Attachment_5_-_Budget_Proposal_Template.xlsx
XLSX spreadsheet 39 KB Posted
- Attached to
- SHF | 2026-06 Medi-Cal Enrollment Services
- Solicitation number
- SFGOV-0000012057
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Budget Proposal Template attachment for the San Francisco Sheriff's Office's Medi-Cal Enrollment Services contract opportunity (SHF 2026-06) in California. The template is designed to structure proposers' budget submissions for providing Medi-Cal enrollment assistance services within San Francisco County Jails. The spreadsheet format enables standardized presentation of costs across all proposals, facilitating comparative evaluation by the awarding agency. Proposers must complete the budget proposal using this template as part of their overall submission, with completion accuracy and clarity being essential to proposal evaluation. The template ensures all bidders present financial information consistently, allowing the San Francisco Sheriff's Office to assess the cost-effectiveness and feasibility of each proposed solution for jail-based Medi-Cal enrollment services.
The budget template establishes the financial framework within which proposers must present pricing for Medi-Cal enrollment services. By requiring use of a standardized format, the template promotes transparency and allows for objective comparison of costs among competing proposals. The San Francisco Sheriff's Office encourages proposers to form contracting teams that reflect diversity and include participation from businesses and residents of disadvantaged San Francisco neighborhoods including Bayview/Hunters Point, Chinatown, the Mission, South of Market, the Tenderloin, Visitacion Valley, and the Western Addition. Proposers should note that submissions are not to be made through the Supplier Portal, indicating an alternative submission method specified elsewhere in the solicitation documentation.
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Text version
Total Program Budget Form
| San Francisco Sheriff's Office |
| Financial Services |
| FY 202X-202X Budget Price Proposal |
| Agency Name: | Date: | |
| 7/1/202X | ||
| Program Title: | Grant/Contract Period: | |
| 7/1/202X - 6/30/202X |
| Total Program Budget Summary | |
| Budget Expense Line Items: | Total Budget Request* |
| A) Program Salaries & Fringe Benefits | $ - |
| B) Direct Program Operating Expenses | $ - |
| C) Program [Sub-]Contract Services | $ - |
| D) Program Equipment Purchase | $ - |
| X) Non-Program Indirect/Admin/Overhead Costs** (20.0%) | $ - |
| TOTAL PROGRAM [& NON-PROGRAM] AMOUNT: | $ - |
Agency's Director or Financial Officer Date:
| FOR SHERIFF USE ONLY |
| Program Budget Approved |
Sheriff's Chief Financial Officer Date:
| Data entry of Approved Budget | Date: |
| Funding Source Codes and Amount: |
Appendix B-2
&8SFSO (rev 2024) &F B-2 &8&A
*Totals must match subtotals on corresponding budget pages. (Hint: complete those pages first and the totals from each page will populate this summary page.)
**Indirect/Admin/Overhead ("Non-Program") costs cannot exceed 20% of Program Costs without sufficient justification and SFSO CFO's approval. There is no corresponding budget page for Indirect/Admin/Overhead costs.
Please note Indirect/Overhead is only allowed for Program Salaries & Fringe Benefits.
A_Salaries&Fringe
| San Francisco Sheriff's Office |
| Financial Services |
| FY 202X-202X Budget Price Proposal |
| Agency Name: | Date: | ||
| 0 | 7/1/202X | ||
| Program Title: | Grant/Contract Period: | ||
| 0 | 7/1/202X - 6/30/202X |
A) Program Salary and Fringe Benefits Budget Summary
| Position/Title | Hrs/ Wk | Wks/ Yr | Hourly Salary | FTE | Salary Amt | Fringe % | Fringe Amt | Total Salary Request |
| 1 | 0 | 0 | $ - 0 | 0.00 | $ - 0 | 0% | $ - 0 | $ - |
| 2 | 0 | 0 | $ - 0 | 0.00 | $ - 0 | 0% | $ - 0 | $ - |
| 3 | 0 | 0 | $ - 0 | 0.00 | $ - 0 | 0% | $ - 0 | $ - |
| 4 | 0 | 0 | $ - 0 | 0.00 | $ - 0 | 0% | $ - 0 | $ - |
| 5 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 6 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 7 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 8 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 9 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 10 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 11 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 12 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 13 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| 14 | 0 | 0 | $ - 0 | $ - 0 | 0% | $ - 0 | $ - | |
| FTE Total: | 0.00 | Subtotal Salary & Fringe Benefits: | $ - |
| Please insert additional lines as needed for all positions in your program budget and double-check the |
| Subtotal line to verify that the formula includes all applicable cells in range. |
Appendix B-2
&8SFSO (rev 2024) &F B-2 &8&A
B_Operating Expenses
| San Francisco Sheriff's Office |
| Financial Services |
| FY 202X-202X Budget Price Proposal |
| Agency Name: | Date: | ||
| 0 | 7/1/202X | ||
| Program Title: | Grant/Contract Period: | ||
| 0 | 7/1/202X - 6/30/202X |
B) Direct Program Operating Expenses Summary
| Description/Purpose | Request | |||
| Expense Item | Monthly Amount | # of Months | Amount | |
| Program Materials/Supplies: | ||||
| Office Supplies | $ - 0 | 0 | $ - | |
| Printing | $ - 0 | 0 | $ - | |
| Educational/Training Materials - Participants | $ - 0 | 0 | $ - | |
| Client travel (public transportation) | $ - 0 | 0 | $ - | |
| Postage | $ - 0 | 0 | $ - | |
| Rent | $ - 0 | 0 | $ - | |
| Office Equipment Lease | $ - 0 | 0 | $ - | |
| Office Equipment/IT/Cells Phones | $ - 0 | 0 | $ - | |
| Utilities | $ - 0 | 0 | $ - | |
| Program Staff Training | $ - 0 | 0 | $ - | |
| Program Staff Travel (Local & Out of Town) | $ - 0 | 0 | $ - | |
| Other (describe): | $ - 0 | 0 | $ - | |
| $ - 0 | 0 | $ - | ||
| $ - 0 | 0 | $ - | ||
| $ - 0 | 0 | $ - | ||
| $ - 0 | 0 | $ - | ||
| $ - 0 | 0 | $ - | ||
| $ - 0 | 0 | $ - | ||
| Subtotal Other Current Expenses: | $ - |
Appendix B-2
&8SFSO (rev 2024)
B-2 &8&A
C_Sub-Contract Services
| San Francisco Sheriff's Office |
| Financial Services |
| FY 202X-202X Budget Price Proposal |
| Agency Name: | Date: | |
| 0 | 7/1/202X | |
| Program Title: | Grant/Contract Period: | |
| 0 | 7/1/202X - 6/30/202X | |
| C) Program [Sub-]Contract Services |
| Consultants/Professional Services* | |||||
| Name | Agency | Description of Services | Estimated Cost Per Hour | Estimated Hours | Request Amount |
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| Other [Sub-]Contract Services (provide description): | |||||
| Item (Example): | Description: | Estimated Cost Per Hour | Estimated Hours | Request Amount | |
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| $ - 0 | 0 | $ - | |||
| Subtotal for [Sub-]Contractual Services: | $ - |
| *Please submit to SFSO Financial Services a copy of your agency's contract or agreement with each |
| [sub-]contractor/consultant identified in your budget. This is normally a one-time submission. |
| Please contact SFSO Financial Services with any questions regarding this. |
| Please insert additional lines as needed for all [sub-]contractors/consultants in your program budget and double-check the |
| Subtotal line to verify that the formula includes all applicable cells in range. |
Appendix B-2
&8SFSO (rev 2024)
B-2 &8&A
D_Equipment Purchase
| San Francisco Sheriff's Office |
| Financial Services |
| FY 202X-202X Budget Price Proposal |
| Agency Name: | Date: | ||
| 0 | 7/1/202X | ||
| Program Title: | Grant/Contract Period: | ||
| 0 | 7/1/202X - 6/30/202X |
D) Program Equipment Purchase
| Request | |||
| Equipment to be purchased | Purpose for Equipment | Amount | |
| $ - | |||
| $ - | |||
| $ - | |||
| $ - | |||
| $ - | |||
| $ - | |||
| Subtotal for Equipment Purchases: | $ - |
Accounting Codes (and amounts if more than one):
Appendix B-2
&8SFSD (rev 2024)
B-2 &8&A
Budget Justifcation
| Use this form only when responding to a Request for Proposals (RFP). | ||
| San Francisco's Sheriff's Office | ||
| Financial Services | ||
| RFP Budget Explanation/Justification Form | ||
| Agency Name: | 0 | |
| Program Title: | 0 |
| Program Budget Expense Line Items | |
| A) | Salaries & Fringe Benefits |
B) Direct Program Operation Expenses
C) Sub-Contract Services
D) Equipment Purchases
Appendix B
&8SFSD (rev 2024)
&8&A
File details come from the government source that posted it. Updated .