Attachment 1 - Budget Template FINAL4.pdf
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- Solicitation number
- 2081627
- Issued by
- Cayuga County, Chautauqua County, Clinton County, Essex County, Greene County, Herkimer County, Kings County, Lewis County, Livingston County, Madison County, Nassau County, Onondaga County, Orleans County, Queens County, Rensselaer County, Richmond County, Rockland County, St. Lawrence County, Saratoga County, Schenectady County, Schuyler County, New York
About this file
This document is an RFP (Request for Proposals) issued by the New York State Office of Children and Family Services (OCFS) to solicit applications for Healthy Families New York (HFNY) home visiting services that include Healthy Families America (HFA) Child Welfare Protocols. The RFP aims to expand the availability of HFNY services in 21 unserved counties across New York State, allowing families with children up to 24 months of age referred by child welfare to enroll. A total of approximately $9 million annually will be available to fund proposals, with annual awards of up to $500,000 per county based on the number of families to be served. The RFP specifies that no more than one proposal per county will be approved for funding, and that proposals should aim to serve the equivalent of up to 15% of Medicaid births in their target county(ies). The submission deadline is June 10, 2022 at 4:00 PM Eastern Time, and the contract term is October 1, 2022 to September 30, 2027.
The RFP includes Minority and Women-Owned Business Enterprise (MWBE) subcontracting goals of 15% each, as well as a Service-Disabled Veteran-Owned Business (SDVOB) contracting goal of 6%. No previous awards for identical or substantially similar procurement contracts within the past five years are specified. Funding sources and amounts for this opportunity are outlined, and applicants are encouraged to review the guidance provided on determining the number of families to be served.
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A-1 Summary of Personnel Costs
Position/Title Annual Salary % of Time Salary times % of Time** Local Share
OCFS Grant Funds Total Cost
1. Personnel Total
2. Fringe Benefits Total Enter Rate:
3. Total Personal Services Costs
** The figures in the column are for comparison purposes only. It may not exactly equal the Total Cost figure.
A-1 Personal Narrative
Budget Narrative: Attach a description of the role/responsibility of each person included above.
Resumes of key project staff should be included as an addendum to the Project Narrative Section.
1. Title:
Enter Role/Responsibility Below
2. Title:
Enter Role/Responsibility Below
3. Title:
Enter Role/Responsibility Below
4. Title:
Enter Role/Responsibility Below
5. Title:
Enter Role/Responsibility Below
6. Title:
7. Title:
Enter Role/Responsibility Below
8. Title:
Enter Role/Responsibility Below
9. Title:
Enter Role/Responsibility Below
10. Title:
11. Title:
12. Title:
Enter Role/Responsibility Below
13. Title:
Enter Role/Responsibility Below
14. Title:
Enter Role/Responsibility Below
15. Title:
16. Title:
17. Title:
Enter Role/Responsibility Below
18. Title:
Enter Role/Responsibility Below
19. Title:
Enter Role/Responsibility Below
20. Title:
B4. Contractual/Consultant
Item Local Share OCFS Funds Total Costs
Total Contractual/Consultant Costs
Enter Budget Narrative Below:
Total Travel Costs
B6. Equipment
Total Equipment Costs
B7. Supply Costs
Total Supply Costs
B8. Other Expenses
Total Other Expenses
Expense Category
Local Share/ Local Match
(if applicable) OCFS Funds Total Project Cost
A. Personal Services
1. Project Staff Salaries
2. Fringe Benefits
3. Total (Lines 1 + 2) B. Non-Personal Services
4. Contractual/Consultant
5. Travel/Per Diem
6. Equipment
7. Supplies
8. Other Expenses
9. Total (Total Lines 4 to 8) C. Project Total (Lines 3 + 9)
OCFS Funds are the funds you are requesting through this application.
Total Cost refers to the combined Local Share and Grant Funds for this project.
* Total Project Cost must agree with Total Anticipated Revenue form as submitted with this application.
Note: All items in the Budget must be consistent with the goals and objectives of the Project Narrative.
Additional budget narrative pages may be attached as necessary.
Local Match (if required) Use *calculation below
*Local Match Calculation = % of matching funds (if required in the RFP or contract agreement ) X OCFS grant award.
Total costs entered for each budget category above must reflect totals from attached Budget Sections.
Local Share refers to all funds other than this grant award, including in-kind contributions to support the project as described in the narrative section of the application. The type and amount of in-kind contributions should be specifically identified under the appropriate Budget Section. The total amount of the in-kind portion of Local Share should be entered in parenthesis next to Local Share Project Total space.
Budget Narrative: Complete the narrative section for each part of the budget. Instructions are included on the following application budget pages.
2 3 4
ATTACHMENT B
BUDGET SUMMARY
(Rev. 1/8/02)
The purpose of this form is to document the budget for the proposed project. Indicate the amount of funds being requested to support the proposed project under “OCFS Funds.”
Contractor Name:
Period of Budget:
Contract Number:
Local Share/Match Breakdown
Source Amount A. Cash Donations
B. In-Kind Donations
C. Volunteers/Intern
D. Fees for Service
E. Unrestricted Cash or Fund Balance
F. Grants:
- Other grants supporting this project Amount of OCFS Funds Non-OCFS Funds supporting this project
Total
Itemize amounts of assured revenue, potentially available funds, and estimated income from in-kind contributions to support this project.
Cash Donations should be calculated on the basis of what the applicant organization can realistically be expected to raise during the program year; attach a description of fund raising efforts.
In-Kind Donations refers to equipment, furnishings and other non-personal expenses that are donated to support the function of this project.
Volunteers (another type of in-kind contribution) refers to project personnel who donate their time to the functioning of this project. Volunteer job descriptions and timecards should be kept to substantiate this line item.
Unrestricted Cash or Fund Balance Unrestricted funds include all revenues that are not specifically restricted as to their use. Unrestricted funds include income from dues, publication sales, advertising sales, conference fees, mailing label sales, interest income from unrestricted funds, fees obtained in the execution of externally funded projects, and contributions.
Fees for Services refers primarily to income received from clients directly. In addition, any income received by the applicant organization for reimbursable activities funded by this contract such as counseling, training, speaking engagements, etc., must be listed here.
Grants refers not only to the amount being requested under this grant but also to monies received (or applied for) from another funding source for activities related to this contract, e.g., state, federal, local. Each grant must be listed separately under Section F.
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| txtPersonTotalCost6: 0 |
| txtPersonTotalCost7: 0 |
| txtPersonTotalCost8: 0 |
| txtPersonTotalCost9: 0 |
| txtPersonTotalCostFrBeneTotal: 0 |
| txtPersonTotalCostPersTotal: 0 |
| txtPersonTotalCostSerCostTotal: 0 |
| txtSourceLocShareMatchBrkdwnAmtOCFS: |
| txtSourceLocShareMatchBrkdwnCashDon: |
| txtSourceLocShareMatchBrkdwnFeeSvc: |
| txtSourceLocShareMatchBrkdwnGrants: |
| txtSourceLocShareMatchBrkdwnKindDon: |
| txtSourceLocShareMatchBrkdwnNonOCFSFunds: |
| txtSourceLocShareMatchBrkdwnOthGrants: |
| txtSourceLocShareMatchBrkdwnTotal: |
| txtSourceLocShareMatchBrkdwnUnresCash: |
| txtSourceLocShareMatchBrkdwnVolInt: |
| txtSupplyItem1: |
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| txtSupplyLocShareTotal: 0 |
| txtSupplyNarrative: |
| txtSupplyOCFSFunds1: |
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| txtTravelItem1: |
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| txtTravelLocShare2: |
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| txtTravelLocShare4: |
| txtTravelLocShare5: |
| txtTravelLocShare6: |
| txtTravelLocShare7: |
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| txtTravelLocShare9: |
| txtTravelLocShareTotal: 0 |
| txtTravelNarrative: |
| txtTravelOCFSFunds1: |
| txtTravelOCFSFunds10: |
| txtTravelOCFSFunds11: |
| txtTravelOCFSFunds12: |
| txtTravelOCFSFunds13: |
| txtTravelOCFSFunds14: |
| txtTravelOCFSFunds15: |
| txtTravelOCFSFunds16: |
| txtTravelOCFSFunds17: |
| txtTravelOCFSFunds18: |
| txtTravelOCFSFunds2: |
| txtTravelOCFSFunds3: |
| txtTravelOCFSFunds4: |
| txtTravelOCFSFunds5: |
| txtTravelOCFSFunds6: |
| txtTravelOCFSFunds7: |
| txtTravelOCFSFunds8: |
| txtTravelOCFSFunds9: |
| txtTravelOCFSFundsTotal: 0 |
| txtTravelTotCost1: 0 |
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| txtTravelTotCost14: 0 |
| txtTravelTotCost15: 0 |
| txtTravelTotCost16: 0 |
| txtTravelTotCost17: 0 |
| txtTravelTotCost18: 0 |
| txtTravelTotCost2: 0 |
| txtTravelTotCost3: 0 |
| txtTravelTotCost4: 0 |
| txtTravelTotCost5: 0 |
| txtTravelTotCost6: 0 |
| txtTravelTotCost7: 0 |
| txtTravelTotCost8: 0 |
| txtTravelTotCost9: 0 |
| txtTravelTotCostTotal: 0 |
| txtTitleCange: B5. Travel |
| txtStateRates: Reimbursement for travel, lodging, and mileage costs must not exceed the State rates in effect at the time the person traveled. |
| txtAppendixB: Attachment B Budget |
File details come from the government source that posted it. Updated .