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["LPA Subrecipient - De minimis Rate MTDC Invoice - (Agreement Options # 2 or # 3)"]
[]
["Enter data in the yellow highlighted cells and the formulas in the worksheet will calculate the totals."]
["LPA Name",{"$nulls":3},"PID Number"]
[null,"For Work Performed by the LPA Beginning date:"]
[null,"Ending date:"]
[]
["Line #","Calculate Allocable Fringe Benefits Cost","Notes"]
[1,"Direct Labor Costs for the period *","enter costs","$"]
[2,"Approved Fringe Benefits Rate **","enter fringe benefits rate","%"]
[3,"Allocable Fringe Benefits Costs","calculated costs","$",{"$f":"IF(E10>0,E9*E10,0)","v":0}]
[null,"Calculate Allocable Modified Total Direct Costs"]
[4,"Direct Labor Costs for the period *","copied from line 1","$",{"$f":"E9","v":0}]
[5,"Allocable Fringe Benefits Costs","copied from line 3","$",{"$f":"E11","v":0}]
[6,"Project Direct Materials *  & ***","enter costs","$"]
[7,"Project Direct Supplies * & ***","enter costs","$"]
[8,"Project Direct Services * & ***","enter costs","$"]
[9,"Project Direct Travel * & ***","enter costs","$"]
[10,"Total Modified Direct Costs (MTDC)","calculated costs","$",{"$f":"SUM(E13:E18)","v":0}]
[11,"De Minimis Indirect Cost Rate","10% of MTDC","%",{"v":0.1,"d":"10%"}]
[12,"De Minimis Indirect Costs","calculated costs","$",{"$f":"E19*E20","v":0}]
[null,"Summary Section"]
[13,"Direct Labor Costs for the period *","copied from line 1","$",{"$f":"E9","v":0}]
[14,"Allocable Fringe Benefits Costs","copied from line 3","$",{"$f":"E11","v":0}]
[15,"De Minimis Indirect Costs","copied from line 12","$",{"$f":"E21","v":0}]
[16,"Other Project Direct MTDC Costs *","sum of lines 6 - 9","$",{"$f":"SUM(E15:E18)","v":0}]
[17,"Total Allocable Costs for Period","sum of lines 13 - 16","$",{"$f":"SUM(E23:E26)","v":0}]
[]
["Notes:"]
["* Applicable documentation to support the costs claimed must be submitted with the invoice."]
["** Any applied fringe benefit rate must be the rate approved by ODOT for application when the labor costs were paid."]
["*** Project Direct Materials, Supplies, Services, and Travel costs eligible for inclusion in MTDC are those nominal costs that originate within the LPA subrecipient entity and DO NOT include project costs that originate with construction contractors, construction material suppliers, architectural engineering and design firms, and other contractors as costs of that nature are classified as \"Capital Expenditures\", and by definition, excluded from MTDC. [see 2 CFR §200.68)]"]
["Cost Recovery method applied when submitting invoices must match the option selected in the LPA Agreement."]
["The direct labor costs entered on line 1 are calculated using the employee's base labor rate multiplied by the number of hours worked and may include overtime wages, but DO NOT include any employee paid leave or other employee fringe benefit costs."]
["By claiming the labor costs as allocable direct labor costs for the project, the LPA certifies that it maintains support for project direct labor costs in compliance with 2 CFR §200.430."]
["Standards for Documentation of Personnel Expenses  [see 2 CFR §200.430(i)]"]
["(1) Charges to Federal awards for salaries and wages must be based on records that accurately reflect the work performed. These records must:"]
["(i) Be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated;"]
["(ii) Be incorporated into the official records of the non-Federal entity;"]
["(iii) Reasonably reflect the total activity for which the employee is compensated by the non-Federal entity, not exceeding 100% of compensated activities . . . ;"]
["(iv) Encompass both federally assisted and all other activities compensated by the non-Federal entity on an integrated basis, but may include the use of subsidiary records as defined in the non-Federal entity's written policy;"]
["(v) Comply with the established accounting policies and practices of the non-Federal entity . . . ; and"]
["(vi) [Reserved]"]
["(vii) Support the distribution of the employee's salary or wages among specific activities or cost objectives if the employee works on more than one Federal award; a Federal award and non-Federal award; an indirect cost activity and a direct cost activity; two or more indirect activities which are allocated using different allocation bases; or an unallowable activity and a direct or indirect cost activity."]
[]
["The information entered into this form and the resulting totals calculated have been confirmed by the LPA subrecipient and are hereby certified as being accurate and complete as evidenced by the approval signature entered below."]
[]
[]
["Engineer's Signature",null,null,"Typed Date"]
[]
[]
["Engineer's Typed Name"]