RFP 202603 BW.xlsx
XLSX spreadsheet 51 KB Posted
- Attached to
- Supervised Visitation
- Solicitation number
- 202603
- Issued by
- Kenosha County, Wisconsin
About this file
This is a budget worksheet template for the Kenosha County Department of Human Services designed to support contract proposals and budgeting for state and local services. The document serves as the standard financial planning tool for agencies bidding on or administering contracts with Kenosha County, particularly for programs such as supervised visitation services for children in out-of-home care. The template is organized into five primary worksheets: FTE and Salary Allocation (Worksheet 1), which captures personnel positions, degrees, annual salaries, and full-time equivalent allocations; Benefit Allocation (Worksheet 2), which calculates FICA, health insurance premiums, unemployment compensation, retirement contributions, and other employee benefits; Total Expense Summary (Worksheet 3), which consolidates personnel costs and itemizes other expenses including contracted services, equipment purchases, data processing, training, travel, insurance, utilities, and supplies; Detail of Other Expenses (Worksheet 4), which provides line-item justifications for contracted services and equipment exceeding $500; and Other Revenue Sources (Worksheet 5), which identifies funding sources to offset program costs. The template accommodates up to 50 staff positions and supports both actual reimbursement budgets and unit-rate budget calculations.
The budget template permits agencies to request actual cost reimbursement or to calculate cost per unit based on direct staff FTE multiplied by 2,080 hours annually at 75 percent utilization. Agencies may allocate indirect administration costs with required detailed explanation of the calculation methodology, and for-profit entities may include expected profit not to exceed 5 percent of the total program budget. Personnel costs must not exceed the program funding level specified by the Department of Human Services, and all blue-shaded fields require input while other fields remain protected. The template was most recently revised in November 2014 to include staff identifiers such as first name, last name, and degree level, with degree options including advanced practice nurse practitioner, bachelor's degree, master's degree, psychiatrist/MD, PhD, psychologist/doctoral, and qualified treatment trainee designations. The worksheet serves as a standardized mechanism to ensure consistent financial proposal submission and evaluation across all potential service providers contracting with Kenosha County.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP 202603 Supervised Visitation Addendum 1.pdf | ||
| RFP 202603 Supervised Visitation.pdf |
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Text version
1. FTE & Salary Allocation
| Kenosha County Department of Human Services Budget Worksheet #1 -- FTE & Salary Allocation | Version: 141104 | ||
| Contract ID: | Entered by Kenosha County | Enter Agency Name Here | |
| Enter Dates of Contract Here | |||
| Please enter all information as indicated by BLUE font color and shaded in BLUE. |
| Enter Program Name Here | |||||||||
| Position | First Name | Last Name | Degree Level | Enter Annual Salary regardless of time allocated to Program | Total FTE | Direct Staff FTE | Admin/ Clerical/ Supervision | Allocation of Salary to Program | |
| 1 | - 0 | - 0 | |||||||
| 2 | - 0 | - 0 | |||||||
| 3 | - 0 | - 0 | |||||||
| 4 | - 0 | - 0 | |||||||
| 5 | - 0 | - 0 | |||||||
| 6 | - 0 | - 0 | |||||||
| 7 | - 0 | - 0 | |||||||
| 8 | - 0 | - 0 | |||||||
| 9 | - 0 | - 0 | |||||||
| 10 | - 0 | - 0 | |||||||
| 11 | - 0 | - 0 | |||||||
| 12 | - 0 | - 0 | |||||||
| 13 | - 0 | - 0 | |||||||
| 14 | - 0 | - 0 | |||||||
| 15 | - 0 | - 0 | |||||||
| 16 | - 0 | - 0 | |||||||
| 17 | - 0 | - 0 | |||||||
| 18 | - 0 | - 0 | |||||||
| 19 | - 0 | - 0 | |||||||
| 20 | - 0 | - 0 | |||||||
| 21 | - 0 | - 0 | |||||||
| 22 | - 0 | - 0 | |||||||
| 23 | - 0 | - 0 | |||||||
| 24 | - 0 | - 0 | |||||||
| 25 | - 0 | - 0 | |||||||
| 26 | - 0 | - 0 | |||||||
| 27 | - 0 | - 0 | |||||||
| 28 | - 0 | - 0 | |||||||
| 29 | - 0 | - 0 | |||||||
| 30 | - 0 | - 0 | |||||||
| 31 | - 0 | - 0 | |||||||
| 32 | - 0 | - 0 | |||||||
| 33 | - 0 | - 0 | |||||||
| 34 | - 0 | - 0 | |||||||
| 35 | - 0 | - 0 | |||||||
| 36 | - 0 | - 0 | |||||||
| 37 | - 0 | - 0 | |||||||
| 38 | - 0 | - 0 | |||||||
| 39 | - 0 | - 0 | |||||||
| 40 | - 0 | - 0 | |||||||
| 41 | - 0 | - 0 | |||||||
| 42 | - 0 | - 0 | |||||||
| 43 | - 0 | - 0 | |||||||
| 44 | - 0 | - 0 | |||||||
| 45 | - 0 | - 0 | |||||||
| 46 | - 0 | - 0 | |||||||
| 47 | - 0 | - 0 | |||||||
| 48 | - 0 | - 0 | |||||||
| 49 | - 0 | - 0 | |||||||
| 50 | - 0 | - 0 | |||||||
| Total Time Allocation | - 0 | - 0 | - 0 | - 0 | - 0 |
Date printed: &D &A Version: 141104
2. Benefit Allocation
| Kenosha County Department of Human Services Budget Worksheet #2 -- Benefit Allocation | Version: 141104 | |
| Agency Name | Enter Agency Name Here | |
| Contract Period | Enter Dates of Contract Here | |
| Please enter all information as indicated by BLUE font color and shaded in BLUE. |
Annual amounts should be entered. The last column will adjust to the actual FTE % allocated to the program as shown on the Time Allocation worksheet (#1).
| Annual Salary and Benefit Calculation | Enter Program Name Here | |||||||||
| Position | Annual Salary | FICA | Annual Health Insurance Premiums (if applicable) | State and Federal UC (if applicable) | Retirement (if applicable) | Other Explanation | Other $ | Total Annual Benefits | Allocated Program Benefits | |
| 1 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 2 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 3 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 4 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 5 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 6 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 7 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 8 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 9 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 10 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 11 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 12 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 13 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 14 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 15 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 16 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 17 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 18 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 19 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 20 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 21 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 22 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 23 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 24 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 25 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 26 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 27 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 28 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 29 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 30 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 31 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 32 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 33 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 34 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 35 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 36 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 37 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 38 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 39 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 40 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 41 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 42 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 43 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 44 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 45 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 46 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 47 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 48 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 49 | - | - 0 | - 0 | - 0 | - 0 | |||||
| 50 | - | - 0 | - 0 | - 0 | - 0 | |||||
| Total Benefits | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 |
Date printed: &D &A Version: 141104
3. Total Expense Summary
| Kenosha County Department of Human Services Budget Worksheet #3 -- Total Expense Summary | Version: 141104 | |
| Agency Name | Enter Agency Name Here | |
| Contract Period | Enter Dates of Contract Here | |
| Please enter all information as indicated by BLUE font color and BLUE shaded area. |
| Total Expense Summary | ||
| Enter Program Name Here | ||
| 1 | Salary Allocation - Worksheet 1 | - 0 |
| 2 | Benefit Allocation - Worksheet 2 | - 0 |
| Total Personnel Costs | - 0 | |
| OTHER EXPENSES: | ||
| 3 | Contracted Program (Enter detail found on Worksheet 4) | - 0 |
| 4 | Contracted Other (Enter detail found on Worksheet 4) | - 0 |
| 5 | Equipment Purchases (Single Item Purchase over $500 AND useful life of more than 1 year) Enter individual descriptions on Worksheet 4 | - 0 |
| 6 | Other (Enter detail found on Worksheet 4) | - 0 |
| 7 | Data Processing | |
| 8 | Staff Training/Development | |
| 9 | Staff Travel | |
| 10 | Insurance | |
| 11 | Interest | |
| 12 | Legal & Accounting | |
| 13 | Licenses | |
| 14 | Postage | |
| 15 | Printing | |
| 16 | Rent - Building | |
| 17 | Rent - Equipment | |
| 18 | Repair & Maintenance | |
| 19 | Building Depreciation | |
| 20 | Supplies | |
| 21 | Non-Payroll Taxes | |
| 22 | Telephone | |
| 23 | Utilities | |
| Sub-Total Other | - 0 | |
| Sub-Total including Personnel | - 0 | |
| Administration Allocation Rate |
A DETAILED EXPLANATION OF CALCULATION METHOD USED MUST BE ATTACHED
| Administration Allocation Rate | ||||
| A DETAILED EXPLANATION OF CALCULATION METHOD USED MUST BE ATTACHED | - 0 | |||
| Expected Profit (Maximum 5%) (FOR PROFIT AGENCIES ONLY) | 0% | |||
| Total PROGRAM Budget | - 0 | |||
| Offset by Other Revenue Sources as Listed on Tab 5 | - 0 | |||
| Total Agency Budget to be used for DHS Contract--Must NOT exceed Program Funding level as specified by Department of Human Services | - 0 |
| STOP HERE IF ACTUAL REIMBURSEMENT BUDGET HAS BEEN REQUESTED. CONTINUE ON ONLY IF UNIT RATE BUDGET HAS BEEN REQUESTED. | |
| Optional: Input units based on Previous Years Actuals | |
| Total Units-Calculated based on Time Allocation Worksheet from Direct Staff Column (DS FTE x 2080 x 75%) | - 0 |
| Cost Per Unit/Program | $ - 0 |
Date Printed: &D &A Version: 141104
4. Other Services Explanation
| Kenosha County Department of Human Services Budget Worksheet #4 - Detail of Other Expenses | Version: 141104 | |
| Agency Name | Enter Agency Name Here | |
| Contract Period | Enter Dates of Contract Here | |
| Please enter all information as indicated by BLUE font color and BLUE shaded area. |
| List Detail of Other Services | |
| Tab 3 Line 3 - Must provide detail explanation including consultant name and degree level if applicable: | Enter Program Name Here |
| Contracted Program |
Contracted Other:
List Equipment over $500 with a useful life of more than 1 year:
Other Expenses
Total - 0
Date Printed: &D &A Version: 141104
5. Revenue Sources (Optional)
| Kenosha County Department of Human Services Budget Worksheet #5 -- Other Revenue Sources | Version: 141104 | |
| Agency Name | Enter Agency Name Here | |
| Contract Period | Enter Dates of Contract Here |
Please enter all information as indicated by BLUE font color and BLUE shaded area.
| List Other Revenue Sources by Program | |
| Enter source of revenue here: | Enter Program Name Here |
| Total Other Revenue Sources | - 0 |
| Use of above revenue sources--Provide detailed explanation: |
Budget - Unit Rate &A Version: 141104
Utility Worksheet
| Utility Worksheet | ||
| Field Name | Value | Description |
| Workbook Type | 9 | Budget - Unit Rate |
| Template Version | 141104 | (Read-Only) Template Version Number |
| Workbook ID | ID of workbook as stored in tlog_CMS_ContractWorkbook | |
| Contract ID | Foreign Key to the system ID for the Contract | |
| Creation Date | Date the Workbook was created | |
| Author | Person creating the workbook | |
| Upload Date | Date the Workbook was uploaded |
Revision History
| Revision History | ||
| Date | Developer | Notes |
| 5/22/06 | BR | - Added Utility Worksheet |
| - Added Revision History Worksheet | ||
| - Added Macro 'UpdateFooter ' | ||
| - Added Version # to display | ||
| - General formatting (font size, display %) | ||
| 7/27/06 | BR | - Protected all Worksheets |
| Note: Blue shaded areas are unprotected | ||
| - Corrected cell reference error (Benefit Allocation Worksheet Col B) | ||
| 8/1/06 | EJ | Sheet One, Columns D & E - Display 3 decimal places. |
| 6/12/07 | BR | Sheet 3 - Decreased size of Column B to 32.57 (was not printing on OOD color printer) |
| 10/22/09 | BR | Sheet 3 - Added Cell C38 |
| Sheet 3 - Updated formula for Cell B38 to check for value in Cell C38 | ||
| 11/4/14 | BR | Sheet 1 - Added columns 'First Name', 'Last Name', 'Degree Level' |
| - Added Lists Worksheet (Hidden) |
Lists
| Degree Level |
| Advanced Practice Nurse Practitioner |
| Bachelors Degree |
| Masters Degree |
| Psychiatrist/MD |
| Less than Bachelor’s Degree |
| PhD Psychologist/Doctoral |
| Registered Nurse/Licensed Practical Nurse |
| Qualified Treatment Trainee |
File details come from the government source that posted it. Updated .