Appendix G Fee For Service Budget Template RFP-SSA-FY26-0522 Community Living Connection_1.xlsx
XLSX spreadsheet 23 KB Posted
- Attached to
- Community Living Connection
- Solicitation number
- RFP-SSA-FY26-0522
- Issued by
- Santa Clara County, California
About this file
This is a Fee for Service Budget Template for the Community Living Connection Request for Proposal (RFP-SSA-FY26-0522) issued by the Santa Clara County Social Services Agency's Department of Aging and Adult Services. The RFP seeks qualified vendors to provide case management and related services enabling high-risk older and disabled adults to continue living independently in Santa Clara County, California. The contract period runs from July 1, 2026, through June 30, 2027, with an initial one-year term and the County's option to renew for up to four additional years. The template accommodates multiple service line items with specified rates, estimated quantities, and units of service, allowing vendors to define contracted services and ancillary offerings through detailed budget narratives.
The budget template requires vendors to detail all direct, indirect, and administrative costs within contracted service rates, encompassing personnel, travel, technology, training, curriculum development, support staff, management, credentialing, and quality assurance expenses. Vendors must provide funding source information with commitment codes indicating whether funding represents firm commitments, anticipated renewals, projections, pending applications, or pre-applications. The template includes a staffing salary section requiring documentation of staff names, job titles, annual salaries, percentage time allocation to the contract, and months of service. Any staffing changes during the contract term necessitate submission of revised staffing salary documentation and potentially amended budget requests. The County General Fund serves as the identified funding source, and the template specifies that the Social Services Agency amount in Column B must equal the grand total of Column D in the Budget Detail section.
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Text version
Resource Table
| Agency Name: | |
| Contract Period: | July 1, 2026 - June 30, 2027 |
| Program Name: | Community Living Connection |
| A | B | C | D |
| Source of Funds | FY26-27 Amount | % of Total Funding | Commitment Code |
| Social Services Agency (SSA)* |
| Total Funding Resources | $ - |
| Commitment Code | |
| 1 | Firm Commitment-Already have an agreement or letter confirming funding |
| 2 | Anticipated Renewal of Existing Funding-Continuation of current year funding |
| 3 | Anticipated Resource-Projection of previous fees or donations |
| 4 | Application Pending-Application has been submitted, no confirmation at this time |
| 5 | Pre-Application-Not yet submitted and expect funding |
| * The SSA line in FY 26-27 Amount, Column "B" should equal the Grand Total of |
| Column "D" in the Budget Detail. |
&"-,Bold"&11Santa Clara County Social Services Agency &"-,Bold"&11REQUEST FOR PROPOSAL
BID NUMBER: RFP-SSA-FY26-0522
FEE FOR SERVICE TEMPLATE &"-,Bold"&11&K000000Appendix G: Budget Plan Resource Table
&"-,Regular"&11County General Fund Contract Between the County of Santa Clara and Insert Agency Name Here MCGF/-Insert Agency Acronym Here-FY2019
Budget Detail
| Agency Name: | - 0 |
| Contract Period: | July 1, 2026 - June 30, 2027 |
| Program Name: | Community Living Connection |
| A | B | C | D |
| Line Items | |||
| Contracted Service* | Rate | Estimated Quantity* | Total |
| Unit of Service 1 | $ - | $ - | |
| Unit of Service 2 | $ - | $ - | |
| Unit of Service 3 | $ - | $ - | |
| Unit of Service 4 | $ - | $ - | |
| Unit of Service 5 | $ - | $ - | |
| Grand Total | $ - |
*To request an adjustment to estimated quantity for budget line items during the course of the fiscal year, contractor must submit to the County an advance budget revision request form and get written pre-approval from the County. Rate changes and adding or removing line items are generally not permitted through a budget revision request.
Social Services Agency &"-,Bold"&11REQUEST FOR PROPOSAL
BID NUMBER: RFP-SSA-FY26-0522
FEE FOR SERVICE TEMPLATE &"-,Bold"&11Appendix G: Budget Plan&K000000 Budget Detail
MCGF/-Insert Agency Acronym Here-FY2018
Budget Narrative
| Agency Name: | - 0 |
| Contract Period: | July 1, 2026 - June 30, 2027 |
| Program Name: | Community Living Connection |
Please provide detail for each line item. Narrative should explain each service, including the ancillary services that are included as part of the primary service. All ancillary services listed in the Outputs section of your Work Plan, but not included as a budget line item, should be included in the Narrative for the line item to which it corresponds.
| Contracted Service(s)* | Narrative |
| Unit of Service 1 | |
| Unit of Service 2 | |
| Unit of Service 3 | |
| Unit of Service 4 | |
| Unit of Service 5 |
*Contracted Services rate always include all direct, indirect, and administrative costs related to providing the services. This includes, but is not limited to, personnel cost, travel, technology, training, curriculum development or acquisition costs, support staff, management, credentialing, and quality improvement and/or quality assurance.
Social Services Agency &"-,Bold"&11REQUEST FOR PROPOSAL
BID NUMBER: RFP-SSA-FY26-0522
FEE FOR SERVICE TEMPLATE &"-,Bold"&11Appendix G: Budget Plan&K000000 Budget Narrative &"Arial,Regular"
MCGF/-Insert Agency Acronym Here-FY2019
Staffing Salary
| Agency Name: | - 0 |
| Contract Period: | July 1, 2026 - June 30, 2027 |
| Project Name: | Community Living Connection |
| A | B | C | D | E |
| Staff Name and Job Title | Annual Salary | % of Time Allocated to this Contract | Number of Months | Salary Allocated to this Contract * |
| $ - | ||||
| $ - | ||||
| $ - | ||||
| $ - | ||||
| $ - | ||||
| $ - | ||||
| $ - | ||||
| $ - |
Total $ -
| *If there are any staffing changes during the contract term, contractor must submit to the County a revised |
| "Staffing Salary". If the staffing change impacts any budget line items, Contractor must also submit to the County |
| a revised budget request form. |
Social Services Agency &"-,Bold"&11REQUEST FOR PROPOSAL
BID NUMBER: RFP-SSA-FY26-0522
FEE FOR SERVICE TEMPLATE &"-,Bold"&11Appendix G: Budget Plan Staffing Salary
&"-,Regular"&11County General Fund Contract
MCGF/-Insert Agency Acronym Here-FY2019
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