3-Project Budget and Funding Sources Worksheet.docx

This is a Project Budget and Funding Sources Worksheet for capital outlay applications submitted to the Aging and Long Term Services Department (ALTSD) of New Mexico for senior center facility improvements. The worksheet is designed for applicants seeking funding for existing facility renovations, code compliance corrections, accessibility improvements, building-system modernization or replacement, or new facility additions. Applicants must complete one worksheet per project, ensuring that all budget amounts align with the project scope and supporting documentation. The form requires identification of the senior center facility name, fiscal agent, application type, project title, and the associated ICIP project title, priority level, and fiscal year.

The worksheet establishes a comprehensive budget structure requiring itemization of capital outlay requests across multiple budget line items with corresponding cost estimates and quotes or estimates for reference. Applicants must identify all funding sources, including capital outlay requests, local government or fiscal-agent funds, tribal funds, state funds, federal funds, and grant or donor funds, noting the status of each source as either secured or pending. The form requires budget completion confirmation through a question set addressing whether total funding equals the total project budget, identification of any remaining funding gaps with expected sources and availability dates, identification of costs not included and their funding mechanisms, and clarification of the fiscal-agent fund or reserve used for advance funding before reimbursement. An authorized representative must certify the accuracy and completeness of the budget, its alignment with supporting quotes and estimates, identification of all known funding sources, and inclusion of all costs necessary to complete the project.