Non-State Capital Outlay
Training Manual
Chapter 6: Non-State Entity Guidelines
FP&C’s Role in Administering Non-State Capital Outlay Projects
Is “reactive”, and is in place to:
Ensure that the project will be functional and within the intent of the Capital
Outlay Request and Act.
Ensure that the Project is in conformance with the Public Bid Law.
Administer the project in accordance with FP&C approved contracts
including that of the Cooperative Endeavor Agreement [includes 1999 Non-
State Guidelines].
Ensure reasonable costs are paid by the State.
Downloading the Non-State Entity Capital Outlay Administrative
Guidelines
The Cooperative Endeavor Agreement will reference the following:
Non-State Entity Capital Outlay Administrative Guidelines, July 1999 edition
This document is available online, at http://www.doa.louisiana.gov/fpc/nstate.htm .
Non-State Entity
Administrative
Guideline s
Facility Planning and Control
July 1999
Capital Outlay
Division of Administration
TABLE OF CONTENTS
Introduction
1
Chapter 1. Allowable Costs
3
Real Estate Acquisition
3
Planning
5
Construction
6
Miscellaneous
8
Equipment
8
Escrow
11
Administrative
12
Chapter 2. Other Requirements
13
Authorized Representative
13
Local Match
13
Appendix
i
Instructions for Completing Forms
Request for Disbursement
ii
Request for FP&C Concurrence in Real Estate Closing
iv
Request for FP&C Concurrence in Construction Contract Award
vi
Request for FP&C Concurrence in Equipment Purchase
viii
July 1999
July 1999
INTRODUCTION
The State Capital Outlay Act tradition-
ally has included funding for non-state entity
capital projects. These projects, while funded
by the State, are not State owned facilities.
The Capital Outlay Act appropriates funds for
these non-state projects to the Office of Fa-
cility Planning and Control (FP&C) within the
Louisiana Division of Administration. FP&C
disburses the State funds to the non-state
entities on an as-needed basis while assuring
that:
There are some cases where FP&C re-
quires submittals in addition to the certifica-
tion. The Guidelines is arranged so that
FP&C’s administrative requirements for each
component of a project can be quickly re-
viewed. For example, if a non-state entity
wishes to know what FP&C requires when
acquiring land with Capital Outlay funds, the
section Real Estate Acquisition in Chapter 1
should be referenced. All of the forms men-
tioned in the Guidelines are customized for
each project and are provided with the ex-
ecuted cooperative endeavor agreement.
State funds are used for the project
scope as described in the Capital Out-
lay Act and/or Capital Outlay Request
Form
Each non-state project is assigned to a
Project Manager at FP&C. This individual is
identified in the FP&C letter that transmits the
executed cooperative endeavor agreement.
All communication with FP&C should be
through this individual. Since the cooperative
endeavor agreement is between the State and
a non-state entity, FP&C will not directly en-
gage with a non-state entity’s contracted con-
sultants or contractors. Refer to the Autho-
rized Representative section of Chapter 2 for
a discussion on the requirement for the non-
state entity to designate a project represen-
tative.
A functional facility is in place upon full
disbursement of the State funds
FP&C administers non-state projects un-
der cooperative endeavor agreements between
the State and the non-state entities. The Non-
State Entity Capital Outlay Administrative Guide-
lines (Guidelines) is part of the cooperative en-
deavor agreement (by reference) and therefore
is a component of a legally binding contract be-
tween the State and a non-state entity.
A principal component of the Capital
Outlay non-state entity program is certifica-
tion by the non-state entity. All requests for
State disbursements, except those associated
with real estate purchase prices, must be
made with a Request for Disbursement form
(see Figure 1). On this form the non-state
entity certifies that:
FP&C has attempted to make this pro-
gram as simple as possible while still main-
taining oversight of the disbursement of State
funds. Many non-state projects funded
through State Capital Outlay have been suc-
cessfully completed, with hundreds more cur-
rently in progress. By following the simple
procedures outlined in the cooperative en-
deavor agreement and the Guidelines , a non-
state entity will assure its dealings with the
State run smoothly.
“... each of the invoices on this list and
attached list(s) is in accordance with the
terms of the applicable contracts and/
or agreements and that the services
have been performed or the goods re-
ceived ... this certification also indicates
compliance with the terms and condi-
tions of the cooperative endeavor agree-
ment ...”
FP&C wishes you well with your project.
July 1999
1
Request for Disbursement
Request No. _______
Project Number :
Grantee:
Contact Person:
Project Name:
Phone Number :
Invoices Enclosed:
Invoice
Number
Vendor Name
Cost
Code*
Amount
Total
This document will hereby certify that each of the invoices on this list and attached list(s) is in
accordance with the terms of the applicable contracts and/or agreements and that the services
have been performed or the goods received. Furthermore, this certification also indicates
compliance with the terms and conditions of the cooperative endeavor agreement by and
between the State of Louisiana and (Grantee).
Certified Correct by Grantee : ____________________________
Date:
______________
(Signature)
(Signature)
____________________________
(Type or Print Name)
Remit to: Facility Planning & Control
*Cost Code
Category
LA Division of Administration
RQ
Real Estate
Post Office Box 94095
PN
Planning
Baton Rouge, La. 70804-9095
CN
Construction
MI
Miscellaneous
EQ
Equipment
Figure 1. Form Used When Requesting Disbursement of State Funds
2
July 1999
 
CHAPTER 1 ALLOWABLE COSTS
Real Estate Acquisition
When acquiring land or immovable prop-
erty with Capital Outlay funds, prior to clos-
ing FP&C must review and approve the fol-
lowing information provided by the non-state
entity:
ing price cannot exceed the appraised value
as determined by a State Certified General
appraisal. The non-state entity should plan
on closing within two weeks after FP&C dis-
burses the funds. A copy of the executed act
of sale as recorded in the local Clerk of Court
office must be provided to FP&C after closing.
State Certified General appraisal
Preliminary title opinion attesting that
the non-state entity will have good,
clear, and merchantable title upon ex-
ecution of the act of sale, or title insur-
ance
State funds can also be used for reimburse-
ment of actual reasonable costs for title work,
appraisals, abstracts, property surveys, legal
fees associated with the purchase of property,
and other such similar costs as determined by
FP&C to be allowable. Requests for FP&C pay-
ments for these costs must be made with a Re-
quest for Disbursement form (see Figure 1).
Phase I environmental assessment, pre-
pared by an environmental professional
according to current ASTM standard
practice, that also considers asbestos
containing materials, lead-based paint,
lead in drinking water and wetlands
All services for which State funds will be
used for payments must be done under writ-
ten contracts. Copies of executed contracts
must be submitted to FP&C prior to or con-
current with Associated Request(s) for Dis-
bursement. The products of professional con-
tracts must be provided to FP&C when the
contract fee is greater than or equal to
$25,000 in order to receive disbursements as-
sociated with these contracts.
Draft act of sale with warranty that the
property is free of CERCLA defined haz-
ards and petroleum products identified
in the environmental assessment as ex-
isting or suspected
The non-state entity would submit a Re-
quest for FP&C Concurrence in Real Estate
Closing form, with this required information
Contracts executed prior to the date of
the cooperative endeavor agreement, or prior
to the date cash was made for the State ap-
propriation, are not eligible for State partici-
pation. For unconditional General Fund Di-
rect monies and NRP bonds, the date cash is
made available is the date the Capital Outlay
Act is approved. For General Obligation
bonds, the date the cash is made available is
the date the Bond Commission approves a
cash line of credit.
When real estate is to be acquired
with Capital Outlay funds, FP&C
must concur that the sale is
ready for closing.
attached (see Figure 2). Faxes will not be
accepted. After FP&C concurs in closing,
FP&C will initiate its check writing process.
The State disbursement for a real estate sell-
If desired by a non-state entity, FP&C will
provide courtesy reviews of draft contracts in
order to confirm that costs will be eligible for
State participation.
July 1999
3
 
Request for FP&C Concurrence in Real Estate Closing
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
To be completed by the Grantee
The following information is attached and Grantee requests FP&C’s concurrence that
the transaction is ready for closing.
State Certified General appraisal
Preliminary title opinion attesting that the non-state entity will have good, clear, and
merchantable title upon execution of the act of sale, or title insurance
Phase I environmental assessment, prepared by an environmental professional according to
current ASTM standard practice, that also considers asbestos containing materials, lead-based
paint, lead in drinking water and wetlands
Draft act of sale with warranty that the property is free of CERCLA defined hazards and
petroleum products identified in the environmental assessment as existing or suspected.
Grantee:
Date:
(Signature)
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs that the transaction is ready for closing
(FP&C will initiate writing a check in the amount of $
)
FP&C does not concur that the transaction is ready for closing
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence in Real Estate
Closing)
Project
Manager:
Date:
(Signature)
Remit to: Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
Figure 2. Form Used for Concurrence in Real Estate Closing
4
July 1999
 
Planning
phase (including a cost estimate) submitted
to FP&C in order to receive an interim dis-
bursement associated with that phase. Non-
state entities are encouraged to allow FP&C
to provide a courtesy review of the plans at
the schematic/preliminary phase for all
projects to confirm that the planned facility is
functional and within the intent of the Capital
Outlay Act/Request.
Planning costs associated with the ap-
proved project can be eligible for State par-
ticipation, up to the amount listed in the co-
operative endeavor agreement project bud-
get.
State disbursements for
Planning costs cannot exceed
10% of the construction cost.
For all projects, FP&C will
review final plans/specs to
confirm that the planned
facility is functional and
within the intent of the
Capital Outlay Act/Request.
All Planning services where State funds
will be used for payments must be done un-
der written contracts. Copies of executed
written contracts must be submitted to FP&C
prior to or concurrent with the first associ-
ated Request(s) for Disbursement. Faxes will
not be accepted. A copy of the final product
of a professional contract must be provided
to FP&C in order for funds to be disbursed
when the fee is greater than or equal to
$25,000.
For all projects, the construction docu-
ments/final design products (plans and speci-
fications) will be reviewed by FP&C to con-
firm that the planned facility is functional and
within the intent of the Capital Outlay Act/
Request. This review can take place either
prior to or after advertisement for bidding, but
the review must be made prior to award of
the construction contract. Non-state entities
are encouraged to submit the plans and speci-
fications with a cost estimate for review prior
to advertising for bids.
Contracts executed prior to the date of
the cooperative endeavor agreement or, prior
to the date cash was made available for the
State appropriation, are not eligible for State
participation. For unconditional General Fund
Direct monies and NRP bonds, the date cash
is made available is the date the Capital Out-
lay Act is approved. For General Obligation
bonds, the date the cash is made available is
the date the Bond Commission approves a
cash line of credit.
Contracts for the preparation of construc-
tion documents where the fee is greater than
or equal to $25,000 will need to have the prod-
ucts of the construction documents/final de-
sign phase (including a cost estimate) sub-
mitted to FP&C in order to receive a disburse-
ment associated with that phase.
If desired by the non-state entity, FP&C
will provide courtesy reviews of draft contracts
in order to confirm that costs will be eligible
for State participation.
Contracts for the preparation of construc-
tion documents where the fee is greater than
or equal to $25,000 will need to have the prod-
ucts of the schematic/preliminary design
State funds can be used for actual costs
for design services, surveys, geotechnical in-
vestigation, supplemental resident inspection,
production and distribution of contract docu-
ments and other such similar costs determined
July 1999
5
by FP&C to be allowable. All requests for FP&C
payments for these costs must be made with a
Request for Disbursement form (see Figure 1).
FP&C payments for Planning costs cannot ex-
ceed 10% of the construction cost.
FP&C must concur in contract award
prior to the actual award. If a construction
contract is awarded prior to FP&C concur-
rence, then the costs are not eligible for State
participation.
Construction
FP&C must concur in contract
award in order for construction
costs to be eligible for State
participation.
If State funds are to be used for construc-
tion costs, FP&C must be provided the fol-
lowing information prior to construction con-
tract award (FP&C considers exhibits to be
construction):
Final construction documents (plans
and specifications)
Once FP&C concurs in contract award,
the construction costs are considered eligible
for State participation. Interim State disburse-
ments can be made based on certified appli-
cations for payment (e.g., AIA Document
G702) that are submitted with a Request for
Disbursement form (see Figure 1). Copies
of the fully executed construction contract
with performance bond (or other form of se-
curity, if allowable by law) must be provided
to FP&C prior to or concurrent with the first
construction Request for Disbursement.
Construction document addenda
Certification that the cooperative en-
deavor agreement’s ownership of prop-
erty requirements have been met
Evidence of current commitment and
availability of match and/or in-kind
match
Certified proof of publication of adver-
tisement for procurement
In order to disburse funds associated with
the 100% application (minus retainage), the
punch list(s) will need to be submitted along
with written confirmation that the punch list(s)
items have been addressed. This written con-
firmation is in addition to the certified appli-
cation for payment. FP&C will hold retainage
until the 45-day Clear Lien Certificate is pro-
vided. Any liquidated damages will be to the
benefit of FP&C; if local match is involved,
proportionately between FP&C and the non-
state entity.
Certified tabulation of bids or propos-
als with recommendation for award
Certification that the procurement was
in accordance with the Public Bid law
This information must be provided
through a Request for FP&C Concurrence in
Construction Contract Award form (see Fig-
ure 3), with the required information attached.
Faxes will not be accepted. Evidence of avail-
ability of match or in-kind match is only re-
quired when other funds (in addition to the
Capital Outlay funds) or services are needed
in order to award a contract, or if volunteer
labor or donated materials are to be used.
Evidence of availability of cash match can
be in the form of bank statements, resolu-
tions from the entity’s governing authority, etc.
Change orders must be approved by
FP&C in order to be eligible for State partici-
pation. Non-state entities are encouraged to
submit draft change orders to FP&C prior to
execution in order for FP&C to confirm that
the costs will be eligible for State participa-
tion. As stipulated in the Public Bid Law,
FP&C will require negotiated change orders
to be fully documented and itemized as to
6
July 1999
 
Request for FP&C Concurrence in Construction Contract Award
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
To be completed by the Grantee
The following information is attached and the Grantee requests FP&C’s concurrence in the award
of the construction contract for
$
to .
(Total Bid)
(Contractor)
Final construction documents (plans and specifications)
Construction document addenda
Certification that the cooperative endeavor agreement’s ownership of property requirements have been met
Evidence of current commitment and availability of match and/or in-kind match
Certified proof of publication of advertisement for procurement
Certified tabulation of bids or proposals with recommendation for award
Certification that the procurement was in accordance with the Public Bid Law
Grantee:
Date:
(Signature )
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs in construction contract award
(Grantee must submit a Request for Disbursement Form(s) to draw from State funds)
FP&C does not concur in construction contract award
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence in Construction Contract Award)
Project Manager:
Date:
(Signature)
Remit to:
Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
Thank you for your cooperation!
Figure 3. Form Used for Concurrence in Construction Contract Award
July 1999
7
Remit to:
 
costs, including material quantities, material
costs, taxes, insurance, employee benefits,
other related costs, profit and overhead.
Contracts executed prior to the date of
the cooperative endeavor agreement, or prior
to the date cash was made available for the
State appropriation, are not eligible for State
participation. For unconditional General Fund
Direct monies and NRP bonds, the date cash
is made available is the date the Capital Out-
lay Act is approved. For General Obligation
bonds, the date the cash is made available is
the date the Bond Commission approves a
cash line of credit.
Change orders must be approved
by FP&C in order to be eligible
for State participation.
Miscellaneous
If desired by the non-state entity, FP&C
will provide courtesy reviews of draft contracts
in order to confirm that costs will be eligible
for State participation.
Miscellaneous costs associated with the
approved project can be eligible for State par-
ticipation, up to the amount listed in the coop-
erative endeavor agreement project budget.
Equipment
State disbursements for
Miscellaneous costs cannot
exceed 5% of the construction cost.
Actual, reasonable costs for moveable
equipment/furnishings required for the project
can be eligible for State participation. FP&C
references State purchasing contract prices
in determining the reasonableness of equip-
ment costs, and the amount eligible for State
participation. Some items that are not eli-
gible for State participation include rolling
stock (e.g., automobiles, tractors, etc.), sup-
plies, computers, and telephones.
State funds can be used for actual capi-
tal project costs including, but not necessarily
limited to laboratory testing services, recor-
dation fees, advertisement for bids, environ-
mental assessments, surveys, geotechnical in-
vestigations, supplemental resident inspection,
builders risk insurance and other such similar
costs determined by FP&C to be allowable.
FP&C payments for Miscellaneous costs can-
not exceed 5% of the construction cost.
Prior to procurement, it is a good
idea to submit the equipment
lists to FP&C for confirmation of
eligible items.
All Miscellaneous services where State
funds will be used for payments must be done
under written contracts. Copies of executed
written contracts must be submitted to FP&C
prior to or concurrent with associated
Request(s) for Disbursement (see Figure 1).
Faxes will not be accepted. The final prod-
uct of a professional contract must be pro-
vided to FP&C in order for funds to be dis-
bursed when the fee is greater than or equal
to $25,000.
All equipment purchases where State
funds will be used for payments must be done
under written contracts or purchase orders.
When purchasing equipment through State
contract, copies of the equipment list and
executed contracts or purchase orders must
be submitted to FP&C prior to or concurrent
with the associated Request for Disbursement
(see Figure 1). Faxes will not be accepted.
If desired by a non-state entity, FP&C will pro-
8
July 1999
vide courtesy reviews of draft contracts or pur-
chase orders prior to procuring the equipment
in order to confirm that costs will be eligible
for State participation. When procuring
equipment through State contract, non-state
entities are strongly encouraged to submit the
equipment lists for FP&C review prior to pro-
curement.
Whether procuring equipment through
State contract, or through bidding, contracts
or purchase orders executed prior to the date
of the cooperative endeavor agreement, or
prior to the date cash was made available for
the State appropriation, are not eligible for
State participation. For unconditional Gen-
eral Fund Direct monies and NRP bonds, the
date cash is made available is the date the
Capital Outlay Act is approved. For General
Obligation bonds, the date the cash is made
available is the date the Bond Commission
approves a cash line of credit.
If equipment is to be procured through a
bidding process, FP&C must be provided the
following information prior to a non-state en-
tity accepting a bid:
Equipment list (with specifications, if
applicable)
Certified proof of publication of ad-
vertisement for procure-
ment
Certified tabulation of bids
or quotes with recom-
mendation for accep-
tance
Certification that the pro-
curement was in accor-
dance with Public Bid law
This information must be
provided through a Request for
FP&C Concurrence in Equipment
Purchase form (see Figure 4),
with the required information at-
tached. Faxes will not be ac-
cepted. FP&C must concur in ac-
ceptance prior to the actual ac-
ceptance. If equipment procure-
ment is by bidding and a contract
or purchase order is executed
prior to FP&C concurrence, then
the costs are not eligible for State
participation. After FP&C has
concurred in acceptance, and the
equipment is obtained, requests
for FP&C payments for equip-
ment costs must be made with a
Request for Disbursement
form(s) (see Figure 1).
July 1999
9
Request for FP&C Concurrence in Equipment Purchase
( Required if equipment is to be procured through a bidding process)
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
T o be completed by the Grantee
The following information is attached and Grantee requests FP&C’s concurrence in
purchasing equipment from in the amount of $ .
(Supplier) (Total Bid)
Equipment list (with specifications, if applicable)
Certified proof of publication of advertisement for procurement
Certified tabulation of bids or quotes with recommendation for acceptance
Certification that the procurement was in accordance with the Public Bid Law
Grantee:
Date:
(Signature)
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs with the equipment purchase
(Grantee must submit a Request for Disbursement Form to draw from State funds)
FP&C does not concur with the equipment purchase
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence for the
equipment purchase)
FP&C concurs with the equipment purchase, with exceptions (see attachment)
Project
Manager:
Date:
(Signature)
Remit to:
Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
Figure 4. Form Used for Concurrence in Equipment Purchase (when procured by bidding)
10
July 1999
 
Escrow
This escrow category is not a cost
category; it is a bookkeeping
category.
Since Capital Outlay is a multi-year pro-
gram, occasionally an appropriation may be
an amount that cannot be completely spent
in the early stages of the project development.
For instance, say a project is in the prelimi-
nary stage and has a total construction cost
estimate of $5 million. Assume the Capital
Outlay appropriation is for $1 million with no
local match. Since only $500,000 (10% of
construction cost) can be budgeted for Plan-
ning costs, and in this example assume only
$30,000 is anticipated for Miscellaneous
costs, the remaining funds (minus FP&C ad-
ministrative) can be assigned to the Escrow
category for future use. These remaining
funds could then be moved to the Construc-
tion category if/when supplemental funds
were obtained in future years to implement
construction. Thus, Escrow is not a cost cat-
egory; it is a bookkeeping category. Refer to
Figure 5 for a sample cooperative endeavor
agreement project budget illustrating this sce-
nario.
EXHIBIT "A "
COOPERATIVE ENDEAVOR AGREEMENT BETWEEN
THE STATE OF LOUISIANA AND NON-STATE ENTITY
Project Name
FP&C No. 50-XX-99-1
Planning and Construction
Parish
COSTS AND FUNDS THIS AGREEMENT ($) :
COST
CATEGORIES
CAPITAL
OUTLAY
CASH
NON-CASH
LINE OF
CREDIT
OTHER
TOTAL
REAL ESTATE
0
0
0
0
PLANNING
500,000
0
0
500,000
CONSTRUCTION
0
0
0
0
MISC.
30,000
0
0
30,000
EQUIPMENT
0
0
0
0
ESCROW
450,000
0
0
450,000
FP&C ADMIN.
20,000
0
0
20,000
TOTAL COSTS
AND FUNDS
1,000,000
0
0
1,000,000
Notes:
1. Planning Costs shall not exceed 10% of Construction Costs. Miscellaneous Costs shall
not exceed 5% of Construction Costs.
2. Capital Outlay Cash includes General Funds, NRP Bonds, Cash Line of Credit and/or
Bonds sold
3. Estimated total project construction cost is $5,000,000
Figure 5. Example Project Budget with Funds in Escrow
July 1999
11
 
Administrative
The Capital Outlay Act authorizes FP&C
to retain up to 6% of the appropriation for State
administrative costs. The amount retained
by the FP&C is typically much less than 6%.
Operating and
maintenance expenses
of a non-state entity are
not eligible for State
participation.
Operating and maintenance expenses of
a non-state entity are not eligible for State
participation. Also, historically typical owner
administrative responsibilities are not eligible
for State participation, even if a contracted
consultant is used (e.g., a project manage-
ment consultant in addition to a professional
designer).
12
July 1999
CHAPTER 2 OTHER REQUIREMENTS
Authorized Representative
Each non-state entity is required to pro-
vide FP&C a copy of a resolution designating
and authorizing an official of the non-state
entity to act on behalf of the non-state entity
in all matters pertaining to the Capital Outlay
project, including certifying requests for State
disbursements. This resolution should be in-
cluded when the non-state entity transmits to
FP&C the signed cooperative endeavor agree-
ment. No State funds can be disbursed with-
out the resolution being provided to FP&C.
ment, and the entity wishes to fund the differ-
ence, then the State participation percentage
will be the percentage the State Construction
budget amount is to the total eligible construc-
tion cost.
If volunteer labor is to be used to in-
stall manufactured materials or equipment
that is to be acquired with Capital Outlay
funds, the materials or equipment must be
purchased and installed prior to FP&C dis-
bursements for the materials or equipment
costs.
The authorized individual must be from
the non-state entity, and not a contracted con-
sultant. Costs for historically typical owner
administrative responsibilities are not eligible
for State participation.
Third party in-kind match is allowable.
Local Match
If an appropriation includes “match”,
then the match can be cash match or some-
thing other than cash (in-kind match). If an
appropriation specifically calls for “cash
match”, then the match must be cash. If an
appropriation specifically calls for “in-kind
match”, then the match can be cash or some-
thing other than cash. The cooperative en-
deavor agreement budget will reflect the
amounts of State funds and “other” funds in
the cost categories’ budgets (“other” funds
can be cash match, the value of in-kind
match, or both, depending on the appropria-
tion language).
For construction costs at or below the
Construction budget in the cooperative en-
deavor agreement, State participation will be
at the percentage reflected in the coopera-
tive endeavor agreement’s Construction bud-
get. If an eligible construction project is bid
at an amount greater than the Construction
budget in the cooperative endeavor agree-
July 1999
13
 
14
July 1999
APPENDIX
Instructions for Completing Forms:
Request for Disbursement .................................................................. ii
Request for FP&C Concurrence in Real Estate Closing ...................... iv
Request for FP&C Concurrence in Construction Contract Award ....... vi
Request for FP&C Concurrence in Equipment Purchase .................. viii
July 1999
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i
July 1999
Instructions for Completing the Request
for Disbursement Form
The following comments are referenced to the Request for Disbursement form on the
next page. The numbers relate to the form spaces that are filled in by an entity when request-
ing a disbursement of State funds.
1
Each time a request for disbursement is made, the sequential number of that request
should be provided. For example, the first request for disbursement would be a “1”.
The second request, at a later date, would be “2”, and so on.
2
This is for the vendor’s invoice number. For construction contracts, this should
be the number on the contractor’s application for payment. If a non-state entity has
already paid for the invoiced service and is seeking State reimbursement, a copy of
the check the entity used to pay for service must be included with the Request for
Disbursement.
3
Vendor name associated with the particular invoice. If a non-state entity has already
paid for the invoiced service and is seeking State reimbursement, a copy of the check
the entity used to pay for service must be included with the Request for Disbursement.
4
This is the Cost Code for the cost categories as listed in this booklet. Refer to the
table at the bottom right corner of the Request for Disbursement form.
5
The actual dollar amount associated with a particular invoice. FP&C will calculate the
amount that is State eligible.
6
The total actual dollar amount of all invoices associated with the request for disburse-
ment. FP&C will calculate the amount that is State eligible.
7
Signature of the individual authorized by the non-state entity to certify invoices (see
Chapter 2 for requirement of authorization resolution).
8
Date that the authorized individual signs the form.
9
Typed or printed name of the authorized individual who signed the form.
16
July 1999
ii
July 1999
Request for Disbursement
R equest No. _
_
Project Number :
Grantee :
Contact Perso :
Project Name :
Phone Numbe :
Invoices Enclosed:
Invoice
Number
Vendor Name
Cost
Code*
Amount
Total
This document will hereby certify that each of the invoices on this list and attached list(s)
is in accordance with the terms of the applicable contracts and/or agreements and that
the services have been performed or the goods received. Furthermore, this certification
also indicates compliance with the terms and conditions of the cooperative endeavor
agreement by and between the State of Louisiana and the Grantee.
Certified Correct by Grantee : ___________
_______________ Date: ____
______
(Signature)
___________
_______________
(Type or Print Name)
Remit to: Facility Planning & Control
*Cost Code
Category
LA Division of Administration
RQ
Real Estate
Post Office Box 94095
PN
Planning
Baton Rouge, La. 70804-9095
CN
Construction
MI
Miscellaneous
EQ
Equipment
July 1999
17
iii
July 1999
Instructions for Completing the Request for FP&C
Concurrence in Real Estate Closing
The following comments are referenced to the Request for FP&C Concurrence in Real
Estate Closing form on the next page. The numbers relate to the form spaces that are filled in
by an entity.
1
Check boxes indicating the information required and attached to the form.
2
Signature of the individual authorized by the non-state entity to certify invoices (see
Chapter 2 for requirement of authorization resolution).
3
Date that the authorized individual signed the form.
4
Typed or printed name of the authorized individual who signed the form.
18
July 1999
iv
July 1999
Request for FP&C Concurrence in Real Estate Closing
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
To be completed by the Grantee
The following information is attached and Grantee requests FP&C’s concurrence that the
transaction is ready for closing.
State Certified General appraisal
Preliminary title opinion attesting that the non-state entity will have good, clear, and
merchantable title upon execution of the act of sale, or title insurance
Phase I environmental assessment, prepared by an environmental professional according to
current ASTM standard practice, that also considers asbestos containing materials, lead-based
paint, lead in drinking water and wetlands
Draft act of sale with warranty that the property is free of CERCLA defined hazards and petroleum
products identified in the environmental assessment as existing or suspected.
Grantee:
Date:
(Signature)
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs that the transaction is ready for closing
(FP&C will initiate writing a check in the amount of $ ___________________________ )
FP&C does not concur that the transaction is ready for closing
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence in Real Estate
Closing)
Project Manager:
Date:
(Signature)
Remit to:
Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
July 1999
19
v
July 1999
 
Instructions for Completing the Request for FP&C
Concurrence in Construction Contract Award Form
The following comments are referenced to the Request for FP&C Concurrence in Con-
struction Contract Award form on the next page. The numbers relate to the form spaces that
are filled in by an entity.
1
The total amount of the recommended bid or proposal, including all alternates.
2
Name of the contractor who submitted the recommended bid or proposal.
3
Check boxes indicating the information required and attached to the form. If match
or in-kind match is not to be used, write “N/A” over the match item’s checkbox. If the
contract price is such that public advertisement is not required, write “N/A” over the
checkbox pertaining to proof of ad publication.
4
Occasionally an entity will recommend executing change orders contemporaneously
with the contract in order to bring the project within the available funds. If this is done,
the change orders must be attached to this form. Other information may be included
on a project by project basis.
5
Signature of the individual authorized by the non-state entity to certify invoices
(see Chapter 2 for requirement of authorization resolution).
6
Date that the authorized individual signs the form.
7
Typed or printed name of the authorized individual who signed the form.
20
July 1999
vi
July 1999
Request for FP&C Concurrence in Construction Contract Award
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
To be completed by the Grantee
The following information is attached and the Grantee requests FP&C’s concurrence in the award
of the construction contract for $
to
.
(Total Bid)
(Contractor)
Final construction documents (plans and specifications)
Construction document addenda
Certification that the cooperative endeavor agreement’s ownership of property requirements have been met
Evidence of current commitment and availability of match and/or in-kind match
Certified proof of publication of advertisement for procurement
Certified tabulation of bids or proposals with recommendation for award
Certification that the procurement was in accordance with the Public Bid Law
Other
Grantee:
Date:
(Signature )
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs in construction contract award
(Grantee must submit a Request for Disbursement Form to draw from State funds)
FP&C does not concur in construction contract award
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence in Construction Contract Award)
Project Manager:
(Signature)
Date:
Remit to: Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
July 1999
21
vii
July 1999
 
Instructions for Completing the Request for FP&C
Concurrence in Equipment Purchase
The following comments are referenced to the Request for FP&C Concurrence in Equip-
ment Purchase form on the next page. This form must be submitted to FP&C when equip-
ment is to be procured through a bidding process. The numbers relate to the form spaces that
are filled in by an entity.
1
Name of the supplier who submitted the recommended bid or proposal.
2
The total amount of the recommended bid or proposal.
3
Check boxes indicating the information required and attached to the form. If the
contract price is such that public advertisement is not required, write “N/A” over the
checkbox pertaining to proof of ad publication.
4
Signature of the individual authorized by the non-state entity to certify invoices
(see Chapter 2 for requirement of authorization resolution).
5
Date that the authorized individual signed the form.
6
Typed or printed name of the authorized individual who signed the form.
viii
July 1999
22
July 1999
Request for FP&C Concurrence in Equipment Purchase
( Required if equipment is to be procured through a bidding process)
Project Number:
Grantee:
Contact Person:
Project Name:
Phone Number:
To be completed by the Grantee
The following information is attached and the Grantee requests FP&C’s concurrence in
purchasing equipment from ________________
__________________ in the amount
____________.
$ __________
(Supplier)
(Total Bid)
Equipment list (with specifications, if applicable)
Certified proof of publication of advertisement for procurement
Certified tabulation of bids or quotes with recommendation for acceptance
Certification that the procurement was in accordance with the Public Bid Law
Grantee:
Date:
(Signature)
(Type or Print Name)
To be completed by FP&C and returned to the Grantee
FP&C concurs with the equipment purchase
(Grantee must submit a Request for Disbursement Form to draw from State funds)
FP&C does not concur with the equipment purchase
Reason:
(Grantee must resolve and then submit another Request for FP&C Concurrence for the equipment
purchase)
FP&C concurs with the equipment purchase, with exceptions (see attachment)
Project Manager:
Date:
(Signature)
Remit to: Facility Planning & Control
LA Division of Administration
Post Office Box 94095
Baton Rouge, La. 70804-9095
Thank you for your cooperation!
July 1999
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ix
July 1999