ANNEX 4 - PHASE 2 BUSINESS APPLICATION TEMPLATES for FY20 RFA (12.4.2019).docx

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American Schools and Hospitals Abroad Program Worldwide
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72ASHA20RFA00001-PC
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Annex 4 business application

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ANNEX 4 – PHASE 2 BUSINESS COST APPLICATION TEMPLATES

Instructions: Applicants should reproduce and complete the templates in Sections 4a, 4b, and 4c under "Annex 4 - Phase 2 Business Cost Application Templates" and return to ASHA for review. All requested information should be submitted.

Annex 4 Section 4a - Summary Budget Template

Click here for template

Cost Categories
USAID
Total USAID

funds

Total Leveraged funds
Total Cost
Prime
Sub
Sub

A: Professional A&E Services

B: Construction

C: Renovation

D. Durable Commodities

E. Program Support

TOTAL ESTIMATED AMOUNT

Annex 4 Section 4b - Budget Template

Click here for template

Description of Categories
Units Description
Unit Cost
Units

Yr 1 Total Cost Yr 1 Units Yr 2 Total Cost Yr 2

Add years as needed
Total Cost
Prime (USO)
Sub (OSI)
Sub (Add)
USAID Request
Funding from other Sources (Leverage)

A: Professional A&E Services

- Construction Drawings

- Environmental plan

- Other

-- Other 1

Subtotal

B: Construction

- Area 1 - Construction

-- Construction 1

-- Construction 2

-- Construction 3

-- Construction 4

- Area 1 - Finishing

-- Finishing 1

-- Finishing 2

-- Finishing 3

-- Finishing 4

- Other

-- Other 1

Subtotal

C: Renovation

- Area 2 - Renovation

-- Renovation 1

-- Renovation 2

-- Renovation 3

-- Renovation 4

- Area 2 - Finishing

-- Finishing 1

-- Finishing 2

-- Finishing 3

-- Finishing 4

- Other

-- Other 1

Subtotal

D. Durable Commodities

- Area 1 - Commodity

-- Commodity 1

-- Commodity 2

-- Commodity 3

-- Commodity 4

- Area 2 - Commodity

-- Commodity 5

-- Commodity 6

-- Commodity 7

-- Commodity 8

- Other

Subtotal

E. Program Support

- Audit costs

- Branding and Marking costs

- Other

-- Other 1

Subtotal

TOTAL COST

Annex 4 Section 4c - Budget Template of Durable Commodities Click here for template

Description of Categories
Units Description
Unit Cost
Units

Yr 1 Total Cost Yr 1 Units Yr 2 Total Cost Yr 2

Add years as needed
Total Cost
Prime (USO)
Sub (OSI)
Sub (Add)
USAID Request
Funding from other Sources (Leverage)

D. Durable Commodities

Area 1

- Commodity 1

- Commodity 2

- Commodity 3

- Commodity 4

- Commodity 5

Subtotal

Area 2

- Commodity 6

- Commodity 7

- Commodity 8

- Commodity 9

- Commodity 10

- Commodity 11

- Other

Subtotal

Total

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