4 Financial Components Workbook OAA HPDP FY25.xlsx
XLSX spreadsheet 162 KB Posted
- Solicitation number
- PE-29016-NONST-2024-000000006
- Issued by
- Cherokee County, Georgia
About this file
This document is a Notification of Funding Availability (NOFA) issued by the Atlanta Regional Commission (ARC) for the provision of a menu of eight evidence-based health promotion, disease, and injury prevention program workshops for older adults, adults with disabilities, and/or informal caregivers across the 10-county ARC Planning and Service Area. The services will be provided for the period of July 1, 2024, to June 30, 2025. All questions from potential applicants will be posted with responses on the ARC website by May 16, 2024.
The NOFA outlines the required services, unit costs, and projected units of service. Applicants must demonstrate capacity to provide the required match funds and leverage grant funding to maximize program outcomes. Detailed information on the contract, including pricing terms, funding requirements and sources, and other salient details, is provided in the NOFA document available on the ARC website.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ARCOAA_1.PDF | ||
| 2 Narrative Response Form OAA HPDP NOFA FY25 .xlsx | XLSX spreadsheet | |
| 3 Applicant Transmittal Cover Page OAA HPDP F.docx | DOCX document | |
| 6 UCM Training Manual.pdf | ||
| 5 DHS pre award risk assessment form.xlsx | XLSX spreadsheet | |
| Directions for Responding.pdf | ||
| Addendum _ Questions and Answers.pdf | ||
| NOFA Packet.pdf |
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Text version
Finance Components Cover Sheet
| FINANCIAL COMPONENTS WORKBOOK - MULTI-COUNTY AND REGIONAL |
| General Requirements: |
| Budget Summary |
| Budget Narrative |
| UCM Personnel |
| UCM Support |
*REMINDER: Fill out each tab completely
AGENCY NAME:
UCM - PERSONNEL
| Enter Provider Name: | #1 | #2 | #3 | #4 | #5 | #6 | #7 | #8 | #9 | #10 | #11 | #12 | #13 | #14 | #15 | #16 | #17 | #18 | #19 | #20 | #21 | #22 | #23 | #24 | #25 |
| STAFF LIST |
(Paid staff only - do not include volunteers
| or other donated) | Number of Staff Positions (Enter number per staff title) | Base Wages (Enter base amount with no benefits included) | Fringe Benefit Rate |
| (Enter benefit costs by % only) | Fringe Benefit Dollars | ||
| (Auto-populates) | Total |
Wages and
| Benefits (Auto-populates) | Productive Hours (Enter annual productive hours) | General Admin |
| (Enter % of staff time in admin) | Admin Hours (Auto-populates) | General Admin |
Costs
| (Auto-populates) | Staff for Building Mainte- | ||||||||||||||||||||||||||||||||||||||||||||||||
| nance (Enter % of staff time) | Shared Building Space Hours | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Shared Building Space | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | |||||||||||||||||||||||||||||||
| TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | W & B | TOTAL | % OF | ||||||
| HOURS | |||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | HOURS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | Billable Hours (Direct Service Staff Only) | STAFF TIME | |||||||||||||||||||||||||||||||||||||||||||||||
| (Enter % of staff time) | COST | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | PROGRAMS | ||||||||||||||||||||||||||||||||||||||||||||||||
| (Auto-populates) | WAGES |
(Auto-populates)
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Enter Staff Title/Name | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Client/Meal Transportation Cost Pool Section Only | |||||||||||||||||||||||||||||||||||||||||||||||||
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| Driver | 0.0 | $ - 0 | 0% | $0 | $ - 0 | 0 | 0% | 0.0 | $0 | 0% | 0 | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 | 0 | 0% | $0 | 0 |
| (The following data calculates automatically - do not enter) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Total Wages and Benefits | 0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||||||||||||||||||||||||||||
| Percent of Total Wages and Benefits | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | |||||||||||||||||||||||||||||||||||||
| Total Hours | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |||||||||||||||||||||||||||||||||||||
| Unit of Service | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Percent of Total Hours 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 100.00%
| Column1 |
| Choose a Service |
| AAA Administration |
| AAA Advocacy |
| AAA Coordination |
| AAA (Gateway_ADRC's Options Couns) |
| AAA I_A (Gateway_ADRC's) - Ind |
| AAA Outreach |
| AAA Program Development |
| Caregiver - Group (Staff Activity Log) |
| Caregiver - Case Management - T-Care Ind |
| Caregiver - Com Ed - PTC -Ind |
| Caregiver - Clinical Assessment |
| Caregiver - Driver Assessment |
| Caregiver - Respite Care In-Home - Ind |
| Caregiver - Respite Care In-Home - Voucher |
| Caregiver - Respite Care Out of Home - Ind |
| Caregiver - Respite Care Out of Home - V |
| CCSP - Care Coordination |
| CLP Community Living Program |
| CLP Financial Management Services |
| CLP - Monitoring Living Installation |
| CLP - Monitoring Living Solution |
| EAP - Elder Abuse Prevention |
| ELAP - Elderly Legal Assistance Program |
| HCBS - Adult Day Care - Ind |
| HCBS - Adult Day Care - Mobile |
| HCBS - Adult Day Health - Ind |
| HCBS - Case Management - Ind |
| HCBS - Community Education - Group |
| HCBS - Com Education - CDSMP -Ind |
| HCBS - Counseling - Ind |
| HCBS - Home Management - Ind |
| HCBS - Home Mod & Home Repair - Ind |
| HCBS - Home Sharing & RM Match - Ind |
| HCBS - Information & Assistance - Ind |
| HCBS - Interpretation & Translating - Group |
| HCBS - Material Aid - Ind |
| HCBS - Material Aid - Voucher |
| HCBS - Outreach - Ind |
| HCBS - Senior Recreation - Group |
| HCBS - Support Group - Ind |
| HCBS - Telephone Reassurance - Ind |
| HCBS - Transition Coordination - Ind |
| HCBS - Transportation - Ind |
| HCBS - Transportation - Ind (Assisted) |
| HCBS - Transportation - Voucher |
| HCBS - Trans - Group (DHR Unified) |
| HCBS - Vol Dev/Oppor/Service - Group |
| In-Home - Chore - Ind |
| In-Home - Emerg Resp Install - Ind |
| In-Home - Emerg Resp Monitoring - Ind |
| In-Home - Friendly Visiting - Ind |
| In-Home - Homemaker - Ind |
| In-Home - Homemaker - Voucher |
| In-Home - Personal Care - Ind |
| Kinship Care - Case Management |
| Kinship Care - Counseling |
| Kinship Care - Group (Staff Act Log) |
| Kinship Care - Respite Care Out of Home |
| LTCO - Long-term Care Ombudsman |
| MFP - MDS-Q Options Counseling |
| MFP - Transition Coordination |
| N/W - C Meals Management Only |
| N/W - C Meals Costs Only |
| N/W - Exer and Phys Fitness - Ind |
| N/W - Health P/Disease Prev-Group |
| N/W - Home-Del Meals Manage Only |
| N/W - Home-Del Meals Meal Cost Only |
| N/W - Medications Management - Ind |
| N/W - Nutrition Counseling - Ind |
| N/W - Nutrition Education - Ind |
| N/W - Nut./Health Rel/Health Scr - Ind |
| SCSEP Employment Program - Ind |
&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES
UNIFORM COST METHODOLOGY
Personnel Spreadsheet
SFY 2012
&"Times New Roman,Regular"&9MAN 5600, Appendix D UCM Spreadsheet - Final - 6/5/12 &P of &N
UCM - SUPPORT
| File is.. | All Other | ||||||||||||||||||||||||||||
| In Balance | #1 | #2 | #3 | #4 | #5 | #6 | #7 | #8 | #9 | #10 | #11 | #12 | #13 | #14 | #15 | #16 | #17 | #18 | #19 | #20 | #21 | #22 | #23 | #24 | #25 | ||||
| Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | Choose a Service | All Other | ||||
| Enter Bldg Space, Line 108 | General Administration | ||||||||||||||||||||||||||||
| COST POOL | Shared Building Space | ||||||||||||||||||||||||||||
| COST POOL | Client/Meal Transportation COST POOL | Support |
COST POOL
| Enter Provider Name: |
| PROPOSED ANNUAL EXPENSES |
(Select Line Item from DAS Chart of Accounts)
| WAGES & BENEFITS (Auto-populates) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Auto-populates % of Wages and Benefits from Personnel Spreadsheet(1) | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Auto-populates % of Hours from Personnel Spreadsheet (1) | 100.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 100.00% |
| STAFF TRAVEL EXPENSES | |||||||||||||||||||||||||||||
| (Auto-populates) | $0 | ||||||||||||||||||||||||||||
| Staff Mileage/Per Diem Reimbursement | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Volunteer Mileage/Per Diem Reimbursement | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Other Staff Travel Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| VEHICLE OPERATING EXPENSES | |||||||||||||||||||||||||||||
| (Auto-populates) | $0 | ||||||||||||||||||||||||||||
| Vehicle Gas & Oil | $0 | no driver personnel | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Vehicle Insurance | $0 | no driver personnel | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Vehicle Maintenance | $0 | no driver personnel | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Other Vehicle Operating Expenses | $0 | no driver personnel | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| BUILDING EXPENSES (Auto-populates) | $0 | |||||||||||||||||||||||||||
| Building Depreciation | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Building Insurance | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Building Maintenance/Janitorial | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Building Repairs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Rent | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Utilities | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Space Expenses (Security) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| COMPUTER OPERATION EXPENSES (Auto-populates) | $0 | |||||||||||||||||||||||||||
| Computer Purchase | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Computer Maintenance | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Computer Supplies | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Computer Training | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Computer Operation Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| CAPITAL EQUIPMENT EXPENSES | |||||||||||||||||||||||||||||
| (Auto-populates) | $0 | ||||||||||||||||||||||||||||
| Capital Equipment Depreciation/Usage Fee | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Equipment Maintenance | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Other Equipment Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| SUPPLY EXPENSES (Auto-populates) | $0 | |||||||||||||||||||||||||||
| Advertising | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Copy/Printing | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Dues/Subscriptions | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Employee Testing | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Insurance | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Office/Paper Supplies | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Postage | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Site Supplies | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Telephone & Other Telecommunications | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Training/Meeting Expense | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Supply Expenses | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| SERVICE CONTRACTS (Auto-populates) | $0 | |||||||||||||||||||||||||||
| SCSEP | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Identify Contract Type | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Identify Contract Type | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Identify Contract Type | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Identify Contract Type | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| CONGREGATE MEAL EXPENSES (Auto-populates) | $0 | |||||||||||||||||||||||||||
| Vendor Meal Contract - Congregate | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| On-Site or Central Kitchen Preparation: | ||||||||||||||||||||||||||||
| Raw Food Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Labor | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Utilities | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Disposable Supplies | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Transportation Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Meal Delivery Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Equipment | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Taxes | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Other Meal Costs (Kinship Care - monthly mtgs) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| HOME DELIVERED MEAL EXPENSES (Auto-populates) | $0 | ||||||||||||||||||||||||||
| Vendor Meal Contract - Home Delivered | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| On-Site or Central Kitchen Preparation: | |||||||||||||||||||||||||||
| Raw Food Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Labor | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Utilities | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Disposable Supplies | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Transportation Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Meal Delivery Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Equipment | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Taxes | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Meal Costs (List) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| OTHER OPERATING COSTS (Auto-populates) | $0 | |||||||||||||||||||||||||||
| Agency Indirect (Federal Cognizant Agency Only) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Audit/Legal Fees | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Profit/Surplus Margin | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Other Misc. Operating Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Spreadsheet Check (Auto-populates) | $0 | |||||||||||||||||||||||||||||||
| TOTAL ALLOWABLE COSTS | ||||||||||||||||||||||||||||||||
| (Auto-populates) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
COST POOL SECTION:
| Service Subcontract Allowance (per contract) | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 | $25,000 |
| Contracts over $50,000 Only - Enter Service Subcontract Adjustment (Contract Amount minus $25,000) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Reallocate Support Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Auto-populates based on Percent of Total Staff Hours from Personnel | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 100.00% |
| Reallocate Shared Building Space | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |
| Enter Square Footage Occupied (In Red Only) | 0.0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Reallocate Client Transportation Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Auto-populates % of Driver Time Per Program from Personnel | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 100.00% |
| Reallocate General Administration Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Auto-populates based on Modified Total Direct Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| TOTAL ACTUAL COSTS BY SERVICE | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter Number of Billing Units | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||
| ACTUAL COST PER UNIT OF SERVICE | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
DONATED PERSONNEL OR
NON-CASH MATCH SECTION
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Enter description (Column A) and then $ value (Column B) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
Donated Cost Pool Section: $0 $0
| Reallocate Donated Building Space | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| (Auto-populates from Cost Pool Section above) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Reallocate Donated Client Transportation Costs | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| (Auto-populates from Cost Pool Section above) | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 100.00% |
| $0 | ||||||||||||||||||||||||||||||
| Reallocate Donated General Administration | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |||
| (Auto-Populates from Cost Pool Section above) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | ||||
| Spreadsheet Check (Auto-populates) | $0 | |||||||||||||||||||||||||||||
| TOTAL COSTS | ||||||||||||||||||||||||||||||
| (Plus Donated/Non-Cash Match) | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | ||
| Number of Billing Units (Auto-populates from Cost Pool Section above) | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | ||||
| POTENTIAL UNIT COST | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES UNIFORM COST METHODOLOGY Support Spreadsheet
SFY 2012
&"Times New Roman,Regular"&9MAN 5600, Appendix D UCM Spreadsheet - Final - 6/5/12 &P of &N&"Arial,Bold"
Budget Summary Table
| Offeror Budget Summary Work Sheet | |||||||||||||||||
| Agency Name: | |||||||||||||||||
| Service | Unit of measure | Unit Cost (per UCM support) | ARC Funding Request | Units of Service to be provided with ARC Funding | Unduplicated Persons Served by ARC Funding | Projected Units Served: July | Projected Units Served: August | Projected Units Served: September | Projected Units Served: October | Projected Units Served: November | Projected Units Served: December | Projected Units Served: January | Projected Units Served: February | Projected Units Served: March | Projected Units Served: April | Projected Units Served: May | Projected Units Served: June |
| Aging Mastery Program | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Bingocize | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Chronic Disease Self Management Program | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Chronic Pain Self Management Program | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Diabetes Self Management Program | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Matter of Balance | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Powerful Tools for Caregivers | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Tai Chi for Arthritis and Falls Prevention | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Additional EBP_______________________ | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Additional EBP_______________________ | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| Additional EBP_______________________ | One Workshop | $ - 0 | $ - 0 | ||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| One Workshop | $ - 0 | $ - 0 | |||||||||||||||
| Total | $ - 0 |
| 1. Enter Units of Service to be provided from the UCM Support Spreadsheet |
| 2. Enter the Unit Cost of the Service |
| 3. Enter the unduplicated persons expected to be served |
| 4. Enter the ARC funding provided in the allocation that will be used to fund the services. |
Budget Narrative
| BUDGET NARRATIVE |
| Your Budget Narrative should address the following bullet points: |
| * The budget justification is clear, logical and specifically describes the program and corresponds with the cost allocation/budget. |
| * The budget proposal clearly demonstrates capacity to provide required match funds and leverage grant funding to maximize program outcomes. |
**The three spaces below are meant to be for separate paragraphs for your narrative. If you need more or less room, feel free to format as needed.**
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