Appendix C - Cost Submittal Worksheet (Addendum 1).xlsx
XLSX spreadsheet 39 KB Posted
- Attached to
- Family Support Programs
- Solicitation number
- 25-RFA-13800
- Issued by
- Pennsylvania
About this file
This is a Cost Submittal Worksheet (Appendix C, Addendum 1) for the Pennsylvania Department of Human Services, Office of Child Development and Early Learning (OCDEL), supporting the Family Support Programs Request for Applications (RFA 25-RFA-13800). The worksheet provides a standardized template for applicants to submit detailed budget information for Evidence-Based Home Visiting (EBHV) programs across Pennsylvania's 67 counties. Applicants must complete cost submissions for both Year 1 and Year 2, using identical total costs for both agreement years, and provide comprehensive budget narratives justifying all proposed expenditures. The application deadline is October 13, 2026, at 12:00 PM EST, with questions due by September 15, 2026. The initial contract term is two years, renewable for up to three additional one-year periods based on performance.
The Cost Submittal Worksheet requires applicants to itemize and justify all direct and indirect costs across multiple budget categories including salaries and wages (with staff position titles and allocation percentages), benefits, supplies and materials, transportation and travel, purchased services, training (including model training and fees), indirect costs (capped at 15 percent of direct costs or approved federal negotiated rate), audit costs, and other operating costs. Applicants must specify which program type (EBHV Model or Enhancement) each cost is associated with, with Enhancement costs not to exceed 25 percent of total requested funding. No minimum or maximum award amount is specified; funding is determined based on applicant cost submissions and evaluated for feasibility and reasonableness relative to proposed activities and per-family service costs. All costs must be calculated to the nearest whole dollar amount, and applicants must perform at least 50 percent of total contract costs themselves while maintaining full responsibility for any subcontracted services. Grantees must submit three years of audited financial statements and comply with federal uniform administrative requirements, with single audits required for organizations expending $1 million or more in federal awards.
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Instructions
| APPENDIX C - COST SUBMITTAL WORKSHEET |
| Applicants must adhere to the requirements specified below: |
| • The Cost Submittal must be completed in its entirety by completing all cells in each tab as appropriate for your submission. |
| • Please refer to the RFA for specific funding requirements. |
| • Applicants must complete and submit a budget or cost submittal, along with a detailed narrative, for Year 1 and Year 2. |
| • Applicants should use the same total costs for both agreement years. |
| • No maxium or minimum award amount is required. However, when considering costs they must be sufficient, not excessive, to complete all the services and activities as described in this application. |
| Cost Worksheet Tab: |
| • Complete the table in its entirety by completeing all applicable cells shaded in yellow. |
| • Amounts listed for EBHV Year 1 should match the total listed in the Chart on Appendix J. |
| • Amounts listed for Enhancements Year 1 should match the total listed in the Chart on Appendix P. |
| • Refer to the RFA for maxium percentages of funding allowable for Enhancements. |
| Cost Submittal Worksheet Tab: |
| • The budgets provided must calculate to the nearest whole numbers. (Example: $10.60; enter $11.00. $10.40; enter $10.00) |
| • For Salary and Benefits please use the total salary and proposed allocation of funds. For example a person that is split evenly between programs would have an allocation of 50%. |
| • It is only necessary to list position titles, not individuals names. |
| • Show ALL costs associated with the application, and include all information to fully determine the Cost Submittal. |
| • Additional rows may be added as necessary. |
| • For each budget catergory specify which program type the cost is associated with. |
| • Indirect costs are incurred for common objectives that benefit multiple programs and projects administered by the applicant and are not readily assignable to a particular funding stream. Indirect costs relate to the general management of the applicant organization, such as executive oversight, grants management, utilities, facility maintenance, accounting, budgeting, personnel and legal services. |
| Submittal Narrative Tabs: |
| • Please provide pertinent information to explain the requested costs for each year of the grant. |
| • Complete the budget narrative such that it describes and justifies the proposed costs for each budget line item. Each line should have a detailed description as to how the dollars will be used. For example, in the description for the wages and salaries line item, the Applicant should break out the positions attached to the project. |
| • Applicants must also indicate the overall amount attributed to each EBHV Model or Enhancement, if implementing more than one of these. |
Cost Worksheet 25-RFA 13800, Family Support Programs Cost Worksheet Applicant Name:
| Total Grant Requested | EBHV Amount Requested | EBHV % | Enhancement Amount Requested | Enhancement % | |
| Year 1 | $0.00 | ERROR:#DIV/0! | ERROR:#DIV/0! | ||
| Year 2 | $0.00 | ERROR:#DIV/0! | ERROR:#DIV/0! |
Enhancement % should be no more than 25% of the total amount requested for each year.
Cost Submittal Worksheet 25-RFA-13800, Family Support Program Cost Submittal Worksheet Applicant Name:
| Categories | Year 1 | Year 2 | TOTAL COST | ||||
| Total Salary | Percentage of Cost Allocated | Total | Total Salary | Percentage of Cost Allocated | Total | ||
| Salary/Wages | |||||||
| (List all Staff Titles Allocated to the Program) | |||||||
| $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 | $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 | |||||
| Salary/Wages Total | $0.00 | $0.00 | $0.00 | ||||
| Benefits | |||||||
| (Calculated as a percentage of the Salary) | |||||||
| $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 | $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 | |||||
| Benefits Total | $0.00 | $0.00 | $0.00 | ||||
| Supplies and Materials | |||||||
| (Itemize, please be descriptive, Supplies include office supplies, minor office equipment (less than $5,000), supplies used in a direct service capacity, etc.) | |||||||
| $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 | |||||||
| Supplies and Materials Total | $0.00 | $0.00 | $0.00 | ||||
| Transportation/Travel | |||||||
| (Itemize, transportation costs include staff travel, mileage for use of personal vehicles and client transportation, vehicle rental) | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| Transportation/Travel Total | $0.00 | $0.00 | $0.00 | ||||
| Purchased Services | |||||||
| (Itemize - Please put Audit Costs in the Audit section below) | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| Purchased Services Total | $0.00 | $0.00 | $0.00 | ||||
| Training | |||||||
| (Itemize - Include Model Training and Yearly Model Fees, Purchased services include contracted services provided by an individual or an approved agency.) | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| Training Total | $0.00 | $0.00 | $0.00 | ||||
| Indirect Cost | |||||||
| (Up to 15% of Direct Costs or up to the Approved Federal Negotiated Agreement) | |||||||
| $0.00 | |||||||
| Indirect Cost Total | $0.00 | $0.00 | $0.00 | ||||
| Audit | 0 | 0 | ERROR:#REF! | ||||
| $0.00 | |||||||
| Audit Total | $0.00 | $0.00 | $0.00 | ||||
| Other Operating Costs | 0 | 0 | ERROR:#REF! | ||||
| (Itemize) Please be descriptive, Other operating costs which cannot be included on the previous operating line items such as insurance, facility insurance agreement, training, parent involvement, dues, subscriptions, employee morale) | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| $0.00 | |||||||
| Other Operating Costs Total | $0.00 | $0.00 | $0.00 | ||||
| TOTAL COST | $0.00 | $0.00 | $0.00 |
Yr 1 . C Submittal Narrative
Year 1 - Budget Narrative, Justification, and Notes.
Please include any pertinent information that further explains the requested costs.
Salary/Wages:
Benefits:
Supplies and Materials:
Transportation/Travel:
Purchased Services:
Training:
Indirect Cost:
Other Operating Costs:
Audit:
Yr 2 . C Submittal Narrative
Year 2 - Budget Narrative, Justification, and Notes.
Please include any pertinent information that further explains the requested costs.
Salary/Wages:
Benefits:
Supplies and Materials:
Transportation/Travel:
Purchased Services:
Training:
Indirect Cost:
Other Operating Costs:
Audit:
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