Attachment B - Proposed Budget Sheet (xls) (Excel 97-2003)

Attachment B - Proposed Budget Sheet (xlsx) (Excel 2007)

RFI Proposal Document Program

Title:

Provider Name:

Provider FEIN:

Street Address: City:

Contact Person:

Contact Phone Number:

Contact Email Address:

Proposal Date:

Proposed Period of Service:

Personnel - FTE Base Salary

(1.0 FTE = ______hours per week)

# of FTEs Monthly Amount Annual Amount Proposed Amount Notes: List applicable quantity, units, percentages, clarifiction, etc.
Position Title 1:
Position Title 2:
Position Title 3:
Position Title 4:
Position Title 5:
Position Title 6:
Position Title 7:
Position Title 8:
Position Title 9:
Position Title 10:
Total $0 $0 $0
FICA @ 7.65% $0 $0 $0
Benefits
Retirement
Life & Health Insurance
Other: ___________
Other: ___________
Total $0 $0 $0
Total Personnel Cost $0 $0 $0
Indirect Cost (or detail by item below)
Percentage:___________________
Contractual Services
Training
Other: ___________
Other: ___________
Total $0 $0 $0
Travel
# Miles (cost per mile=
Mileage costs $0 $0 $0
Other transportation
Lodging
Per diems/meals
Other: ___________
Total $0 $0 $0
Commodities
Office Supplies
Other: ___________
Other: ___________
Total $0 $0 $0
Equipment/Furniture
Desks
Chairs
Other: ___________
Total $0 $0 $0
Information Technology
Desktop Computer
Laptop Computer
Printer
Software
Internet Service
Other: ___________
Total $0 $0 $0
Telecommunications
Land Phone (equipment)
Cell Phone (equipment)
Installation
Monthly Service for land phones
Monthly Service for cell phones
Total $0 $0 $0
Operation of Automotive Equipment
Vehicle Lease
Vehicle Purchase
Gasoline
Maintenance
Licenses and fees
Total $0 $0 $0
Occupancy
Rent (Cost per sq ft = __________)
Utilities
Repairs & Maintenance
Insurance
Taxes
Total $0 $0 $0
Renovation Costs
Other Start-up Costs
_____________________________
_____________________________
_____________________________
Other Indirect Cost
_____________________________
_____________________________
_____________________________
Total Non-Personnel Cost $0 $0 $0
Total Program Cost $0 $0 $0