Program_Budget_Form.doc

DOC document 88 KB Posted

Attached to
Refugee Employment and Skills Enhancement Training (RESET) Program - Springfield only
Solicitation number
BD-27-1078-1078C-1078L-132327
Issued by
Hampden County, Massachusetts

About this file

This is a Program Budget Form attachment for a Purchase of Service contract with the Commonwealth of Massachusetts, specifically related to the Refugee Employment and Skills Enhancement Training (RESET) Program operated by the Office for Refugees and Immigrants (ORI) in Springfield. The form provides a standardized template for contractors to submit detailed fiscal year budgets organized by cost categories including direct care and program support staff with associated payroll taxes and fringe benefits, occupancy and facility operation costs, other direct care and program support expenses such as consulting, training, client transportation, and program supplies, and direct administrative expenses. The budget structure accommodates both current amendments and new fiscal year submissions, allowing contractors to specify full-time equivalents (FTEs) and corresponding dollar amounts for each line item.

The budget form is designed for cost reimbursement contracts and requires contractors to identify reimbursable costs separately from non-reimbursable costs, with the latter requiring detailed documentation on Attachment 5 for programs subject to Federal OMB Circular A-122 and Massachusetts 808 CMR 1.00 regulations. Contractors must specify their board-approved capitalization levels for negotiated expense costs and indicate any commercial fees applicable to for-profit entities. The form also requires allocation of agency administrative support costs as a percentage and dollar amount. The RESET program is federally funded under the Massachusetts Refugee Resettlement Program (MRRP) and provides integrated employment services including ESOL/VESOL training, employment counseling, and workforce development to eligible refugees in Springfield to support economic self-sufficiency.

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Text version

FY:

Contractor Name:

Amendment #,if Applicable:

If Federal Funds, CFDA #:

PURCHASE OF SERVICE - ATTACHMENT 3: FISCAL YEAR PROGRAM BUDGET

Program Name:

Document ID#:
MMARS Activity Code:
Program Type:
UFR Prog. #:
Current
Amend. Change
New
FTE
Amount
FTE
Amount
FTE
Amount
COST REIMBURSEMENT ONLY

Program Component

Offset
Source
Reimbursable

Cost

UFR Title

Direct Care/Program Support Staff/Overtime/

Shift Differential & Relief (Titles 101-141)

SUBTOTAL STAFF

150
Payroll Taxes
151
Fringe Benefits
T 100
Total Direct Care/Program Staff
Title
Occupancy
301
Program Facilities
*
390
Fac. Oper/Main/Furn
T 300
Total Occupancy
UFR Title
Other Direct

Care/Program Support

201
Direct Care Consultant
202
Temporary Help
203
Clients/Caregivers. Reimb/Stipends
206
Subcontract Dir.Care
204
Staff Training
205
Staff Mileage/Travel
207
Meals
208
Contracted Client Trans.
*
208
Vehicle Expenses
*
208
Vehicle Depreciation
209
Incid. Health/Med Care
211
Client Per. Allowances
212
Prov. of Material Good
214
Direct Client Wages
214
Other Commercial Prod. & Svs.
*
215
Program Supplies/Mat
T 200
Total Other Direct Care/Program
Title
Direct Admin Expenses
216
Program Support
*
510 (410 & 390)
Other Direct Administrative Expenses
T 500
Total Direct Administrative Exp.
T
SUBTOTAL PROGRAM COSTS
*
410
Agency Admin. Support Allocation
% $
T
PROGRAM TOTAL

Commercial Fee, if applicable, for for-profit contractors only (for informational purposes only; not to be included in the price paid by the Commonwealth): %___$___: N/A for Cost Reimbursement

A. $ ___________ Subtotal of offsets which are for non-reimbursable costs.

Non-reimbursable costs must be shown in detail on Attachment 5 when the program is subject to the provisions of Federal OMB Circular A-122 and/or 808 CMR 1.00.

* Contractor’s Board approved capitalization level relative to any negotiated expense costs in lines 208, 215, 390 or 410 is $___________ Updated 6/19/07 Sensitivity level - low

File details come from the government source that posted it. Updated .