BLANK EXHIBIT B FINANCIAL PROPOSAL FORM RFA.xlsx
XLSX spreadsheet 34 KB Posted
- Solicitation number
- BPM054750
- Issued by
- Maryland
About this file
This is a blank financial proposal form for the Maryland Department of Health's Behavioral Health Administration in response to a Request for Applications (RFA) for the Bipartisan Safer Communities Act (BSCA) Community Outreach Project. The form is designed for applicants to submit detailed financial information as part of their proposal to provide outreach to clinical programs serving youth and young adults experiencing first episode psychosis, with a focus on training in Coordinated Specialty Care (CSC) and related resources. The document serves as the standardized template that all bidders must complete when submitting their financial proposals for this community outreach initiative.
The financial proposal form functions as a blank Excel spreadsheet that applicants must populate with their cost estimates, budget breakdowns, and pricing terms according to the RFA requirements. Since this is a blank template rather than a completed submission, it does not contain specific pricing information, funding amounts, or other financial details. Applicants are expected to use this form to clearly itemize all direct and indirect costs associated with their proposed project delivery, ensuring transparency and consistency across all submissions for evaluation and comparison purposes.
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Text version
Sheet1
| Exhibit B - Financial Proposal Form |
| The Financial Proposal shall contain all price information in the format specified on these pages. Complete the Financial Proposal Form only as provided in the Financial Proposal Form format. Do not amend, alter or leave blank any items on the Financial Proposal Form. If option years are included, Offerors must submit costs for each option year. Failure to adhere to any of these instructions may result in the financial proposal being determined non- responsive and rejected by the Department. |
| Please Note: Budget Narrative (to be completed in Word) must accompany each Financial Proposal Form. |
Sydnee Distance: Sydnee Distance:
Please be sure to submit the Budget Narrative (in Word) as well.
| Maryland Department of Health Behavioral Health Administration |
| TITLE |
Sydnee Distance: Sydnee Distance:
Please insert the Project Name.
| (Award Period to include Option Periods eg: July 1, 2026-June 30, 2029) | ||||||||
| Service Description | FY26 | Total Price | ||||||
| Salaries | ||||||||
| Personnel | ||||||||
| Name | Title | % Effort | Annual Salary each period | |||||
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| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Fringe Benefits | % Effort | Fringe Benefit Rates | ||||||
| $ - 0 | ||||||||
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| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Travel | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Supplies | ||||||||
| $ - 0 | ||||||||
| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Subcontracts | ||||||||
| $ - 0 | ||||||||
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| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Procurement Contracts | ||||||||
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| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| Other Direct Costs | ||||||||
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| COST: | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| TOTAL COST | ||||||||
| TOTAL DIRECT COSTS | $ - 0 | $ - 0 | $ - 0 | $ - 0 | ||||
| TOTAL MODIFIED DIRECT COSTS | $ - 0 | $ - 0 | $ - 0 | |||||
| TOTAL INDIRECT COSTS - IDC | 10 |
Aaron Jenkins: Aaron Jenkins:
| Please select the indirect cost percentage.from the drop down | % | $ - 0 | $ - 0 | $ - 0 | |||
| TOTAL COSTS - DIRECT + INDIRECT | $ - 0 | $ - 0 | $ - 0 |
Signature
| Printed Name & Title |
| Company Name |
| Company Address |
| Location(s) from which services will be performed (City, State) |
| Telephone |
| Fax |
| FEIN |
| eMMA# |
| Please Note: Budget Narrative (to be completed in Word) must accompany each Financial Proposal Form. |
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