Auxiliary Enterprise Activities - Blink by xiuliliaofz

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									                 Request to Establish a New Activity or Modify Rates/Services for an Existing Activity For Auxiliary Enterprise Activities


Part I -    Request Form
    Date:   ______________________________
      To:   Business and Financial Services-General Accounting (BFS-GA)
   From:    __________________________________________________________Title:_______________________________________________

  Subject: Name of Activity ______________________________________ If applicable, existing fund number ________________

            This is a request to (place "X on one of the following items):
            ______ To establish a new auxiliary enterprise activity
            ______ To modify the rates or services/goods of an existing activity.

Part II - Information Requested
         1 The faculty member or administrative unit head who accepts responsibility for the activity.
           Name_________________________ Title _________________________________
           Email_____________________________
           Telephone______________________ Mail Code ____________________________

         2 The activity's financial manager.
            Name_________________________ Title ____________________________________________________
            Email_____________________________
            Telephone______________________ Mail Code ____________________________


         3 The requested starting date of the activity or the effective date of the modification. In some instances the activity may be
            retroactively approved to a date not preceding the beginning of the current fiscal year. ___________________________

         4 Briefly describe the proposed activity or modification to an existing activity.




         5 Briefly describe the rate methodolgy to be used.


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                Request to Establish a New Activity or Modify Rates/Services for an Existing Activity For Auxiliary Enterprise Activities




         6 If activity has primary use of a specific space, provide the building(s) and room number(s).




         7 Briefly describe and provide the location of commercial and other non-University sources from which similar goods or services
           may be obtained.




         8 Briefly describe other University sources from which similar goods or services may be obtained.




         9 If similar goods or services may be obtained from non-University sources or other University sources, explain the necessity for
           the proposed activity or modifications to existing activity.




        10 Describe and provide the fund number(s) that has provided goods or services free of charge in the past, if applicable.



        11 Explain the necessity for now charging for the goods or services.



        12 State the activity's anticipated number of annual users. _________________________

        13 State the activity's anticipated annual dollar volume of combined recharge and revenue/income. ________________________

        14 State the number of years the activity is anticipated to continue to provide its goods or services. ______________________

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                Request to Establish a New Activity or Modify Rates/Services for an Existing Activity For Auxiliary Enterprise Activities
        15 State the estimated percentage of users by the following categories:
                                                                                                       UC Departments (Paid by Index #) Percentage
                                                                                                         Fed & fed flow-thru funded users          %
                                                                                                               Non-federally funded users          %
                                                                                                    UC Individuals (Not Paid by Index #)
                                                                                                                                 Students          %
                                                                                                                                  Faculty          %
                                                                                                                                    Staff          %
                                                                                                                                  Patients         %
                                                                                                           Non-UC Individuals & Entities           %
                                                                                                       TOTAL (formula; should = 100%)            0%
        16 Describe any unique connection between the proposed activity and any Federal contract(s) or grant(s).




        17 Describe any subsidy, direct or overhead, to be provided by Federal contract(s) or grant(s). Provide amount of subsidy and fund
           number.




        18 Describe any limitation the Federal contract(s) or grant(s) place on the activity or on the use of the activity's income.




        19 Describe any unique connection between the activity and any non-federal funding source.




        20 Describe any subsidy, direct or overhead, to be provided by non-federal funding source. Provide amount of subsidy and fund
           number.



        21 Describe any limitation the non-federal funding source places on the activity or on the use of the activity's income.


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                    Request to Establish a New Activity or Modify Rates/Services for an Existing Activity For Auxiliary Enterprise Activities

        22 Provide information showing that satisfactory commercial or other non-University sources for similar goods or services do not
           exist.



        23 Provide proposed funding sources for start-up costs.




        24 Provide proposed funding sources for operating deficits, anticipated or unanticipated.




        25 If the activity sells tangible personal property (goods), it is subject to California sales tax regulations unless you can explain
           why the activity should not be subject to California sales tax regulations.



        26 Sales to individual or non-UC users must relate to the University's educational, public service or research mission. Sales not
           related will be reported as unrelated business income and will subject to Federal tax regulations. Explain how sales to
           individual or non-UC users relate to the university's educational, public service or research mission.




        27 Provide the following financial documentation using the approved templates:
           a. Proposed rate methodology or rate calculation.
           b. A projected annual operating (profit and loss) statement.
           c. Provide a depreciation schedule of capital (inventorial) equipment to be purchased or transferred to the activity.
           d. Provide a copy of recharge procedures, including a sample of the monthly statement to be provided to recharge users.
           e. For activities modifying rates/services, provide a list comparing existing rates to proposed rates.

Part III - Checklist                                                                                                                            "x" Box
        1 Part I and Part II pertinent questions have been adequately answered.


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                Request to Establish a New Activity or Modify Rates/Services for an Existing Activity For Auxiliary Enterprise Activities
         2 The information entered on the request matches the data in the supporting documentation, e.g., operating statement, depreciation
           schedules, etc.

         3 The recharge rate proposal excel worksheet has been completed. The excel worksheet has not been converted to a PDF file -- the
           formulas are intact.

         4 The formulas are correct.

         5 If modifying rates, the balance in the current IFIS fund summary has been taken into consideration and adjustments made to the
           proposal for deficit or surplus balances.

         6 If applicable, the equipment depreciation schedule is included.

         7 If applicable, the equipment depreciation expense does not include Federally funded or fully depreciated equipment.

         8 If applicable and if the activity is being subsidized, the rate calculation includes the subsidy.

Part IV - Signatures
           Please sign below, scan this document and send via email with the proposal package. Retain original for audit purposes.
           Financial Manager's Signature ______________________________________________ Date______________________

           Print Name _________________________________________________ Title _________________________________

           Department Head/Chairperson Signature ______________________________________Date______________________
           Print Name _________________________________________________ Title _________________________________




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