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DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> b.) Program Budget Detail <br /> What is the cost to deliver your project/program? List each project/program element in the table below, <br /> including the cost of each element, the quantity and unit of measure, and the subtotal for each element. <br /> Where necessary, allocate costs to the use of shared space, vehicles or equipment. <br /> Example Program: Credit Counseling Class <br /> Cost Elements Cost($) Quantity/Unit of Measure Subtotal ($) <br /> Credit Counseling Teacher-in class $25 96 hours (8 hrsImth x 12 months) $2,400 <br /> Credit Counseling Teacher—class prep $25 48 hours (4hrslmth x 12 mths) $1,200 <br /> Credit Counselor—one-on-one $20 120 hours(10 hrstinth x12 mths $2,400 <br /> Materials $25 120 course packets/credit reports $3,000 <br /> Total $9,000 <br /> Complete the table below for the project/program for which you are requesting funds. <br /> Attach additional rows/pages, as needed. <br /> Program: Supplemental Funding for client enrollment and program operations <br /> Cost Elements Cost($) Quantity/Unit of measure Subtotal($) <br /> Client cost per day $44.00 -I unit/day ( 240 days) $10,560 <br /> Program Cost(supplies&personnel) $90.00 Average cost per day for operabons(253) $22,770 <br /> Total $33,330 <br /> c.) Cost per Unit <br /> Actual 2014-15 Estimated 2015-16 Projected 2016-17 <br /> Total Cost of Program $348,847 $363,991 $362,561 <br /> Total # of Units 6024 6072 6072 <br /> Cost Per Unit $57.90 $59.94 $5911 <br /> This Cost Per Unit must reflect the total program budget and the total number of <br /> program beneficiaries (households or persons) in this application and must be <br /> consistent with report submittals from previous years (if applicable). <br /> Main Application 1/25/2016 12:26:51 PM Page 19 of 21 <br />