3-Project Budget and Funding Sources Worksheet.docx

This is a Project Budget and Funding Sources Worksheet developed by the Aging and Long Term Services Department (ALTSD) in New Mexico for senior centers applying for capital outlay funding to support vehicles and equipment necessary for senior-center services. The worksheet is designed to be completed for all application types, with one worksheet required per project. Applicants must provide project information including the senior center facility name, fiscal agent, application type, project title, ICIP project title with priority and fiscal year, and amount requested alongside total project cost. The form requests detailed line-item budgeting across up to ten budget categories, requiring applicants to specify amounts for capital outlay requests and identify other funding sources through quotes or estimates.

The funding sources section requires applicants to identify all financing mechanisms, including capital outlay requested, local government or fiscal-agent funds, tribal funds, state funds, federal funds, and grant or donor funds, with each source marked as either secured or pending. Applicants must certify that total funding equals total project budget and, if not, must identify any remaining funding gap, expected source, and date available. The worksheet also requires disclosure of costs not included in the budget and identification of the fiscal-agent fund, reserve, or appropriation source used to pay allowable costs before reimbursement. An authorized representative must sign and certify that the budget is complete, accurate, aligns with supporting quotes and estimates, identifies all known funding sources, and includes all costs necessary to complete the project or identifies any remaining gap.