Attachment 2 FY27 Budget Template Fixed Price.xlsx
XLSX spreadsheet 151 KB Posted
- Attached to
- Produce Prescription Program
- Solicitation number
- RFP FAAA 2026000284 1
- Issued by
- Arapahoe County, Denver City, Colorado
About this file
This is a Fixed Price Budget Template with Justification Form for FY27 issued by the Colorado Department of Public Health and Environment (CDPHE) Prevention Services Division. The template is designed for contractors to submit budget proposals for fixed-price contracts or purchase orders. The document provides a standardized format requiring contractors to identify primary activities and deliverables, describe associated activities including payment terms and submission requirements, specify rates and quantities, and calculate total amounts requested from CDPHE. The template includes fields for contractor information, program and fiscal contact details, budget period dates, project name, and existing contract or purchase order numbers for renewals or amendments.
The sample budget provided demonstrates application of the template using ABC Health Center as an example contractor, with a budget period of July 1, 2021 through June 30, 2022, and a total contract value of $16,000. The sample includes three deliverables: a draft workplan ($5,000), a final workplan ($5,000), and technical assistance workshops ($2,000 per workshop for up to three workshops totaling $6,000). Payment is contingent upon submission and CDPHE staff review and approval of deliverables. The template requires that the total amount be expressed as a whole dollar figure without cents and must match the award amount. This budget template serves as the official exhibit for fixed-price contracting under CDPHE's Prevention Services Division.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Budget Template
| Version 7.2026 | |
| PREVENTION SERVICES DIVISION- FIXED PRICE BUDGET WITH JUSTIFICATION FORM | |
| Original Contract Routing # |
ID#AAAAdhwOrKA Aukema, Abigail (2022-08-02 21:19:15) To be filled out by CDPHE contracting staff
| Contractor Name | Program Contact Name, Title, Phone and Email |
| Budget Period | Fiscal Contact Name, Title, Phone and Email |
| Project Name | Contract (CT or PO) Number |
| Budget Information |
| Primary Activity / Deliverable |
ID#AAAAdhwOrKU Aukema, Abigail (2022-08-02 21:19:15) Please include description of deliverable, such as "Progress Report" Description of Activity ID#AAAAdhwOrJ4 Aukema, Abigail (2022-08-02 21:19:15)
| Provide description of activity. Should include how work will be paid for, such as rate, number of items/services provided, and what type of submission is required to prompt payment. | Rate | Quantity | Total Amount Requested from CDPHE | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| Primary Activity/Deliverable # | $ - 0 | 0.00 | $ - 0 | |||
| TOTAL | $ - 0 |
ID#AAAAdhwOrKE Aukema, Abigail (2022-08-02 21:19:15) Amount should match award amount. This figure should be a whole dollar figure and should not include any cents.
ID#AAAAdhwOrKA Aukema, Abigail (2022-08-02 21:19:15) To be filled out by CDPHE contracting staff ID#AAAAdhwOrKY Deborah J. Polk (2022-08-02 21:19:15) Enter Budget Period Dates ID#AAAAdhwOrKU Aukema, Abigail (2022-08-02 21:19:15) Please include description of deliverable, such as "Progress Report" ID#AAAAdhwOrKI Aukema, Abigail (2022-08-02 21:19:15) Unless budget is for a new contract, please provide existing "CT" or "PO" number.
ID#AAAAdhwOrJ4 Aukema, Abigail (2022-08-02 21:19:15) Provide description of activity. Should include how work will be paid for, such as rate, number of items/services provided, and what type of submission is required to prompt payment.
Page &P of
Sample Budget
| PREVENTION SERVICES DIVISION- FIXED PRICE SAMPLE BUDGET WITH JUSTIFICATION FORM |
| Original Contract Routing # |
ID#AAAAdhwOrJ8 Aukema, Abigail (2022-08-02 21:19:15) To be filled out by CDPHE contracting staff
| Contractor Name | ABC Health Center | Program Contact Name, Title, Phone and Email | Jane Smith, Executive Director, 303-888-5555, jane.smith@abchealthctr.org |
| Budget Period | 7/1/21-6/30/22 |
ID#AAAAdhwOrKM Deborah J. Polk (2022-08-02 21:19:15)
| Enter Budget Period Dates | Fiscal Contact Name, Title, Phone and Email | John Williams, Finance Director, 303-888-5556, john.williams@abchealthctr.org | |||
| Project Name | XYZ Project | Contract (CT or PO) Number | CT 2018*123 |
ID#AAAAdhwOrKc
Unless budget is for a new contract, please provide existing "CT" or "PO" number.
| Budget Information |
| Primary Activity / Deliverable |
ID#AAAAdhwOrKQ Aukema, Abigail (2022-08-02 21:19:15) Please include description of deliverable, such as "Progress Report" Description of Activity ID#AAAAdhwOrKk Aukema, Abigail (2022-08-02 21:19:15)
| Provide description of activity. Should include how work will be paid for, such as rate, number of items/services provided, and what type of submission is required to prompt payment. | Rate | Quantity | Total Amount Requested from CDPHE | |||
| Draft Workplan (Deliverable #1) | Develop draft workplan. Payable at $5,000 upon submission, review and approval by CDPHE staff. | $ 5,000.00 | 1.0 | $ 5,000.00 | ||
| Final Workplan (Deliverable #2) | Finalize workplan. Payable at $5,000 upon submission, review and approval by CDPHE staff. | $ 5,000.00 | 1.0 | $ 5,000.00 | ||
| Technical Assistance Workshops (Deliverable #3) | Conduct technical assistance workshops in the community. Payable at $2,000 for up to 3 workshops. Payable submission of attendee list, and review and approval by CDPHE staff. | $ 2,000.00 | 3.0 | $ 6,000.00 | ||
| TOTAL | $ 16,000.00 |
ID#AAAAdhwOrKg
Amount should match award amount. This figure should be a whole dollar figure and should not include any cents.
ID#AAAAdhwOrKM Deborah J. Polk (2022-08-02 21:19:15) Enter Budget Period Dates ID#AAAAdhwOrKQ Aukema, Abigail (2022-08-02 21:19:15) Please include description of deliverable, such as "Progress Report" ID#AAAAdhwOrKc Aukema, Abigail (2022-08-02 21:19:15) Unless budget is for a new contract, please provide existing "CT" or "PO" number.
ID#AAAAdhwOrKk Aukema, Abigail (2022-08-02 21:19:15) Provide description of activity. Should include how work will be paid for, such as rate, number of items/services provided, and what type of submission is required to prompt payment.
Exhibit C Budget
Page &P of January 2018 image1.png
File details come from the government source that posted it. Updated .