3-Project Budget and Funding Sources Worksheet.docx

This is a Project Budget and Funding Sources Worksheet template issued by the Aging and Long Term Services Department (ALTSD) of New Mexico for senior center capital outlay applications. The worksheet is designed for applicants seeking funding for facility improvements, code compliance corrections, accessibility upgrades, building system modernization or replacement, or new additions to existing senior center facilities. Applicants must complete one worksheet per project, providing detailed information including the senior center facility name, fiscal agent, application type, project title, ICIP project title with priority and fiscal year designation, amount requested, and total project cost. The worksheet requires identification of a project manager or contact person and comprehensive budget line-item documentation supporting the capital outlay request.

The budget section requires itemization of up to ten budget categories with line-item descriptions, capital outlay request amounts, other funding sources, and supporting quote or estimate references. The funding sources section mandates identification of all financing mechanisms, including capital outlay requested, local government or fiscal-agent funds, tribal funds, state funds, federal funds, grant or donor funds, and other sources, along with their respective amounts and status (secured or pending). Applicants must confirm that total funding equals total project budget and identify any remaining funding gaps with expected sources and availability dates. The worksheet requires certification by an authorized representative that the budget is complete, accurate, aligned with supporting documentation, and includes all costs necessary for project completion. Costs not covered by the application must be identified along with their funding source, and applicants must specify the fiscal-agent fund, reserve, or appropriation used for advance funding and reimbursement purposes.