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Audit - 2004 Cert. of Achievement CERTIFICATE OF ACHIEVEMENT FOR EXCELLENCE IN FINANCIAL REPORTING PROGRAM Participant Application (Please type or print) roP'l Section I: Government Information: Three copies of this completed application, three copies of the government unit's comprehensive annual financial report (CAFR) and the appropriate fee should be sent (postmarked) to GFOA within six months of the government unit's fiscal year end. In addition, if the CAFR was submitted to the program in the immediate prior year, please include three copies of the government unit's responses to the comments and suggestions for improvement and any other correspondence that may assist the program with the current year's review. This information will be sent to Special Review Committee (SRC) members to assist them in their review. The official requesting the review will receive the results upon completion of the review process. Note: This application includes preprinted information for questions I through 6. If this is the application you send with your next submission, simply update the information on the preprinted application, as necessary, and complete all of the other information for Sections I through VII of the application. Alternatively, you may complete a new application for each submission to the program (visit the "Forms" section ofGFOA's website, www.gfoa.org, to download a copy). If you have any questions contact us at: cafrprogram@gfoaorg or call the Technical Services Center at (312) 977-9700. I. Name of Unit City of Salina 2. Fiscal Year Ended (month, day, year) 12/31/04 3. Is the government unit a previous participant in the Certificate of Achievement Program? Yes a. What was the most recent year? 2003, and b. What was the report number which appeared in the upper left-hand comer of the government's "Summary of Grading" 3,250.00 4. Official Requesting Review (receives notification of results, detailed comments and suggestions for improvement, the Award for Financial Reporting Achievement(AFRA), a press release, information regarding presentation by a GFOA State Representative and the Certificate of Achievement plaque). A street address is required for shipment of the plaque. Name: Rodney Franz Phone: 785/309-5735 Fax: Title: Director of Finance & Administration E-Mail: rod. franz@sa 1 i na. org Results Address I: P.O. Box 736 Results Address 2: City: Salina State: KS Zip: 67402-0736 Plaque Address I: 300 West Ash, Suite 206 Plaque Address 2: City: Salina State: KS Zip: 67402-0736 5. If the government unit is awarded a Certificate of Achievement for Excellence in Financial Reporting, the Award of Financial Reporting Achievement (AFRA) will be prepared for the individual or department noted below as being primarily responsible for the unit's success in earning the certificate. Rodney Franz, Director of Finance & Administration 6. If the submission qualifies for the Certificate of Achievement for Excellence in Financial Reporting, whom (mayor, board chair, etc.) should GFOA send a formal announcement of the award and a related press release Name:-Dennis-M:~sstRgeF-- Jason A. Gage Title: City Manager Address I: 300 West Ash, Suite 206 Address 2: City: Salina State: KS Zip: 67402-0736 E-mail: 7. For municipalities (e.g., cities, townships, villages and counties, please provide your population figure. For school districts, please provide your total student enrollment figure 45,969 lemA u.. Only, Date, Check #: Amount: I Section I: Government Information (Continued): 8. To support the GFOA's recent recommended practice titled Using Websites to Improve Access to Budget Documents and Financial Reports *, the GFOA will provide a link to CAFRs that are available on a government's website. Does your entity follow this recommendation and publish its CAFR on its website? Yes No (circle one) If yes, please provide the direct hyperlink address to the CAFR document (rather than your government's general home page information) below: http://www. This link will be on the list of award winners of the Certificate of Achievement for Excellence in Financial Reporting that can be found in the "Awards program" area ofGFOA's website, www.gfoa.org. (*Please refer to the recommended practices area of the GFOA's website. www.gfoa.org.forthefull text of the recommendation). Section II: Audit Information: Agency or Firm Name: Contact name (optional): Street Address: Phone: 785-749-5050 City: Lawrence Lowenthal, Sinqleton, Webb & Wilson Thomas E. Sinqleton. CPA 900 Massachusetts. Suite 301 E-mail: State: KS Zip Code: 66044 Section III: Fee Calculation: Is the fee calculation based on the government unit's implementation of GASB Statement No 34, Basic Financial Statements-and Management's Discussion and Analysis-for State and Local Governments?@No (circle one) If not, use the amounts from the General Purpose Financial Statements(GPFS) that correspond to the applicable items below. * Total revenues from the governmental funds Statement of revenues, expenditures and changes in fund balances (exclude other financing sources) * Total expenses from the proprietary funds Statement of revenues, expenses and changes in net assets/fund equity * Total additions from the fiduciary funds Statement of changes in fiduciary net assets (if total additions are negative, use the total amount of contributions from all sources) * Total program revenues of discretely presented component units from the governmen~wide Statement of activities * If applicable, total revenues reported for discretely presented component units and not-for-profit organizations reported on a separate operating statemen(s) or statement(s) of activity $ 23,648,957 $ 16,106,666 $ $ 2.924.497 $ TOTAL $ 42,678,120 If you have not already paid for this review, please include a check payable to the GFOA with this application form or provide the following information if you wish to pay by credit card Credit card type: Signature (mandatory): Account number: Expiration date (mandatory): Use the following schedule to determine the appropriate fee based on the TOTAL calculated above. Member rates apply if a govemmentjoins GFOA at the time of their submission(in this case indicate below that the government is a GFOA membei). TOTAL GFOA Member Nonmember $1-10 million $ 960 350 $ 700 $50- 100 million $250-500 million $ 690 $750 million - $1 billion $ 965 Name of the government as it is listed in our membership database City of Salina We show that your government is amember and your account number is 194523005 Name of unit: City of Salina (as a reference for SRC reviewers) Section IV: Fund Information: Indicate below how many individual funds of each generic fund type for which the primary government reports operations anlbr balances (including the funds of blended component units and component units that are fiduciary in natur~ and how many discretely presented component units the government-wide statements report at year end (if GASB 34 has not been implemented include the total number of discretely presented component units from all general purpose financial statement$. Also, indicate the number of individual funds of each generic fund type with legally adopted annual budgets. Fund Tvpe Number of Funds and Discretely Presented Component Units Number of Funds with Legally Adopted Annual Budgets Primary Government Revenue Pension Trust Trust Other (apply only ifGASB 34 has not been im lemented): Nonexpendable Trust Discretely Presented Component Units: Other (e.g., nongovernmental entities Section V: Pension Information: Indicate below the individual pension plans in which the government unit participates or with which it is otherwise connected (e.g., contributions made on behalf of employees by another governmen) and indicate the type of plan (see GASB Statement 27, Para. 8, 19,28 and 39 for guidance). Also, indicate whether the government unit includes a pension trust fund in its CAFR to report the individual pension plan. For the separate report of a Public Employee Retirement System (PERS) list the individual pension plans reported by the PERS. Pension Plan Multiple Employer Defined Benefit Plans Cost Sharing Agent Single Employer Dermed Benefit Plans Defined Contribution Special Funding Situations (GASBS 27, Paragraph 28) Reported as a Pension Trust Fund? Yes or No I ~ KPERS x a) b) c) d) e) f) g) Section VI: Displav and Disclosure Questions: Please answer each of the following questions by circling the appropriate response. Your answers will assist the SRC in determining whether the item addressed by the question is properly displayed or disclosed in the CAFR. Comments and suggestions for improvement will be issued to your government unit if discrepancies are noted between the information presented in the CAFR and the answers to these questions (Note: The following questions are in order by when a question relating to the topic first appears on theGenera/ Purpose Checklist.) All Questions are Applicable to Material Items Only. 1. Does the government unit have any debt that is being repaid by special assessments? G) No N/A If yes: G;J a. Is the government unit obligated in some manner for all or a portion of the debt? No N/A b. Is the government unit not obligated in any manner for the debt? Yes @ N/A 2. Has the government unit given or received a capital contribution in connection with a @ public entity risk pool? Yes N/A If yes: ~ a. Does the pool actually pool or transfer the risks of participants? Yes No b. Is the return ofthe contribution probable? Yes No 3. Did the government unit engage in securities lending transactions during the year? Yes c5J N/A 4. Did the government unit engage in any reverse repurchase agreements during the year? Yes ~ N/A 5. During the year, has the government unit or its component units engaged in any G) refunding(s) of debt that resulted in the defeasance or redemption of debt? No N/A If yes: Cj;) a. Did the transaction(s) take place in a fund that uses governmental fund accounting? No N/A b. Did the transaction(s) take place in a fund that uses proprietary fund accounting? Yes No N/A c. Did the transaction(s) take place in a discretely presented component unit? Yes No N/A 6. Is the government retaining risk(i.e., "self-insurance")? ~ No N/A If yes: a. Please identify the fun<Xs) used to report this activity: Risk Mngmt, Employee Hea lth , Worker1s Comp 7. Does the government unit own or operate a municipal solid waste landfill where it is required by federal, state, or local law or regulation to incur closure and postclosure care costs? G 8. Does the government unit sponsor an arrangement that commingles(pools) the resources of legally separate entities that are not part of the same financial reporting entity as the sponsoring government and invests those resources on behalf of the participants in an investment portfolio? Yes If yes, a. Is a separate fmancial report issued for the pool? Yes 9. Is the government unit included in the reporting entity of another governmental unit(e.g., as a department, enterprise fund, fiduciary fund, or component uniO? Yes If yes: a. Is this government unit reported either I) in one or more separate funds within the primary government, or2) as a discretely presented component unit in that government's CAFR? Yes No N/A c;s N/A No @ G) N/A No @ 10. Which option does the government unit use for its enterprise funds(and business-type activities, if applicable)? ~ Apply only F ASB Statements and Interpretations, Accounting Principles Board Opinions and Accounting Research Bulletins Issued on or before November 30, 1989, unless they conflict with or contradict GASB Pronouncements(GASBS 20, Paragraph 6). List relevant funds ifboth options are used Section VI: Displav and Disclosure Questions (Continued): Option 2: Also apply all F ASB Statements and Interpretations issued after November 30, 1989, except for those that conflict with or contradict GASB pronouncements (GASBS 20, Paragraph 7). List relevant funds if both options are used II. As of the end of the fiscal period, did the government have uninsured deposits that were 1) uncollateralized, 2) collateralized with securities held by the pledging financial institution, or 3) collateralized with securities held by the pledging financial institution's trust department or (9 agent but not in the depositor-government's name? Yes N/A 12. As of the end of the fiscal period, did the government have investments evidenced by securities that were neither insured nor registered and that were held by either 1) the counterparty, 2) the ~ counterparty's trust department or agent but not in the government's name? Yes N/A 13. As of the end of the fiscal period, is the government party to a derivative that is not reported ~ at fair value on the face of the financial statements? Yes N/A 14. Did any significant subsequent events occur after the balance sheet date but before the date of the auditor's report (e.g., debt issuances or settlements of litigation)? Yes ~ N/A 15. Has the government unit violated any finance-related legal or contractual provisions? Yes No N/A 16. Is the government unit a lessee in an operating lease? Yes ~ N/A If so, c;;;;;) a. Are any of the agreements noncancelable? Yes No b. Do any of the agreements have scheduled rent increases? Yes No ~ 17. Is the government unit a lessor in an operating lease? Ifso, Yes (3) N/A If so, ~ a. Are any ofthe agreements noncancelable? Yes No b. Do any of the agreements have scheduled rent increases? Yes No 18. Does the government unit have any construction commitments outstanding at year end? @ No N/A 19. Does the government unit sponsor and include as part of its fmancial reporting entity a public entity risk pool that provides coverage to units outside the government unit's financial (3) reporting entity? Yes N/A 20. Did the government engage in short-term debt activity during the year (e.g., anticipation notes, use of lines of credit), even if no short-term debt was outstanding at the beginning or 6) end of the year? No N/A 21. Did the government unit engage in transactions with any related parties? Yes (9 N/A 22. Is the government unit a participant in one or more joint ventures? ~ No N/A If yes: @ a. are any of these joint ventures reported as component units of this government unit? Yes N/A If no: b. does this government unit have an equity interest in the joint venture that it reports in ~ 1. Governmental funds? Yes N/A 2. Proprietary funds? Yes N/A 23. Does the government unit pay all or a portion of the cost of post employment benefits other than G;) pension benefits (OPEB) for employees? No N/A If yes: ~ a. Are the OPEB provided through a pension plan? Yes N/A If yes: b. Are any OPEB healthcare benefits provided through a pension plan that is reported as a @ pension trust fund by this government? Yes N/A Section VI: Displav and Disclosure Questions (Continued): 24. Has another entity made on-behalf payments for fringe benefits and salaries(e.g., pension con- tributions, health and life insurance premiums, and salary supplement$ to a third party recipient for the government unit's employees? Yes e N/A & Yes. No N/A 25. Has the government issued debt in its name for which it is not liable in any manner(Le., conduit or no commitment debt) and where the debt is not reported as a liability in the financial statements? 26. If separately issued financial statements are not available for any individual discretely presented component unit, does the CAFR include fund information for that component unit(Le., fund financial statements with major funds, nonmajor funds, and fund type information, as appropriat~? Yes No ~ 27. Ifblended component units are included in the financial reporting entity, has the government unit refrained from including the general fund of a blended component unit as part of the general fund of the primary government? Yes No G0 28. Describe, in detail, your government unit's legal level of budgetary control Legal level of budgetary control is at the fund level. a. If the government unit does not demonstrate compliance at the legal level of budgetary control within the CAFR, do the notes to the fmancial statements refer to a separately issued budgetary report that does so? Ifso, one copy of that report must be included as part of the submission packet. Please note that the annual budget document itself is not adequate for this purpose as it does not demonstrate compliance. Yes No ~ Section VII: Authorization: With this applic tion form we are officially requesting that the Certificate of Achievement for Excellence in Financial Reporting Program review ur C We agree to comply with the policies and procedures of the program R'I 3 ( / ~ ( - (Date) The following lis is provided to help the government unit ensure the completeness of its submission: Did you include three copies of the application? Did you include three copies of the CAFR? Did you include three copies of responses to prior year comments (applies only if the CAFR was submitted to the program in the immediate prior year)? Did you provide payment (e.g., by a check or credit card) for the amount of the appropriate fee? If applicable, did you include a copy of the separately issued budget report that demonstrates legal compliance at the legal level of budgetary control (See Section VI, questions 28 and 28a)? Ifnot postmarked within six months of the government unit's fiscal year end, was an extension requested and approved? Mail all necessary items to: Government Finance Officers Association Certificate of Achievement Program 203 North LaSalle Street Suite 2700 Chicago, IL 60601 Section VIII: Special Review Committee Membership (Optional): For more information regarding Special Review Committee(SRC) membership for yourself or other staff members, please provide the following information and an SRC membership information packet will be sent Name: Title: Employer: Address: City: Email: State: Zip Code: