M04__Budget_Form 4-2025.xlsx

This is a Budget Form M04 for the Commonwealth of Massachusetts Department of Public Health, designed for standard contracts and engagement contracts. The form serves as a template for documenting budget allocations for new contracts, renewals, and additional budget submissions. The document is structured to capture fiscal year information, vendor details, contract identification numbers, and budget numbers, along with a brief summary section for contract or engagement descriptions. The form accommodates both new funding amounts and offset amounts, with provisions for identifying alternative funding sources where multiple funding mechanisms are involved.

The budget form employs a standardized Uniform Fiscal Reporting (UFR) code structure organized into five primary expense categories: Program Staff (codes 101-151), including positions such as Program Manager, Program Director, and Case Worker/Manager with associated payroll taxes and fringe benefits; Occupancy costs (codes 301-390) for facilities and operations; Non-Personal Expenses (codes 201-215) encompassing consultants, temporary help, training, travel, subcontracts, meals, materials, and supplies; Direct Administrative Expenses (code 216) for program support; and Agency Administrative Support Allocation (code 410). All line items currently display zero dollar amounts, indicating this is a blank template. The form requires submission to the Massachusetts Department of Public Health and mandates that any funds allocated to subcontracts (code 206) must be accompanied by a completed Subcontractor Identification List. The document was revised on April 22, 2025, with text limit restrictions applied to the summary field.