Financial Components Workbook.xlsx

XLSX spreadsheet 162 KB Posted Jan 2, 2025

Attached to: NOFA - FY26 Telephone Reassurance One 2 One Service
Solicitation number: PE-29016-NONST-2025-000000021
Issued by: Georgia

About this file

Written by GovTribe AI · Jan 6, 2025

This is a financial components workbook template from the DHS Division of Aging Services for the Uniform Cost Methodology (UCM) program. The workbook consists of multiple spreadsheets designed to capture detailed personnel costs, operating expenses, and budget information for multi-county and regional service providers. The template includes tabs for budget summary, budget narrative, and detailed personnel tracking for up to 25 staff positions across various aging services programs.

The workbook requires providers to input detailed financial data including wages, benefits, staff hours, administrative costs, building expenses, vehicle operations, computer expenses, supplies, meal service costs, and other operating expenses. It includes formulas to automatically calculate cost allocations, cost pools, and unit costs across different service categories. The template accommodates various funding sources and requires providers to document both actual costs and any donated/non-cash match contributions. Service categories covered include AAA administration, caregiver support, community living programs, home and community-based services, nutrition programs, and transportation services.

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Finance Components Cover Sheet

FINANCIAL COMPONENTS WORKBOOK - MULTI-COUNTY AND REGIONAL

General Requirements:

Budget Summary

Budget Narrative

UCM Personnel

UCM Support

*REMINDER: Fill out each tab completely

AGENCY NAME:

UCM - PERSONNEL

Enter Provider Name:

#10

#11

#12

#13

#14

#15

#16

#17

#18

#19

#20

#21

#22

#23

#24

#25

STAFF LIST

(Paid staff only - do not include volunteers

or other donated)	Number of Staff Positions (Enter number per staff title)	Base Wages (Enter base amount with no benefits included)	Fringe Benefit Rate
(Enter benefit costs by % only)	Fringe Benefit Dollars
(Auto-populates)	Total

Wages and

Benefits (Auto-populates)	Productive Hours (Enter annual productive hours)	General Admin
(Enter % of staff time in admin)	Admin Hours (Auto-populates)	General Admin

Costs

(Auto-populates)

Staff for Building Mainte-

nance (Enter % of staff time)

Shared Building Space Hours

(Auto-populates)

Shared Building Space

(Auto-populates)

Choose a Service

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

W & B

TOTAL

% OF

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

HOURS

(Auto-populates)

Billable Hours (Direct Service Staff Only)

STAFF TIME

(Enter % of staff time)

COST

(Auto-populates)

PROGRAMS

(Auto-populates)

WAGES

(Auto-populates)

Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Enter Staff Title/Name	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
Client/Meal Transportation Cost Pool Section Only
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
Driver	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
(The following data calculates automatically - do not enter)
Total Wages and Benefits	0	$0			$0				$0			$0				$0				$0				$0				$0				$0				$0				$0				$0				$0
Percent of Total Wages and Benefits					0.00%				0.00%			0.00%				0.00%				0.00%				0.00%				0.00%				0.00%				0.00%				0.00%				0.00%				0.00%
Total Hours						0		0			0			0				0				0				0				0				0				0				0				0
Unit of Service														1.00				1.00				1.00				1.00				1.00				1.00				1.00				1.00				1.00

Percent of Total Hours 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 100.00%

Column1

Choose a Service

AAA Administration

AAA Advocacy

AAA Coordination

AAA (Gateway_ADRC's Options Couns)

AAA I_A (Gateway_ADRC's) - Ind

AAA Outreach

AAA Program Development

Caregiver - Group (Staff Activity Log)

Caregiver - Case Management - T-Care Ind

Caregiver - Com Ed - PTC -Ind

Caregiver - Clinical Assessment

Caregiver - Driver Assessment

Caregiver - Respite Care In-Home - Ind

Caregiver - Respite Care In-Home - Voucher

Caregiver - Respite Care Out of Home - Ind

Caregiver - Respite Care Out of Home - V

CCSP - Care Coordination

CLP Community Living Program

CLP Financial Management Services

CLP - Monitoring Living Installation

CLP - Monitoring Living Solution

EAP - Elder Abuse Prevention

ELAP - Elderly Legal Assistance Program

HCBS - Adult Day Care - Ind

HCBS - Adult Day Care - Mobile

HCBS - Adult Day Health - Ind

HCBS - Case Management - Ind

HCBS - Community Education - Group

HCBS - Com Education - CDSMP -Ind

HCBS - Counseling - Ind

HCBS - Home Management - Ind

HCBS - Home Mod & Home Repair - Ind

HCBS - Home Sharing & RM Match - Ind

HCBS - Information & Assistance - Ind

HCBS - Interpretation & Translating - Group

HCBS - Material Aid - Ind

HCBS - Material Aid - Voucher

HCBS - Outreach - Ind

HCBS - Senior Recreation - Group

HCBS - Support Group - Ind

HCBS - Telephone Reassurance - Ind

HCBS - Transition Coordination - Ind

HCBS - Transportation - Ind

HCBS - Transportation - Ind (Assisted)

HCBS - Transportation - Voucher

HCBS - Trans - Group (DHR Unified)

HCBS - Vol Dev/Oppor/Service - Group

In-Home - Chore - Ind

In-Home - Emerg Resp Install - Ind

In-Home - Emerg Resp Monitoring - Ind

In-Home - Friendly Visiting - Ind

In-Home - Homemaker - Ind

In-Home - Homemaker - Voucher

In-Home - Personal Care - Ind

Kinship Care - Case Management

Kinship Care - Counseling

Kinship Care - Group (Staff Act Log)

Kinship Care - Respite Care Out of Home

LTCO - Long-term Care Ombudsman

MFP - MDS-Q Options Counseling

MFP - Transition Coordination

N/W - C Meals Management Only

N/W - C Meals Costs Only

N/W - Exer and Phys Fitness - Ind

N/W - Health P/Disease Prev-Group

N/W - Home-Del Meals Manage Only

N/W - Home-Del Meals Meal Cost Only

N/W - Medications Management - Ind

N/W - Nutrition Counseling - Ind

N/W - Nutrition Education - Ind

N/W - Nut./Health Rel/Health Scr - Ind

SCSEP Employment Program - Ind

&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES

UNIFORM COST METHODOLOGY

Personnel Spreadsheet

SFY 2012

&"Times New Roman,Regular"&9MAN 5600, Appendix D UCM Spreadsheet - Final - 6/5/12 &P of &N

UCM - SUPPORT

File is..

All Other

In Balance

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Choose a Service

All Other

Enter Bldg Space, Line 108

General Administration

COST POOL

Shared Building Space

COST POOL

Client/Meal Transportation COST POOL

Support

COST POOL

Enter Provider Name:

PROPOSED ANNUAL EXPENSES

(Select Line Item from DAS Chart of Accounts)

WAGES & BENEFITS (Auto-populates)	$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
Auto-populates % of Wages and Benefits from Personnel Spreadsheet(1)	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
Auto-populates % of Hours from Personnel Spreadsheet (1)	100.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	100.00%

	STAFF TRAVEL EXPENSES
(Auto-populates)	$0
	Staff Mileage/Per Diem Reimbursement	$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
	Volunteer Mileage/Per Diem Reimbursement	$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 Staff Travel Expenses	$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

	VEHICLE OPERATING EXPENSES
(Auto-populates)	$0
	Vehicle Gas & Oil	$0	no driver personnel	$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
	Vehicle Insurance	$0	no driver personnel	$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
	Vehicle Maintenance	$0	no driver personnel	$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 Vehicle Operating Expenses	$0	no driver personnel	$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

BUILDING EXPENSES (Auto-populates)	$0
Building Depreciation	$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
Building Insurance	$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
Building Maintenance/Janitorial	$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
Building Repairs	$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
Rent	$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
Utilities	$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 Space Expenses (Security)	$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

COMPUTER OPERATION EXPENSES (Auto-populates)	$0
Computer Purchase	$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
Computer Maintenance	$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
Computer 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
Computer Training	$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 Computer Operation Expenses	$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

	CAPITAL EQUIPMENT EXPENSES
(Auto-populates)	$0
	Capital Equipment Depreciation/Usage Fee	$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 Maintenance	$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 Equipment Expenses	$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

SUPPLY EXPENSES (Auto-populates)	$0
Advertising	$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
Copy/Printing	$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
Dues/Subscriptions	$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
Employee Testing	$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
Insurance	$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
Office/Paper 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
Postage	$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
Site 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
Telephone & Other Telecommunications	$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
Training/Meeting Expense	$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 Supply Expenses	$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

SERVICE CONTRACTS (Auto-populates)	$0
SCSEP	$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
Identify Contract Type	$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
Identify Contract Type	$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
Identify Contract Type	$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
Identify Contract Type	$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

CONGREGATE MEAL EXPENSES (Auto-populates)	$0
Vendor Meal Contract - Congregate	$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
On-Site or Central Kitchen Preparation:
Raw Food Costs	$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
Labor	$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
Utilities	$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
Disposable 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
Transportation Costs	$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
Meal Delivery Costs	$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	$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
Taxes	$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 Meal Costs (Kinship Care - monthly mtgs)	$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

HOME DELIVERED MEAL EXPENSES (Auto-populates)	$0
Vendor Meal Contract - Home Delivered	$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
On-Site or Central Kitchen Preparation:
Raw Food Costs	$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
Labor	$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
Utilities	$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
Disposable 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
Transportation Costs	$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
Meal Delivery Costs	$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	$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
Taxes	$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 Meal Costs (List)	$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 OPERATING COSTS (Auto-populates)	$0
Agency Indirect (Federal Cognizant Agency Only)	$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
Audit/Legal Fees	$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
Profit/Surplus Margin	$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 Misc. Operating Costs	$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

	Spreadsheet Check (Auto-populates)	$0
	TOTAL ALLOWABLE COSTS
(Auto-populates)	$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

COST POOL SECTION:

Service Subcontract Allowance (per contract)	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000	$25,000
Contracts over $50,000 Only - Enter Service Subcontract Adjustment (Contract Amount minus $25,000)	$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

Reallocate Support Costs	$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
Auto-populates based on Percent of Total Staff Hours from Personnel	0.00%	0.00%		0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	100.00%

Reallocate Shared Building Space		$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
Enter Square Footage Occupied (In Red Only)	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

Reallocate Client Transportation Costs	$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
Auto-populates % of Driver Time Per Program from Personnel		0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	100.00%

Reallocate General Administration Costs	$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
Auto-populates based on Modified Total Direct Costs		$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

TOTAL ACTUAL COSTS BY SERVICE	$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
Enter Number of Billing Units			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
ACTUAL COST PER UNIT OF SERVICE			$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00

DONATED PERSONNEL OR

NON-CASH MATCH SECTION

Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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
Enter description (Column A) and then $ value (Column B)	$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

Donated Cost Pool Section: $0 $0

Reallocate Donated Building Space	$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
(Auto-populates from Cost Pool Section above)	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

Reallocate Donated Client Transportation Costs	$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
(Auto-populates from Cost Pool Section above)		0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	100.00%

			$0
	Reallocate Donated General Administration		$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
	(Auto-Populates from Cost Pool Section above)				$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
	Spreadsheet Check (Auto-populates)	$0
	TOTAL COSTS
(Plus Donated/Non-Cash Match)	$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
	Number of Billing Units (Auto-populates from Cost Pool Section above)				- 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
	POTENTIAL UNIT COST				$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00

&"Arial,Bold"&16DHS DIVISION OF AGING SERVICES UNIFORM COST METHODOLOGY Support Spreadsheet

SFY 2012

&"Times New Roman,Regular"&9MAN 5600, Appendix D UCM Spreadsheet - Final - 6/5/12 &P of &N&"Arial,Bold"

Budget Summary Table

Offeror Budget Summary Work Sheet
Agency Name:
Service	Unit of measure	Unit Cost (per UCM support)	ARC Funding Request	Units of Service to be provided with ARC Funding	Unduplicated Persons Served by ARC Funding	Projected Units Served: July	Projected Units Served: August	Projected Units Served: September	Projected Units Served: October	Projected Units Served: November	Projected Units Served: December	Projected Units Served: January	Projected Units Served: February	Projected Units Served: March	Projected Units Served: April	Projected Units Served: May	Projected Units Served: June
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
	one 15-minute call	$ - 0	$ - 0
Total			$ - 0

1. Enter Units of Service to be provided from the UCM Support Spreadsheet

2. Enter the Unit Cost of the Service

3. Enter the unduplicated persons expected to be served

4. Enter the ARC funding provided in the allocation that will be used to fund the services.

Budget Narrative

BUDGET NARRATIVE

Your Budget Narrative should address the following bullet points:

* The budget justification is clear, logical and specifically describes the program and corresponds with the cost allocation/budget.

* The budget proposal clearly demonstrates capacity to provide required match funds and leverage grant funding to maximize program outcomes.

**The three spaces below are meant to be for separate paragraphs for your narrative. If you need more or less room, feel free to format as needed.**

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File details come from the government source that posted it. Updated Jan 6, 2025.