Program_Budget_Form~1.doc
DOC document 88 KB Posted
- Solicitation number
- BD-27-1078-ORI1A-ORI-131563
- Issued by
- Massachusetts
About this file
This is a Program Budget Form for a cost reimbursement purchase of service contract with the Massachusetts Office for Refugees and Immigrants (ORI) related to the Citizenship for New Americans Program (CNAP) Technical Assistance initiative. The form serves as Attachment 3 to the contract proposal and requires contractors to detail fiscal year budgeting across multiple cost categories, including direct care and program support staff with associated payroll taxes and fringe benefits, occupancy costs including facilities and operations, other direct care and program support expenses such as consulting, temporary help, client transportation, and program supplies, and direct administrative expenses. The budget structure accommodates both current and amended figures with separate columns for full-time equivalents (FTE) and dollar amounts, allowing contractors to present baseline budgets alongside any proposed modifications.
The form establishes reimbursable cost categories with designated UFR (Uniform Fiscal Reporting) title numbers and includes provisions for offset sources and non-reimbursable costs that must be detailed separately when federal OMB Circular A-122 or 808 CMR 1.00 provisions apply. Contractors must identify agency administrative support allocation percentages and amounts, with an additional line for commercial fees applicable only to for-profit organizations for informational purposes. The document requires contractors to specify their board-approved capitalization levels for negotiated expenses in designated line items and indicates a low sensitivity classification level, suggesting standard budgeting requirements without heightened financial scrutiny or restrictions.
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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 .