Office of the State AuditorLocal Government Audit Division1525 Sherman St., 7th FloorDenver, CO 80203

Email: OSA.LG@state.co.usCall (303) 869-3000 if you need help completing this form.

Instructions:1. Prepare this form completely and accurately. Please note that there are 11 parts to this form and all questions must be answered for the application to be considered complete. a. Please use whole dollars. Do not include any cents. Please round consistently to ensure that the financial information balances between schedules.2. File this form with the Office of the State Auditor within 3 months after the end of the year. For years ended December 31, the form must be received by the Office of the State Auditor by March 31.3. The form must be completed by an independent accountant (separate from the entity) with knowledge of governmental accounting.4. The application must be personally reviewed and approved by a majority of the governing body as evidenced by one of the following methods: a. Resolution of the governing body - application may be emailed, faxed, or mailed. b. Original signatures - application must be mailed. Email or fax will NOT be accepted.5. The preparer must sign the application that is submitted in order for it to be accepted.6. Additional information may be attached to the exemption at the preparer's discretion.

Yes NoHas the Entity Filed for Has the district filed a Title 32, Article 1 Special District Notice of Inactive Statusduring the year? [Applicable to Title 32 special districts only, pursuant to Sections 32-1-103 (9.3) and 32-1-104 (3), C.R.S.] X

If Yes, Date Filed:

Date Prepared:I affirm that I am independent from this entity and skilled in governmental accounting (Required): The application will be rejected if not signed by the preparer.

The Audit Law requires that a person independent of the entity complete the application if revenues or expenditure are at least $100,000 but not more than $750,000. Independent means someone who is separate from the entity.Please describe your relationship to the entity in the above box, with your signature.

Outside accountant; all major decisions made by the Board.

Firm Name (if applicable): Marchetti & Weaver, LLCAddress: 28 Second Street, Suite 213, Edwards, CO 81632Telephone Number: (970) 926-6060

CERTIFICATION OF PREPARERI certify that I am an independent accountant with knowledge of governmental accounting and that the information in the Application is complete and accurate to the best of my knowledge. Independent means someone who is separate from theentity.

Name: Kenneth J. MarchettiTitle: Accountant/CPA

Return to:

Fax: 303-869-3061

or fiscal year ended:

Section 29-1-604, C.R.S., outlines the provisions for an exemption from audit. Generally, any local government for which neither revenue nor expenditures exceed $750,000 in any year may qualify for an exemption.

If either revenues or expenditures are $100,000 or greater, but not more than $750,000, you may use this form. If both revenues and expenditures are less than $100,000 individually, use the shortform application for exemption from audit.

Please review ALL instructions prior to the completion of this form.

PLEASE READ THE ABOVE INSTRUCTIONS BEFORE SUBMITTING THECOMPLETED APPLICATION

Fax: (970) 926-6040

Contact Person: Kenneth J. MarchettiTelephone: (970) 926-6060Email: Ken@mwcpaa.com

APPLICATION FOR EXEMPTION FROM AUDIT - LONG FORM - FOR GOVERNMENTS WITH REVENUE OR EXPENDITURES GREATER THAN $100,000BUT NOT MORE THAN $750,000

Name of Government: Cordillera Valley Club Metropolitan DistrictAddress: 28 Second Street, Suite 213

Edwards, CO 81632For the Year

Ended December 31, 2015

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GeneralLn # Description Fund* Fund* Description Fund* Fund*

Assets Assets1-1 Cash & Cash Equivalents 43,455$ -$ Cash & Cash Equivalents -$ -$ 1-2 Investments 549,082$ -$ Investments -$ -$ 1-3 Receivables 475,381$ -$ Receivables -$ -$ 1-4 Due from Other Entities or Funds 1,887$ -$ Due from Other Entities or Funds -$ -$

Other Current Assets -$ -$ 1-5 4,617$ -$ -$ -$ 1-6 -$ -$ Capital Assets, net (from Part 6-3) -$ -$ 1-7 -$ -$ -$ -$ 1-8 -$ -$ -$ -$ 1-9 -$ -$ -$ -$

1-10 -$ -$ -$ -$ 1-11 1,074,422$ -$ -$ -$ 1-12 Total Deferred Outflows of Resources -$ -$ Total Deferred Outflows of Resources -$ -$ 1-13 Total Assets and Deferred Outflows 1,074,422$ -$ Total Assets and Deferred Outflows -$ -$

Liabilities and Fund Balance Liabilities and Net PositionLiabilities Liabilities

1-14 Accounts Payable 86,064$ -$ Accounts Payable -$ -$ 1-15 Accrued Payroll and Related Liabilities -$ -$ Accrued Payroll and Related Liabilities -$ -$ 1-16 Accrued Interest Payable -$ -$ Accrued Interest Payable -$ -$ 1-17 Due to Other Entities or Funds -$ -$ Due to Other Entities or Funds -$ -$ 1-18 All Other Current Liabilities -$ -$ All Other Current Liabilities -$ -$ 1-19 86,064$ -$ Total Current Liabilities -$ -$ 1-20 -$ -$ Proprietary Debt Outstanding (from Part 4-4) -$ -$ 1 21 $ $ $ $

All Other Liabilities (specify)Other Liabilities (specify)

Total Assets (add lines 1-1 through 1-10) Total Assets (add lines 1-5 through 1-10)

Total Current Liabilities

Prepaid Insurance Total Current Assets

Other Long Term Assets (specify)

Governmental Funds Proprietary/Fiduciary Funds

All Other Assets (specify)

PART 1 - Financial Statements - Balance Sheet

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1-21 -$ -$ -$ -$ 1-22 -$ -$ -$ -$ 1-23 -$ -$ -$ -$ 1-24 -$ -$ -$ -$ 1-25 -$ -$ -$ -$ 1-26 -$ -$ -$ -$ 1-27 -$ -$ -$ -$ 1-28 86,064$ -$ -$ -$ 1-29 Total Deferred Inflows of Resources 475,382$ -$ Total Deferred Inflows of Resources -$ -$

Fund Balance Net Position Nonspendable :

1-30 4,617$ -$ Net Investment in Capital Assets -$ -$ 1-31 -$ -$

1-32 20,153$ -$ Emergency Reserves -$ -$

1-33 -$ -$ Other Designations/Reserves -$ -$

1-34 121,243$ -$ Restricted -$ -$

1-35 366,963$ -$ Undesignated/Unreserved/Unrestricted -$ -$

1-36 512,976$ -$ $ - $ -

1-37 1,074,422$ -$ $ - $ - *Indicate Name of FundNote: Attach additional sheets as necessary.

Unassigned:

Total Fund Balance (add lines 1-30 through 1-35) This total should be the same as line 3-31.

Total Net Position (add lines 1-30 through 1-35) This total should be the same as line 3-31.

Total Liabilities, Deferred Inflows, and Fund Balance (add lines 1-28, 1-29and 1-36) This total should be the same as line 1-13

Total Liabilities, Deferred Inflows, and Net Position (add lines 1-28, 1-29 and 1-36) This total should be the same as line 1-13

Restricted:(specify) TABOR

Committed:(specify)

Assigned:(specify) Replacement Reserve

Total Liabilities (add lines 1-14 through 1-27) Total Liabilities (add lines 1-14 through 1-27)

PrepaidInventory

Other Liabilities (specify)

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GeneralFund* Fund* Fund* Fund*

2-1 406,481$ -$ -$ -$ 2-2 20,810$ -$ -$ -$ 2-3 -$ -$ -$ -$ 2-4 -$ -$ Other Tax Revenue (specify) : -$ -$ 2-5 -$ -$ -$ -$ 2-6 -$ -$ -$ 2-7 -$ -$ -$ -$ 2-8 427,291$ -$ -$ -$ 2-9 -$ -$ -$ -$

2-10 Highway Users Tax Funds (HUTF) -$ -$ -$ -$ 2-11 Conservation Trust Funds (Lottery) -$ -$ Conservation Trust Funds (Lottery) -$ -$ 2-12 Community Development Block Grant -$ -$ Community Development Block Grant -$ -$ 2-13 -$ -$ -$ -$ 2-14 -$ -$ -$ -$ 2-15 -$ -$ -$ -$ 2-16 Charges for Sales and Services -$ -$ Charges for Sales and Services -$ -$ 2-17 -$ -$ -$ -$ 2-18 -$ -$ -$ -$ 2-19 Interest/Investment Income 1,892$ -$ Interest/Investment Income -$ -$ 2-20 -$ -$ -$ -$ 2 21 -$ -$ -$ -$

Property Specific Ownership Sales and Use Tax Other Tax Revenue (specify) :

Tax Revenue

Developer Advances Developer Advances

Grants

Rental Income Fines and Forfeits

Tap Fees

Total Tax Revenue Total Tax Revenue

Donations Donations

PART 2 - Financial Statements - Operating Statement - Revenues

Governmental Funds Proprietary/Fiduciary Funds

Grand TotalsTax Revenue

Fire & Police Pension

Property Specific Ownership Sales and Use Tax

Licenses and Permits Highway Users Tax Funds (HUTF)

Fire & Police Pension

Tap Fees

Grants

Rental Income Fines and Forfeits

Licenses and Permits

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2-21 -$ -$ -$ -$ 2-22 -$ -$ -$ -$ 2-23 242,582$ -$ -$ -$

2-24 671,765$ -$ -$ -$

2-25 -$ -$ -$ -$

2-26 Proceeds from Sale of Capital Assets -$ -$ Proceeds from Sale of Capital Assets -$ -$

2-27 -$ -$ -$ -$

2-28 -$ -$ -$ -$

2-29 $ 671,765 $ - $ - $ - $ 671,765

Note: If Total Revenues and Other Financing Sources - Total of All Funds (Line 2-29) are greater than $750,000 - STOP, you may not use this form. An audit may be required. See Section 29-1-604, C.R.S., or contact us at (303) 869-3000 for assistance.

Other (specify) Other (specify)

Total Other Financing Sources (Add lines 2-25 through 2-27)

Total Other Financing Sources (Add lines 2-25 through 2-27)

Total Revenues and Other Financing Sources (Add lines 2-24 and 2-28)

Total Revenues and Other Financing Sources (Add lines 2-24 and 2-28)

All Other (specify) All Other (specify) Contribution from POA and other misc

Total Revenues (Add lines 2-8 through 2-23) Total Revenues (Add lines 2-8 through 2-23)

Developer Advances Developer Advances

Other Financing Sources Debt Proceeds Debt Proceeds

Other Financing Sources

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GeneralFund* Fund* Fund* Fund*

Expenditures Expenditures3-1 General Government 49,077$ -$ General Operating & Administrative -$ -$ 3-2 Judicial -$ -$ Salaries -$ -$ 3-3 Law Enforcement -$ -$ Payroll Taxes -$ -$ 3-4 Fire -$ -$ Contract Services -$ -$ 3-5 Highways & Streets -$ -$ Employee Benefits -$ -$ 3-6 Solid Waste -$ -$ Insurance -$ -$ 3-7 Contributions to Fire & Police Pension Assoc. -$ -$ Accounting and Legal Fees -$ -$ 3-8 Health -$ -$ Repair and Maintenance -$ -$ 3-9 Culture and Recreation -$ -$ Supplies -$ -$

3-10 -$ -$ Utilities -$ -$ 3-11 367,573$ -$ -$ -$ 3-12 -$ -$ -$ -$ 3-13 -$ -$ -$ -$ 3-14 Capital Outlay 30,860$ -$ Capital Outlay -$ -$

Debt Service Debt Service3-15 Principal (matches part 4) 21,202$ -$ Principal (matches part 4) -$ -$ 3-16 Interest 933$ -$ Interest -$ -$ 3-17 Bond Issuance Costs -$ -$ Bond Issuance Costs -$ -$ 3-18 Developer Repayments (matches part 4) -$ -$ Developer Repayments (matches part 4) -$ -$ 3-19 -$ -$ -$ -$ 3-20 -$ -$ -$ -$

3-21 $ 469,645 $ - $ - $ - 469,645$ 3-22 -$ -$ -$ -$

$ $ $ $

Other (specify)

I t f d T f (O t)Net Interfund Transfers InN t I t f d T f (O t)

Interfund Transfers In

All Other (specify) All Other (specify)

Total Expenditures (Add lines 3-1 through 3-20) Total Expenditures (Add lines 3-1 through 3-20)

Public Safety, Community Operations Contributions to Fire & Police Pension Assoc. Other (specify)

PART 3 - Financial Statements - Operating Statement - ExpendituresGovernmental Funds Proprietary/Fiduciary Funds

Grand Totals

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3-23 -$ -$ -$ -$ 3-24 -$ -$ -$ -$ 3-25 -$ -$ -$ -$ 3-26 -$ -$ -$ -$ 3-27 -$ -$ -$ -$

3-28 -$ -$ -$ -$

3-29 $ 202,120 $ - $ - $ -

3-30 $ 310,856 $ - $ - $ -

3-31 $ 512,976 $ - $ - $ -

Interfund Transfers (Out)

Excess (Deficiency) of Revenues and Other Financing Sources Over (Under) Expenditures (Line 2-29, less line 3-21, plus line 3-28)

Net Increase (Decrease) in Equity (Line 2-29, less line 3-21, plus line 3-28, plus line 3-22, less line 3-23)

Fund Balance, January 1 from December 31 prior year report

Net Position, January 1 from December 31 prior year report

Fund Balance, December 31 (Line 3-29 plus line 3-30) This total should be the same as line 1-36.

Net Position, December 31 (Line 3-29 plus line 3-30)This total should be the same as line 1-36.

Note: If Total Expenditures - Total of All Funds (Line 3-21) are greater than $750,000 - STOP, you may not use this form. An audit may be required. See Section 29-1-604, C.R.S., or contact us at (303) 869-3000 for assistance.

Capital Outlay (from line 3-14) Debt Principal (from line 3-15)

Total Transfers and Other Expenditures (Add lines 3-22 through 3-27)

Total Reconciling Items (Line 3-26, plus line 3-27, less line 3-24, less line 3-25)

Other (specify) :Net Interfund Transfers (Out) Depreciation Other Financing Sources (from line 2-28)

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Yes No4-1 X

X

4-3 X

21,202$ -$ 21,202$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$

21,202$ -$ 21,202$ -$ Yes No

4-5 X

4-6 XIf yes:

4-7 XIf yes:

4-8 X

X

4-9 X

If yes: What is being leased?What is the original date of the lease?Number of years of lease?Is the lease subject to annual appropriation?What are the annual lease payments? -$

Developer AdvancesOther (specify): Total:

If yes: How much? 5,747,000.00$ Date the debt was authorized: 2002 and 2010

Does the entity have any lease agreements?

Please answer the following questions by marking the appropriate boxes.Does the entity have any authorized, but unissued, debt?

How much? -$ Does the entity have debt that has been refinanced that it is still responsible for?What is the amount outstanding? -$

Is the entity current in its debt service payments? If no, please explain:

Issued during year

4-4Please complete the following debt schedule, if applicable:

(please only include principal amounts) Outstanding at beginning of year

PART 4 - DEBT OUTSTANDING, ISSUED, AND RETIREDPlease answer the following questions by marking the appropriate boxes. Please use this space to provide any explanations or comments:

4-2 Is the debt repayment schedule attached? If no, please explain:

Does the entity have a certified mill levy?

Does the entity have outstanding debt?

Retired during year Outstanding at year-end

General obligation bondsRevenue bondsNotes/Loans

Does the entity intend to issue debt within the next calendar year?

Leases

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4 9 XIf yes: Please provide the following current year mills levied: Bond Redemption

General/OtherTotal

Amount Total5-1 43,455$ 5-2 -$ 5-3 -$

43,455$

5-4 549,082$ 5-5 -$ 5-6 -$ 5-7 -$

549,082$ 592,537$

Yes No5-8

X

25.00

Total InvestmentsTotal Cash and Investments

PART 5 - CASH AND INVESTMENTS

Please provide the entity's cash deposit and investment balances. Please use this space to provide any explanations or comments:Checking accountsSavings accountsCertificates of depositTotal Cash DepositsInvestments (if investment is a mutual fund, please list underlying investments):

ColoTrust

Please answer the following question by marking in the appropriate boxAre the entity's deposits in an eligible (Public Deposit Protection Act) public depository (Section 11-10.5-101, et seq. C.R.S.)? If no, please explain:

1.44

26.44

Does the entity have a certified mill levy?

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Yes No

6-1 X

X

Balance - beginning of the year Additions Deletions Year-End Balance

-$ -$ -$ -$

-$ -$ -$ -$

130,304$ 12,650$ 14,727$ 128,227$

-$ -$ -$ -$

4,318,063$ 18,210$ -$ 4,336,273$

655,742$ -$ -$ 655,742$

-$ -$ -$ -$

(1,243,990)$ (245,220)$ (14,727)$ (1,474,483)$

3,860,119$ (214,360)$ -$ 3,645,759$

Balance - beginning of the year Additions Deletions Year-End Balance

-$ -$ -$ -$

-$ -$ -$ -$

Infrastructure

Construction In Progress (CIP)

Other (explain):

Accumulated Depreciation

PART 6 - CAPITAL ASSETS

Please answer the following questions by marking in the appropriate boxes. Please use this space to provide any explanations or comments:Does the entity have capital assets?

If yes: Has the entity performed an annual inventory of capital assets in accordance with Section 29-1-506, C.R.S.,? If no, please explain:

Total6-3

Complete the following table for PROPRIETARY FUNDS:

Land

Buildings

6-2Complete the following table for GOVERNMENTAL FUNDS:

Land

Buildings

Machinery and equipment

Furniture and fixtures

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$ $ $ $

-$ -$ -$ -$

-$ -$ -$ -$

-$ -$ -$ -$

-$ -$ -$ -$

-$ -$ -$ -$

-$ -$ -$ -$

-$ -$ -$ -$

Yes No7-1 X

7-2 X

-$

-$

-$

Total: -$

-$

Who administers the plan?

Does the entity have an "old hire" firemen's pension plan?

Does the entity have a volunteer firemen's pension plan?If yes:

Indicate the contributions from:

Tax (property, SO, sales, etc.):

State contribution amount:

Other (gifts, donations, etc.):

What is the monthly benefit paid for 20 years of service per retiree as of Jan 1?

Accumulated Depreciation

Total

PART 7 - PENSION INFORMATION

Please answer the following questions by marking in the appropriate boxes. Please use this space to provide any explanations or comments:

Machinery and equipment

Furniture and fixtures

Infrastructure

Construction In Progress (CIP)

Other (explain):

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Yes No8-1 X

X

Yes No9-1

X

Yes No

10-1 X

If yes:

10-2 X

Please use this space to provide any explanations or comments:Is this application for a newly formed governmental entity?

If Yes: Please list the NEW name & PRIOR name:

Fund Name Budgeted ExpendituresGeneral Fund 529,931$

-$

PART 9 - TAX PAYER'S BILL OF RIGHTS (TABOR)Please answer the following question by marking in the appropriate box Please use this space to provide any explanations or comments:

Is the entity in compliance with all the provisions of TABOR [State Constitution, Article X, Section 20(5)]?

Note: An election to exempt the government from the spending limitations of TABOR does not exempt the government from the 3 percent emergency reserve requirement. All governments should determine if they meet this requirement of TABOR.

-$

PART 10 - GENERAL INFORMATIONPlease answer the following questions by marking in the appropriate boxes.

Date of formation:

Has the entity changed its name in the past or current year?

8-2 Did the entity pass an appropriations resolution? In no, please explain:

Please answer the following questions by marking in the appropriate boxes. Please use this space to provide any explanations or comments:Did the entity file a current year budget with the Department of Local Affairs? If no, please explain:

If yes: Please indicate the amount appropriated for each fund for the current year

PART 8 - BUDGET INFORMATION

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10-3 X

10-5 X

If yes:

Entity Wide: General Fund Governmental FundsUnrestricted Cash & Investments Unrestricted Fund Balanc Total Tax RevenueCurrent Liabilities Total Fund Balance Revenue Paying Debt ServiceDeferred Inflow PY Fund Balance Total Revenue

Total Revenue Total Debt Service PrincipalTotal Expenditures Total Debt Service Interest

Governmental Interfund InTotal Cash & Investments Interfund Out Enterprise FundsTransfers In Proprietary Net PositionTransfers Out Current Assets PY Net PositionProperty Tax Deferred Outflow Government-WideDebt Service Principal Current Liabilities Total Outstanding DebtTotal Expenditures Deferred Inflow Authorized but UnissuedTotal Developer Advances Cash & Investments Year AuthorizedTotal Developer Repayments Principal Expense

592,537$ 86,064$

475,382$

488,206$ 512,976$ 310,856$

427,291$ 671,765$ 671,765$

21,202$ 933$ 469,645$

-$ -$

-$

Please use this space to provide any additional explanations or comments not previously included:

Is the entity a metropolitan district?

10-4 Please indicate what services the entity provides:

Finance, construct, operate, and maintain the basic public infrastructure as weII as parks and recreation facilities and other improvements within the District's boundaries.Does the entity have an agreement with another government to provide services?

List the name of the other governmental entity and the services provided:

-$

21,202$ 469,645$

-$

-$ -$

-$ -$

592,537$

-$ -$

406,481$

-$

-$ -$

OSA USE ONLY

5,747,000$ 2002 and 2010

-$

671,765$

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Applying for Exemption from Audit

In accordance with the Local Government Audit Law (Section 29-1-601, et seq., C.R.S.), any local government may apply for an exemption from audit if revenues or expenditures for the year are not more than $750,000. This means thaneither revenues nor expenditures can exceed $750,000 in the year.

General Instructions READ ALL INSTRUCTIONS BEFORE COMPLETING OR SUBMITTING THIS FORM

Exemptions from audit are not automatic. Every year, in order to be exempt from audit, the local government must complete an Application for Exemption from Audit and submit it to the Office of the State Auditor. An exemption from audit is only granted upon the review and approval of the Office of the State Auditor.

The application must be received and filed with the Office of the State Auditor within 3 months after the end of the year. The application must be received in our office on or before March 31 for governments with a December 31 year-end. POSTMARK DATES WILL NOT BE CONSIDERED.

The appropriate version of the Application for Exemption from Audit must be used.

The mailing address is:

Office of the State Auditor

Prior years’ forms are obsolete and will not be accepted. Applications submitted on forms other than those prescribed by the State Auditor will also not be accepted.

The application must be fully and accurately completed.

Please note our new address:1525 Sherman St 7th Floor

We Moved!

The preparer must sign the application.

The application must be personally reviewed and approved by the governing body. Approval is evidenced by one of the following two methods:

1) If the completed application is going to be submitted electronically using email or fax, the application MUST include a resolution of the governing body that states the completed application was personally reviewed and approved by a majority of the body in an open public meeting. The resolution MUST include the signatures of a majority of the governing body (see sample resolution).

2) If the completed application is going to be submitted through postal mail (U.S. Post Office, UPS, FedEx), the application must include the original ink signatures of a majority of the governing body.

USE ONLY ONE OF THE ABOVE METHODS WHEN FILING THE APPLICATION.

Local Government Audit Division

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303-869-3000

Important: All Applications for Exemption from Audit are subject to review and approval by the Office of the State Auditor. Failure to file an application or denial of the request could cause the local government to lose its exemption from audit for that year and the ensuing year. In that case, an audit shall be required.

1) The “short form” should be submitted if both revenues and expenditures are less than or equal to $100,000. A preparer of the short form must be a person skilled in governmental accounting.

2) The “long form” should be submitted if either revenues or expenditures are greater than $100,000 but are less than or equal to $750,000. A preparer of the long form must be an independent accountant with knowledge of governmental accounting.

Please call (303) 869-3000 if you need help completing the Application for Exemption from Audit forms.

1525 Sherman St., 7th FloorDenver, CO 80203

Local Government Audit Division

Two forms are available:

1525 Sherman St, 7th Floor

Denver, CO 80203

The fax number is: (303) 869-3061

The e-mail address is: OSA.LG@state.co.us

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