2-Appendix A-2 Services Cost Proposal Forms.xlsx

TIPS

How to use the Excel forms with formulas

Begin with APP #5. Operating expenses will populate APP #2. Agency Name and Project Title will populate other tabs.

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APP#2

1. Agency Name:

2. Project Title:

Total Direct Costs (Personnel & Operating) $ - 0 $ - 0

Indirect Costs ( ____%; attach Rate Letter)

TOTAL PROGRAM EXPENSES $ - 0 $ - 0

q As applicable, attach Indirect Cost Rate Letter

APP#3

1. Agency Name:

2. Project Title:

(On separate lines, list each Federal Agency providing fees/funding and the amount of funding) Grants from Federal Government Agencies:

Medicaid Reimbursements:

Other Federal Revenues:

Subtotal Federal Agencies $ - 0 $ - 0

Revenues from State Government (On separate lines, list each State Agency providing fees/funding and the amount of funding) Grants from State Government Agencies:

Other State Government Revenues:

Subtotal State Agencies $ - 0 $ - 0

Revenues from County Government:

Revenues from the City of Albuquerque (including this proposal or contract):

(On separate lines, list each City-funded project and the amount of funding)

Other Municipal Government Revenues:

TOTAL REVENUE FROM ALL SOURCES: $ - 0 $ - 0

APP#4

1. Agency Name:

2. Project Title:

Personnel costs: Use this form to justify all salaries, wages, payroll taxes and fringe benefits shown on the Expense Summary Form. Add additional rows as necessary.

APP#5

2. Project Title:

q As applicable, attach cost allocation plan

APP#6

1. Agency Name:

2. Project Title:

4. As applicable: Reimbursement Rate – only applicable to unit of service contracts:

Annual units:

5. As applicable: Rate Justification – only applicable to unit of service contracts:

APP#2 instructns INSTRUCTIONS - APPENDIX #2: Expense Summary Form

Expenditures charged to Social Services category must conform to the FCS Administrative Requirements, be reasonable, be allowable and be allocable.

Payroll and Benefits: A formula is embedded in the Excel worksheet to automatically enter the amounts from Appendix #4. Enter the amounts budgeted to pay payroll taxes, and employee benefits. Payroll taxes should include legally mandated payroll taxes for regular employees of the organization, including FICA and unemployment insurance tax. The amounts charged to the City must constitute an allocable percentage of salaries and wages.

Total Personnel Costs: A formula is embedded in the Excel worksheet to automatically enter the sums of salaries, wages, payroll taxes, and employee benefits. Manual Calculation: provide a subtotal for Personnel costs in this section.

Audit Costs: Enter the amount budgeted to pay the costs of conducting annual or special audits of the organization. The amount budgeted to the City shall not exceed the proportion that the City contract revenue is of the total agency revenue budget.

Consumable Supplies: Enter the amount budgeted to pay the costs of supplies and equipment utilized by the project which have a price which does not exceed $5,000 per unit.

Telephone: Enter the amount budgeted to pay for the costs of project telephone services, including installation, local service, and long-distance tolls.

Postage and Shipping: Enter the amount budgeted for project postage and shipping.

Utilities: Enter the amount budgeted for the cost of project allocable electrical services, heating and cooling, sewer, water, and other utilities charged not otherwise included in rental or other charges for space.

Other: Enter the amount budgeted for other project allocable occupancy costs including the costs of security, janitorial services, elevator services, upkeep of grounds, leasehold improvements not exceeding $5,000, and related occupancy costs not otherwise included in rental or other charges for space.

Equipment Lease: Enter the amounts budgeted for the purchase or lease of equipment allocable to the project

Equipment Maintenance: Enter the amount budgeted to maintain or repair existing agency equipment utilized in a funded project that is allocable to the project.

Printing and Publications: Enter the amount budgeted for the purchase and/or reproduction of project- printed materials, including the cost of photo-reproduction that is allocable to the project.

Out-of-Town Travel: Enter the amount budgeted for the costs of project travel outside of Bernalillo County, including costs for transportation, lodging, subsistence, and related expenses incurred by employees, board members, or clients who are in travel status on official business allocable to the project.

Conferences, Meetings, etc.: Enter the amount budgeted for the costs of registration and materials for staff, board, or clients’ attendance at meetings and conferences allocable to the project or for the costs of meetings conducted by the agency in connection with that contract.

Direct Assistance to Beneficiaries: Enter the costs budgeted for the payment of participant wages and benefits, stipends, food, clothing, and other goods and services purchased directly on behalf of clients funded in this project.

Membership Dues: Enter the amount budgeted to pay the costs of dues paid by the agency on behalf of staff, board members, or the agency itself to professional organization related to the purposes of the project.

Equipment, Land, Buildings: Enter the amount budgeted for the purchase of equipment, land, and for the acquisition or construction of buildings allocable to the project, the cost of which exceeds $5,000. Costs charged to Equipment, Land, Buildings, or renovation capital costs must conform to Administrative Requirements.

Insurance: Enter the amount budgeted to pay the costs of insurance, including bonding, allocable to the project.

Fuel and Vehicle Maintenance: Enter the amount budgeted to pay for fuel and maintenance not covered under local travel, i.e. fuel for a bus.

Total Operating Costs: A formula is embedded in the Excel worksheet to sum the total. Manual calculation: Enter the sum of all line items under operating costs.

Total Direct Costs: A formula is embedded in the Excel worksheet to sum the Total Personnel Costs and Total Operating Costs. Manual calculation: Enter the sum of Total Personnel Costs and Total Operating Costs.

Indirect Costs: Enter the amounts budgeted to pay indirect costs for the project. Costs charged to Indirect must conform to Administrative Requirements. As applicable, attach explanation of basis for each indirect cost or an approved cost rate letter from cognizant Federal agency.

Total Program Expenses: A formula is embedded in the Excel worksheet to sum the total of Direct and Indirect Costs. Manual calculation: sum the Direct and Indirect Costs.

Percent Requested: A formula is embedded in the Excel worksheet to calculate the Percent Requested. Manual Calculation: Divide City Funding Request in Column C by Project Total in Column B for each individual row. Display as a percentage with one decimal point (e.g. 33.3%).

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APP#3 instructns INSTRUCTIONS - APPENDIX #3: Revenue Summary Form

List each agency of government providing funding in the column “Revenue Source.” Enter the anticipated revenues for the total agency budget and total program budget from each of the listed funding sources in the appropriate columns.

Insert lines as needed.

When inserting line items, check to ensure data from new lines were included in totals and percentages.

A formula is embedded in the Excel worksheet to calculate the "Percent of Agency Budget" and "Percent of Program Budget" subtotals and totals. Manual Calculation: Divide the Subtotals in the Agency Total Column by the Total in Total Revenue From All Sources; Divide the Subtotals in the Program Total Column by the Total in Total Revenue From All Sources. Display as a percentage with one decimal point (e.g., 33.3%).

Medicaid Reimbursements are funds paid to the agency as a result of billing Medicaid for reimbursable expenses for services to eligible clients.

Other Federal Revenues are funds paid to the Agency by a unit of Federal government for goods or services provided as a contractor other than Grants or Medicaid.

Grants from State Government Agencies are funds paid to the agency as a recipient or sub-recipient by a unit of State government.

Other State Government Agencies are funds paid to the Agency by a unit of State government for goods or services provided as a contractor other than Grants.

Revenues from County Government are funds paid to the agency from a County.

Revenues from City of Albuquerque are funds paid to the agency from the City of Albuquerque. List each funded project (or contract) on a separate line. Include the request in this proposal on a separate line.

Total Revenues from Government Sources: Manual calculation is a subtotal of all federal, state and local funds.

Contributions means money income donated to the agency by any non-government sources.

Other Revenue means income to the agency from sources not falling into another category. (Charitable foundation grants, loans, etc.)

Total Revenue From all Sources means the total of money revenue from all sources including public, private and foundation sources.

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APP#4 instructns APPENDIX #4: Instructions for Project Budget Detail Form – Personnel

Section 1. Enter the name of the agency submitting the proposal.

Section 2. Enter the project title as shown on the Proposal Summary and Certification form.

Section 3. Detail each staff member included in Personnel Costs in the Expense Summary Form in APPENDIX #2. Use one line per staff member working on the project. Add rows and use additional sheets as necessary. The following illustration is provided for clarification purposes only.

q In the column labeled “FTE on Project” list each individual staff working on the project, regardless of funding source (e.g., if an FTE will spend half time on this City-funded project, insert .50).

q In the column labeled “Position Title” give the title of each position working on this project.

q In the column labeled “Salary Dedicated to this Project” enter the salary amount dedicated to the project for each individual by multiplying the %FTE by total annual salary (a change from previous years’ forms that may have included multiple FTEs).

q In the column labeled “Amount Requested” enter the amount of funding requested from the City for each individual position.

q In the column “Percent Requested” calculate as: Amount Requested / Salary on Project. Note: The Annual Salary dedicated to the project / % FTE should = Annual Salary for this position.

Section 4. Provide a sum of the columns for "Salary for the Project" and "Amount Requested" and calculate "Percent Requested" by dividing the sum of “Amount Requested” by the sum of “Annual Salary Dedicated to Project”

Section 5. Enter the total amount of payroll taxes and employee benefits for project salaries in the column labeled “Salary for the Project,” the “Amount Requested” from the City, and the percent of the total to the charged to the City.

Section 6. Enter the sum of the lines 4 and 5 in the column’s labeled “Salary for the Project,” and “Amount Requested.” Enter the percentage of the total amount requested from the City.

Section 7. Enter the percentage of salaries and wages charged to FICA, Unemployment Compensation, health insurance, retirement, and other employee benefits in Section 5.

Note: Each individual must be on a separate line. Should an individual’s percentage of time change during the contract, a revised Project Budget Detail Form will be required.

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APP#5 instructns INSTRUCTIONS - APPENDIX #5: Program Budget Detail Form – Operating Expenses

Section 1. Enter the name of the agency submitting the proposal.

Section 2. Enter the project title as shown on the Proposal Summary and Certification form.

Section 3. Detail each Operating Cost line item on the Expense Summary Form in APPENDIX #2. Use one line per expense included in project. Add rows and use additional sheets as necessary. The following illustration is provided for clarification purposes only.

q Describe all elements included in the line item costs and indicate the basis used for determining the costs in the first column.

q In the column headed “Project Total” enter the agency total program costs of the line item.

q In the column headed “Amount Requested” enter the amount requested from the City.

q In the column headed “Amount Other Sources” enter the amount to be paid from other sources.

q In the column headed “Percent Requested” enter the percent of the total program expenditures requested from the City.

q Include detail for each separate item as shown in the above illustration (e.g., each contractor, each type of direct assistance to beneficiaries).

q If cost is allocated, provide the allocation plan.

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APP#6 instructns

Section 1. Enter the appropriate Quarter Ending dates (e.g., September 30, December 31, March 31, June 30).

Section 2. For each of the quarterly periods indicated, enter the amount of City funding the agency projects expending in the column headed “Amount to be Requested.” For each of the quarterly periods indicated, enter the amount of City funding the agency projects expending in the column headed “Amount to be Requested.”

Section 3. In the column headed “Percent of Total,” enter the percentage of all City funds projected to be expended during the quarter.

If the applicant anticipates expending more than 25% of the total requested from the City in any one quarter, provide a brief explanation of these expenditures in the space provided.

Section 4. As applicable, if reimbursement will be based on a unit rate, identify the per unit reimbursement rate for services to be provided, the unit basis (unduplicated client, hour, etc.) and the proposed number of annual units. Rate shall include any applicable taxes and shall constitute full and complete compensation for the successful applicant’s services under this proposal.

If separate rates are required for services based on factors such as service location, service type or other factors, please provide a list of specific rates, one individual rate at a time, and explain in the Rate Justification section (5).

Section 5. As applicable, if a reimbursement will be based on a unit rate, provide a rate justification. The intent of the justification is to tie together the budget with program activities and outcomes. To accomplish this, applicants should identify the basis used in establishing the reimbursement rate in context of the proposed services. Include the rationale used in developing cost components noted on the required budget forms. Additionally, indicate how the proposed reimbursement rate is necessary and reasonable to accomplish the program proposed in the narrative.

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