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STATE OF NORTH CAROLINA <br />DIVISION OF SOCIAL SERVICES <br />PURCHASE CONTRACT BUDGET <br />SUMMARY Effective <br />Provider RmTl~yment Secnrit~ C:nmmiccinn ID # fiRF.nl Perind 7/1/2004 through 6/30/2005 <br /> <br />Part I -Estimated Expenditures <br /> <br /> <br />Object of Expenditure Total Non- Matchable Total Matchable <br /> Program Costs Costs Costs <br /> 1 2 3 <br />A. Salaries $20,649 <br />B. Fringe Benefits 4,353 <br />C. Staff Development-Services <br />D. Travel 360 <br />E. Equipment Purchase-Tangible <br />Property <br />F. Transportation-Recipient <br />G. Medical Supplies and Expense <br />H. Cost of Space-Non-Residential <br />I. Room &Board-Residential Treatment <br />J. Service Payments <br />K. Other <br />L. Indirect Costs 2,682 <br />M. Totals 28,044 <br />Part II -Computation of Unit Cost or Individual Fixed Rate <br />A. 1. Total Matchable Costs $ <br />2. Less: Earned Income for Unit Cost Method $ <br />3. Net Matchable Costs $ <br />B. 1. Total Service Unit Capacity, or <br />2. Total Anticipated Utilization Capacity <br />Method of Computation or Source of Data <br />