United States Institute of Peace
Pre -Award Assessment
USIP conducts a survey to assess whether a partner organization can manage the award and comply with its
requirements and applicable regulations.
Instructions: A designated representative of a partner’s organization must complete and sign the following
questionnaire and include necessary attachments, as required.
PART I. General Information
Organization Name:
Type of Organization: ☐ University ☐ For Profit ☐ Non-profit ☐ Other ___________________
Employer Identification Number: DUNS #:
(US organizations only) (If registered in SAM)
Address: Telephone #:
Fax Number:
Website:
Authorized Name: Telephone #:
Representative:
Title: Email Address:
PART II. Internal Controls
1. Identify the key personnel responsible for performing the following duties:
Responsibilities Name Position Title Note
Performing cash and bank
reconciliation
Preparing financial reports
Signing checks*
Approving expenses
Tracking and keeping financial
documentation including invoices
and receipts
Maintaining accounting records
*Note: Good internal controls suggest two signatures on checks.
2. Does your organization’s financial controls segregate responsibilities so that no single individual has
complete authority over an entire transaction? ☐ Yes ☐ No
3. Are personnel charges supported by timesheet reports and signed by employee and supervisor?
☐ Yes ☐ No. If not, can the partner maintain timesheet to fulfill USIP requirements? ☐ Yes ☐ No
4. Do you keep inventory records for equipment? ☐ Yes ☐ No. If yes, how often do you conduct
physical inventory count? _____________________________________
5. Are procurement records appropriately maintained relative to each type of procurement? ☐ Yes
☐ No
PART III. Policies and Procedures
1. Does your organization have written policies and procedures on the following?
a) Accounting and Financial ☐ Yes ☐ No
b) Procurment ☐ Yes ☐ No
c) Property Management ☐ Yes ☐ No
d) Human Resources ☐ Yes ☐ No
e) Code Conduct and Ethics ☐ Yes ☐ No
f) Travel ☐ Yes ☐ No
PART IV. Financial Management System
1. What basis of financial reporting does your organization use? ☐ Cash basis ☐ Accrual basis
2. As part of the financial management systems, does your organization maintain the following?
a) General Ledger ☐ Yes ☐ No
b) Chart of Accounts ☐ Yes ☐ No
c) Cash Receipt Journal ☐ Yes ☐ No
d) Cash Disbursement Journal ☐ Yes ☐ No
e) General Journal ☐ Yes ☐ No
f) Computerized Accounting System ☐ Yes ☐ No
g) Briefly describe your organization’s accounting system in the space provided below.
3. Does your accounting system produce the following financial reports?
a) Income statement ☐ Yes ☐ No
b) Balance Sheet ☐ Yes ☐ No
c) Accounts payable and receivable ☐ Yes ☐ No
d) List of fixed assets ☐ Yes ☐ No
4. Does your organization’s accounting system have the capacity to do the following:
a) Track receipts, payments and expenditures from various donor sources and project activities?
☐ Yes ☐ No
b) Summarize expenditures according to budget line items such as salaries, supplies, travel, etc.?
☐ Yes ☐ No
PART V. Banking and Audits
1. Does your organization have audits performed by either an independent audit firm or a Certified Public
Accountant? ☐ Yes ☐ No. If yes,
a) provide the name and contact information of the audit firm or accountant.
___________________________________________________________________________________.
b) what type of audit was performed? ☐ Financial ☐ A-133/Single ☐ Other _________
c) how often are audits performed? ☐ Quarterly ☐ Semi-annually ☐ Annually
☐ Other __________________________________
2. Does your organization have a bank account registered under its name? ☐ Yes ☐ No
If not, how is cash kept safely? __________________________________________________________
PART VI. Human Resource
1. Does your organization have written job descriptions? ☐ Yes ☐ No
2. Do you issue an employment letter or contract which includes the employee’s salary, terms of
contract, etc.? ☐ Yes ☐ No
3. Does your organization keep timesheets or other attendance records for each paid employee that
tracks actual hours worked? ☐ Yes ☐ No
4. Has your organization implemented payroll system that regularly disperses salary to employees?
☐ Yes ☐ No
PART VII. Attachments
Attach the following documents to this questionnaire, as applicable.
☐ Certificate of Incorporation and/or active license (Certificate of Good Standing)
☐ Evidence for tax status
☐ Copy of recent audited financial statement
☐ If your organization does not have a recent audit, a “Balance sheet” and “Revenue and Expense”
statement for prior fiscal year.
☐ Written policies and procedures checked in PART III of this questionnaire
Certification
I certify that the information included in and attached to this questionnaire is accurate and complete. I
understand that false or intentionally misleading certification may result in actions up to termination of the
resulting award. I further understand that USIP reserves the right to request further documentation and/or
inspect the organization’s financial records and books, procedures, or other documents related to the
resulting award and its administration.
Name: Title:
Signature: Date:
