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California Safe Harbor Indirect Cost Rate Program <br />Consultant Firm Certification of Eligibility and Certification of Financial <br />Management System <br />Consultant Firm Name Monument ROW, Inc <br />Local Agency (if applicable) <br />Contract Number / Federal Project Number <br />Contract Total $ <br />For Subconsultant Firms - estimated % of work to be performed <br />✓• <br />Safe Harbor Indirect Cost Rate (SHR): Home: 120% and/or Field: 90% <br />Field SHR will be utilized for contracts where the work deliverables are not completed from <br />the consultant offices (i.e. Construction Inspection, Material Testing, Sources Inspection, <br />others). <br />Consultant Firm Certification of Eligibility <br />I, the undersigned, certify that I am eligible to use the Safe Harbor indirect cost rate as I: <br />1. Am not a Prime Consultant Firm on a Caltrans contract > $3.5M, or <br />Local Government contract > $1 M, regardless of the participation amount. <br />2. Have not used SHR for more than three (3) years since entering the program on a state <br />or federally funded contract. <br />AND <br />1. Do not have relevant contract cost history to use as a base for developing a Federal <br />Acquisition Regulations (FAR) of Title 48, Code of Federal Regulations (CFR), Part 31 <br />compliant ICR. <br />2. Do not have a previously accepted ICR by a cognizant agency, or with an <br />audited/accepted actual ICR, and do not have an existing contract with a provisional <br />rate. <br />Certification of Financial Management System <br />I, the undersigned, certify that our financial management system in place for this contract <br />and moving forward meets the standards for the Safe Harbor indirect cost rate requirements <br />and financial reporting, accounting records, internal and budget control as set forth in 2 CFR <br />200, Subpart D. These standards require consulting firms have an accounting system <br />SHR Form ty ounce 28 - 219 5/17/2022 <br />