Attachment_2_Budget_Forms__12-24__-_RFP_Only.xlsx
XLSX spreadsheet 91 KB Posted
- Solicitation number
- SFGOV-0000012206
- Issued by
- San Francisco County, California
About this file
This is a budget forms template from the City and County of San Francisco Human Services Agency (HSA) for RFP #1239 CalWORKs Learning Needs Assessments. The document serves as a standardized budget submission form for non-profit organizations proposing to provide learning needs assessment services to CalWORKs participants engaged in employment activities or paths. The full contract term spans four years from July 1, 2026, through June 30, 2030, with annual budget periods for each fiscal year. A pre-proposal conference is scheduled for November 3, 2026, at 9:00 a.m. PT via Microsoft Teams. The template is structured to accommodate detailed budget planning across the entire four-year performance period, with the option to classify proposals as either new, modifications, or revisions.
The budget form includes comprehensive sections for salaries and benefits, operating-direct expenses, indirect costs calculated at 15 percent, consultant and subcontractor costs (with threshold tracking for amounts exceeding $50,000), direct client pass-through expenses, and capital expenses for equipment and remodeling. The form displays a 25 percent fringe benefit rate applied to salary and benefits calculations. All budget line items in the provided template currently show $0, indicating this is a blank form template awaiting completion by prospective vendors. The budget structure accommodates full-time equivalent (FTE) tracking with percentage allocations for HSA-funded portions of employee positions, allowing contractors to clearly delineate time and cost allocation across programs.
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Text version
Budget Summary Appendix B, Page 1
| HUMAN SERVICES AGENCY BUDGET SUMMARY | |||||
| BY PROGRAM | |||||
| Grantee/Contractor: Vendor Name | Full Term: | 7/1/26 - 6/30/30 | |||
| Program: Program Name | Effective Date: | ||||
| New Modification Revision (Check One) | Modification # | ||||
| 7/1/26- 6/30/27 | 7/1/27 - 6/30/28 | 7/1/28 - 6/30/29 | 7/1/29 - 6/30/30 | 7/1/26 - 6/30/30 | |
| Expenses | Original | Original | Original | Original | Total |
| Salaries & Benefits | $0 | $0 | $0 | $0 | $0 |
| Operating-Direct | $0 | $0 | $0 | $0 | $0 |
| Subtotal | $0 | $0 | $0 | $0 | $0 |
| Indirect Percentage (%) | 15% | 15% | 15% | 15% | 15% |
| Indirect Costs (Line 16 X Line 15) | $0 | $0 | $0 | $0 | $0 |
| Consultant/Subcontractor ($50,000+) | $0 | $0 | $0 | $0 | $0 |
| Direct Client Pass-Through | $0 | $0 | $0 | $0 | $0 |
| Capital Expenses | $0 | $0 | $0 | $0 | $0 |
| Total Expenses | $0 | $0 | $0 | $0 | $0 |
| HSA / DAS Revenues | |||||
| Funding | $0 | ||||
| $0 | |||||
| $0 | |||||
| CODB Eligible 1 | $0 | ||||
| CODB Eligible 2 | $0 | ||||
| CODB Eligible 3 | $0 | ||||
| CODB FY 1 |
Patrick Garcia: Note:
| Zero for brand new programs | $0 | |||||
| CODB FY 2 | $0 | |||||
| CODB FY 3 | $0 | |||||
| CODB FY 4 | $0 | |||||
| OTO | $0 | |||||
| Addback | $0 | |||||
| $0 | ||||||
| $0 | ||||||
| $0 | ||||||
| $0 | ||||||
| Total HSA / DAS Revenues | $0 | $0 | $0 | $0 | $0 | |
| Grantee/Contractor Revenues | ||||||
| $0 | ||||||
| $0 | ||||||
| $0 | ||||||
| $0 | ||||||
| Total Grantee/Contractor Revenues | $0 | $0 | $0 | $0 | $0 | |
| Total Revenues | $0 | $0 | $0 | $0 | $0 | |
| Prepared by and Date: | ||||||
| Telephone No. & Email: | HSA Budget Form (3/24) |
(Vendor Name) Appendix B &P (Program), (FY Length) (F$P), (Commission Month)
Salary & Benefits
| Grantee/Contractor: Vendor Name | Appendix B, Page 2 |
| Program: Program Name |
Salaries & Benefits Detail
| Agency Totals | HSA Program | 7/1/26- 6/30/27 | Agency Totals | HSA Program | 7/1/27 - 6/30/28 | Agency Totals | HSA Program | 7/1/28 - 6/30/29 | Agency Totals | HSA Program | 7/1/29 - 6/30/30 | 7/1/26 - 6/30/30 | |
| POSITION TITLE | Annual Full Time Salary for FTE |
Kim: Annual Full Time Salary for FTE:
Please report in this column the total annual compensation for this classification for a Full Time Employee Total FTE Kim: Total FTE:
Percentage of time employee works on this specific program % FTE funded by HSA (Max 100%) Kim: % FTE funded by HSA
Percentage of employee's time in this program that is paid by HSA.
Adjusted FTE Kim: Adjusted FTE
Total FTE x % FTE funded by HSA Original Annual Full Time Salary for FTE Kim: Annual Full Time Salary for FTE:
Please report in this column the total annual compensation for this classification for a Full Time Employee Total FTE Kim: Total FTE:
Percentage of time employee works on this specific program % FTE funded by HSA (Max 100%) Kim: % FTE funded by HSA
Percentage of employee's time in this program that is paid by HSA.
Adjusted FTE Kim: Adjusted FTE
Total FTE x % FTE funded by HSA Original Annual Full Time Salary for FTE Kim: Annual Full Time Salary for FTE:
Please report in this column the total annual compensation for this classification for a Full Time Employee Total FTE Kim: Total FTE:
Percentage of time employee works on this specific program % FTE funded by HSA (Max 100%) Kim: % FTE funded by HSA
Percentage of employee's time in this program that is paid by HSA.
Adjusted FTE Kim: Adjusted FTE
Total FTE x % FTE funded by HSA Original Annual Full Time Salary for FTE Kim: Annual Full Time Salary for FTE:
Please report in this column the total annual compensation for this classification for a Full Time Employee Total FTE Kim: Total FTE:
Percentage of time employee works on this specific program % FTE funded by HSA (Max 100%) Kim: % FTE funded by HSA
Percentage of employee's time in this program that is paid by HSA.
Adjusted FTE Kim: Adjusted FTE
| Total FTE x % FTE funded by HSA | Original | Total | ||||||||||||||||||||
| Employee A (example) | 1.00 | 100% | 1.00 | $0 | 1.00 | 100% | 1.00 | $0 | 1.00 | 100% | 1.00 | $0 | 1.00 | 100% | 1.00 | $0 | $0 | |||||
| Employee B (example) | 0.50 | 80% | 0.40 | $0 | 0.50 | 80% | 0.40 | $0 | 0.50 | 80% | 0.40 | $0 | 0.50 | 80% | 0.40 | $0 | $0 | |||||
| Employee C (example) | 0.50 | 100% | 0.50 | $0 | 0.50 | 100% | 0.50 | $0 | 0.50 | 100% | 0.50 | $0 | 0.50 | 100% | 0.50 | $0 | $0 | |||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| - 0 | $0 | - 0 | $0 | - 0 | $0 | - 0 | $0 | $0 | ||||||||||||||
| TOTALS | $0 | 2.00 | 2.80 | 1.90 | $0 | $0 | 2.00 | 280% | 1.90 | $0 | $0 | 2.00 | 280% | 1.90 | $0 | $0 | 2.00 | 280% | 1.90 | $0 | $0 |
| FRINGE BENEFIT RATE | 25% | 25% | 25% | 25% | |||||
| EMPLOYEE FRINGE BENEFITS | $0 | $0 | $0 | $0 | $0 |
| TOTAL SALARIES & BENEFITS | $0 | $0 | $0 | $0 | $0 |
| HSA Budget Form (3/24) |
(Vendor Name) Appendix B &P (Program), (FY Length)
Operating-Direct
| Grantee/Contractor: Vendor Name | Appendix B, Page 3 |
| Program: Program Name |
Operating Expenses Detail
| 7/1/26- 6/30/27 | 7/1/27 - 6/30/28 | 7/1/28 - 6/30/29 | 7/1/29 - 6/30/30 | 7/1/26 - 6/30/30 | |
| Original | Original | Original | Original | Total | |
| Expenditure Category | |||||
| Rental of Property | $0 | ||||
| Utilities(Elec, Water, Gas, Phone, Garbage) | $0 | ||||
| Office Supplies, Postage | $0 | ||||
| Building Maintenance Supplies and Repair | $0 | ||||
| Printing and Reproduction | $0 | ||||
| Insurance | $0 | ||||
| Staff Training | $0 | ||||
| Staff Travel-(Local & Out of Town) | $0 | ||||
| Rental of Equipment | $0 | ||||
| Consulting/Professional Services | |||||
| Consultant A (first $50k; anything over on next tab) | $0 | ||||
| Subcontractor A (first $50k; anything over on next tab) | $0 | ||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| Other | |||||
| Other A | $0 | ||||
| Other B | $0 | ||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 |
| Total Operating Expense | $0 | $0 | $0 | $0 | $0 |
| HSA Budget Form (3/24) |
Appendix B &P (Program), (FY Length)
Subcontractors-Pass Thru
| Grantee/Contractor: Vendor Name | Appendix B, Page 4 |
| Program: Program Name |
Subcontractors-Pass Thru
| 7/1/26- 6/30/27 | 7/1/27 - 6/30/28 | 7/1/28 - 6/30/29 | 7/1/29 - 6/30/30 | 7/1/26 - 6/30/30 | |
| Original | Original | Original | Original | Total | |
| Subcontractor | |||||
| Consultant A (only amount above $50k) | $0 | ||||
| Subcontractor A (only amount above $50k) | $0 | ||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 |
Total Subcontractor $0 $0 $0 $0 $0
| Direct Client Pass-Through | |
| Direct Client Pass-Through A | $0 |
| Direct Client Pass-Through B | $0 |
| $0 | |
| $0 | |
| $0 | |
| $0 | |
| $0 | |
| $0 | |
| $0 | |
| $0 |
| Total Direct Client Pass-Through | $0 | $0 | $0 | $0 | $0 |
| HSA Budget Form (3/24) |
Appendix B &P (Program), (FY Length)
Capital Expenses
| Grantee/Contractor: Vendor Name | Appendix B, Page 5 |
| Program: Program Name |
Capital Expenses Detail
| 7/1/26- 6/30/27 | 7/1/27 - 6/30/28 | 7/1/28 - 6/30/29 | 7/1/29 - 6/30/30 | 7/1/26 - 6/30/30 | |
| Original | Original | Original | Original | Total | |
| Equipment (any single item $10k+) | |||||
| Equipment A | $0 | ||||
| Equipment B | $0 | ||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| Remodeling | |||||
| Remodeling A | $0 | ||||
| Remodeling B | $0 | ||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 | |||||
| $0 |
| Total Capital Expenditure | |||||||
| (Equipment and Remodeling Cost) | $0 | $0 | $0 | $0 | $0 | ||
| HSA Budget Form (3/24) |
Appendix B &P (Program), (FY Length)
Justifications
File details come from the government source that posted it. Updated .