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LCA Payment Request Form instructions and glossary

The numbers below correspond to those on an annotated version of the LCA payment form (pdf), or see the sample of a completed payment form (pdf).

#1 - LCA Grant Number

The grant number, which begins with “SG,” is a unique number assigned by the Council’s Finance Division for administrative purposes. Please include this number on all correspondence sent to the Council regarding your grant.

#2 - Grant Expiration Date

LCA grants are awarded for an approximate two-year term, with expiration dates of June 30 or December 31, whichever is closer to a two-year term following the award date. Enter the current expiration date shown on page 1 of your grant agreement.

#3 - Request #

Most grant awards are reimbursed in a series of requests as work is completed and invoices are collected to submit to the Council. For recordkeeping purposes, each Reimbursement Request must be numbered consecutively. There is no limit to the number of Reimbursement Requests that can be submitted prior to full expenditure of grant funds.

#4 - Project name

The formal project name as shown in the grant agreement. Please include the project name on all correspondence sent to the grants administration staff.

#5 - Award amount

Enter the total funding awarded to this LCA grant; the field is formatted as currency.

#6 - Period covered

List the dates when work commenced and was completed for the costs listed on the current reimbursement request.

#7 - Grantee

Enter the Grantee’s full legal name as shown on the Grant Agreement.

#8 - Grant type

Click on the down arrow to select TBRA, LHIA, or LCDA.

#9 - Request date

Specify the date the Pay Request is submitted to the Council.

#10 - Partial or Final

Indicate whether this Payment Request represents partial or final payment. If this is a final Reimbursement Request, it must be accompanied by the Grantee’s completed Grant Activity Close-Out Report.

#11 - Grantee fax #

Enter the fax number to which the Council may send communications to the person who signs the Payment Request.

#12 - Certification of Information Accuracy

The Payment Request must be signed by the Grantee’s Authorized Signer. Unsigned Payment Requests or those signed by anyone other than the Authorized Signer will be returned to the Grantee. This signature certifies that the activities cited in the current Payment Request are eligible according to the Grant Agreement.

#13 - Eminent Domain Certification

The Metropolitan Council has adopted two policies that restrict local governments from using Metropolitan Livable Communities Act grant funding for projects that used eminent domain authority for "economic development" purposes. (See the Eminent Domain Policy at www.metrocouncil.org/services/livcomm/EminentDomainPolicy.htm). Place an “X” in the option that describes how eminent domain has or has not been used to acquire property for this project, then the Authorized Signer must sign and date.

#14 - #

These numbers correspond to the Budgeted Activities in #15 and are used to correlate the line item detail on page 2.

#15 - Budgeted Activity

Refer to Attachment A of the Grant Agreement to list the Budgeted Activities in the grant. Please match the claimed Budgeted Activities to those listed in the Grant Agreement.

#16 - Beginning Balance

For the first Payment Request for the grant, the Beginning Balance will be the budgeted amount shown in Attachment A of the Grant Agreement. For subsequent Payment Requests, the Beginning Balance will carry over from the Ending Balance for this line item on the previous Payment Request. The field is formatted as currency.

#17 - Total Requested Amount

Sum of all funds requested for this Budgeted Activity on the current Reimbursement Request. Refer to the line item detail in sections 28 through 30. This field is formatted as currency. For grants issued 12/1/2007 or later, LCA grantees must adhere to the listed activities to within 20 % of the budget amount specified in the Grant Agreement. The Council is not responsible for any cost overruns.

#18 - Ending Balance

The Beginning Balance less the Requested Amount for this Payment Request. This field calculates automatically and is formatted as currency.

#19 - Approved Amount

This column is for Met Council use only. LCA grants administration staff will review each line item for eligibility and hand-enter the approved amount.

#20 - Corrected Ending Balance

This column is also for Met Council use only. LCA grants administration will update the ending balance if any portion of the requested amount was disapproved.

#21 - Budget Variance

This column is also for Met Council use only. LCA grants administration will track the total amount of line item budget variances. For LCDA and LHIA grants awarded 12/1/2007 and later, grantees are allowed to vary by line item up to 20% from the budgets in their grant application without Council approval, provided they do not exceed the total amount awarded.

#22 - Total Requested Amount

This cell will total automatically. Please do not change the formula.

#23 - Approved Amount

This column is for Met Council use only. LCA grants administration staff will total the approved amount and enter it here.

#24 - Corrected Ending Balance

This column is also for Met Council use only. LCA grants administration will update the total ending balance if any portion of the requested amount was disapproved.

#25 - Request for Grantee’s Concurrence

If the Payment Request was only partially approved, LCA grant administration staff will enter a checkmark at the beginning of this sentence and fax the corrected Payment Request to the grantee. The Authorized Signer is asked to review the corrected Payment Request, discuss any issues with LCA staff, and indicate his/her agreement with the final approved amount, sign and date the form, and fax it back to LCA staff for final processing.

#26 - Activity Number

For each line item entered in the “Detail of Amount Requested” section, match the detail item with the Budgeted Activity line item in sections 14 and 15, on page 1 of the request.

#27 - Contractor / Developer / Builder

Enter the name of the vendor who has issued the invoice being claimed for payment.

#28 - Invoice #

Enter the invoice number or other identifying reference number for the amount being claimed.

#29 - Total Invoice Amount

Enter the TOTAL amount of the invoice – not the amount being claimed.

#30 - Requested Amount

Enter the amount being claimed from this invoice.

#31 - Approved Amount/Reason

Do not make any entries this section. LCA staff will use this column to tally the amount approved for each line item. If any portion of the line item is declined, LCA staff will make a brief note as to the reason it was declined.

#32 - Total Approved Amount

Do not make any entries in this section. LCA staff will use this cell to tally the total amount approved for this payment request.

 

Please attach clearly legible copies of all citied invoices or other substantiating documentation and mail the signed Payment Request to:

Community Development Grants Coordinator
Metropolitan Council
390 North Robert Street
Saint Paul MN  55101

Or, you may fax all documentation to (651) 602-1442.