Exhibit M - 27-28 IWTF Request Template.pdf

FDC-ITN-27-022

Facility: Fiscal Year:

Title of Program:

Program Instructor's Name:

Program Instructor's Title/Position:

Target Inmate Population (Inmate Criteria):

OBIS Course Code:

(Include information about service delivery and timelines.):

(Include biographical information or required minimum qualifications for any staff and volunteers):

Contractor-Operated Correctional Facilities Attachment A: COIIWTF Program Request and Narrative Contractor-Operated Institutions Inmate Welfare Trust Fund (COIIWTF)

2027-2028 Correctional Facility

Total Hours of Program Participation per Inmate per Week: COIIWTF Funds Requested:

Previous Year's Approved Budget:

5. Describe your evaluation plan for assessing how well the program met its goals and objectives.

6. Staff Qualifications (Attach Job Description)

7. Attach Program Curriculum (e.g. Department of Education, Auburn University, etc.)

3. How does this program have the potential to aid the inmate's reintegration into society?

4. What are the specific goals and objectives of this program?

1. Program Narrative:

2. Specific Activities

Contractor-Operated Institutions Inmate Welfare Trust Fund (IWTF)

Attachment A: IWTF Program Request and Narrative

Electronic Signature Date

The warden or designee certifies that this COIIWTF application is compliant with the contract, all Laws, and Rules of the State of Florida.

Attachment A: IWTF Program Request and Narrative

1. Personnel

a. Each individual should be identified by name and position.

b. Time commitments should be included as hours or percentage of time stated for each position.

c. The total charges for each person listed includes an explanation of how the costs have been calculated.

d. Indicate which individuals (if any) are volunteers.

2. Fringe Benefits

a. Identify which individuals are eligible for fringe benefits.

b. Identify the elements that comprise the fringe benefits figures.

c. Indicate whether fringe benefits are in the same proportion to other salaries not funded by POIIWTF.

3. Travel

a. The narrative must include a detailed breakdown of estimated travel costs.

b. All travel costs must comply with state policies and procedures.

c. Reimbursement requests for travel must include a state travel voucher.

e. Detail the purpose of the proposed travel.

f. For each item, include an explanation of how these charges are necessary for the successful completion of the program.

4. Supplies

a. Supplies must be itemized by type of material and nature of expense.

b. For general office or business supplies, the total charge must provide support for the program activities.

c. For specific items, include the number of units, cost per unit and total cost.

d. Explain how these charges are necessary for the successful completion of the program.

5. Equipment Rental/Purchase

a. List each item of equipment with an explanation of how this item is necessary for the successful completion of the program.

b. If the purchase is more than $5,000, provide a description of how it will be used and disposed of after it is no longer needed or useable.

c. For each item, include the number of units, cost per unit and total cost specified.

d. For each item over $5,000, a lease-versus-purchase analysis should be completed.

e. For each item over $5,000, a competitive procurement method should be indicated.

6. Other

a. Items should be listed by type of material.

b. Each item should include an explanation of how this item is necessary for the successful completion of the program.

c. Each item should be allowable, allocable and documented.

d. All costs will be reasonable.

d. For each trip, indicate destination, estimated mileage, method of travel, cost per mile and duration, number of travelers, per diem rate for meals and lodging.

The budget narrative provides a complete description of the costs associated with the program activities. As you prepare to assemble the budget, go back through the program narrative and make a list of all personnel and non-personnel items related to the operation of the program. The list of budget items and the calculations used to arrive at the dollar figures should be summarized below. All significant costs must be broken out within the subcategories and should include a detailed description. The following information will be used by the COIIWTF Committee to determine funding level. It should include the following areas:

Contractor-Operated Correctional Facilities Attachment B: Budget Instructions

Contractor-Operated Institutions Inmate Welfare Trust Fund (COIIWTF)

Attachment B: Budget Instructions

Facility: 2027-2028

Title of Program: Program Instructor's Name:

Previous Year's Approved Budget for This Program:

Previous Year's Expenditure for This Program:

COIIWTF Funds Requested for this program:

Item Quantity Amount Requested Narrative Staffing Salary Staffing Fringe Benefits Travel Supplies Equipment Other (Please Specify in Narrative) Total

Description Number of Units Cost per Unit Total Cost

Supplies & Materials Total -$

Description Number of Units Cost per Unit Total Cost

Equipment Total -$

Attachment C: Budget Narrative Contractor-Operated Correctional Facilities

Supplies & Materials Breakdown (Lines can be added as needed)

Equipment Breakdown (Lines can be added as needed)

Budget Summary (Lines can be added as needed)

Contractor-Operated Institutions Inmate Welfare Trust Fund (COIIWTF)

Correctional Facility

Attachment C: Budget Narrative