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 project/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: _Family Advocacy Network Cost Elements Cost( ) Quantity/Unit of measure Subtotal( ) Common Sense Parenting Class–6 $ 240/class 12 hours/class x 11 classes = $ 2,640 sessions, 2 hours each –Teacher in class series 132 hours Common Sense Parenting Class Prep, Set- $240/class 2 hours/session x 6 sessions x $2,640 up-3 hours/class session series 11 classes = 132 hours Parent Consultation and Referral to $ 30 1.5 hours/consultation x 240 $ 7,200 Services consultations = 360 hours Total $ 12,480 C.) Cost per Unit Actual 2014-15 Estimated 2015-16 Projected 2016-17 Total Cost of Program $ 144,640 $ 115,967 $ 129,877 Total # of Units 345 325 365 Cost Per Unit $ 419 $ 479 $ 355 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 5/25/2016 9:20:28 AM .. of 20