2016-597-E Finance - Orange Congregations in Mission - Samaritan Relief Ministry - Outside Agency Performance Agreement

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DocuSign Envelope ID:A3E0213B-1DCD-43A3-9C41-A2EC55A8CA94 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: Samaritan Relief Ministry Cost Elements Cost( ) Quantity/Unit of measure Subtotal( ) Personnel 79,958 1 f/t with H/R & 1 p/t 79,958 Occupancy 11,382 11,382 Food Purchase 27,045 27,045 Food Donation/assistance value 1.69 Per pound 406,374 Client Financial Assistance 42,094 42,094 Miscellaneous/other 2,846 2,846 Total 569,699 C.) Cost per Unit: A unit is one person assisted. Actual 2014-15 Estimated 2015-16 Projected 2016-17 Total Cost of Program 569,699 440,200 440,200 Total # of Units 10,775 11,278 11,278 Cost Per Unit 52.87 39.03 39.03 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 9:39:17 AM .. , 1 of 22