5_ Uniform Cost Methodology (UCM) ARC FY28 _ .xlsx

XLSX spreadsheet 353 KB Posted Oct 5, 2026

Attached to: NOFA800 - FTA Section 5310 FY2028-FY2029
Solicitation number: PE-29016-NONST-2028-000000074
Issued by: Fulton County, Georgia

About this file

Written by GovTribe AI · Oct 8, 2026

Summary of Files

The Uniform Cost Methodology (UCM) spreadsheet is an Excel-based costing tool developed by the State of Georgia, Division of Aging Services, designed for use by service providers and Area Agencies on Aging (AAAs) to calculate unit costs for services delivered to older adults under the Older Americans Act. The tool enables providers to estimate personnel and support costs associated with service delivery and is required for organizations bidding for aging services funding. The UCM model consists of input tabs for personnel and support expenses, along with corresponding output tabs that auto-calculate costs and allocate expenses to cost pools including General Administration, Shared Building Space, Client/Meal Transportation, and Support services. The spreadsheet accommodates up to 25 staff positions and supports allocation of costs across numerous service types including congregate meals, home-delivered meals, case management, transportation, adult day care, counseling, respite care, and various health promotion and disease prevention programs.

The UCM uses color-coded formatting to distinguish between manual input cells (green), instructional guidance (blue), and auto-calculated outputs (black) to facilitate proper completion. Personnel inputs require entry of staff positions, base wages, fringe benefit rates, and productive hours allocated to specific services and administrative functions, while support inputs capture expenses across staff travel, vehicle operations, building, computer, equipment, supplies, service contracts, meal costs, and other operating expenses. The methodology allocates costs using a hierarchical system that first calculates direct wages and benefits by service, then distributes indirect costs proportionally based on staff time percentages, billing units, and square footage occupied. The tool automatically generates actual cost per unit of service for each program and accommodates donated personnel and non-cash match contributions, enabling providers to demonstrate true cost of service delivery for reimbursement, rate-setting, and grant application purposes.

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Other files

File	Type	Posted
2_ Transmittal Cover Page FTA 5310 FY28_FY29.pdf	PDF	Oct 5, 2026
4_ Financial Components Workbook FTA 5310 FY2.xlsx	XLSX spreadsheet	Oct 5, 2026
6_ UCM Instruction Manual 2024.pdf	PDF	Oct 5, 2026
3_ Proposal Response Template FTA 5310 FY28_F.docx	DOCX document	Oct 5, 2026
1_ ARC FTA 5310 NOFA FFY28 _ FFY29.pdf	PDF	Oct 5, 2026

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Cover

Uniform Cost Methodology

Organization Name	State of Georgia, Division of Aging
Model Name	Uniform Cost Methodology
File Name	Uniform Cost Methodology_September 2024
Last Updated	September 2024
Model Contact	Please contact UCM_DAS@dhs.ga.gov for questions

Sheet No.	Sheet Name
1	Cover (This Sheet)
2	Quick Start Guide
3	Inputs Label
4	PERSONNEL_INPUTS
5	SUPPORT_INPUTS
6	Outputs Label
7	PERSONNEL_OUTPUTS
8	SUPPORT_OUTPUTS

&"Arial,Bold"&16DHS DIVISON OF AGING SERVICES

UNIFORM COST METHODOLOGY

Cover

SFY 2024

Page &P of &N

Quick Start Guide

The Uniform Cost Methodology (UCM) is a tool for estimating unit costs involved in delivering services for older adults. The methodology enables providers and Area Agencies on Aging (AAAs) to understand the personnel and support components of their service cost; identifying the cost of services is also a requirement for providers to bid for services and receive funding for programs under the Older Americans Act.

The tables below provide an orientation to completing the UCM:

The UCM spreadsheet is divided into inputs and outputs tabs as listed in Table 1 below. The spreadsheet also utilizes color coding, outlined in Table 2 below, to differentiate modes of cell calculation.

The Inputs Tabs:

• Includes input columns and spreadsheet checks

• Are the only tabs used to enter data

The Outputs Tabs:

• Contain all UCM columns

• Auto-populate values based on the inputs tabs

• Used by AAAs and DAS to review entries

Table 1
Sheet Name	Sheet Purpose
PERSONNEL_INPUTS	To input staff wages and benefits.
SUPPORT_INPUTS	To input expenses for supplies and services.
PERSONNEL_OUTPUTS	Auto-calculates wages and benefits costs for cost pools and services.
SUPPORT_OUTPUTS	Allocates expenses to cost pools and calculates the unit cost per service.

Table 2
Font Color	Meaning
Green	Enter value here; manual inputs
Blue	Brief instructions on entering values
Black	Auto-calculated outputs (do not enter values here)
Please refer to the UCM Instructions Manual and Training Videos for additional help on filling out the UCM.

&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES

UNIFORM COST METHODOLOGY

Quick Start Guide

SFY 2024

Inputs-->

UNIFORM COST METHODOLOGY

Inputs Label

SFY 2024

Page &P of &N

Utilize the following two tabs, PERSONNEL_INPUTS & SUPPORT_INPUTS, to input UCM-related data.

PERSONNEL_INPUTS

Enter Provider Name:

#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 Benefits Rate

(Enter benefit costs by % only)

Productive Hours

(Enter annual productive hours)

Admin Hours

(Enter admin hours)

Shared Building Space Hours

(Enter shared building space hours)

Choose a Service

All Other

Billable Hours

All Other Hours

Enter Staff Title/Name
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Unit of Service							1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00

&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES

Personnel Inputs

SFY 2024

SUPPORT_INPUTS

File is..

In Balance

#10

#11

#12

#13

#14

#15

#16

#17

#18

#19

#20

#21

#22

#23

#24

#25

All Other

Choose a Service

All Other

General Administration

COST POOL

Shared Building Space

COST POOL

Client/Meal Transportation COST POOL

Support

COST POOL

Enter Provider Name:
PROPOSED ANNUAL EXPENSES
STAFF TRAVEL EXPENSES
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
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
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
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
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
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
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
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
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
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
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 $0

COST POOL SECTION:

Service Subcontract Allowance (per contract)
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 Shared Building Space
Enter Square Footage Occupied (In Green 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

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

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
Spreadsheet Check (Auto-populates)	$0

Support Inputs

SFY 2024

Outputs-->

UNIFORM COST METHODOLOGY

Outputs Label

SFY 2024

Page &P of &N

The following two tabs, PERSONNEL_OUTPUTS & SUPPORT_OUTPUTS, reflect all outputs for the entered data.

PERSONNEL_OUTPUTS

Enter Provider Name:

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STAFF LIST

(Paid staff only - do not include volunteers

or other donated)	Number of Staff Positions
(Auto-populates)	Base Wages
(Auto-populates)	Fringe Benefits Rate
(Auto-populates)	Fringe Benefit Dollars
(Auto-populates)	Total Wages

and Benefits

(Auto-populates)	Productive Hours
(Auto-populates)	General Admin %
(Auto-populates)	Admin Hours
(Auto-populates)	General Admin

Costs

(Auto-populates)

Staff for Building Maintenance %

(Auto-populates)

Shared Building Space Hours

(Auto-populates)

Shared Building Space

(Auto-populates)

Choose a Service

All Other Programs

(Auto-populates) All Other Wages (Auto-populates)

TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(Auto-populates) TOTAL

HOURS

(Auto-populates)	Billable Hours
(Auto-populates)	% OF

STAFF TIME

(Auto-populates) W & B

COST

(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
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% 1.0

Column1

Choose a Service

AAA Administration

AAA Advocacy

AAA Coordination

AAA Outreach

AAA Program Development

ADRC Information and Assistance

Adult Day Care

Adult Day Care - Mobile

Adult Day Health

Aging Mastery Program

Behavioral Health Coaching - Congregate

Behavioral Health Coaching - Non-Congregate

Bingocize

BRI Care Consultation

Care Receiver Supervision

Caregiver - Group

Case Management

Case Management Brokering

CDSME - CDSMP

CDSME - CPSMP

CDSME - Diabetes

CDSME - Tomando

Chore

Community and Public Education

Community Options Counseling

Congregate Meals Cost Only

Congregate Meals Management Only

Congregate Meals - Voucher

Counseling - Group

Counseling - Individual

Disaster Services - Congregate Meals

Disaster Services - Home Delivered Meals

Emergency Home Delivered Meals

Falls Prevention - Matter of Balance

Falls Prevention - Tai Chi

Geri-Fit Program

Health Coaches for Hypertension Control

Health Promotion/Disease Prevention

Home Delivered Meals Cost Only

Home Delivered Meals Management Only

Home Delivered Meals - Voucher

Home Management

Homemaker

Homemaker - Voucher

Hospital Transition - Care Transitions Intervention

Hospital Transition - The Bridge Model

Kinship Care - Group

Map Habit

Material Aid - Assistive Technology

Material Aid - Assistive Technology - Voucher

Material Aid - Home Modifications/Home Repair

Material Aid - Other - Group

Material Aid - Other - Individual

Material Aid - Other - Individual - Voucher

MDSQ Options Counseling

Medications Management - Group

Medications Management - Individual

MFP - Transition Coordination

Monitored Living Solution - Installation

Monitored Living Solution - Monitoring

Nursing Home Transitions

Nutrition Counseling

Nutrition Education

Nutrition Risk Assessments

Outreach

Personal Care

Personal Care - Voucher

Powerful Tools for Caregivers

RCI Caring for You, Caring for Me (CFYCFM)

RCI Dealing with Dementia

RCI REACH (Resources Enhancing Alzheimer’s Caregiver Health)

Respite Care - In-Home

Respite Care - In-Home - Voucher

Respite Care - Out-of-Home

Respite Care - Out-of-Home - Voucher

Senior Recreation

Support Group

Support Groups - Caregiver Group

Support Options

Support Options Coordination

Telephone Reassurance

Training

Transportation - Individual

Transportation - Individual - Voucher

Tutoring

VIVO

Personnel Outputs

SFY 2024

SUPPORT_OUTPUTS

File is..

In Balance

#10

#11

#12

#13

#14

#15

#16

#17

#18

#19

#20

#21

#22

#23

#24

#25

All Other

Choose a Service

All Other

General Administration

COST POOL

Shared Building Space

COST POOL

Client/Meal Transportation COST POOL

Support

COST POOL

Enter Provider Name:

PROPOSED ANNUAL EXPENSES

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
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%	0.00%

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
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%	0.00%

			$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

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File details come from the government source that posted it. Updated Oct 8, 2026.