Add's duties
$23.00
In-Service (attend)
$23.00
In-Service (preparation)
$23.00
In-Service (presentation)
$36.00
Summer School Teaching
$42.00
ATTENDANCE & SIGN-IN F
OR COMPENSATED TIME
Event/Meeting/
Workshop Name:
______________________________________________
Date:
_____ / _____ / _____
Description:
______________________________________________
Time:
______________ am / pm
Location: ____________________
RATES OF PAY: Compensated hourly rates
Certificated Personnel:
ATTENDEES: PLEASE
COMPLETE ALL BOXES BELOW. Information must be legible or payment will not be processed.
TOTAL STIPEND AMOUNT= $
Event Administrator’s Printed Name:__
_____________________________________ Signature_____________________________________ Date:__________
Revised Aug 19 lm
Page ____ of ____
Preapproval date and Signature from building supervisor or Grant Administrator:
___________
_____________________________________________
Yes
No
If Yes, 3 digit Fund number: ___________
GENERAL FUND:
State/Federal Grant Funded?
___ ______ __________ __________________ _______ ____ __________
Fnd = 1 2 digit SPCC Functio n Subject 2 digit OPU 1 dig IL 3 digit Acct
Non-GENERAL FUND (Grant):
2 CRF 200.430 states: “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…(iii) Reasonably reflect the total activity for which the employee is compensated by the non-Federal entity…(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.” As the supervisory official for [name of fund] ___________________________________, I hereby certify that the above employee worked solely for the single cost objective covered by the Federal Fund for the time designated above.
Federal Fund Administrator’s Printed Name:__________________________________________ Signature_______________________________________ Date:_________
SCHOOL BLDG.
PRINTED NAME SIGNATURE
Last 4 Of SS#
No. Of Hours
Off Duty
Stipend Rate
per Hour
Total $
Amount Due
________ ___________ ______________ __________ ________ ___________
3 digit Fnd 4 digit SPCC Functio n 3 digit OPU 2 dig IL 3 digit Acct
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signature
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click to sign
signature
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