Attachment C - Budget Template~1.xlsx

XLSX spreadsheet 24 KB Posted

Attached to
24PMOPRTCLNCLSFTYRSKSTE - RFR for Clinical and Safety Risk Assessment Sites, Staffing, and Related
Solicitation number
BD-24-1039-EHS01-ASHWA-96819
Issued by
Norfolk County, Massachusetts

About this file

This document is an Attachment C - Budget Template for a Request for Response (RFR) issued by the Executive Office of Health and Human Services (EOHHS) in Massachusetts. The RFR is for the procurement of one or more qualified vendors to operate and staff one or more Clinical and Safety Risk Assessment (CSRA) Sites. The budget template provides a detailed line-item breakdown of the expected expenses, including direct care/program staff, occupancy, other direct care/program costs, and administrative expenses. The contract opportunity is for the provision of staffing and services related to the CSRA Sites.

The budget template indicates that the billed costs and expenditures shall be on a time and materials basis, with a maximum 10% mark-up over the contractor's actual incurred expenses. The contractor's budget and invoicing for the physical CSRA Sites, if applicable, shall not exceed the actual cost of the CSRA Site.

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Text version

Budget Template

Attachment C - Budget Template
Clinical Safety and Risk Assessment Sites
Organization name:
FTEMonthly ExpensesNarrative: Provide justification for each line with cost
Direct Care/Program Staff
Program Director
Assistant Program Director
Operations Supervisor
Medical Director
Registered Nurse
Caseworker/Manager
Program Secretarial, Clerical
Program Support
Caseworker/Manager
Other Direct Care Staff
SUBTOTAL STAFF
Payroll Taxes
Fringe Benefits
Total Direct Care/Program Staff
Occupancy
Program Facilities
Fac. Oper/Main/Furn
Total Occupancy
Direct Care Consultants
Temporary Help
Clients/Caregivers, Reimb/Stipends
Staff Training
Staff Mileage/Travel
Subcontracted Dir. Care
Meals
Contracted Client Trans.
Vehicle Expenses
Vehicle Depreciation
Incid. Health/Med Care
Client Per. Allowance
Prov. of Material Goods
Data Processing
Other Commercial Prod. & Svs.
Program Supplies/Mat
Total Other Direct
Care/Program
Direct Admin Expenses
Program Support
Other Direct Administrative Expenses
Total Direct Administrative Expenses
SUBTOTAL PROGRAM COSTS
Agency Admin.
Support Allocation %
PROGRAM TOTAL

*Billed costs and expenditures shall be on a time and materials basis and may not contain more than a 10% mark-up over the Contractor’s actual incurred expenses. The Contractor’s budget and invoicing for the physical CSRA Sites, if applicable, shall not exceed the actual cost of the CSRA Site

Attachment C - Budget Template

Clinical and Safety Risk Assessment Sites Staffing and Services RFR &P of &N

File details come from the government source that posted it. Updated .