Budget Template .pdf

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SAMHSA Detailed Budget and Narrative Justification Page of 02/2021 v1.2 Applicant/Recipient Enter the name of your organization.

Application/Award Number Enter the application or award number. If your grant has been awarded, refer to your Notice of Award (NoA) for the award number.

An example of the application or award number is SM065432 where SM is the Institute Code or Center from which the grant originates, for example, SM, SP, TI, and FG; and 065432 is the six-digit core grant number unique to that specified project.

SM refers to the Center for Mental Health Services (CMHS).

SP refers to the Center for Substance Abuse Prevention (CSAP).

TI refers to the Center for Substance Abuse Treatment (CSAT).

FG refers to the Center for Flex Grants.

Budget Identifier Table Project Title:

Enter the title of the project.

Project Title Table Start Date Select the budget period start date from the calendar window or enter the date as MM/DD/YYYY. For example, enter September 30, 20YY as 09/30/20YY.

End Date Select the budget period end date from the calendar window or enter the date as MM/DD/YYYY. For example, enter September 29, 20YY as 09/29/20YY.

Budget Year Select the budget year (1, 2, 3, 4, or 5) from the drop-down list . If your grant has been awarded, refer to your Notice of Award (NoA) for the budget year.

The budget year selected will auto-populate “Year” in the following tables:

BUDGET SUMMARY

BUDGET SUMMARY FOR REQUESTED FUTURE YEARS

FUNDING LIMITATIONS AND RESTRICTIONS

Note: If after entering amounts in the FUNDING LIMITATIONS AND RESTRICTIONS table(s), you change the budget year to remove future years from the table(s), remember to delete any amounts entered in those future years to ensure they are not included in the Total for Budget Category.

Budget Period:

Enter the actual budget period start and end dates if your grant has been awarded. Otherwise, enter the proposed/ projected budget period dates based on the anticipated project start date.

Most SAMHSA grants have budget periods beginning 09/30 of one year and ending on 09/29 of the next.

Project Date Table Before completing the Detailed Budget and Narrative Justification, review the program-specific Funding Restrictions/Limitations and the Standard Funding Restrictions in the Funding Opportunity Announcement (FOA).

Before completing the Detailed Budget and Narrative Justification, review the program-specific Funding Restrictions/Limitations and the Standard Funding Restrictions in the Funding Opportunity Announcement (FOA).

This text will NOT be visible on the document printed to PDF or to a printer.

For applicable administrative requirements and cost principles, refer to the 45 CFR Part 75.

For applicable administrative requirements and cost principles, refer to the 45 CFR Part 75.

This text will NOT be visible on the document printed to PDF or to a printer.

For costs that are generally unallowable, refer to the 45 CFR Part 75, Subpart E, the HHS Grant Policy Statement (GPS), and SAMHSA’s Funding Opportunity Announcements (FOAs).

For costs that are generally unallowable, refer to the 45 CFR Part 75, Subpart E, the HHS Grant Policy Statement (GPS), and SAMHSA’s Funding Opportunity Announcements (FOAs).

This text will NOT be visible on the document printed to PDF or to a printer.

Help Text Table To determine whether the project requires non-federal matching funds or contributions, review the FOA Section III-2 - Cost Sharing and Matching Requirements.

To determine whether the project requires non-federal matching funds or contributions, review the FOA Section III-2 - Cost Sharing and Matching Requirements.

This text will NOT be visible on the document printed to PDF or to a printer.

Matching Required:

Match Ratio stated in the FOA:

The match ratio for the Budget Year as stated in the FOA, Section III-2 – Cost Sharing and Matching Requirements.

The matching funds must not be less than The matching funds must not be less than $___ for each $___ of federal funds provided.

for each of federal funds provided.

The match ratio you entered above means that for every $1,000 of federal funds requested, the minimum required match will be The match ratio you entered above means that for every $1,000 of federal funds requested, the minimum required match will be:

This text will NOT be visible on the document printed to PDF or to a printer.

Blank Line Item # Line Item # An auto-generated number.

Position Position:

Enter the title of the position. The position must be relevant and allowable under the project. Show only positions held by full-time, part-time, or temporary employees of your organization in A. Personnel.

Show consultants, contractors/subcontractors, subrecipients and other persons who are NOT employees of your organization in F. Contractual.

Note that the salaries of indirect or facilities & administration (F&A) administrative and clerical staff are usually covered by J. Indirect Charges.

Name Name:

Enter the name of the organization employee in the position. If the position is vacant, state “vacant” or “TBD” and indicate the anticipated hire date or time frame (e.g., 3 months, 4 months etc.) for hire.

If the position is held by someone other than a full-time, part-time, or temporary employee of the organization, show the position in F. Contractual.

Key Position per the FOA Key Position per the FOA:

Check the box if the position is identified as key personnel in the FOA.

Key positions require prior approval by SAMHSA after review of credentials and job descriptions.

Check if Hourly Rate Check if Hourly Rate:

Check the box if you would prefer to use Hourly Rate instead of Annual Salary.

Checking this box will remove values entered in Annual Salary and Percent LOE for the line item.

Un-checking this box will remove values entered in Hourly Rate and Hours for the line item.

Calculation Hourly Rate Hourly Rate:

Enter the Hourly Rate. Ensure the Hourly Rate does not include fringe benefit costs.

The Hourly Rate must not exceed the Executive Level II salary level of $95.81 per hour for a full-time appointment of 2080 hours per year, effective January 3, 2021.

Hours Hours:

Enter the number of hours.

Hours must not exceed 2,080, which is typically full-time status or 100% level of effort for an individual.

For Key Positions whose personnel cost is based on Hourly Rates and Hours, indicate the percent Level of Effort for each position in the Personnel Narrative.

Annual Salary Annual Salary:

Enter the actual or projected Annual Salary. Ensure the Annual Salary does not include fringe benefit costs.

The Annual Salary must not exceed the Executive Level II salary level of $199,300 annually (or $95.81 per hour for a full-time appointment of 2080 hours per year), effective January 3, 2021.

Annual salaries must be reasonable for the services provided and conform to the established policy of the organization, consistently applied to both federal and non-federal activities.

% Level of Effort (LOE) % Level of Effort (LOE):

Enter the percentage of time the employee will work on the project during the budget period.

An employee’s total LOE across all active projects (including other federal awards) must NOT exceed 100%.

Personnel Cost Personnel Cost:

This is an auto-calculated field showing the personnel cost.

If Annual Salary and Percent LOE are entered:

Personnel Cost = Annual Salary x Percent LOE.

If Hourly Rate and Hours are entered:

Personnel Cost = Hourly Rate x Hours.

If the position will not be charged to the project, identify the position as an “in-kind” cost in the In-Kind Personnel table.

Contractual Personnel Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Personnel Cost.

(Enter TOTAL in SF-424A Section B, line 6a, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Personnel Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

(Enter TOTAL in SF-424A Section B, line 6a, column 2) Blank Blank

TOTAL

TOTAL

Contractual Personnel Table Blank Line Item # Line Item # An auto-generated number.

Personnel Narrative:

Personnel Narrative:

Describe the roles and responsibilities of each position and explain how they relate to achieving the goals and objectives of the project.

For individuals whose Annual Salaries or Hourly Rates exceed the Executive Level II Salary Limitation, provide their actual institutional base salaries or hourly rates.

For Key Positions whose personnel cost is based on Hourly Rates and Hours, indicate the percent Level of Effort for each position.

Individuals cannot exceed 100% level of effort across all active projects including other federal awards.

Blank Personnel Narrative Table In-Kind Personnel In-Kind Personnel Table:

If an employee will be working on the project, but the position will not be charged to the project, enter the position as an “in-kind” cost in the table below.

Blank Line Item # Line Item # An auto-generated number.

Position Position:

Enter the title of the position. The position must be relevant and allowable under the project. Show only positions held by full-time, part-time, or temporary employees of your organization in this table.

Show consultants, contractors/subcontractors, subrecipients and other persons who are NOT employees of your organization in F. Contractual.

Note that the salaries of indirect or facilities & administration (F&A) administrative and clerical staff are usually covered by J. Indirect Charges.

Name Name:

Enter the name of the organization employee in the position. If the position is vacant, state “vacant” or “TBD” and indicate the anticipated hire date or time frame (e.g., 3 months, 4 months etc.) for hire.

If the position is held by someone other than a full-time, part-time, or temporary employee of the organization, show the position in F. Contractual.

Key Position per the FOA Key Position per the FOA:

Check the box if the position is identified as key personnel in the FOA.

Key positions require prior approval by SAMHSA after review of credentials and job descriptions.

Check if Hourly Rate Check if Hourly Rate:

Check the box if you would prefer to use Hourly Rate instead of Annual Salary.

Checking this box will remove values entered in Annual Salary and Percent LOE for the line item.

Un-checking this box will remove values entered in Hourly Rate and Hours for the line item.

Hourly Rate Hourly Rate:

Enter the Hourly Rate. Ensure the Hourly Rate does not include fringe benefit costs.

The Hourly Rate must not exceed the Executive Level II salary level of $95.81 per hour for a full-time appointment of 2080 hours per year, effective January 3, 2021.

Hours Hours:

Enter the number of hours.

Hours must not exceed 2,080, which is typically full-time status or 100% level of effort for an individual.

For Key Positions shown as Hourly Rates and Hours, indicate the percent Level of Effort for each position in the In-Kind Personnel Narrative.

Annual Salary Annual Salary:

Enter the actual or projected Annual Salary. Ensure the Annual Salary does not include fringe benefit costs.

The Annual Salary must not exceed the Executive Level II salary level of $199,300 annually (or $95.81 per hour for a full-time appointment of 2080 hours per year), effective January 3, 2021.

Annual salaries must be reasonable for the services provided and conform to the established policy of the organization, consistently applied to both federal and non-federal activities.

% Level of Effort (LOE) % Level of Effort (LOE):

Enter the percentage of time the employee will work on the project during the budget period.

An employee’s total LOE across all projects (including other federal awards) must NOT exceed 100%.

In-Kind Personnel Table Blank Line Item # In-Kind Personnel Narrative:

Personnel Narrative:

Describe the roles and responsibilities of each position and explain how they relate to achieving the goals and objectives of the project.

For individuals whose Annual Salaries or Hourly Rates exceed the Executive Level II Salary Limitation, provide their actual institutional base salaries or hourly rates.

For Key Positions shown as Hourly Rates and Hours, indicate the percent Level of Effort for each position.

Blank In-Kind Personnel Narrative Table Our organization's fringe benefits consist of the components shown below:

Our organization's fringe benefits consist of the components shown below:

Blank Fringe Components Fringe Components:

Enter the various components of the allowances and services provided to employees as part of their compensation.

Fringe benefits may be in the form of employer contributions or expenses for FICA (Social Security and Medicare tax), employee life, health, unemployment, worker's compensation insurance, and other similar reasonable and allowable benefits as required by law, organization – employee agreement, or established written policies of the applicant/recipient organization (45 CFR Part 75.431: Compensation – fringe benefits).

Rate (%) Rate (%):

Enter the percentage for each fringe component.

Total Fringe Rate Total Fringe Rate Fringe Components Table Fringe Benefits Cost Fringe Benefits Cost:

Fringe benefits shown in this table must apply only to the personnel listed in A. Personnel and only for the percentage of time devoted to the project.

Blank Line Item # Line Item # An auto-generated number.

Position Position:

This field is auto-populated from A. Personnel. It is title of the position to which the fringe benefits rate will be applied.

Name Name This field is auto-populated from A. Personnel. It is the name of the organization employee associated with the position.

Calculation Calculation Personnel Cost Personnel Cost:

This field is auto-populated from A. Personnel. It is the amount shown for each employee under Personnel Cost in A. Personnel.

Total Fringe Rate (%) Total Fringe Rate:

Enter the Total Fringe Rate percent for your organization.

Fixed / Lump Sum Fringe (if any) Fixed / Lump Sum Cost (if any):

Enter any fixed or lump sum fringe benefit that is not based on a percentage of the Personnel Cost.

Leave blank if there is no fixed or lump sum fringe benefit to be applied to the employee.

Fringe Benefits Cost Fringe Benefits Cost:

This is an auto-calculated field showing the fringe benefits cost.

Fringe Benefits Cost = (Personnel Cost x the Total Fringe Rate) + Any Fixed or Lump Sum Cost.

Fringe Benefits Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Fringe Benefits Cost.

(Enter TOTAL in SF-424A Section B, line 6b, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Fringe Benefits Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

(Enter TOTAL in SF-424A Section B, line 6b, column 2) Blank Blank Blank Blank Blank

TOTAL

TOTAL

Fringe Benefits Cost Table Blank Fringe Benefits Narrative:

Fringe Benefits Narrative:

Explain any differences in the Total Fringe Rate between positions, anticipated increases in the Total Fringe Rate, and any fixed or lump sum fringe benefit costs.

Blank Fringe Benefits Narrative Table Blank Trip # Trip # An auto-generated number.

Purpose Purpose:

Briefly specify the purpose of the travel, e.g., mandatory grantee meeting, site visit, conduct participant/client activities, national conference, regional conference, professional meeting, convention, seminar, symposium etc.

Destination Destination:

Specify the location (City and State/District/Territory/Possession) where the trip will end. If destination is unknown, indicate “TBD” for “To Be Determined.”

Calculation Calculation Blank Item Item:

Select from the drop-down list one or more of the following items of cost associated with the travel:

Hotel/Lodging Per Diems (Meals and Incidental Expenses (M&IE) only) Airfare Train/Bus Local Travel (Privately Owned Vehicle or POV mileage) Car Rental Taxis/Parking/Tolls Baggage Fees Other (No registration fees) Cost / Rate per Item Cost/Rate per Item:

Enter the cost/rate for each item:

a. Hotel/Lodging – enter the rate per night

b. Per Diems (M&IE only) – enter the cost per day

c. Airfare or Train/Bus – enter the cost per round trip

d. Local travel (POV mileage) – enter the cost per mile

e. Car Rental – enter the cost per day

f. Taxis, Parking, and/or Tolls – enter the cost per day

g. Baggage Fees – enter the cost per round trip

h. Other (No registration fees)

Costs for contingencies and miscellaneous items are NOT allowable.

Basis Basis:

The basis for the travel cost is auto-populated depending on the selection from the drop-down list of Items:

a. “Night” if Hotel/Lodging is selected.

b. “Day” if Per Diems (M&IE only) is selected.

c. “Round Trip” if Airfare or Train/Bus is selected.

d. “Mile” if Local travel (POV mileage) is selected.

e. “Day” if Car Rental is selected.

f. “Day” f Taxis, Parking, and/or Tolls is selected.

g. “Round Trip” if Baggage Fees is selected.

If Other (No registration fees) is selected, enter the relevant basis.

Quantity per Person Quantity of Item per Person:

Enter the number of nights, days, miles, round trips, or other item for each person.

Number of Persons Number of Persons:

Enter the number of organization staff who will be travelling.

Travel Cost Travel Cost:

This is an auto-calculated field showing the travel cost.

Travel Cost = Cost or Rate per Item x Quantity per Person x Number of Persons.

Travel Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Travel Cost.

(Enter TOTAL in SF-424A Section B, line 6c, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Travel Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

(Enter TOTAL in SF-424A Section B, line 6c, column 2) Travel Calculation Table Blank Blank Blank

TOTAL

TOTAL

Main Travel Table Blank Trip # Trip # An auto-generated number.

Travel Narrative:

Travel Narrative:

Describe the purpose for each travel in relation to achieving the project goals and objectives. Describe the need for the travel (that is, explain how it will benefit the project) if the travel is not specifically required by the FOA. Indicate the number of trips planned, staff who will be making the trip, and approximate dates.

If specific travel details are unknown, the basis for proposed travel costs should be explained (e.g., historical information).

If you select “Other (No registration fees)” as an Item, describe the Item.

Blank Travel Narrative Table Blank Line Item # Line Item # An auto-generated number.

Item Item:

Describe the equipment to be purchased or rented/leased.

Note that general purpose equipment such as office equipment and furnishings, modular offices, telephone networks, information technology equipment and systems, air conditioning equipment, reproduction and printing equipment, and motor vehicles are unallowable as direct costs without SAMHSA’s prior written approval (45 CFR Part 75.439).

Calculation Calculation Quantity Quantity:

Enter the number of items of equipment to be purchased or rented/leased.

Purchase or Rental/Lease Cost Purchase or Rental/Lease Cost:

Enter the unit cost of the equipment purchase or rental/lease. Other charges such as shipping, installation, taxes, duty or protective in-transit insurance, and maintenance costs should be included in the unit cost consistent with the organization’s regular accounting practices.

Percent Charged to the Project Percentage Charged to the Project:

Enter the percentage of the equipment’s value to be charged to the project.

If the equipment will be used by several projects, you may only charge a percentage of the costs for the purchase or rental/lease based on the amount of time the equipment will be used for this grant project.

Equipment Cost Equipment Cost:

This is an auto-calculated field showing the equipment cost.

Equipment Cost = Quantity x (Purchase or Rental/Lease Cost) x Percent Charged to the Project.

Equipment Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Equipment Cost.

(Enter TOTAL in SF-424A, Section B, line 6d, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Equipment Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

(Enter TOTAL in SF-424A, Section B, line 6d, column 2) Blank Blank

TOTAL

TOTAL

Equipment Table Blank Line Item # Line Item # An auto-generated number.

Equipment Narrative:

Equipment Narrative:

Describe the need for the equipment, i.e., explain how the use of each item of equipment is related to the implementation of the required/approved activities to achieve the specific project objectives.

Provide the basis for the unit cost of the equipment, e.g., fair market value, cost quotes etc., and describe the procurement method to be used (45 CFR Part 75.329 – Procurement procedures).

If you are proposing to purchase vehicles and other high value equipment instead of rental/lease, provide a rental/lease versus purchase analysis, or a statement explaining whether it is feasible and/or cost effective to purchase versus rental/lease.

Blank Equipment Narrative Table Blank Line Item # Line Item # An auto generated number.

Item Item:

List supplies by type, e.g., general office supplies, printing supplies, postage, laptops, desktop computers, printers, projectors, etc.

Calculation Calculation Unit Cost Unit Cost:

Enter the unit cost for the basis shown. If the basis is for example, copy, laptop, or printer etc., enter the cost for each copy, laptop, or printer etc. If the basis is a unit of time (for example, week, month, quarter, year), enter the cost for each week, month, quarter, or year.

Basis Basis:

This field is for text only. Enter the basis for the unit cost, i.e., by type of item (for example, copy, laptop, printer, etc.) or by unit of time (for example, week, month, quarter, year etc.).

Quantity Quantity:

Enter the number of items needed.

You may enter a value in either Quantity or Duration, or both, if applicable.

Duration Duration:

Enter the duration or length of time that the item will be needed.

You may enter a value in either Quantity or Duration, or both, if applicable.

Supplies Cost Supplies Cost:

This is an auto-calculated field showing the supplies cost.

Supplies Cost = Unit Cost x Quantity x Duration.

For example, cost for general office supplies, printing supplies, postage etc. may be determined by multiplying the estimated cost per month entered in Unit Cost by the number of months entered in Duration with the Basis shown as “month.”

Supplies Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Supplies Cost.

(Enter TOTAL in SF-424A, Section B, line 6e, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Supplies Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

(Enter TOTAL in SF-424A, Section B, line 6e, column 2) Blank Blank

TOTAL

TOTAL

Supplies Table Blank Line Item # Line Item # An auto generated number.

Supplies Narrative:

Supplies Narrative:

Describe the type of supplies to be purchased and explain how each supply item is related to the implementation of the required/approved activities to achieve the specific project objectives. Include the breakdown of costs to show how you determined the unit cost for each supply item, if appropriate.

Blank Supplies Narrative Table Enter in the table below, the Name of the Organization or Consultant and Summary of Services & Deliverables Provided. The amounts in Contractual Cost, FEDERAL REQUEST, and NON-FEDERAL MATCH (only visible if you selected match is required on page 1) will be auto-populated from the budget category tables for each “contract” in the Contractual Details section.

Click one or more check boxes in the Contractual Details section to access the budget category tables for Personnel, Fringe Benefits, Travel, Supplies, Other, and Indirect Charges to enter the line item details.

Click the “+” button to add a new “contract” to the Summary of Contractual Costs table and generate a new Contractual Details section with the budget category tables for that “contract.”

Clicking the “X“ button to remove a “contract” will DELETE all data in the budget category tables for that “contract.”

Enter in the table below, the Name of the Organization or Consultant and Summary of Services & Deliverables Provided. The amounts in Contractual Cost, FEDERAL REQUEST, and NON-FEDERAL MATCH (only visible if you selected match is required on page 1) will be auto-populated from the budget category tables for each “contract” in the Contractual Details section.

Click one or more check boxes in the Contractual Details section to access the budget category tables for Personnel, Fringe Benefits, Travel, Supplies, Other, and Indirect Charges to enter the line item details.

Click the “+” button to add a new “contract” to the Summary of Contractual Costs table and generate a new Contractual Details section with the budget category tables for that “contract.”

Clicking the “X“ button to remove a “contract” will DELETE all data in the budget category tables for that “contract.”

Blank Contract # Contract # An auto-generated number.

Name of Organization or Consultant Name of Organization or Consultant:

Enter the name of the organization or individual providing the service(s) and deliverable(s), and indicate whether they are a consultant, contractor/subcontractor/vendor, subrecipient, or a consortium.

Summary of Services & Deliverables Provided Summary of Services & Deliverables Provided:

Briefly describe the services and deliverables to be provided.

Contractual Cost Contractual Cost:

This field is auto-populated from the budget category tables in the Contractual Details section. It is the total cost of each “contract.”

FEDERAL REQUEST

FEDERAL REQUEST:

This field is auto-populated from the budget category tables in the Contractual Details section. It is the total FEDERAL REQUEST for each "contract."

(Enter TOTAL in SF-424A, Section B, line 6f, column 1)

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

This field is auto-populated from the budget category tables in the Contractual Details section. If matching is required by the FOA, this is the total amount of matching funds entered in NON-FEDERAL MATCH for each "contract."

(Enter TOTAL in SF-424A, Section B, line 6f, column 2) Blank Blank

TOTAL

TOTAL

Summary of Contractual Costs Table Blank Contract # Contract # An auto-generated number.

Contractual Summary Narrative:

Contractual Summary Narrative:

For each “contract,” explain the need for the services and deliverables and how they relate to the goals and objectives of the project.

For each “contract,” provide the following information:

a. Method of selection/procurement (45 CFR Part 75.329 – Procurement procedures) – indicate whether the procurement method is a micro-purchase, small purchase, sealed bid, competitive proposal, or non-competitive proposal (provide justification if non-competitive/sole source)

b. Summary of specific tasks/activities to be performed and deliverables (any verifiable outcome, result, service or product that must be delivered, developed, performed or produced under the “contractor” as defined by the statement of work); and

c. Period of performance.

Note that costs incurred outside the award project period cannot be charged to the federal award.

Blank Contractual Summary Narrative Table Contractual Details for Contractual Details:

Provide separate budgets for each "contract."

Costs for each "contract" must be broken out in sufficient detail with the supporting narrative justification provided for each line item expense.

Include the number of clients or participants in the costs, if applicable.

Select one or more applicable budget categories for the "contract" shown in the Summary of Contractual Costs table above:

Select one or more applicable budget categories for each "contract" shown the Summary of Contractual Costs table above:

This text will NOT be visible on the document printed to PDF or to a printer.

Contractual Personnel Costs for Contractual Personnel Costs:

All positions shown must be relevant and allowable under the project.

If the Project Director (PD) key position will be held by a consultant or contractor/subcontractor or subrecipient, show the PD in this table, and ensure the PD shown is the same PD identified in the SF-424.

Also, if the PD key position will be held by a consultant or contractor/subcontractor or subrecipient, include a copy of the formal written agreement/contract that specifies the roles and responsibilities of the PD even if the relationship does not involve a fee or other form of remuneration.

Contractual Personnel Costs for:

Blank Line Item # Line Item # An auto-generated number.

Position Position:

Enter the title of the position to be charged to the project. The position must be relevant and allowable under the project.

Name Name:

Enter the name of the person in the position.

Key Position per the FOA Key Position per the FOA:

Check the box if the position is identified as key personnel in the FOA.

Key positions require prior approval by SAMHSA after review of credentials and job descriptions.

If the Project Director (PD) key position will be held by a consultant or contractor/subcontractor or subrecipient, show the PD in this table, and ensure the PD shown is the same PD identified in the SF-424.

Check if Annual Salary Check if Annual Salary:

Check the box if you would prefer to use Annual Salary instead of Hourly Rate.

Checking this box will remove values entered in Hourly Rate and Hours for the line item.

Un-checking this box will remove values entered in Annual Salary and LOE for the line item.

Calculation Hourly Rate Hourly Rate:

Enter the Hourly Rate. Ensure the Hourly Rate does not include fringe benefit costs.

For subawards and subcontracts, the Hourly Rate must not exceed the Executive Level II salary level of $95.81 per hour for a full-time appointment of 2080 hours per year, effective January 3, 2021.

Hours Hours:

Enter the number of hours.

Note that 2,080 hours is typically full-time status or 100% level of effort for an individual.

For Key Positions whose personnel cost is based on Hourly Rates and Hours, indicate the percent Level of Effort for each position in the Contractual Personnel Narrative.

Annual Salary Annual Salary:

Enter the actual or projected Annual Salary. Ensure the Annual Salary does not include fringe benefit costs.

For subawards and subcontracts, ensure the Annual Salary does not exceed the Executive Level II salary level of $199,300 annually, effective January 3, 2021.

Annual salaries must be reasonable for the services provided and conform to the established policy of the organization, consistently applied to both federal and non-federal activities.

% Level of Effort (LOE) % Level of Effort (LOE):

Enter the percentage of time the individual will work on the project during the budget period.

An individual’s total LOE across all active projects (including other federal awards) must NOT exceed 100%.

Contractual Personnel Cost Contractual Personnel Cost:

This is an auto-calculated showing the contractual personnel cost.

If Hourly Rate and Hours are entered:

Contractual Personnel Cost = Hourly Rate x Hours.

If Annual Salary and Percent LOE are entered:

Contractual Personnel Cost = Annual Salary x Percent LOE.

Contractual Personnel Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Contractual Personnel Cost.

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Contractual Personnel Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

Blank Blank

TOTAL

TOTAL

Contractual Personnel Table Bank Line Item # Line Item # An auto-generated number.

Contractual Personnel Narrative:

Contractual Personnel Narrative:

Describe the roles and responsibilities of each position and explain how they relate to achieving the goals and objectives of the project.

If the PD key position will be held by a consultant or contractor/subcontractor or subrecipient, include a copy of the formal written agreement/contract that specifies the roles and responsibilities of the PD even if the relationship does not involve a fee or other form of remuneration.

For individuals whose Annual Salaries or Hourly Rates exceed the Executive Level II Salary Limitation, provide their actual institutional base salaries or hourly rates.

For Key Positions whose personnel cost is based on Hourly Rates and Hours, indicate the percent Level of Effort for each position.

Individuals cannot exceed 100% level of effort across all active projects including other federal awards.

Blank Contractual Personnel Narrative Table Contractual Fringe Benefits Costs for Fringe benefits are allowances and services provided to staff as compensation in addition to regular salaries and wages.

Fringe benefits cost must comply with HHS regulations at 45 CFR Part 75.431 (Compensation – fringe benefits). The cost of fringe benefits in the form of employer contributions or expenses for social security; employee life, health, unemployment, and worker's compensation insurance (except as indicated in §75.447 – Insurance and indemnification); pension plan costs; and other similar benefits are allowable, provided such benefits are reasonable and are required by law, organization-employee agreement, or an established written policy of the entity/organization.

Contractual Fringe Benefits Costs for:

Contractual fringe benefits consist of the components shown below:

Contractual fringe benefits are comprised of the components shown below:

Blank Fringe Components Fringe Components:

Fringe benefits may be in the form of employer contributions or expenses for FICA (Social Security and Medicare tax), employee life, health, unemployment, worker's compensation insurance, and other similar reasonable and allowable benefits as required by law, organization – employee agreement, or established written policies of the entity/organization (45 CFR Part 75.431: Compensation – fringe benefits).

Rate (%) Rate:

Enter the percent for each fringe component.

Total Fringe Rate Total Fringe Rate Contractual Fringe Components Table Contractual Fringe Benefits Costs Contractual Fringe Benefits Costs:

Fringe benefits are allowances and services provided to staff as compensation in addition to regular salaries and wages.

Fringe benefits cost must comply with HHS regulations at 45 CFR Part 75.431 (Compensation – fringe benefits). The cost of fringe benefits in the form of employer contributions or expenses for social security; employee life, health, unemployment, and worker's compensation insurance (except as indicated in §75.447 – Insurance and indemnification); pension plan costs; and other similar benefits are allowable, provided such benefits are reasonable and are required by law, organization-employee agreement, or an established written policy of the entity/organization.

Blank Line Item # Line Item # An auto-generated number.

Position Position:

This field is auto-populated from Contractual Personnel. It is the title of the position to which the contractual fringe benefits rate will be applied.

Name Name:

This field is auto-populated from Contractual Personnel. It is the name of the individual associated with the position.

Calculation Contractual Personnel Cost Contractual Personnel Cost:

This field is auto-populated from Contractual Personnel. It is the amount shown for each individual under Contractual Personnel Cost in the Contractual Personnel table.

Total Fringe Rate (%) Total Fringe Rate:

Enter the percent Total Fringe Rate for the individual or organization.

Fixed / Lump Sum Cost (if any) Fixed / Lump Sum Cost (if any):

Enter any fixed or lump sum fringe benefit (i.e., not based on a percentage of the Contractual Personnel Cost).

Leave blank if there is no fixed or lump sum fringe benefit to be applied to the individual.

Contractual Fringe Benefits Cost Contractual Fringe Benefits Cost:

This is an auto-calculated field showing the contractual fringe benefits cost.

Contractual Fringe Benefits Cost = (Contractual Personnel Cost x Total Fringe Rate) + Any Fixed or Lump Sum Cost.

Contractual Fringe Benefit Cost Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Contractual Fringe Benefits Cost.

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Contractual Fringe Benefits Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

Blank Blank Blank Blank Blank

TOTAL

TOTAL

Contractual Fringe Benefit Cost Table Blank Contractual Fringe Benefits Narrative:

Contractual Fringe Narrative:

Explain any differences in the Total Fringe Rate between positions, anticipated increases in the Total Fringe Rate, and any fixed or lump sum fringe benefit costs.

Blank Contractual Fringe Narrative Table Contractual Travel Costs for Contractual Travel Costs:

Show the travel costs for participants and consultants/contractors (along with consultant/contractor other travel-related fees and costs). Show registration fees for conferences and other events in Contractual Other.

Funds requested for travel should be for relevant and allowable travel costs.

Travel costs charged to the project must comply with HHS regulations at 45 CFR Part 75.474 – Travel costs. If the consultant or organizational entity does not have documented travel policies, the Federal GSA rates available at https://www.gsa.gov/travel-resources must be used.

Contractual Travel Costs for:

Blank Trip # Trip # An auto-generated number.

Purpose Purpose:

Briefly specify the purpose of the travel, e.g., mandatory grantee meeting, site visit, conduct participant/client activities, national conference, regional conference, professional meeting, convention, seminar, symposium etc.

Destination Destination:

Specify the location (City and State/District/Territory/Possession) where the trip will end. If destination is unknown, indicate “TBD” for “To Be Determined.”

Calculation Item Item:

Select from the drop-down list one or more of the following items of cost associated with the travel:

Hotel/Lodging Per Diems (Meals and Incidental Expenses (M&IE) only) Airfare Train/Bus Local Travel (Privately Owned Vehicle or POV mileage) Car Rental Taxis/Parking/Tolls Baggage Fees Other (No registration fees) Cost / Rate per Item Cost/Rate per Item:

Enter the cost/rate for each item:

a. Hotel/Lodging – enter the rate per night

b. Per Diems (M&IE only) – enter the cost per day

c. Airfare or Train/Bus – enter the cost per round trip

d. Local travel (POV mileage) – enter the cost per mile

e. Car Rental – enter the cost per day

f. Taxis, Parking, and/or Tolls – enter the cost per day

g. Baggage Fees – enter the cost per round trip

h. Other (No registration fees)

Costs for contingencies and miscellaneous items are NOT allowable.

Basis Basis:

The basis for the travel cost is auto-populated depending on the selection from the drop-down list of Items:

a. “Night” if Hotel/Lodging is selected.

b. “Day” if Per Diems (M&IE only) is selected.

c. “Round Trip” if Airfare or Train/Bus is selected.

d. “Mile” if Local travel (POV mileage) is selected.

e. “Day” if Car Rental is selected.

f. “Day” if Taxis, Parking, and/or Tolls is selected.

g. “Round Trip” if Baggage Fees is selected.

If Other (No registration fees) is selected, enter the relevant basis.

Quantity per Person Quantity of Item per Person:

Enter the number of nights, days, miles, round trips, or other item for each person.

Number of Persons Number of Persons:

Enter the number of persons who will be travelling.

Contract Travel Cost Contract Travel Cost:

This is an auto-calculated field showing the travel cost.

Contract Travel Cost = Cost or Rate per Item x Quantity per Person x Number of Persons.

Contractual Travel Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Contractual Travel Cost.

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Contractual Travel Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

Contractual Travel Calculation Table Blank Blank Blank

TOTAL

TOTAL

Contractual Travel Main Table Blank Trip # Trip # An auto-generated number.

Contractual Travel Narrative:

Contractual Travel Narrative:

Describe the purpose for each travel in relation to achieving the project goals and objectives. Describe the need for the travel (that is, explain how it will benefit the project) if the travel is not specifically required by the FOA. Indicate the number of trips planned, staff who will be making the trip, and approximate dates.

If specific travel details are unknown, the basis for proposed travel costs should be explained (e.g., historical information).

For each line item cost, include adequate justification and a detailed breakdown of your estimate. If you select “Other (No registration fees)” as an Item, describe the Item.

If the consultant or organizational entity will be serving clients/participants, show the number of clients/ participants in the costs.

Blank Contractual Travel Narrative Table Contractual Supplies Costs for Contractual Supplies Costs:

Supplies are items that cost less than $5,000 per unit and often have a one-time use, that is, materials which are expendable or consumed during the performance of the Federal award. A computing device is a supply if the acquisition cost is less than the lesser of the capitalization level established by the organization for financial statement purposes or $5,000, regardless of the length of its useful life.

For each line item cost, include adequate justification and a detailed breakdown of your estimate. List the items by type of supplies (e.g., general office supplies, postage, training materials, books, desktop computers, laptops, projectors etc.), unit cost, and quantity or duration.

If the individual or organizational entity will be serving clients/participants, show the number of clients/ participants in the costs.

Note that in the specific case of computing devices, charging as direct costs is allowable for devices that are essential and allocable, but not solely dedicated, to the performance of a Federal award (45 CFR Part 75.453).

Contractual Supplies Costs for:

Blank Line Item # Line Item # An auto generated number.

Item Item:

List supplies by type, e.g., general office supplies, printing supplies, postage, laptops, desktop computers, printers, projectors, etc.

Calculation Calculation Unit Cost Unit Cost:

Enter the unit cost for the basis shown. If the basis is e.g., copy, laptop, or printer etc., enter the cost for each copy, laptop, or printer etc. If the basis is a unit of time (e.g., week, month, quarter, year), enter the cost for each week, month, quarter, or year.

Basis Basis:

This field is for text only. Enter the basis for the unit cost, i.e., by type of item (e.g., copy, laptop, printer, etc.) or by unit of time (e.g., week, month, quarter, year etc.).

Quantity Quantity:

Enter the number of items needed.

You may enter a value in either Quantity or Duration, or both, if applicable.

Duration Duration:

Enter the duration or length of time that the item will be needed.

You may enter a value in either Quantity or Duration, or both, if applicable.

Contractual Supplies Cost Contractual Supplies Cost:

This is an auto-calculated field showing the supplies cost.

Contractual Supplies Cost = Unit Cost x Quantity x Duration.

For example, cost for general office supplies, printing supplies, postage etc. may be determined by multiplying the estimated cost per month entered in Unit Cost by the number of months entered in Duration with the Basis shown as “month.”

Contractual Supplies Calculation Headers Table

FEDERAL REQUEST

FEDERAL REQUEST:

The FEDERAL REQUEST equals the amount in Contractual Supplies Cost.

NON-FEDERAL MATCH

NON-FEDERAL MATCH:

If matching is required by the FOA, enter the amount of matching funds in NON-FEDERAL MATCH.

Note that the FEDERAL REQUEST will automatically decrease by the amount entered in NON-FEDERAL MATCH.

In the Contractual Supplies Narrative section, indicate whether the matching funds are cash or in-kind contributions and identify the source(s) of the matching funds, that is, specify the name of the state and/or local governmental appropriations (non-federal), foundations, and other private non-profit or for-profit organizations providing the matching funds.

Blank Blank

TOTAL

TOTAL

Contractual Supplies Table Blank Line Item # Line Item # An auto generated number.

Contractual Supplies Narrative:

Contractual Supplies Narrative:

Describe the type of supplies to be purchased and explain how each supply item is related to the implementation of the required/approved activities to achieve the specific project objectives. Include the breakdown of costs to show how you determined the unit cost for each item, if appropriate.

Blank Contractual Supplies Narrative Table Contractual Other Costs for Contractual Other Costs:

The Other category is for any expenses not covered in the previous budget categories. Ensure that costs shown under “Other” are not already covered by the Indirect Charges. Costs you may show under “Other” include:

• Minor alteration and renovation (A&R)

• Rent

• Participant/ client incentives (a recipient or treatment or prevention provider may provide up to $30 non-cash incentive to individuals to participate in required data collection follow up)

• Telephone

• Training activities (except for consultant and contractual costs)

• Travel for training participants

• Registration fees

List items or type of expense and explain why each is needed to achieve the project goals and objectives. Show the basis for the calculations – breakdown costs into the cost per unit or rate (e.g., cost per square foot, cost per light snack, cost per participant etc.) and quantity.

For training projects, list the travel and meals for trainees separately. Show the number of trainees/ attendees/ participants and the unit costs involved. Itemize travel costs the same way as in C. Travel.

Contractual Other Costs for Blank Line Item # Line Item # An auto generated number.

Item Item:

List each item by type of expense. “Miscellaneous” and “contingency” expenses are NOT acceptable line items.

Meals are generally unallowable unless they are an integral part of a conference grant or…