsheet. After the vendor has received three (3) notifications of Non-Conforming Products or Services recorded on the Approved Vendor Spreadsheet, the vendor is removed from the Approved Vendor List in TxEIS. In extenuating circumstances, the administration has the discretion to immediately discontinue use of a vendor due to vendor performance or product quality.

Purchasing Ethics – Smithville ISD must be responsible, in accordance with good administrative practice and sound business judgment, for the settlement of all contractual and administrative issues arising out of procurements. These issues include, but are not limited to, source evaluation, protests, disputes, and claims. These standards do not relieve Smithville ISD of any contractual responsibilities under its contracts. Penalties for violations of purchasing laws and ethics may include criminal prosecution, or violation will be referred to local, state, or federal authority having proper jurisdiction, and loss of employment opportunities.

Petty Cash

A minimal petty cash drawer is maintained in the Business Office for urgent reimbursement of miscellaneous out-of-pocket expenses limited to $15 per reimbursement. Petty cash may be reimbursed upon receipt of an actual invoice initialed by the Campus Principal/Director, an appropriate budget code, and signature of the employee.

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Payment Authorization

A Payment Authorization is utilized only for those expenditures requiring prepayment (i.e., for a company that does not accept purchase orders, or for workshop registrations only when a purchase order will not be accepted), in emergency situations (waterlines rupturing), or reimbursement of emergency out-of-pocket expenses. Payment authorizations must be submitted to the Business Office completed, coded, signed, and with a valid reason for no prior purchase order. An original invoice or registration form must be attached to the payment authorization.

Payment authorizations are reviewed for completeness, availability of funds, and given final approval in the Business Office. Payment authorizations will be returned to the purchaser if an original invoice or appropriate documentation is not attached, if the form is not properly coded, completed and signed, or the funds are not available.

The Business Office will assign the payment authorization number and vendor number.

Central Supply Requisition

In order to request supply items that are kept in inventory at the Central Office, employees must first fill out a Supply Requisition Form. Once this has been turned into the campus secretary/principal for coding and approval, it is forwarded to the Accounts Payable Assistant in the Business Office to be filled. If inventory is temporarily out of stock, orders will be placed to obtain the items requested.

Once the items have been sent to the appropriate campus for distribution, the appropriate accounting entries will be made to charge the campus for the supplies received. The cost associated with the supplies will be entered on the Supply Requisition Form and a copy will be returned with the supplies to the campus/department.

Travel Policy and Procedures

All travel must be pre-approved by the employee’s principal or director. Advanced travel payments will not be processed without documentation verifying an undue hardship. A district employee that plans to travel must complete a Travel Request/Expense Reimbursement Form. The Travel Request/Expense Reimbursement form must:

Be completed at least 10 days prior to travel.

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Include estimated cost, including all known cost such as prepayments of registration and hotel, and account coding.

Be approved by the campus principal/department head and assistant superintendent.

Include topic and subject matter of workshop/convention (75% of workshop/convention topic must be related to curriculum, ECA, or job related).

Important: All travel should be scrutinized by campus principals/directors to

determine the benefits gained if more than one person attends the same workshop/meeting. In some cases, one person rather than two could receive the needed information and share with others.

All travel should be related to an employee’s job title. Professional staff members, excluding UIL sponsors, coaches, or

directors, will be allowed to attend one workshop/conference, etc., per year, unless approved by the Superintendent/Asst. Superintendent in advance.

UIL sponsors and head coaches are allowed no more than two workshops/conferences per year, unless approved by the Assistant Superintendent/Superintendent.

Campus Principals/Directors are allowed no more than three workshops/conferences per year.

The district does not reimburse individuals for membership fees. Principals/Directors may be reimbursed for membership in one professional organization subject to approval by Superintendent.

Hotel – Each campus or department is responsible for reserving its own hotel accommodations. The maximum allowable reimbursement for a hotel room is $85.00 per night plus city tax only. When lodging is not available at this rate, requests will be considered on an individual basis to be reimbursed at a higher rate.* Reimbursement will not be made for Texas Hotel Occupancy Taxes. Employees are responsible for presenting a Texas Hotel Occupancy Tax Exemption Certificate to the hotel upon arrival to claim exemption from state taxes. Hotel receipts must be attached to the Travel Request/Expense Reimbursement Form when submitting to Business Office for reimbursement. Mileage – Personal car mileage is reimbursed in accordance with the Texas Comptroller’s Office guidelines. Mileage is determined from the lesser of the campus to destination or departing point to destination. Travelers are required to calculate mileage based upon an electronic mapping source such as MapQuest. Mileage is reimbursed by providing the necessary documentation with the Travel Reimbursement Form. When more than one employee attends the same meeting or workshop, mileage will be reimbursed to only one employee driving his/her vehicle with a minimum of three SISD employees. Mileage for intra-district travel for hourly employees conducting school business should be

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documented on the Mileage Record and submitted to the Business Office at the end of each month for reimbursement.

Meals – Meals are reimbursable for travel exceeding a 50 mile radius of the SISD Administration Office up to $46 per day only when travel requires an overnight stay. Receipts are required for verification, including a hotel receipt or documentation of overnight stay. Attach all itemized receipts to the travel reimbursement form prior to submitting it to the Business Office. The following chart indicates departure and arrival time from and to the employee’s station to calculate meal eligibility:

To be eligible

You must LEAVE BEFORE

or

RETURN AFTER

Breakfast @$11 4 a.m. 8 a.m. Lunch @$12 10 a.m. 2 p.m. Dinner @$23 4 p.m. 8 p.m.

Airfare and Registration – Airfare and Registration should be requested with a purchase order. In the event that a purchase order will not be accepted for registration, then a payment authorization shall be submitted requesting prepayment. Airline ticket stubs or copy of e-ticket must be attached to the travel reimbursement form prior to submitting for reimbursement.

Other – Reimbursement is made for taxi, shuttle service, airport parking or parking only when supported by appropriate receipts. Tips and gratuities are not reimbursable. In certain cases, when travel requires it, auto rental is approved. Insurance must be purchased when renting an automobile.

Travel Reimbursement Form Completion – Reimbursement forms must be fully completed and received in the Business Office within 15 days after completion of travel. To complete the form:

Any receipts received after 15 days of travel completion is subject to non-reimbursement.

Enter the date with time departed and date with time returned. Enter the total actual amount of expenses, total the expenditures on the

form, deduct prepayments, and indicate total reimbursement due to the traveler on the total actual cost line.

Attach all original receipts and invoices not prepaid, including itemized hotel, taxi, parking, meals, etc.

*At the discretion of the Business Office, the U.S. General Services Administration per diem rates will be reviewed.

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Make sure the employee and supervisor have signed, coded and approved all travel before submitting to the Assistant Superintendent Office for reimbursement.

Upon approval, the reimbursement will be forwarded to the Business Office for payment.

When an employee shares expenses for lodging or mileage, please indicate the person(s) name on the Travel Request/Expense Reimbursement Form.

Exclusions for Travel Reimbursement – Reimbursement will not be allowed for alcoholic beverages, spouse’s travel expenses, non-district-related travel, non-district-related telephone calls, taxes, or entertainment. Lodging will not be reimbursed for overnight stay in Austin. Gifts/Prizes – any gift/prize received while attending a school funded event/conference is property of SISD and must be turned into the proper department upon return from the event/conference.

Important: The District’s fiscal year ends on August 31 of each year. All travel reimbursement must be submitted prior to the fiscal year end. If travel is conducted on August 31, reimbursement must be submitted on the first workday after the trip. Once the fiscal year has been closed, reimbursement will NOT be paid.

Student Travel

The district may purchase meals for student groups, and their sponsors/coaches, when traveling for beyond district competition only. These meals should average $7.00 per meal. The coach or teacher should provide the restaurant with a Tax Exemption Certificate to allow the purchase of these meals to be tax-free. These forms are available from the Business Office. When purchasing meals for a student group, the teacher/sponsor will submit a Purchase Requisition to Central Office. Upon approval, the teacher/sponsor can pick up the meal check from the Business Office. Upon returning, an itemized invoice from the restaurant is required. Attach the receipt to the gold copy of the Purchase Requisition after the trip. If money for meals is given directly to the student, have the student sign a receipt for the amount given and attach these receipts to the gold copy of the Purchase Requisition after the trip and return to the business office. Sponsors/coaches will be allotted $7.00 per meal for all travel beyond district competition with students that does not require an overnight stay. When an overnight stay is mandatory, sponsors/coaches will be reimbursed the U.S. General Service Administration per diem rate.

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Grants Management Procedures

Responsibilities of the Grant Management Department –Grants Management is in the Central Office under the direction of the Assistant Superintendent and Director of Finance and is responsible to the Superintendent, the Smithville Independent School District, the district SISD Board of Trustees and to the granting agencies for the financial and regulatory administration of all state and federal financial assistance to the District.

Overall responsibility for submitting proposals and for executing and administering awards rests with the Assistant Superintendent/Superintendent. The District has adopted an institutional oversight model for state and federal financial assistance. The oversight model establishes lines of authority within the District related to financial transactions on government assistance received. There are three fundamental principles:

1. The Assistant Superintendent is the final approval authority for all grant activity prior to submission to the Superintendent.

2. Responsibility is defined as the authority to make a decision and be accountable for any outcomes associated with that decision.

3. Oversight is always distinct from the operating unit that makes the decisions.

The overall responsibilities of the Grants Management function include, but are not limited to: a. Reviewing all grant applications that have a financial reporting or compliance requirement prior to submission for approval by the Superintendent; b. Establishing, communicating and promoting policies and procedures consistent with federal, state, and local regulations; c. Providing assistance to project managers for the preparation of grant applications; d. Exercising budgetary control of grant funds; e. Providing overall financial support and performance monitoring to include;

Comparing actual accomplishments to objectives

Maintain reasons goals were not met, if appropriate

Maintain lists of pertinent information (i.e. analysis of cost overruns) and significant developments (i.e. adverse conditions that would impair an objective and/or favorable developments).

f. Providing overall compliance monitoring to include;

Maintaining an adequate internal control structure to ensure compliance with The U.S. Comptroller General’s Standard for Internal Control Integrated Framework and the Internal Control Integrated Framework issued by the Committee of

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Sponsoring Organizations of the Treadway Commission (COSO).

o Effectiveness and efficiency of operations o Reliability of reporting for internal and external use;

and o Compliance with applicable laws and regulations.

Coordinating formal agency audits or interim reviews of grants by federal or state agencies; and

Providing support and guidance to campus and central administrative offices for the effective administration and financial management of grants.

g. An authorized official must certify on annual and final fiscal reports or vouchers requesting payment on behalf of Smithville ISD.

Financial Reporting – Smithville ISD submits accurate, current, complete disclosure of financial results of each federal award. The federal awarding agency can only collect OMB approved data elements, no less than annually and no more than quarterly. Smithville ISD must submit performance reports at intervals required by the federal agency or the pass-through agency. Annual performance reports are due 90 days after the reporting period and quarterly performance reports are due 30 days after the reporting period. Salaries of administrative and clerical staff should be treated as “indirect” unless such services are integral to the activity, individuals can be specifically identified with the activity, such costs are explicitly included in the budget and costs not also recovered as indirect.

Cash Management – Smithville ISD utilizes the reimbursement method for all federal awards. Reimbursement will be requested within 30 calendar days after receipt of the payment invoice. In order to avoid subsequent disallowance: Smithville ISD may seek prior written approval from the Federal awarding agency in advance of an incurrence of special or unusual costs. Payments made for costs determined to be unallowable by either the Federal awarding agency or pass-through will be refunded (including interest) to the Federal government in accordance with instructions from the Federal agency that determined that the costs are unallowable.

Staff Responsibilities Director of Federal Programs – is a duty shared by the Assistant Superintendent and Director of Finance

Submitting all state and federal grant applications

Monitoring finance and compliance of all state and federal grants

Reporting unusual or irregular activities related to grants to the Superintendent

Maintaining current knowledge of federal, state and District policies related to grants

Providing central staff and campus training for federal and state grants, as appropriate

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Board of Trustees

Superintendent

Maintenance & Transportation

Director

Athletic

Director

High

School

Principal

Jr. High

School

Principal

Elementary

Principal

Brown Primary Principal

Chief Financial Officer

Assistant Superintendent

Technology

Director

Special Education Coordinator

Smithville ISD Organization Chart

Department Responsibilities

Duties Staff Responsible

Review CIP and DIP for compliance Assistant Superintendent/CFO/Principals

Conduct comprehensive needs assessment for District

Special Education Director/Grant Professional Services/Principals

Develop plan from assessment, identified needs and prepare budget, staffing and program descriptions

Assistant Superintendent/CFO/Principals

Compliance reporting Assistant Superintendent/CFO/Principals

Training on budgeting, budget amendments, coding, time and effort, purchasing, purchasing cards, credit cards, split-funded salary allocations, contract monitoring (including debarred vendors), travel reimbursements and other employee reimbursements, and selected unallowable costs

CFO

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Approval of all purchases to ensure compliance with grant requirements, coding, allowability of costs, competitive procurement, correct pricing on bids and proposals, eligible vendors (not on debarred list) and alignment with identified needs, CIPs and DIPs

Assistant Superintendent/CFO/Principals

Compliance reporting Grant Professional Services/Assistant Superintendent/CFO/Principals

Periodic reporting (cash draw- downs)

CFO

Quarterly reporting CFO

Budget reporting to budget managers, campuses, and central administration

CFO

Reconciliation of accounting records with expenditure reports to grantor agencies

CFO

Annual review of code of ethics (34CFR Section 80.36), policies and administrative procedures for all of the above listed duties and responsibilities

Assistant Superintendent/CFO

Supplement Not Supplant Procedures

Smithville ISD has implemented guidelines to ensure compliance with the federal fiscal requirement of supplement, not supplant. The purpose of the procedures is to ensure that the level of state and local support for programs remains at least constant and is not replaced by federal funds. Federal funds are used to supplement (add to, enhance, to expand, or increase the funds available from non-federal sources, and not to supplant (replace or take the place of) the existing non-federal funds.

1) Federal funds shall not be used to provide services that the District is required to provide under federal, state, or local laws/policies.

a) Salary expenditures for staff required by federal, state, or local policy shall not be paid from federal funds. For example, teacher FTEs that meet the state’s 22:1 student-teacher ratio for grades PK through 4th will not be funded from federal funds. Excess teacher unity, if any, may be eligible for payment through federal funds.

i) Documentation shall include a report that reflects the teacher units throughout the district mandated by the state and the excess units, if any.

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b) Salary expenditures for staff required by local policy shall not be paid from federal funds. Excess staff units, if any, may be eligible for payment though federal funds.

i) Documentation shall include Board minutes or local policy reflecting the staffing requirement and a report that reflects the staff units throughout the district mandated by the local minutes/policy and the excess units, if any.

c) Federal funds shall not be used to pay for state required activities, such as state-mandated assessments.

i) Documentation shall include purchase orders for state required activities. The purchase orders shall reflect that non-federal funds were used to pay for the expenditures.

2) Procedures for determining that a school participating in a school-wide program is using federal funds available only to supplement the amount of funds that would, in the absence of NCLB federal funds, be available from non-federal sources for the school (including funds needed to provide services for children with disabilities and children with limited English proficiency. Note: In a Title I school wide program, a school is not required to provide supplemental services to identified children;

3) Procedures for determining supplement, not supplant when state or local funds are no longer available. Federal funds shall not be used to provide services that the District is required to make available under other Federal, State or local laws (Board Policy).

a) Salary expenditures for staff required by federal, state, or local policy shall not be paid from federal funds. For example, teacher FTEs that meet the state’s 22:1 student-teacher ratio for grades PK through 4th will not be funded from federal funds. Excess teacher units, if any, may be eligible for payment through federal funds.

i) Documentation shall include a report that reflects the teacher units throughout the district mandated by the state and the excess units, if any.

b) Salary expenditures for staff required by local policy shall not be paid from federal funds. Excess staff units, if any, may be eligible for payment through federal funds.

i) Documentation shall include the Board minutes or policy and a report that reflects the staff units throughout the district mandated by the minutes or policy and the excess units, if any.

c) Federal funds shall not be used to pay for state required activities, such as state-mandated assessments.

i) Documentation shall include purchase orders for state required activities. The purchase orders shall reflect that non-federal funds were used to pay for the expenditures.

4) Procedures for determining that program-specific supplement, not supplant provisions are met.

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a) A review of the non-federal funds available to each campus (school-wide and non-participating) shall be conducted on an annual basis by CFO.

i) TEA’s Comparability Computation Report (CCR) should provide valuable information related to the level of state and local funding available at each Title I A participating and non-participating campus. ii) All purchase orders with federal funds shall be reviewed by the CFO to ensure compliance with the supplement, not supplant provision. The final approver’s signature and date is his/her representation that the grantee complied with local policy and procedure and state and/or federal law, rules and/or grant requirement, as applicable.

5) Procedures for determining supplement, not supplant when state or local funds are no longer available.

a) Federal funds shall not be used to provide staff that the District provided with non-federal funds in the prior year.

i) Documentation may include a report that reflects the staff units throughout the district and the prior year and current year source of funding.

b) Federal funds shall not be used to pay for goods or services that the District provided with non-federal funds in the prior year.

i) Documentation may include Budget Worksheets or other budget documents.

6) Procedures for determining that program-specific supplement, not supplant provisions are met. a) Title 1, Part A – School wide Programs

i) Title 1, Part A federal funds shall be used only to supplement the amount of funds available from non-federal sources for the campus including funds needed to provide services that are required by law for children with disabilities and children with limited English proficiency. A school wide campus does not have to demonstrate that activities are supplemental. The school is not required to identify particular children or to provide supplemental services to identified children. ii) A review of the non-federal funds available to each campus (School wide and non-participating) shall be conducted on an annual basis.

b) IDEA – Part B, Formula i) IDEA-B funds must be used to expand or increase the level of services for students with disabilities and not to take the place of funds from non-IDEA sources. Supplanting may occur if the LEA uses IDEA-B funds to provide services that the LEA is required to make available under other federal, state, or local laws or policy.

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ii) Supplanting may also occur if the LEA uses IDEA-B funds to provide services for students with disabilities that the LEA also provides for non-disabled student.

c) Career & Technical –Basic Grant to States (Perkins IV) i) Funds made available under this Act for career and technical education activities shall supplement, and shall not supplant, non-Federal funds expended to carry out career and technical education activities and tech prep program activities.

d) Title II, Part A – Teacher/Principal Training and Recruitment i) Using Title II, Part A funds to meet any state mandate or local board policy would be considered a supplanting issue. For example, if an LEA decides to use Title II, Part A funds to hire additional teachers to reduce class size in Grade 2, the state mandate of 22:1 must be met with state and/or local funds before additional teacher may be hired with Title II, Part A funds. ii) Documentation may include a report that reflects the teacher units throughout the district mandated by the state and the excess units, if any.

e) Title III, Part A – English Language Acquisition i) Title III, Part A funds shall be used so as to supplement the level of Federal, State, and local public funds that, in the absence of such availability, would have been expended for programs for limited English proficient children and immigrant children and youth and in no case to supplant such Federal, State, and local public funds. ii) Documentation may include a report that reflects the state and/or local funds used to provide Bilingual education or ESL services to students as required by state law and the federal funds used to provide additional services beyond the basic education program that is already provided.

f) Title IV, Part B – 21st Century Community Learning Centers i) Academic remediation is often funded with Title I funds and is also an allowable use of 21st Century Community Learning Centers (CCLC) funds. When a 21st CCLC grant is awarded, grantees may want to divert their Title I funds to other uses and use 21st CCLC funds for academic remediation in place of the Title I funds. This would be a supplanting issue. Using 21st CCLC funds to increase the number of students served or the scope of services offered through academic remediation would be allowable.

Time and Effort Requirements

Staff funded 100% from federal grants will be required to certify semi-annually that they have worked exclusively on the grant objectives. At the end of each semester, the business office will provide a personnel certification form and job description for the employee and his/her supervisor to sign and return. These documents will be reviewed by the Assistant Superintendent, Program Director,

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and Director of Finance. They will be retained in accordance with grant requirements in the business office.

Source: OMB Circular A-87

Where employees are expected to work solely on a single Federal award or cost objective, charges for their salaries and wages will be supported by periodic certifications that the employees worked solely on that program for the period covered by the certification. These certifications will be prepared at least semi-annually and will be signed by the employee and supervisory official having firsthand knowledge of the work performed by the employee.

Staff funded from both local and federal sources or from more than one federal source will be required to keep detailed timesheets to record the time spent on each program objective. Timesheets specific to the job duties performed will be completed at least monthly and submitted to the business office where they will be retained in accordance with grant requirements.

Source: OMB Circular A-87

Where employees work on multiple activities of cost objectives, a distribution of their salaries or wages will be supported by personnel activity reports or equivalent documentation which meets the standards in subsection (5) unless a statistical sampling system (see subsection (6)) or other substitute system has been approved by the cognizant Federal Agency.

Personnel activity reports or equivalent documentation must meet the following standards:

a) They must reflect an after the fact distribution of the actual activity of each employee, b) They must account for the total activity, for which each employee is compensated, c) They must be prepared at least monthly and must coincide with one or more pay periods, and

d) They must be signed by the employee. e) Budget estimates or other distribution percentages determined before the services are performed do not qualify as support for charges to Federal awards but may be used for interim accounting purposes.

i) Because practices vary as to the activity constituting a full workload, records may reflect categories of activities expressed as a percentage distribution of total activities. ii) All necessary adjustments must be made such that the final amount charged to the Federal award is accurate, allowable, and properly allocated.

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Contracts

All contracts must be submitted to the Superintendent’s office and approved by the Superintendent or designee, then forwarded to the Business Office for payment and filing.

Smithville ISD will use value engineering clauses in contracts for construction projects of sufficient size to offer reasonable opportunities for cost reductions. Consequently, the vendor should be carefully selected and monitored to ensure that the district receives the highest quality products and services at a fair value. When contracting for architectural and engineering services, geographic location may be a selection criterion provided its application leaves an appropriate number of qualified firms, given the nature and size of the project, to compete for the contract.

Vendor Award Criteria – Smithville ISD shall consider the following criteria, when awarding a project to a vendor.

The purchase price

The reputation of the vendor and of the vendor’s goods and services

The quality of the vendor’s goods or services

The extent to which the goods or services meet the district’s needs

The vendor’s past relationship with the district

The impact on the ability of the district to comply with laws and rules relating to historically underutilized businesses

The total long-term cost to the district to acquire the vendor’s goods or services

Any other relevant factor specifically listed in the request for bids or proposals. These factors may include vendor response time and/or compatibility of goods/products purchased with those already in use in the district.

Smithville ISD will use a time and materials type contract only after a determination that no other contract is suitable and if the contract includes a ceiling price that the contractor exceeds at its own risk. Time and materials type contract means a contract whose cost to Smithville ISD Is the sum of the actual cost of materials and the direct labor hours charged at fixed hourly rates that reflect wages, general and administrative expenses, and profit. Conflict of Interest – No employee, officer, or agent may participate in the selection, award, or administration of a contract supported by an award if he or she has a real or apparent conflict of interest. The officers, employees, and agents of the entity may neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts. If a board member or member of their immediate family has a financial interest in a business entity(s), they are required to disclose this relationship through the execution of an affidavit. Board members must abstain from voting on award of

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contracts to businesses in which they are or their immediate family members have a financial interest. Smithville ISD will disclose in writing any potential conflict to the federal awarding agency in accordance with applicable Federal awarding agency policy. All conflicts, as well as, violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affect the Federal award will be disclosed in a timely manner. Smithville ISD understands that failing to make all disclosures can result in remedies for noncompliance that include suspension and debarment.

Bonding – For construction or facility improvement contracts or subcontracts exceeding a $25,000 threshold they require payment bonds. In any construction project costing $100,000 or more they require performance bonds. Minimum bonding requirements include a bid guarantee from each bidder equivalent to five percent of the bid price. The “bid guarantee” must consist of a firm commitment such as a bid bond, certified check, or other negotiable instrument accompanying a bid as assurance that the bidder will, upon acceptance of the bid, execute such contractual documents as may be required within the time specified.

Capital Assets

Capital assets are items defined by TEA as physical items of equipment or property having an expected life longer than one year; are of a significant value at purchase; and may be reasonably identified and controlled through an inventory system. The District may also include some low-cost items for insurance purposes and because of the risk of theft as inventory in the capital asset system. Equipment and property having a per-unit cost of $5,000 or more must be coded as a capital asset. Smithville ISD will review using Federal excess and surplus property in lieu of purchasing new equipment and property whenever such use is feasible and reduces project costs.

Purchasing Capital Assets – Capital assets and inventory items are acquired through purchase and donation. Donated property must be identified, tagged, maintained, and disposed of in accordance with the state property regulations. Follow normal purchasing procedures for ordering capital asset/inventory items; however, include the room number in which the item will be located in the body of the requisition. Where appropriate, an analysis will be made of lease versus purchase alternatives, and any other appropriate analysis to determine the most economical approach. Capital Asset Inventory Tags – When capital asset items are received by the Business Office, an inventory tag with an identification number and bar code will be attached to the item. The tag identifies each inventory item, funds used for the purchase, location, original cost, description, and other required information. The Business Office tags each capital asset and inventory item upon receipt of item prior to delivery to the appropriate department. Replacement tags should be requested when needed. State law requires a property number to be affixed to

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each capital asset at all times as long as the asset is owned by the district. Any property discovered that is not on the computer listing needs to be reported to the Business Office for tracking its origination and tagging.

Property owned by an employee, which may be construed to be a capital asset or inventory item, must be tagged “personal property.” Failure to do so may result in the property being identified as a district capital asset during a property physical inventory.

All inventory purchased with federal “awards” must be identified with the name of the federal program, identification # of the award, CFDA title and number, fiscal year of the award and pass-through (if purchased through a SSA).

Accountability for Property – Each Campus Principal/Director is the designated property officer over all property assigned to his/her campus/department and directly under his/her control. Inherent with this responsibility is the authority of the Superintendent to forbid movement of property within or out of the classroom without permission and the required documentation.

Each Campus Principal/Director may designate a custodian(s) to assist in controlling property. The designated custodian(s) is required to physically inventory all district property annually and be held personally liable for property lost, damaged, or destroyed. Items not located will be replaced and charged to the campus’ budget.

When a change of custodian occurs, a current computer listing of the property charged to that division must be requested. The incoming and outgoing custodian must conduct a physical inventory of the property charged to that classroom. Any lost, damaged, or destroyed property, property needing replacement tags, and any property that might be considered for deletion must be reported to the Business Office.

Transfer of Property – If a capital asset or inventory item is to be relocated to another campus or department, complete the Capital Asset/Inventory Add/Delete Form prior to moving the items. The campus/department relocating the property must complete the transfer of property form and obtain the director’s approval signature. The receiving campus/department must review the form, assuring that the information is correct, and obtain the campus/department’s approval signature. The Capital Asset/Inventory Add/Delete Form shall then be submitted to the Business Office for updating the capital asset or inventory item records. If this process in not completed, the capital asset or inventory item remains the responsibility of the original campus/department.

Disposal of Property – The disposal methods available to the district are trade-in, sale, or deletion. Disposal of property by any other method or failure to follow procedures prescribed for these methods could result in the campus/department custodian becoming liable for financial reimbursement to the district.

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The district may offer property as a trade-in on new property of the same general type when such exchange is in the best interest of the district. The inventory number, serial number, and value of inventory must be identified prior to the item being traded. Only the Business Office may remove inventory tags.

Property may be considered for sale when items are identified as surplus property and have no useful purpose to the district at present or in the foreseeable future. If not needed as a trade-in, the following types of capital assets, which must be disposed of through sale, are:

Audio-Visual Equipment Vehicles Furniture Equipment

The preferred method of sale is an auction. The Business Office will normally manage the sale of capital assets.

Property may be removed from the capital asset records when it no longer fulfills a useful function. Property is deleted when it is lost, stolen, sold by the district, or declared “salvage”. Salvage property is an asset that through use, time, or accident is so depleted, worn out, used, or consumed that it has no value for the purpose for which it was originally intended. The property custodian must submit a Capital Asset/Inventory Add/Delete Form to the Director of Finance stating the reason for the deletion. The Business Office will inspect the property, remove inventory tags immediately after the deletion is approved, and recycle salvaged property.

Equipment purchased with Federal Funds – According to the Code of Federal Regulations, equipment shall be used by the grantee in the program or project for which it was acquired as long as needed, whether or not the project or program continues to be supported by Federal funds. The property cannot be encumbered without approval of the Federal agency or the pass-through agency. When no longer needed for the original program or project, the equipment may be used in other activities currently or previously supported by a Federal agency. The grantee shall also make equipment available for use on other projects or programs currently or previously supported by the Federal government, providing such use will not interfere with the work on the projects or program for which it was originally acquired. First preference for other use shall be given to other programs or projects supported by the awarding agency. User fees should be considered if appropriate.

When original or replacement equipment acquired under a grant or sub-grant is no longer needed for the original project or program or for other activities currently or previously supported by a Federal agency, disposition of the equipment will be made as follows:

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Items of equipment with a current per-unit fair market value of less than

$5,000 may be retained, sold, or otherwise disposed of with no further obligation to the awarding agency.

Items of equipment with a current per unit fair market value of $5,000 or greater may be retained or sold and the awarding agency shall have a right to an amount calculated by multiplying the current market value or proceeds from sale by the awarding agency’s share of the equipment.

Smithville ISD must request disposition instructions from the federal awarding agency, if required by the terms of the grant.

Cash Receipts

Proper controls must be used when collecting money. Use the following guidelines when collecting money for tuition, library fines and fees, lost books/textbooks, any type of reimbursements/revenue, or any other campus cash transactions:

A pre-numbered cash receipt must be written for all money received. A copy of the receipt should be given to the individual turning in the money

and the campus should keep a copy. All receipts should be deposited in the District’s bank account on a timely

basis. Un-deposited receipts should NEVER be used to make purchases. Send copy of deposit slip and pre-numbered cash receipt to the business office for posting.

If a cash receipt needs to be voided, the original receipt should be attached to the receipt copy and clearly marked VOID. If the original receipt is not available, the student/individual should sign the receipt copy indicating he/she received the money back.

All cash should be counted immediately upon receipt and recounted by a second individual to verify the amount.

One office staff member should prepare the deposit and another should take the deposit to the bank.

The cash receipts should be balanced to the actual amount of money received. If differences cannot be reconciled, notify the campus principal immediately.

Cash should not be taken out of receipts collected and replaced with a personal check.

Never commingle District money with money for another organization or with personal funds. A separate cash box should be used.

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Credit Cards

A VISA card from the Superintendent’s Office may be utilized to reserve hotel rooms or pay for certain registration fees when purchase orders are not accepted. Use of this card must be pre-authorized by the Superintendent or his secretary. All itemized receipts, along with the coding and approvals must be immediately submitted to the Accounts Payable Assistant in the Business Office. The employee is responsible for the security of the credit card and the transactions made with it. If these guidelines are not followed when using a credit card, the employee could receive disciplinary action, including termination.

Records Retention

Records retention ensures that critical records are identified and retained in accordance with State and Federal Guidelines. The Local Government Records Act establishes the primary requirements for records retention policies and plans. These records retention guidelines are specified in the retention schedules adopted by the State Library and Archives Commission. The schedules that pertain to school districts include:

Local Schedule GR – Records common to all governments

Local Schedule EL – Records of elections and voter registration

Local Schedule TX – Records of property taxation

Local Schedule SD – Records for public school districts

When original records are electronic and cannot be altered, there is no need to create and retain paper copies. When original records are paper, electronic versions may be substituted through the use of duplication or other forms of electronic media provided they are subject to periodic quality control reviews, provide reasonable safeguards against alterations and remain readable.

In addition, the Local Government Records Act requires the District to designate a records management officer to coordinate the District’s records management activities. The Director of Finance is the designated records management officer for SISD. A comprehensive records retention schedule may be obtained from the Business Office.

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2016-2017 Payroll Dates

ALL TIME CARDS AND ABSENTEE LOGS NEED TO BE TURNED IN ON MONDAY

Cut-off Dates Last day to submit information to Payroll

Pay Date

08/14-08/27 08/31/2016 09/09/2016

08/28-09/17 09/20/2016 09/23/2016

09/18-10/01 10/05/2016 10/10/2016

10/02-10/15 10/19/2016 10/25/2016

10/16-10/29 10/26/2016 11/10/2016

10/30-11/12 11/14/2016 11/18/2016

11/13-11/26 11/30/2016 12/09/2016

11/26-12/10 12/12/2016 12/16/2016

12/11-12/31 01/04/2017 01/10/2017

01/01-01/14 01/18/2017 01/25/2017

01/15-01/27 02/01/2017 02/10/2017

01/29-2/11 02/15/2017 02/24/2017

02/12-02/25 03/01/2017 03/10/2017

02/26-3/18 03/20/2017 03/24/2017

03/19-04/01 04/05/2017 04/10/2017

04/02-04/15 04/19/2017 04/25/2017

04/16-04/29 05/03/2017 05/10/2017

04/30-05/13 05/17/2017 05/25/2017

05/14-05/27 05/31/2017 06/09/2017

05/28-06/17 06/19/2017 06/23/2017

06/18-07/01 07/03/2017 07/10/2017

07/02-07/15 07/19/2017 07/25/2017

07/16-07/29 08/02/2017 08/10/2017

07/30-08/19 08/21/2017 08/25/2017

Note: This excludes Summer School which is paid after the completion of Summer School. SUBSTITUTES ARE PAID ACCORDING TO RECEIPT OF TIME WORKED.

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Smithville Independent School District Budget Amendment/Adjustment

Request for Budget:

Amendment

Adjustment

Date: _________________

Person Requesting Amendment / Adjustment_____________________________________________

Requires Agency Approval: YES ____ NO _____ Page _____ of _____

Fund

Func.

Class

Obj.

Sub

Obj.

Org.

Program

Description

Debit

Credit

Reason(s) for Request(s):

Campus Principal: ______________________ Director of Business: ______________________

Date: ___________________ Date: ___________________

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NAME DATE

SUBJECT / GRADE

PHONE NO.

FAX NO.

QuantityCatalog Number Unit Price Total Amount

Subtotal (All Pages) -$ Discount (% off catalog)Shipping & Handling

Total Expenditure -$

Originators Signature

Principal Approval

Fund Function Object Sub-Obj. Org. Program Amount

Director of Business Approval

Purchase Order Number

SMITHVILLE I.S.D.PURCHASE REQUISITION

PAYEE NAME & ADDRESS

Description of item requested

Complete and turn in to your campus principal.

Principal file 1 copy and forward 1 copy

to the Business Office. If disapproved, return to

originator with reasons for disapproval noted.

District Improvement Plan (DIP) and Campus Improvement Plan (CIP) Objective/Justification:

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Travel Request and PO Procedure

1. Fill out a Travel Request & PO; give it to your campus secretary to get signed approval from your campus

principal for you to attend the workshop.

2. Your campus secretary will send the Travel Request to Stacy Tiner.

3. Cheryl Burns will sign and code the Travel Request.

4. A copy of the Travel Request will be made; the original will be initialed in red ink in the top right corner and

returned to the campus secretaries.

5. The PO will be processed and Terri Harris will send the gold copy of the PO to the campus secretary.

6. You will then be responsible for registering for the workshop with the PO# by fax, mail or online.

7. You are also responsible for making hotel reservations. A PA will need to be filled out payable to hotel, if you

can pay with a check at check-in. Reminder: Get quote with NO STATE TAX (Copy of Tax Exempt form: Terri,

Campus Sec. or Business Manual on SISD Web-site). You can pay for it out of pocket and be reimbursed when

you return from the workshop (keep all itemized receipts). Meals are only paid for overnight stay (keep all

itemized receipts, NO Tips, NO Tax or Alcohol paid). Departure & Arrival time must be filled out for meal

reimbursement.

8. After you have returned from the workshop, fill out the bottom portion of the Travel Request, sign it, have it

signed by the campus principal and attach a MapQuest map(with mileage), all receipts(if applicable)and totals.

Make a copy of your certificate (keep original for your records) and attach it to the Travel Request. Give it to

your campus secretary and they will give you credit in Eduphoria for your certification records and send a copy

of the certificate with the original Travel Request to Stacy Tiner.

9. Stacy Tiner will get the Travel Request signed for payment by Cheryl Burns or Jean Ann McCarthy and give it to

Terri Harris to issue you a check (checks are printed on Thursday or Friday of each week). You can pick them up

at Central Office, we can send them over in inter-office mail, and reimbursements that are done during the

summer please indicate an address that you need it to be mailed to on the Travel Request. NOTE: You have 15

days to return the Travel Request or PA for reimbursement.

*Please refer to the Employee Business Procedures Manual for travel policies & procedures. Reference

page 12- 15 (available on SISD web-site).

Eduphoria Procedures

1. Campus secretaries will enter campus workshops into Eduphoria. Send a copy of all sign-in-sheets with

agenda/materials attached to Stacy Tiner.

2. Stacy Tiner will enter all workshops that are held outside the district.

3. Campus secretaries are responsible for collecting all certificates.

4. Campus secretaries will verify credits and grant credits in Eduphoria for all workshops when they receive the

certificates or verify signatures from sign-in sheets.

5. Campus secretaries will make a copy (for campus records) of the certificate or sign-in sheets and send to Stacy

Tiner.

6. Stacy Tiner will verify credits given in Eduphoria and close out the workshop.

7. Stacy Tiner will give the certificates to Denise Behrens to place in employee’s permanent folder or send back to

the campus secretary.

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Smithville Independent School District

Vendor Performance Report

Today’s Date: _______________________

Your Name: ___________________________________________

Campus: ___________________________

Principal’s Signature: ____________________________________

Company Name: _________________________________________________________

Purchase Order Number: ________________

Date of Purchase Order: _________________

Item/Catalog Number: ________________________________

Please Check Reason for Noncompliance:

□ Wrong Item Ordered

□ Wrong Item Shipped

□ Quality Not As Expected

□ Item Arrived Damaged

□ Item Arrived Defective

□ Other______________________________________________________

Upon receipt of three (3) notifications of Nonconforming Products/Services from vendor, the

vendor shall provide a written response to the business office. Vendor may be deleted from

vendor file for no response or an unsatisfactory response.

2016-2017

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2016-2017

Smithville Independent School District

NOTICE TO “NO BID” FORM

Dear Vendor:

Please check the appropriate box below, complete the remainder of this form and return it prior

to the scheduled date and time:

□ Our company cannot provide a quote for the line items in this request. Please move our

and address to the following category(ies) so that we may bid at a later date:

Catergory(ies):___________________________________________________________

□ We have chosen not to submit a bid at this time, but would like to remain on your list for

this bid category. We did not submit a bid because:

Reason(s): ______________________________________________________________

_______________________________________________________________________

□ Please remove our name from all Smithville Independent School District lists until

further notice.

Reason(s): ______________________________________________________________

Company Name: _______________________________________________________________

Representative: _________________________________________________________________

Address: ________________________________________________ Phone: _______________

Name of Bid and Opening Date: ___________________________________________________

PLEASE RETURN THIS FORM ONLY TO:

Authorized Signature: ___________________________________________________________

Title: ____________________________________________ Date: ___________________

Thank you for your time and assistance.

Vendors who respond to this invitation with a completed bid form will remain on our

mailing list. Vendors making no response at all will be removed from that listing.

Smithville ISD

Notice of “No-Bid”

Business Office

P.O. Box 479

Smithville, TX 78957

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Smithville Independent School District Product Information Bid Sheet

2016-2017

Date: _____________________

Department: __________________________________________

Request: _____________________________________________________________________________

Product/Part Needed For: _______________________________________________________________

Product/Part Description Including Brand Name, Model, and Quantity:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

1. Company Called: _______________________________________________

Phone Number: _____________________________

Price (To Include Delivery, Trade In’s, Etc.)

Written Quote Received: Yes____ No____ $________________________

Availability and Terms: __________________________________________________________________

2. Company Called: _______________________________________________

Phone Number: _____________________________

Price (To Include Delivery, Trade In’s, Etc.)

Written Quote Received: Yes____ No____ $________________________

Availability and Terms: __________________________________________________________________

3. Company Called: _______________________________________________

Phone Number: _____________________________

Price (To Include Delivery, Trade In’s, Etc.)

Written Quote Received: Yes____ No____ $________________________

Availability and Terms: __________________________________________________________________

Please try and get a written quote for all bids and attach them to this bid sheet.

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2016-2017

Smithville Independent School District

AFFIDAVIT OF NON-COLLUSION

By submission of this bid/proposal/quote, the undersigned certifies that:

A. This bid/proposal/quote has been independently arrived at without collusion with

any bidder or competitor;

B. This bid/proposal/quote has not been knowingly disclosed and will not be

knowingly disclosed, to any other bidder competitor or potential competitor, prior

to the opening of bids/proposals/quotes for this project;

C. No attempt has been or will be made to induce any other person, partnership or

corporation to submit or not submit a bid/proposal/quote;

D. The undersigned certifies that he/she is fully informed regarding the accuracy of

the statements contained in this certification, and that the penalties herein are

applicable to the bidder as well as to any person signing in his behalf.

___________________________________________________

Company Name

___________________________________________________

Address

___________________________________________________

City/State/Zip

___________________________________________________

Phone Number/Fax Number

___________________________________________________

Authorized Signature

___________________________________________________

Print Name/Title

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2016-2017

Smithville Independent School District

CERTIFICATE OF RESIDENCY

The State of Texas has passed a law concerning non-resident contractors. This law can be

found in the Texas Education Code under Chapter 2252, Subchapter A. This law makes it

necessary for the Smithville Independent School District to determine the residence of its

offerors. In part, this law reads as follows:

“Section: 2252.001

(3) ‘Non-resident bidder’ refers to a person who is not a resident.

(4) ‘Resident bidder’ refers to a person whose principal place of business is in this

state, including contractor whose ultimate parent company or majority owner has

its principal place of business in this state.

Section: 2252.002

A governmental entity may not award a governmental contract to a nonresident bidder

unless the nonresident underbids the lowest bid submitted by a responsible resident

bidder by an amount that is not less than the amount by which a resident bidder would be

required to underbid the nonresident bidder to obtain a comparable contract in the state in

which the nonresident’s principal place of business is located.”

I certify that

________________________________________________________

is, under Section: 2252.001 (3) and (4), a

____Resident Bidder or ____Non-resident Bidder

My/Our principal place of business under Section: 225201 (3) and (4), is in the city of

_____________________________ in the state of ______________________________.

___________________________________________

Signature of Authorized Company Representative

___________________________________________

Print Name

___________________________________________ ____________________

Title Date

38

2016-2017

Smithville Independent School District

REQUEST FOR COMPETITIVE SEALED BID/PROPOSAL COMPLIANCE FORMS

I, the undersigned for the firm named below, certify that the information concerning

notification of felony convictions has been reviewed by me and the following information

furnished is true to the best of my knowledge.

Name of Vendor: __________________________________________________

(please type or print)

Name of Company Official: _________________________________________

(please type or print)

CHECK THE FOLLOWING APPLICABLE STATEMENT AND SIGN/DATE:

___ A. My firm is a publicly held corporation; therefore, this reporting requirement is not

applicable.

___ B. My firm is not owned or operated by anyone who has been convicted of a felony.

___ C. My firm is owned or operated by the following individuals who has/have been

convicted of a felony.

Name of individual(s): ______________________________________________

Details of conviction(s): _____________________________________________

_________________________________________________________________

__________________________________ _____________

Signature of Authorized Agent Date

FELONY CONVICTION

NOTIFICATION

State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states

“a person or business entity that enters into a contract with a school district must give advance notice to the district

if the person or owner or operator of the business entity has been convicted of a felony.” The notice must include a

general description of the conduct resulting in the conviction of a felony.

Subsection (b) states “a school district may terminate a contract with a person or business entity if the district

determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented

the conduct resulting in the conviction. The district must compensate the person or business entity for services

performed before the termination of the contract.

This notice is not required of a publicly help corporation.

39

VEN Vendor

D Mo. Da. Yr. Number

OR

Fund Func Object/Sub Ob Org Inv#

Director of Business Approval:Approved by:

Check

Number

List District Improvement Plan(DIP) or Campus Improvement Plan(CIP) Objective/Justification:Total

Description

Date

Payment Authorization(Sign and Attach invoice)

Smithville Independent School District

Tax I.D. # 74-6002323

Prog

Prepared by:

Disbursement Amount

40

2016-2017

Smithville Independent School District

Confirmation of Sole Source Compliance by Vendor

The Texas Education Code Subchapter B., Sec. 44.031 provides for the purchase of an item that

is available from a sole source. Subsection (j) and (k) from the Texas Education Code

Subchapter B., Sec. 44.031 define a sole source.

Subsection (j)

Without complying with Subsection (a), a school district may purchase an item that is available

from only one source, including:

1. an item for which competition is precluded because of the existence of a patent,

copyright, secret process, or monopoly;

2. a film, manuscript, or book;

3. a utility service, including electricity, gas or water; and

4. a captive replacement part or component for equipment

Subsection (k)

The exceptions provided by Subsection (j) do not apply to mainframe data-processing equipment

and peripheral attachments with a single-item purchase price in excess of $15,000.

I, _________________________, an authorized representative of ________________________.

(Representative’s Name) (Company Name)

have carefully reviewed the Texas Education Code Subchapter B., Sec. 44.031 and hereby

certify that we meet and comply with Subsections (j) and (k) of the aforementioned code for the

sale of the following products. No one else produces our materials and we are the exclusive

distributor of these listed products.

Product listing (attach additional pages if necessary): ___________________________________

______________________________________________________________________________

________________________________ is claiming sole source status based on the following:

(Company Name)

Please check at least one:

□ an item for which competition is precluded because of the existence of a patent,

copyright, secret process, or monopoly

□ a film, manuscript, or book

□ a utility service, including electricity, gas or water

□ a captive replacement part or component for equipment

Vendor Representative Signature Title Date

Vendor Address City/State/Zip Code Telephone Number

41

42

43

44

2016-2017

SUPPLY REQUISTION FORM

Campus_________________________________________________ Date______________

Program_____________________________________________________________________________ (Office, Regular Class, G/T, ESL, Athletics, etc.)

____________________________________________ Signature Central Office Use Only # of items Description of item Unit Price Total Price _______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

_______ ____________________________________________ _________ _________

____________________________________________ Items Delivered _________

Principal Approval Items Ordered_________

45

Smithville Independent School District Travel Request/Expense Reimbursement Form

Name: __________________________________ Campus: ___________________ Vendor #: ____________

Travel Request (PREAPPROVAL IS REQUIRED IN ADVANCE OF REGISTRATION)

Please check the appropriate box that applies to your travel request

Staff Development Student Supervision Travel

Title of Workshop: ___________________________________ Workshop Number: ___________________________

CIP/DIP Goal: ___________________________________________________________________________________

Location of Workshop/Convention: __________________________________________________________________

Date of Workshop/Convention: _________________________ Content Area: ________________________________

Number of Clock Hours of Training in the Workshop: ___________________________________________________

List attendees not receiving mileage reimbursement:_____________________________________________________

Estimated Expenses: _________________________________________________

Miles _____________X .54 = _____________

Meals (Overnight Stay Required - $46/day Maximum at $11.00, $12.00, $23.00): ______________________________

Hotel ($85/night Maximum – Unless Authorized by Asst. Supt. or Designee):_________________________________

Registration Fee: _________________________________________________________________________________

Employee Signature: ________________________________Date: ________________

Supervisor’s Signature: _____________________________Date: ________________

Asst. Superintendent/Designee Signature: ____________________________________ Date: ________________

*Reimbursement is subject to review in accordance with the Business Manual.

Travel Reimbursement (TO BE SUBMITTED WITHIN 15 DAYS AFTER COMPLETION OF TRAVEL)

Departure Date: _____________ Time: __________ Destination: ____________________ Arrival Time: ___________

Return Departure Date: __________ Time: _________ Arrival Time: __________

Expenses Accrued:

Attach MapQuest: Total Miles____________ X .54 = ______________

Meals (must attach itemized receipts): ___________________ (taxes are not reimbursable)

Hotels (must attach itemized receipts): ________________________________________________________________

Registration fee (Complete only if not paid in advance. Must attach receipt): _________________________________

Other Expenses (please itemize and attach receipts): _____________________________________________________

Employee Signature: ________________________________Date: ________________

Supervisor’s Signature: _____________________________Date: ________________

Asst. Superintendent/Designee Signature: ____________________________________ Date: ________________

Budget Code: _____________________________________________ Total Cost: ____________________

Credit Type: □ Campus □ SPED □ ESL □ CTE □ GT-6hr □ GT-30hr □ SBEC/CE □Title I □ Title II □ HQ

(2016-2017 School Year)

46

Travel Request and PO Procedure

1. Fill out a Travel Request & PO; give it to your campus secretary to get signed approval from your campus

principal for you to attend the workshop.

2. Your campus secretary will send the Travel Request to Stacy Tiner.

3. Cheryl Burns will sign and code the Travel Request.

4. A copy of the Travel Request will be made; the original will be initialed in red ink in the top right corner and

returned to the campus secretaries.

5. The PO will be processed and Terri Harris will send the gold copy of the PO to the campus secretary.

6. You will then be responsible for registering for the workshop with the PO# by fax, mail or online.

7. You are also responsible for making hotel reservations. A PA will need to be filled out payable to hotel, if you

can pay with a check at check-in. Reminder: Get quote with NO STATE TAX (Copy of Tax Exempt form: Terri,

Campus Sec. or Business Manual on SISD Web-site). You can pay for it out of pocket and be reimbursed when

you return from the workshop (keep all itemized receipts). Meals are only paid for overnight stay (keep all

itemized receipts, NO Tips, NO Tax or Alcohol paid). Departure & Arrival time must be filled out for meal

reimbursement.

8. After you have returned from the workshop, fill out the bottom portion of the Travel Request, sign it, have it

signed by the campus principal and attach a MapQuest map(with mileage), all receipts(if applicable)and totals.

Make a copy of your certificate (keep original for your records) and attach it to the Travel Request. Give it to

your campus secretary and they will give you credit in Eduphoria for your certification records and send a copy

of the certificate with the original Travel Request to Stacy Tiner.

9. Stacy Tiner will get the Travel Request signed for payment by Cheryl Burns or Jean Ann McCarthy and give it to

Terri Harris to issue you a check (checks are printed on Thursday or Friday of each week). You can pick them up

at Central Office, we can send them over in inter-office mail, and reimbursements that are done during the

summer please indicate an address that you need it to be mailed to on the Travel Request. NOTE: You have 15

days to return the Travel Request or PA for reimbursement.

*Please refer to the Employee Business Procedures Manual for travel policies & procedures. Reference

page 12- 15 (available on SISD web-site).

Eduphoria Procedures

1. Campus secretaries will enter campus workshops into Eduphoria. Send a copy of all sign-in-sheets with

agenda/materials attached to Stacy Tiner.

2. Stacy Tiner will enter all workshops that are held outside the district.

3. Campus secretaries are responsible for collecting all certificates.

4. Campus secretaries will verify credits and grant credits in Eduphoria for all workshops when they receive the

certificates or verify signatures from sign-in sheets.

5. Campus secretaries will make a copy (for campus records) of the certificate or sign-in sheets and send to Stacy

Tiner.

6. Stacy Tiner will verify credits given in Eduphoria and close out the workshop.

7. Stacy Tiner will give the certificates to Denise Behrens to place in employee’s permanent folder or send back to

the campus secretary.

47

Smithville Independent School District Mileage Record

Name: _________________________________________ Employee#________ Home Address: ___________________________________ Department/Campus Location: _______________________

Date Campus/Location Reason Total Miles

Budget Code:

Total Miles X .54 per mile

Employee Signature:_________________________ Date:____________ Principal/Administrator: ______________________ Date: ____________ Director of Business & Finance:_______________________ Date: ____________ 2016-2017

48

Smithville Independent School District Capital Asset/Inventory Item Add/Delete Form

This form is to be completed and sent to the Business Office when you are changing

the status of one or more items on your Fixed Assets listing.

Campus: Date:

1.) Complete

Tag # Serial # Description:

Tag # Serial # Description:

Tag # Serial # Description:

Tag # Serial # Description:

Tag # Serial # Description:

For untagged furniture, give quantity , and describe

2.) Check appropriate reason(s)

Add

________:Location change from ٱ Gift (attach documentation) ٱ

Delete

______________:Location change to ٱ Burglary ٱ To be sent to warehouse as surplus ٱ Trade-in ٱ No ٱ Yes ٱ ?Other (explain): ______________ Does it work ٱ ___________________________ ___________________________

3.) Was the item(s) purchased with federal dollars (i.e. grant)? ٱ Yes ٱ No Authorized Signature Transferring Assets Authorized Signature Receiving Assets

Business Office: Warehouse: Changes have been made on the FA System: Item(s) has been picked up from above

location:

Bus.Off. Signature Date Maintenance Signature Date

49

2016-2017

Smithville Independent School District

School Property Disposition Form

1) TYPE OF DISPOSITION

□ Sale, Trade, Exchange, or Gift of Land and/or Building(s)

□ Demolition of Building(s)

□ Equipment or other Personal Property

□ Other, please explain briefly:

__________________________________________________________________

__________________________________________________________________

2) REASONS FOR DISPOSING OF THIS PROPERTY:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

3) PROPOSED METHOD OF DISPOSITION:

□ Public Auction

□ Solicitation of sealed bids

□ Other: ____________________________________________________________

4) Provide a complete and detailed description of the property. If more room is necessary,

additional pages may be used to clearly explain the descriptions below:

Date of original acquisition. Approximate if you do not have the exact date.

Original Cost: _________________________________________

Current Resale or Market Value: __________________________

Description of equipment and/or Personal Property:

Year Manufactured: ___________________

Model: ______________________________

Serial Number: _______________________

Mileage: ____________________________

Other Characteristics: ________________________________________________

Federal Purchase: Yes No

Legal Description of Real Property ___________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Business Office Signature________________________________________ Date__________________ Superintendent Signature________________________________________ Date _________________

50

SMITHVILLE INDEPENDENT SCHOOL DISTRICT MULTIPLE RECEIPT FORM

Purpose: Documentation for monies collected from individual students in the SISD organization.

The SISD sponsor may choose to submit their own record if all requested information is provided. The Sponsor shall total, sign, and date the form. The money count box

should be completed.

Account Name ______________________________________

Funds Collected for the event of: _____________________________________________

NAME DATE TOTAL AMOUNT

CASH CHECK

TOTAL $______________________ Money Count (to be completed by sponsor

___________________________________ Sponsor Signature Date

___________________________________ Witness Name

Checks Quarters

$100s Dimes

$50s Nickels

$20s Pennies

$10s Other

$5s

$1s Total $

51

Revised 11/30/2015Form provided by Texas Ethics Commission www.ethics.state.tx.us

FORM CIQ

OFFICE USE ONLYThis questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.

This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor whohas a business relationship as defined by Section 176.001(1-a) with a local governmental entity and thevendor meets requirements under Section 176.006(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not laterthan the 7th business day after the date the vendor becomes aware of facts that require the statement to befiled. See Section 176.006(a-1), Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. Anoffense under this section is a misdemeanor.

CONFLICT OF INTEREST QUESTIONNAIREFor vendor doing business with local governmental entity

Date Received

A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,other than investment income, from the vendor?

Yes No

B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the directionof the local government officer or a family member of the officer AND the taxable income is not received from thelocal governmental entity?

Yes No

7

Check this box if the vendor has given the local government officer or a family member of the officer one or more giftsas described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).

Signature of vendor doing business with the governmental entity Date

Name of vendor who has a business relationship with local governmental entity.1

Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated

completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which

you became aware that the originally filed questionnaire was incomplete or inaccurate.)

2

3 Name of local government officer about whom the information is being disclosed.

Name of Officer

Describe each employment or other business relationship with the local government officer, or a family member of theofficer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.Complete subparts A and B for each employment or business relationship described. Attach additional pages to this FormCIQ as necessary.

4

6

5Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation orother business entity with respect to which the local government officer serves as an officer or director, or holds an

ownership interest of one percent or more.

52

Revised 11/30/2015Form provided by Texas Ethics Commission www.ethics.state.tx.us

CONFLICT OF INTEREST QUESTIONNAIRE

For vendor doing business with local governmental entity

A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.

Local Government Code § 176.001(1-a): "Business relationship" means a connection between two or more partiesbased on commercial activity of one of the parties. The term does not include a connection based on:

(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or anagency of a federal, state, or local governmental entity;(B) a transaction conducted at a price and subject to terms available to the public; or(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency andthat is subject to regular examination by, and reporting to, that agency.

Local Government Code § 176.003(a)(2)(A) and (B):(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:

***(2) the vendor:

(A) has an employment or other business relationship with the local government officer or afamily member of the officer that results in the officer or family member receiving taxableincome, other than investment income, that exceeds $2,500 during the 12-month periodpreceding the date that the officer becomes aware that

(i) a contract between the local governmental entity and vendor has been executed;or(ii) the local governmental entity is considering entering into a contract with thevendor;

(B) has given to the local government officer or a family member of the officer one or more giftsthat have an aggregate value of more than $100 in the 12-month period preceding the date theofficer becomes aware that:

(i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor.

Local Government Code § 176.006(a) and (a-1)(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationshipwith a local governmental entity and:

(1) has an employment or other business relationship with a local government officer of that localgovernmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);(2) has given a local government officer of that local governmental entity, or a family member of theofficer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding anygift described by Section 176.003(a-1); or

(3) has a family relationship with a local government officer of that local governmental entity.(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administratornot later than the seventh business day after the later of: (1) the date that the vendor:

(A) begins discussions or negotiations to enter into a contract with the local governmentalentity; or(B) submits to the local governmental entity an application, response to a request for proposalsor bids, correspondence, or another writing related to a potential contract with the localgovernmental entity; or

(2) the date the vendor becomes aware:(A) of an employment or other business relationship with a local government officer, or afamily member of the officer, described by Subsection (a);(B) that the vendor has given one or more gifts described by Subsection (a); or(C) of a family relationship with a local government officer.

53

Revised 11/30/2015Form provided by Texas Ethics Commission www.ethics.state.tx.us

FORM CIS

Name of Local Government Officer

This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.

This is the notice to the appropriate local governmental entity that the following localgovernment officer has become aware of facts that require the officer to file this statementin accordance with Chapter 176, Local Government Code.

LOCAL GOVERNMENT OFFICERCONFLICTS DISCLOSURE STATEMENT (Instructions for completing and filing this form are provided on the next page.)

Office Held

Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code

Description of the nature and extent of each employment or other business relationship and each family relationshipwith vendor named in item 3.

Title of officer administering oathPrinted name of officer administering oathSignature of officer administering oath

AFFIX NOTARY STAMP / SEAL ABOVE

Sworn to and subscribed before me, by the said _______________________________________________, this the ______________ day

of ________________, 20 _______ , to certify which, witness my hand and seal of office.

AFFIDAVITI swear under penalty of perjury that the above statement is true and correct. I acknowledge

that the disclosure applies to each family member (as defined by Section 176.001(2), Local

Government Code) of this local government officer. I also acknowledge that this statement

covers the 12-month period described by Section 176.003(a)(2)(B), Local Government Code.

Signature of Local Government Officer

Date Gift Accepted ____________ Description of Gift _________________________________________________

(attach additional forms as necessary)

List gifts accepted by the local government officer and any family member, if aggregate value of the gifts acceptedfrom vendor named in item 3 exceeds $100 during the 12-month period described by Section 176.003(a)(2)(B).

Date Gift Accepted ____________ Description of Gift _________________________________________________

4

5

2

3

1

6

OFFICE USE ONLOFFICE USE ONLOFFICE USE ONLOFFICE USE ONLOFFICE USE ONLYYYYY

Date Received

Date Gift Accepted ____________ Description of Gift _________________________________________________

54

Revised 11/30/2015Form provided by Texas Ethics Commission www.ethics.state.tx.us

LOCAL GOVERNMENT OFFICER CONFLICTS DISCLOSURE STATEMENT

Section 176.003 of the Local Government Code requires certain local government officers to file this form. A "localgovernment officer" is defined as a member of the governing body of a local governmental entity; a director, superintendent,administrator, president, or other person designated as the executive officer of a local governmental entity; or an agent ofa local governmental entity who exercises discretion in the planning, recommending, selecting, or contracting of a vendor.This form is required to be filed with the records administrator of the local governmental entity not later than 5 p.m. on theseventh business day after the date on which the officer becomes aware of the facts that require the filing of this statement.

A local government officer commits an offense if the officer knowingly violates Section 176.003, Local Government Code.An offense under this section is a misdemeanor.

Refer to chapter 176 of the Local Government Code for detailed information regarding the requirement to file this form.

INSTRUCTIONS FOR COMPLETING THIS FORM

The following numbers correspond to the numbered boxes on the other side.

1. Name of Local Government Officer. Enter the name of the local government officer filing this statement.

2. Office Held. Enter the name of the office held by the local government officer filing this statement.

3. Name of vendor described by Sections 176.001(7) and 176.003(a), Local Government Code. Enter the name ofthe vendor described by Section 176.001(7), Local Government Code, if the vendor: a) has an employment or otherbusiness relationship with the local government officer or a family member of the officer as described by Section176.003(a)(2)(A), Local Government Code; b) has given to the local government officer or a family member of the officerone or more gifts as described by Section 176.003(a)(2)(B), Local Government Code; or c) has a family relationship withthe local government officer as defined by Section 176.001(2-a), Local Government Code.

4. Description of the nature and extent of each employment or other business relationship and each familyrelationship with vendor named in item 3. Describe the nature and extent of the employment or other businessrelationship the vendor has with the local government officer or a family member of the officer as described by Section176.003(a)(2)(A), Local Government Code, and each family relationship the vendor has with the local government officeras defined by Section 176.001(2-a), Local Government Code.

5. List gifts accepted, if the aggregate value of the gifts accepted from vendor named in item 3 exceeds $100.List gifts accepted during the 12-month period (described by Section 176.003(a)(2)(B), Local Government Code) by thelocal government officer or family member of the officer from the vendor named in item 3 that in the aggregate exceed $100in value.

6. Affidavit. Signature of local government officer.

Local Government Code § 176.001(2-a): “Family relationship” means a relationship between a person and anotherperson within the third degree by consanguinity or the second degree by affinity, as those terms are defined by SubchapterB, Chapter 573, Government Code.

Local Government Code § 176.003(a)(2)(A):(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:

***(2) the vendor:

(A) has an employment or other business relationship with the local government officer or afamily member of the officer that results in the officer or family member receiving taxable income,other than investment income, that exceeds $2,500 during the 12-month period preceding thedate that the officer becomes aware that:

(i) a contract between the local governmental entity and vendor has been executed; or(ii) the local governmental entity is considering entering into a contract with the vendor.

55