SOW_DHAPP TEMPLATE for Proposal Submission_Y1.xlsx

XLSX spreadsheet 37 KB Posted Sep 19, 2022

Attached to: Department of Defense HIV/AIDS Prevention Program
Opportunity number: W81XWH-22-DHAPP
Issued by: Department of the Army Medical Command

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SOW DHAPP Template Year 1

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Summary & Instructions

Data Prepopulated From Data Entry Tabs
Federal Agency	DOD	Partner Name	0	DHA PO	0
Funding Source	0	Award Number	0	Vendor ID	0
Mech ID	0	Phase	0	Unique Entity Identifier (UEI)	0
Prime DUNS Number	0	Operating Unit	0	Execution Office	0
COP/DOP YR	0	Implementation Year	FY25

COP/DOP IM Total Auth
Total Budget per Intervention from COP Auth	$0
Work Plan Budget Total	$0
Delta	$0
Instructions
	Data Entry requirements are in Blue Work Plan Budget tab and Green DHAPP SOW tab. Data Entry only allowed in GREEN CELLS
Work Plan Budget	1. Row: 2-6: DHAPP HQ will complete Metadata Section: this pre-populates info throughout this workbook. *DUNS Number MUST be 9 characters in length.
	2. Row 10: Select from the drop down list each Program Area for each intervention listed. Guidance on Budget Classifications structure can be found at the following website https://datim.zendesk.com/hc/en-us/articles/360015671212-PEPFAR-Financial-Classifications-Reference-Guide
	3. Row 11: Select from the drop down list each Beneficiary for each intervention listed.
	4. Rows 13 - 31: Enter the budgeted amount for each cost category within each intervention.
	6. Row 40: Indicate the number of subrecipients

DHAPP SOW	1.Columns A-F should be prepopulated from Metadata in the Work Plan Budget tab.
	2. Columns G-J will be pre-populated from the work plan budget tab.
	3. Column K: Populate MER Indicator Target as applicable.
	4. Column L: If intervention is for Above Site (AS) activities, populate outputs as applicable.
	5. Column M: Populate narrative field for intervention.
	5. Total budgeted in column J should equal total budgeted in Work Plan Budget.
Reference Tab	Available Program Areas, Beneficiaries, Budget Codes and Interventions are listed in the reference tab.

System Metadata dc2

Work Plan Budget

Metadata
Federal Agency	DOD	Partner Name		DHA PO
Funding Source		Award Number		Vendor ID
Mech ID		Phase		Unique Entity Identifier (UEI)
Prime DUNS Number		Operating Unit		Execution Office
COP/DOP YR		Implementation Year	FY25

				Program
Management	Categorization of Intervention 2	Categorization of Intervention 3	Categorization of Intervention 4	Categorization of Intervention 5	Categorization of Intervention 6	Categorization of Intervention 7	Categorization of Intervention 8	Categorization of Intervention 9	Categorization of Intervention 10	Categorization of Intervention 11	Categorization of Intervention 12	Categorization of Intervention 13	Categorization of Intervention 14	Categorization of Intervention 15	Categorization of Intervention 16	Categorization of Intervention 17	Categorization of Intervention 18	Categorization of Intervention 19	Categorization of Intervention 20
	Intervention Name or Number			1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20
	Program Area			PM: IM Program Management-NSD
	Beneficiary			Non-Targeted Populations
	Object Class/Cost Category			Program management budget	Budget against Intervention 2	Budget against Intervention 3	Budget against Intervention 4	Budget against Intervention 5	Budget against Intervention 6	Budget against Intervention 7	Budget against Intervention 8	Budget against Intervention 9	Budget against Intervention 10	Budget against Intervention 11	Budget against Intervention 12	Budget against Intervention 13	Budget against Intervention 14	Budget against Intervention 15	Budget against Intervention 16	Budget against Intervention 17	Budget against Intervention 18	Budget against Intervention 19	Budget against Intervention 20	TOTAL	% Total
	Personnel: Salaries- Health Care Workers			NA																				$0	0%
	Personnel: Salaries- Other Staff																							$0	0%
	Fringe Benefits																							$0	0%
	Travel: International Travel																							$0	0%
	Travel: Domestic Travel																							$0	0%
	Equipment: Health Equipment																							$0	0%
	Equipment: Non-Health Equipment																							$0	0%
	Supplies: Pharmaceutical			NA																				$0	0%
	Supplies: Health- Non Pharmaceutical			NA																				$0	0%
	Supplies: Other Supplies																							$0	0%
	Contractual: Contracted Health Care Workers			NA																				$0	0%
	Contractual: Contracted Interventions			NA																				$0	0%
	Contractual: Other Contracts																							$0	0%
	Construction																							$0	0%
	Training																							$0	0%
	Subrecipient Total			NA																				$0	0%
	Other: Financial Support for Beneficiaries																							$0	0%
	Other: Other																							$0	0%
	Indirect Charges				NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	$0	0%
	Total Budget per Intervention (Sum of Cost Categories)			$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	0%
	Total Budget per Intervention from COP Auth																							$0
	Total Budget in Template minus Total Budget from COP																							$0
			% by Intervention	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!	ERROR:#DIV/0!
			Fringe Benefit Rate
			Indirect Rate	ERROR:#DIV/0!
	Number of subrecipients (0-100)

DHAPP SOW

Pre-populates from Metadata						Pre-populates from Work Plan Budget Tab				Data Entry - to be completed by IP
Award Number	Phase	COP/DOP YR	Operating Unit	Partner Name	Mech ID	Program Area	Beneficiary	Intervention	Total Amount Budgeted	MER Indicator Target	Outputs for Above Site (AS) Activities	Narrative
									$0
0	0	0	0	0	0	PM: IM Program Management-NSD	Non-Targeted Populations	1	$0
0	0	0	0	0	0	0	0	2	$0
0	0	0	0	0	0	0	0	3	$0
0	0	0	0	0	0	0	0	4	$0
0	0	0	0	0	0	0	0	5	$0
0	0	0	0	0	0	0	0	6	$0
0	0	0	0	0	0	0	0	7	$0
0	0	0	0	0	0	0	0	8	$0
0	0	0	0	0	0	0	0	9	$0
0	0	0	0	0	0	0	0	10	$0
0	0	0	0	0	0	0	0	11	$0
0	0	0	0	0	0	0	0	12	$0
0	0	0	0	0	0	0	0	13	$0
0	0	0	0	0	0	0	0	14	$0
0	0	0	0	0	0	0	0	15	$0
0	0	0	0	0	0	0	0	16	$0
0	0	0	0	0	0	0	0	17	$0
0	0	0	0	0	0	0	0	18	$0
0	0	0	0	0	0	0	0	19	$0
0	0	0	0	0	0	0	0	20	$0

Reference Data Guidance around Budget Classifications structure can be found at the following website https://datim.zendesk.com/hc/en-us/articles/360015671212-PEPFAR-Financial-Classifications-Reference-Guide

List Drop Downs

Program Area	Beneficiary	Program Area
ASP	AGYW	ASP: Health Management Information Systems (HMIS)
C&T	Children	ASP: Human resources for health-NSD
HTS	Key Populations	ASP: Laboratory systems strengthening-NSD
PREV	Military	ASP: Laws, regulations & policy environment-NSD
SE	Non-Targeted Populations	ASP: Management of disease control programs-NSD
PM	OVC	ASP: Procurement & supply chain management-NSD
	Pregnant & Breastfeeding Women	ASP: Public financial management strengthening-NSD
		ASP: Surveys, Surveillance, Research, and Evaluation (SRE)
		C&T: HIV Clinical Services-NSD
		C&T: HIV Clinical Services-SD
		C&T: HIV Drugs-NSD
		C&T: HIV Drugs-SD
		C&T: HIV Laboratory Services-NSD
		C&T: HIV Laboratory Services-SD
		C&T: HIV/TB-NSD
		C&T: HIV/TB-SD
		HTS: Community-based testing-NSD
		HTS: Community-based testing-SD
		HTS: Facility-based testing-NSD
		HTS: Facility-based testing-SD
		Not Specified: Not specified-NSD
		PM: IM Closeout costs-NSD
		PM: IM Program Management-NSD
		PM: USG Program Management-NSD
		PREV: Condom & Lubricant Programming-NSD
		PREV: Condom & Lubricant Programming-SD
		PREV: Medication assisted treatment-NSD
		PREV: Medication assisted treatment-SD
		PREV: Non-Biomedical HIV Prevention
		PREV: Not Disaggregated-NSD
		PREV: Not Disaggregated-SD
		PREV: PrEP-NSD
		PREV: PrEP-SD
		PREV: Violence Prevention and Response-NSD
		PREV: Violence Prevention and Response-SD
		PREV: VMMC-NSD
		PREV: VMMC-SD
		SE: Case Management-NSD
		SE: Case Management-SD
		SE: Economic strengthening-NSD
		SE: Economic strengthening-SD
		SE: Education assistance-NSD
		SE: Education assistance-SD
		SE: Food and nutrition-NSD
		SE: Food and nutrition-SD
		SE: Psychosocial support-NSD
		SE: Psychosocial support-SD

File details come from the government source that posted it. Updated Nov 14, 2023.