2016-582-E Finance - Freedom House Recovery Center, Inc. - Outside Agency Performance Agreement

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DocuSign Envelope ID:636AFD33-DA5C-4B55-88DC-03C0863BAFE3 t A - continued Provider's Outside Agency Application MAIN APPLICATION b.) Program Budget Detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Example Program: Credit Counseling Class Cost Elements Cost($) Quantity/Unit of Measure Subtotal ($) Credit Counseling Teacher–in class $25 96 hours (8 hrs/mth x 12 months) $2,400 Credit Counseling Teacher—class prep $25 48 hours(4hrs/mth x 12 mths) $1,200 Credit Counselor—one-on-one $20 120 hours (10 hrs/mth x12 mths $2,400 Materials $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the proiect/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: Chapel Hill Residential Rehab Services Cost Elements Cost($) Quantity/Unit of measure Subtotal ($) Staff $948.12 One Bed Day(24 hours)X 365 $346,064 Utilities $53.42 One Bed Day(24 hours)X 365 $19,500 Supplies and Equipment $292.60 One Bed Day(24 hours) X 365 $106,800 Travel and Training $21.17 One Bed Day(24 hours)X 365 $7,726 Other Expenses $29.32 One Bed Day(24 hours) X 365 $10,700 Total $490,790 C.) Cost per Unit Actual 2014-15 Estimated 2015-16 Projected 2016-17 Total Cost of Program $465,810 $482,675 $490,790 Total # of Units 7201 7228 7235 Cost Per Unit $64.69 $66.78 $67.84 This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/25/2016 4:55:19 PM Page 22 of 24