ESBD_383499_1732773251501_2025_Budget Allocation Form_State Services.xlsx

35 KB Posted

Attached to
STDC South Texas RFP No 25-01. 02. 03.
Solicitation number
STDC_SOUTH-TEXAS_RFP-NO_25-01.02.03.
Issued by
Cameron County, Texas

About this file

Written by GovTribe AI ·

This is a budget allocation form template for State Services, designed for tracking allocations across various medical and support services programs. The form is structured to cover a 5-month period and includes sections for both core medical services (such as Early Intervention Services, Home Health Care, Medical Case Management) and support services (like Child Care Services, Food Bank/Home-Delivered Meals, Housing Services).

The budget template is divided into seven main cost categories: Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual, and Other, with an additional section for indirect costs. Each category allows for detailed line-item budgeting across multiple service areas, with automatic calculation of total allocations and percentage distributions. The form appears to be blank/unused, with all monetary fields showing "$0" values and percentage calculations showing "ERROR:#DIV/0!" due to the lack of entered data.

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ESBD_383499_1732773516643_Appendix I - Letter of Intent.doc DOC document
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SS Budget Allocation

LEGAL BUSINESS NAMESTATE SERVICES BUDGETEarly Intervention ServicesHealth Insurance Premium and Cost SharingHome and Community Based Health ServicesHome Health CareHospice ServicesLocal AIDS Pharmaceutical Assistance/CSAMedical Nutrition TherapyMedical Case MgmtMental Health ServicesOral Health CareOutpatient Ambulatory Health ServicesSubstance Abuse Outpatient CareChild Care ServicesEmergency Financial AssistanceFood Bank/Home-Delivered MealsHealth Education/Risk Reduction (HE/RR)Housing ServicesLinguistics ServicesMedical Transportation ServicesNon-Medical Case MgmtOther Professional ServicesOutreach ServicesPsychosocial Support ServicesReferral for Health Care/ Supportive ServicesRehabilitation ServicesRespite CareSubstance Abuse Services (Residential)Treatment Adherence (Non-Medical)Other ServicesAdmin/
OperatingDifference
DESCRIPTIONTotal
A. PERSONNEL
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
PERSONNEL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
B. FRINGE BENEFITS
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
FRINGE BENEFITS TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
C. TRAVEL
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
TRAVEL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
D. EQUIPMENT
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
EQUIPMENT TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
E. SUPPLIES
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
SUPPLIES TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
F. CONTRACTUAL
Description/Justification:$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
CONTRACTUAL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
G. OTHER
Description/Justification:$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
OTHER TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
Indirect Cost Rate%%
Total Indirect Cost$ - 0- 0- 0- 0
- 0
TOTAL BUDGET$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
% of Total BudgetERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!

TOTAL OF CORE MEDICAL SERVICES $ - 0 %

TOTAL OF SUPPORT SERVICES $ - 0 %

&"Arial,Bold"

BUDGET ALLOCATION FORM

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