attachment-7-rfp-2027-dbh-13-techn-appendix-g-rev--1-.xlsx
XLSX spreadsheet 46 KB Posted
- Solicitation number
- RFP-2027-DBH-16-FACIL
- Issued by
- Hillsborough County, New Hampshire
About this file
This is a budget sheet appendix for RFP-2027-DBH-13-TECHN, issued by the New Hampshire Department of Health and Human Services (DHHS), Division of Behavioral Health. The document serves as Appendix G and provides comprehensive budgeting instructions and templates for contractors responding to a Technical Assistance for the Alcohol and Other Drug (AOD) Continuum of Care System solicitation. The budget forms must be completed for two separate state fiscal year periods: SFY 2027 (July 1, 2026 through June 30, 2027) and SFY 2028 (July 1, 2027 through June 30, 2028). Contractors must submit one completed budget form for each budget period, with all costs entered in whole dollar amounts and accompanied by detailed budget narratives explaining the direct relationship of each line item to meeting the solicitation's objectives.
The budget sheet requires itemization across nine primary cost categories: Salary and Wages, Fringe Benefits, Consultants, Equipment, Supplies (Educational, Laboratory, Pharmacy, Medical, and Office), Travel, Software, Other costs (Marketing/Communications, Education and Training, and other specified costs), and Subrecipient Contracts. The document establishes strict compliance with 2 CFR 200 regulations, including provisions that indirect cost rates cannot be applied to equipment costs and may only be applied to the first $25,000 of subrecipient contracts. Contractors must also complete a detailed Salary and Wages Breakdown sheet for each budget period, identifying position titles, current personnel, projected hourly rates, FTE allocations, and the percentage of salary funded by the program. All costs are to be funded by DHHS, and the budget templates provided show all line items currently populated at $0, indicating this is a blank template for contractor completion.
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Instructions
| Budget Sheet Instructions | |
| Contractor Name: | Enter the Contractor's name, which must match the P-37. |
| Budget Request for: | Enter the name of the project/program title. |
| Budget Period | Enter the applicable State Fiscal Year (7/1/xx - 6/30/xx) for the budget period. A separate budget sheet must be completed for each State Fiscal Year/budget period. |
| Indirect Cost Rate (if applicable) | The Contractor's indirect cost rate as a percentage will auto populate. See 2 CRF 200.414 Indirect (F&A) Costs for more information. |
Line Item Instructions All costs should be entered in whole dollars with no cents.
Next to each cost, enter a description in the Budget Narrative column that explains the specific line item costs included and their direct relationship to meeting the objectives of this solicitation.
1. Salary & Wages Enter total salary and wage costs for personnel allocated to this agreement for the specified budget period.
2. Fringe Benefits Enter total fringe benefits costs for personnel allocated to this agreement for the specified budget period.
3. Consultants Enter total costs for individuals (who are not employees of the Contractor) to provide consultant services, including, but not limited to, professional expertise, training, and/or education.
| 4. Equipment |
| Enter total Equipment costs. Equipment is defined as tangible, non-expendable personal property (including exempt property) that has a useful life of more than one year AND an acquisition cost of $5,000 or more per unit. Note all equipment costs must be excluded when calculating indirect costs. |
| 5.(a) Supplies - Educational | Enter total Educational Supplies costs. |
| 5.(b) Supplies - Laboratory | Enter total Laboratory Supplies costs. |
| 5.(c) Supplies - Pharmacy | Enter total Pharmacy Supplies costs. |
| 5.(d) Supplies - Medical | Enter total Medical Supplies costs. |
| 5.(e) Supplies Office | Enter total Office Supplies costs. |
6. Travel Enter Travel costs, including expenses for transportation necessary to complete the required services.
7. Software Enter Software costs.
| 8. (a) Other - Marketing/Communications | Enter Other - Marketing/Communications costs. |
| 8. (b) Other - Education and Training | Enter Other - Education and Training costs. |
| 8. (c) Other - Other | Enter Other - Other costs in the available rows below. |
| Other (please specify) | Using as many rows as needed, specify the type of Other costs (e.g. Postage) in Column A and enter the costs in column B. |
| 9. Subrecipient Contracts |
| Enter total costs for Subrecipient Contracts. Note if a contractor is identified as a Subrecipient in accordance with 2 CFR § 200.331, the indirect cost rate may only be applied to the first $25,000 of each subrecipient contract (i.e. subaward) per Appendix IV to 2 CFR 200. |
| Total Direct Costs | Unless the formula needs to be modified, Total Direct Costs will automatically total in this line. |
| Total Indirect Costs | Enter the total indirect costs (if applicable) based on the indirect cost rate percentage. Any one cost must be treated consistently as either a direct or indirect cost and cannot be charged as both. Note the indirect cost rate cannot be applied to Equipment costs. The indirect cost rate may only be applied to the first $25,000 of each subrecipient contract (i.e. subaward). |
TOTAL TOTAL Costs will automatically total in this line.
Budget Period SFY 2027
| New Hampshire Department of Health and Human Services | |
| Complete one budget form for each budget period. | |
| Contractor Name: | Enter Vendor Name |
| Budget Request for: | RFP-2027-DBH-13-TECHN |
| Budget Period | State Fiscal Year 2027 (July 1 2026 - June 30 2027) |
| Indirect Cost Rate (if applicable) | ERROR:#DIV/0! |
Line Item Program Cost - Funded by DHHS Budget Narrative Explain specific line item costs included and their direct relationship to meeting the objectives of this solicitation.
| 1. Salary & Wages | $0 | |
| 2. Fringe Benefits | $0 | |
| 3. Consultants | $0 | |
| 4. Equipment | ||
| Indirect cost rate cannot be applied to equipment costs per 2 CFR 200.1 and Appendix IV to 2 CFR 200. | $0 | |
| 5.(a) Supplies - Educational | $0 | |
| 5.(b) Supplies - Lab | $0 | |
| 5.(c) Supplies - Pharmacy | $0 | |
| 5.(d) Supplies - Medical | $0 | |
| 5.(e) Supplies Office | $0 | |
| 6. Travel | $0 | |
| 7. Software | $0 | |
| 8. (a) Other - Marketing/ Communications | $0 | |
| 8. (b) Other - Education and Training | $0 | |
| 8. (c) Other - Other (specify below) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| 9. Subrecipient Contracts | $0 | |
| Total Direct Costs | $0 | |
| Total Indirect Costs | $0 |
TOTAL $0
Appendix G - Budget Sheet
Budget Period SFY 2028
| New Hampshire Department of Health and Human Services | |
| Complete one budget form for each budget period. | |
| Contractor Name: | Enter Vendor Name |
| Budget Request for: | RFP-2027-DBH-13-TECHN |
| Budget Period | State Fiscal Year 2028 (July 1 2027- June 30 2028) |
| Indirect Cost Rate (if applicable) | ERROR:#DIV/0! |
Line Item Program Cost - Funded by DHHS Budget Narrative Explain specific line item costs included and their direct relationship to meeting the objectives of this solicitation.
| 1. Salary & Wages | $0 | |
| 2. Fringe Benefits | $0 | |
| 3. Consultants | $0 | |
| 4. Equipment | ||
| Indirect cost rate cannot be applied to equipment costs per 2 CFR 200.1 and Appendix IV to 2 CFR 200. | $0 | |
| 5.(a) Supplies - Educational | $0 | |
| 5.(b) Supplies - Lab | $0 | |
| 5.(c) Supplies - Pharmacy | $0 | |
| 5.(d) Supplies - Medical | $0 | |
| 5.(e) Supplies Office | $0 | |
| 6. Travel | $0 | |
| 7. Software | $0 | |
| 8. (a) Other - Marketing/ Communications | $0 | |
| 8. (b) Other - Education and Training | $0 | |
| 8. (c) Other - Other (specify below) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| 9. Subrecipient Contracts | $0 | |
| Total Direct Costs | $0 | |
| Total Indirect Costs | $0 |
TOTAL $0
Appendix G - Budget Sheet
Salary & Wages Breakdown SFY 27
Salary & Wages Breakdown
New Hampshire Department of Health and Human Services
| Proposal Agency Name: | |
| Program: | Technical Assistance for the Alcohol and Other Drug (AOD) Continuum of Care System |
| Budget Period: | State Fiscal Year 2027 (July 1 2026 - June 30 2027) |
| A | B | C | D | E | F | G | H |
| Position Title | Current Individual in Position | Projected Hrly Rate as of 1st Day of Budget Period | Hours per Week dedicated to this program - FTE | Amnt Funded by this program for Budget Period | Total Salary for Budget Period | % of Salary Funded by this program | Site* |
| Example: | |||||||
| Program Coordinator | Example Staff | $21.00 | 20 | $21,840 | $43,680 | 50% |
| Administrative Salaries | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| Total Admin. Salaries | $0 | $0 | ERROR:#DIV/0! |
| Direct Service Salaries | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| Total Direct Salaries | $0 | $0 | ERROR:#DIV/0! |
| Total Salaries by Program | $0.00 | $0.00 | ERROR:#DIV/0! |
| *Please list which site(s) each staff member works at, if your agency has multiple sites. |
Salary & Wages Breakdown SFY 28
Salary & Wages Breakdown
New Hampshire Department of Health and Human Services
| Proposal Agency Name: | |
| Program: | Technical Assistance for the Alcohol and Other Drug (AOD) Continuum of Care System |
| Budget Period: | State Fiscal Year 2028 (July 1, 2027 - June 30, 2028) |
| A | B | C | D | E | F | G | H |
| Position Title | Current Individual in Position | Projected Hrly Rate as of 1st Day of Budget Period | Hours per Week dedicated to this program - FTE | Amnt Funded by this program for Budget Period | Total Salary for Budget Period | % of Salary Funded by this program | Site* |
| Example: | |||||||
| Program Coordinator | Example Staff | $21.00 | 20 | $21,840 | $43,680 | 50% |
| Administrative Salaries | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| Total Admin. Salaries | $0 | $0 | ERROR:#DIV/0! |
| Direct Service Salaries | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| ERROR:#DIV/0! | |||
| Total Direct Salaries | $0 | $0 | ERROR:#DIV/0! |
| Total Salaries by Program | $0.00 | $0.00 | ERROR:#DIV/0! |
| *Please list which site(s) each staff member works at, if your agency has multiple sites. |
Budget to Print New Hampshire Department of Health and Human Services
| Contractor Name: | Enter Vendor Name |
| Budget Request for: | RFP-2027-DBH-13-TECHN |
| Budget Period | State Fiscal Year 2027 (July 1 2026 - June 30 2027) |
| Indirect Cost Rate (if applicable) | ERROR:#DIV/0! |
| Line Item | Program Cost - Funded by DHHS | |
| 1. Salary & Wages | $0 | |
| 2. Fringe Benefits | $0 | |
| 3. Consultants | $0 | |
| 4. Equipment | ||
| Indirect cost rate cannot be applied to equipment costs per 2 CFR 200.1 and Appendix IV to 2 CFR 200. | $0 | |
| 5.(a) Supplies - Educational | $0 | |
| 5.(b) Supplies - Lab | $0 | |
| 5.(c) Supplies - Pharmacy | $0 | |
| 5.(d) Supplies - Medical | $0 | |
| 5.(e) Supplies Office | $0 | |
| 6. Travel | $0 | |
| 7. Software | $0 | |
| 8. (a) Other - Marketing/ Communications | $0 | |
| 8. (b) Other - Education and Training | $0 | |
| 8. (c) Other - Other (specify below) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| Other (please specify) | $0 | |
| 9. Subrecipient Contracts | $0 | |
| Total Direct Costs | $0 |
Total Indirect Costs $0
TOTAL $0
&"Arial,Regular"Exhibit C-X Budget
&"Arial,Regular"Project ID # &"Arial,Regular"Contractor Initial: __________
Date: ___________
File details come from the government source that posted it. Updated .