BUDGET_FORMS_NAU_11-22-ED_22-23-Revised_11.20.22.pdf
PDF 194 KB Posted
- Attached to
- Master Agreement AZ|CTR041692
- Contract number
- CTR041692
- Issued by
- Arizona
About this file
This document is an Interagency Service/Intergovernmental Agreement Budget form from the Arizona Department of Education, involving Northern Arizona University. The agreement is numbered 11-22-ED and covers the budget period from October 1, 2022, to September 30, 2023. The funding source is identified as IDEA200FAY20 with a CFDA No. of 84.027A, and the proposal is focused on Speech Language Pathologists.
The total agreement budget is $280,000, broken down into several categories including salaries (instructional and non-instructional), employee benefits, student wages, and tuition. Key budget components include $76,489 for instructional salaries, $15,022 for non-instructional salaries, $20,865 in employee benefits, $158,633.92 for tuition, and $8,990.08 for indirect costs. The budget details specific allocations for staff members Sandra Stewart (Coordinator/Instructor) and Anna Sosa (Project Investigator/Project Director), with their respective salaries and benefits calculated at different percentage assignments to the agreement. The document appears to be an amendment to a previous agreement, indicating ongoing work in supporting speech language pathology services.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| FE_11-22-ED_AMD_17.pdf | ||
| 11-22-ED_Amendment_11_FE.pdf | ||
| FE_11-22-ED_Amendment_12.pdf | ||
| FE_11-22-ED_Amendment_13.pdf | ||
| 11-22-ED_FE_AMD_14.pdf | ||
| 11-22-ED_FE_Amendment_No._15.pdf | ||
| FE_11-22-ED_Amendment_16.pdf |
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Text version
ADE FORM-701d (99)
ARIZONA DEPARTMENT OF EDUCATION INTERAGENCY
SERVICE/INTERGOVERNMENTAL AGREEMENT BUDGET/
ESTIMATED NEEDS PAYMENT SCHEDULE FOR
INSTITUTIONS OF HIGHER EDUCATION, STATE AGENCIES
AND OTHER AGENCIES
INSTRUCTIONS
Submit original to ADE Contracts Management Unit as part of proposed Agreement/amendment. Final Agreement will contain instructions for submission of periodic/completion reports
A. AGREEMENT IDENTIFICATION FOR THE BUDGET PERIOD FROM : 10/1/22 TO: 9/30/23
1. Applicant Agency:
Northern Arizona University
2. Contact Person: Anna Sosa Phone No: 928-523-3845
3. Agreement No.: 11-22-ED
Index No.: IDEA200FAY204. Funding Source (Chapter 1, etc.)
CFDA No: 84.027A
5. Date submitted 11/20/2022
6. Proposal Name (if any):
Speech Language Pathologists
7. Check ONE ☐ New ☐ Renewal Application ☐ Completion Report ☒ Amendment ☐ADE Revision
B. AGREEMENT BUDGET
*EXPENDITURE CATEGORIES
BUDGET
(1)
REQUEST
CHANGES
(2)
AMENDED
BUDGET
(3)
EXPENDITURE
TO DATE
(4)
BUDGET
BALANCE
(5)
8. Salaries – Instructional 76,489
9. Salaries – Non-Instructional 15,022
10. Employee Benefits 20,865
11. Travel
12. Supplies and Materials
13. Purch Services/Consultant Fees
14. Tuition 158,633.92
15. Printing and Reproduction
16. Utilities and Communications
17. Other:
18. SUBTOTAL 271,009.92
19. Indirect Cost (8% of subtotal less tuition expenses) 8,990.08
20. Capital Outlay
21. TOTAL 280,000
22. Administrative Costs
23. Cash Balance (For Completion Purposes)
*SEE INSTRUCTIONS ON REVERSE SIDE
C. COMPLETION REPORT SIGNATURE (Blue Ink Only)
I hereby certify that this is a reasonable statement of total expenditures for this contract.
Applicant Authorized Agent Date
D. SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE
Prior FY C/O + FY State C/O + FY (New)+ Other = TOTAL FY
E. ESTIMATED NEEDS PAYMENT SCHEDULE ☐Original ☐Revised Date:
FY_____ State C/O FY______ FY_______
Jul: Jan: Jul: Jan: Jul: Jan:
Aug: Feb: Aug: Feb: Aug: Feb:
Sep: Mar: Sep: Mar: Sep: Mar:
Oct: Apr: Oct: Apr: Oct: Apr:
Nov: May: Nov: May: Nov: May:
Dec: Jun: Dec: Jun: Dec: Jun:
TOTAL TOTAL TOTAL
ADE FORM-701b (01)
ARIZONA DEPARTMENT OF EDUCATION
DETAILED INTERAGENCY SERVICE AGREEMENT BUDGET
(1) Applicant Name/Agency: Northern Arizona University (2) Agreement No. 11-22-ED
(3)
EXPENDITURE
CATEGORY
NUMBER
(4)
AGREEMENT
BUDGET
LINE ITEM NAME
(5)
NAME AND TITLE OF STAFF AND/OR BREAKDOWN OF INDIVIDUAL ITEMS
INCLUDED IN AGREEMENT BUDGET LINE ITEM TOTAL
(6)
100% COST OF
EACH ITEM LISTED
COLUMN (3)
(7)
% ASSIGNED
TO THIS
AGREEMENT
(8)
AGREEMENT
COST
Salaries Instructional
Salaries - Non- Instructional
Wages –Student
Employee Benefits
Tuition
Indirect Cost (8%)
Sandra Stewart, Coordinator/Instructor
Anna Sosa, Project Investigator/Project Director
Student Wages
Benefits for Anna Sosa, Principal Investigator/Project Director Benefits for Sandra Stewart, Coordinator/Instructor Benefits for student wages
Student Tuition
84,988
127,265
1,023
47,088 17,422
158,633.92
8.990.08
90%
11%
100%
11% 90% 100%
100%
100%
76,489
13,999
1,023
5,180 15,680
158,633.92
8,990.08
TOTAL: 280,000
ARIZONA DEPARTMENT OF EDUCATION
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