Program_Budget_Form~1.doc
DOC document 88 KB Posted
- Solicitation number
- BD-27-1078-1078C-1078L-132471
- Issued by
- Massachusetts
About this file
This is a Program Budget Form for a Purchase of Service contract with the Commonwealth of Massachusetts, specifically for the Office for Refugees and Immigrants (ORI) 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 budgets organized by cost categories. The document does not specify project timelines, response dates, due dates, site visits, or bidders' meetings; instead, it functions as a standardized budget template for cost reimbursement contracts.
The budget form itemizes allowable cost categories including direct care and program support staff (with associated payroll taxes and fringe benefits), occupancy and facility operational costs, other direct care and program support expenses (such as consultants, temporary help, client transportation, and program supplies), and direct administrative expenses. The form accommodates both current and amended budget figures along with full-time equivalent (FTE) positions, requires disclosure of offset sources and non-reimbursable costs, and includes provisions for agency administrative support allocation and commercial fees for for-profit contractors. Contractors must reference their board-approved capitalization levels for designated expense categories and provide supporting documentation on Attachment 5 when applicable under Federal OMB Circular A-122 and Massachusetts 808 CMR 1.00 regulations. The form was last updated on June 19, 2007, and applies to cost reimbursement contracts only.
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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 .