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					                                        Financial Reporting for Water Systems



Section 1: Utility Information


Utility Name

PWS #

Address



Telephone Number                                                                               Fax Number

E-Mail Address

Contact Person                                                                                 Title _________________________

Accounting Basis                               _____Cash                     _____ Accrual                         _____Unknown


Section 2: Customer Information
                                 Number of Connections at
        Beginning of Fiscal year 20__                    End of Fiscal Year 20__                     Total




Section 3: Water Production and Consumption
A. What is the total amount of water produced/pumped/purchased?                                              gal

B. What is the total amount of water sold/billed?                                                            gal

C. How much water is unaccounted for?                                                                        gal

 What is the total percent of water unaccounted for? (Divide Row C by Row A, then multiply by 100)           %


Comments: _____________________________________________________________________________




Section 4: Ratios
Operating Ratio:
(current income divided by current expenses)
Coverage Ratio:
(current income divided by debt service)




                                                                                                                              1
                                              Financial Reporting for Water Systems



Section 5: Current Budget                          Fiscal Year Ending:________

Operating Revenues
 User Charges (Water Sales)
 Hook-up Fees
 Disconnect/Reconnect Fees
 Bulk Water Fees
 Surcharges
Other Revenues
 Interest Earned on Deposits
 Other (describe)


Total Revenues

Operations Expenses:
 Salaries and Wages (Operators)
 Rent
 Contract Labor
 Purchased Water
 Chemicals for Treatment
 Utilities (Plant)
 Repairs/Maintenance/Supplies
 Vehicle Expenses
 Equipment Lease
 Permits/Fees
 Operator Training
 Payroll Taxes
 Misc. (describe)
 Depreciation



Administrative Expenses
 Salaries and Wages (Office, Billing, etc.)
 Rent
 Contract Labor
 Offices Supplies
 Utilities (office)
 Professional Services (Accounting, Legal, Engineering, etc.)
 Insurance and bonding
 Debt repayment
 Debt reserves
 Repair and Replacement Reserves
 Depreciation and Amortization
 Payroll Taxes
 Federal and Other Taxes
 Misc. (describe)



Total Expenses

Surplus (Deficit)



                                                                                      2
                                              Financial Reporting for Water Systems



Section 6: Revenue and Expenses                            Fiscal Year Ending:____________ (Most current completed year)

Operating Revenues                                                            Budget                   Actual
User Charges (Water Sales)
Hook-up Fees
Disconnect/Reconnect Fees
Bulk Water Fees
Surcharges
Other Revenues
Interest Earned on Deposits
Other (describe)


Total Revenues

Operations Expenses:
Salaries and Wages (Operators)
Rent
Contract Labor
Purchased Water
Chemicals for Treatment
Utilities (Plant)
Repairs/Maintenance/Supplies
Vehicle Expenses
Equipment Lease
Permits/Fees
Operator Training
Payroll Taxes
Misc. (describe)




Administrative Expenses
Salaries and Wages (Office, Billing, etc.)
Rent
Contract Labor
Offices Supplies
Utilities (office)
Professional Services (Accounting, Legal, Engineering, etc.)
Insurance and bonding
Debt repayment
Debt reserves
Repair and Replacement Reserves
Depreciation and Amortization
Payroll Taxes
Federal and Other Taxes
Misc. (describe)



Total Expenses

Surplus (Deficit)




                                                                                                                           3
                                      Financial Reporting for Water Systems


Section 7: Reserves
Account Balances at the start of the current year
Operating Reserce
Debt Reserve
Repair and Replacements Reserve
Capital Improvements Reserve
Emergency Reserve
Other Reserves



Debt Reserve
Purpose:


Balance at beginning of fiscal year
Deposits to fund during fiscal year
Withdrawals from fund during fiscal year
Balance at end of fiscal year



Repair and Replacement Reserve
Purpose:


Balance at beginning of fiscal year
Deposits to fund during fiscal year
Withdrawals from fund during fiscal year
Balance at end of fiscal year



Capital Improvements Reserve
Purpose:


Balance at beginning of fiscal year
Deposits to fund during fiscal year
Withdrawals from fund during fiscal year
Balance at end of fiscal year



Other Reserves
Purpose:


Balance at beginning of fiscal year
Deposits to fund during fiscal year
Withdrawals from fund during fiscal year
Balance at end of fiscal year




                                                                              4
                          Financial Reporting for Water Systems


      Section 8: Rate Chart
                                                                 Usage
                    Monthly
                                  Average       Monthly     Allowance in
                  Median (or                                              Unit Charge
                                 Number of      Minimum      thousands
                    Actual                                                  per 1000
Usage Class                     Customers in   Charge for      (Amount
                   Average)                                              Gallons Within
                                 this usage    this usage    included in
                    use in                                                This Class
                                    class         class       minimum
                  thousands
                                                                charge)
                                Residential Customers
   Under 1,000            0.5
   1,000-1,999            1.5
   2,000-2,999            2.5
   3,000-3,999            3.5
   4,000-4,999            4.5
   5,000-5,999            5.5
   6,000-6,999            6.5
   7,000-7,999            7.5
   8,000-8,999            8.5
   9,000-9,999            9.5
 10,000-14,999           12.5
 15,000-19,999           17.5
 20,000-29,999           25.0
 30,000-39,999           35.0
 40,000-49,999           45.0

                               Commercial Customers
   Under 1,000            0.5
   1,000-1,999            1.5
   2,000-2,999            2.5
   3,000-3,999            3.5
   4,000-4,999            4.5
   5,000-5,999            5.5
   6,000-6,999            6.5
   7,000-7,999            7.5
   8,000-8,999            8.5
   9,000-9,999            9.5
 10,000-14,999           12.5
 15,000-19,999           17.5
 20,000-29,999           25.0
 30,000-39,999           35.0
 40,000-49,999           45.0

                                Wholesale Customers
  15,000-19,999          17.5
  20,000-29,999          25.0
  30,000-39,999          35.0
  40,000-49,999          45.0
 50,000 or more          76.6


                                                                                          5
                              Financial Reporting for Water Systems


Section 9: Accounts Receivable
                             Current          30 days            60 days        90 days    Over 90 Days


Beginning of Fiscal Year



End of Fiscal Year




Section 10: Debt Summary
Lender                     Date of Loan   Original Amount     Interest Rate      Term     Current Balance




Section 11: Signatures

Board President                                             Financial Officer




                                                                                                          6

				
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