ISB_CTR066198.pdf
PDF 207 KB Posted
- Attached to
- Master Agreement AZ|CTR066198
- Contract number
- CTR066198
- Issued by
- Arizona
About this file
This document is an Itemized Service Budget (ISB) Workbook for a Domestic Violence Statewide Contract (CTR066198 Amendment 7) for Mariposa Community Health Center, Inc., located in Mariposa Community Health Center. The document is prepared for the contract period of 7/1/25 - 6/30/26 and involves the Arizona Department of Economic Security (ADES) providing state funds to cover the 20% Family Violence Prevention and Services Act (FVPSA) Match Requirement.
The budget totals $156,000.00, with $137,374.86 from other fund sources and $18,625.14 from FVPSA. The budget covers personnel costs for three positions (a Health and Social Services Manager and two Patient Advocates), employee-related expenses, travel, space, equipment, materials and supplies, operating services, and flexible financial assistance for clients. Key line items include laptop replacement, technical support, vehicle expenses, marketing materials, and client assistance vouchers. The service type is primarily categorized as MCBA (Maricopa County Business Area), with a shelter service type for emergency vouchers and equipment. The budget allocates funds for direct service provision, administrative costs, and client support in the domestic violence service domain.
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MATCH REQUIREMENT: ADES will provide State funds to cover the 20% FVPSA Match Requirement
REMINDER: Please review the ISB Instructions tab before completing the ISB and Budget Narrative tabs. If your agency will be providing services at multiple locations, please list the name of the facility next to each budget line item and group them together.
REMINDER: Please do not edit the formulas.
1. PERSONNEL
Number of Positions
FTE Level Position Title Total Salary Service Type Other Fund Sources FVPSA DES Total
1 0.25 Health and Social Services Manager (FT) $63,875 MCBA $10,968.75 $5,000.00 $15,968.75
1 1.00 Patient Advocate- D (FT) $41,763 MCBA $36,763.00 $5,000.00 $41,763.00
1 0.75 Patient Advocate- V (FT) $36,847 MCBA $22,635.25 $5,000.00 $27,635.25
MCBA $0.00
MCBA $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
TOTAL PERSONNEL $70,367.00 $15,000.00 $85,367.00
2. EMPLOYEE RELATED EXPENSES
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $22,277.62 $1,425.36 $23,702.98
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL EMPLOYEE RELATED EXPENSES $22,277.62 $1,425.36 $23,702.98
3. PROFESSIONAL AND OUTSIDE SERVICES
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $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 PROFESSIONAL AND OUTSIDE SERVICES $0.00 $0.00 $0.00
4. TRAVEL
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $500.00 $500.00
MCBA $500.00 $500.00
MCBA $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 $0.00
TOTAL TRAVEL $1,000.00 $0.00 $1,000.00
5. SPACE
ITEM Service Type Other Fund Sources FVPSA Total
SHELTER $6,300.22 $1,199.78 $7,500.00
$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
Motel/Hotel Emergency Voucher
Employee Mileage Agency Owned Vehicle Gas
Attachment 3 Itemized Service Budget (ISB) Workbook
Contract Period: 7/1/25 - 6/30/26
AGENCY NAME: Mariposa Community Health Center, Inc.
FACILITY NAME(S): Mariposa Community Health Center
28% ERE
CONTRACT SERVICE: Domestic Violence - Statewide CTR066198 Amendment 7
$0.00 $0.00
TOTAL SPACE $6,300.22 $1,199.78 $7,500.00
6. EQUIPMENT
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $2,000.00 $0.00 $2,000.00
MCBA $1,650.00 $0.00 $1,650.00
SHELTER $0.00 $1,000.00 $1,000.00
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
TOTAL EQUIPMENT $3,650.00 $1,000.00 $4,650.00
7. MATERIALS AND SUPPLIES
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $200.00 $0.00 $200.00
MCBA $500.00 $0.00 $500.00
MCBA $1,000.00 $0.00 $1,000.00
MCBA $1,500.00 $0.00 $1,500.00
MCBA $500.00 $0.00 $500.00
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL MATERIALS AND SUPPLIES $3,700.00 $0.00 $3,700.00
8. OPERATING SERVICES
ITEM Service Type Other Fund Sources FVPSA Total
MCBA $600.00 $0.00 $600.00
MCBA $50.00 $0.00 $50.00
MCBA $780.00 $0.00 $780.00
MCBA $450.24 $0.00 $450.24
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL OPERATING EXPENSES $1,880.24 $0.00 $1,880.24
9 INDIRECT COSTS
ITEM Service Type Other Fund Sources FVPSA Total $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TOTAL INDIRECT COSTS $0.00 $0.00 $0.00
SUBTOTAL ADMIN COSTS $109,175.08 $18,625.14 $127,800.22
10 VOUCHERS - FLEXIBLE FINANCIAL ASSISTANCE
ITEM Service Type Other Fund Sources Total
MCBA $28,199.78 $0.00 $28,199.78
MCBA $0.00 $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL VOUCHERS $28,199.78 $0.00 $28,199.78
11. TOTAL COST: $137,374.86 $18,625.14 $156,000.00
Flexible Financial Assistance for Clients Flexible Financial Assistance for Clients
Vehicle Insurance Premium Vehicle Registration Cell Phone/ Hot Spot Training/ Conference Registration
Marketing and Outreach Material Snacks/Food for group/classes/meetings
Laptop and Docking Station Replacement Needed for FTE Advocate Osnium Annual Technical Support (yearly fee) Cel phone replacement
Photocopies Copier Lease Program Supplies
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