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DocuSign Envelope ID:40C90B7F-D85F-4E1C-A5CA-4BC263526A8E 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 hrs/mth x 12 months) $2,400 <br /> Credit Counseling Teacher—class prep $25 48 hours (4hrs/mth x 12 mths) $1,200 <br /> Credit Counselor—one-on-one $20 120 hours (10 hrs/mth 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: Meals on Wheels <br /> Cost Elements Cost( ) Quantity/Unit of measure Subtotal( ) <br /> Personnel 24,751 24,751 <br /> Occupancy 7,213 7,213 <br /> Food Purchase 3.25 Cost per meal 28,197 <br /> Miscellaneous 3,186 3,186 <br /> Total 63,347 <br /> C.) Cost per Unit (one meal delivered) <br /> Actual 2014-15 Estimated 2015-16 Projected 2016-17 <br /> Total Cost of Program 61,736 63,347 63,347 <br /> Total # of Units 8,175 8,676 8,676 <br /> Cost Per Unit 7.55 7.30 7.30 <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 5/25/2016 9:29:51 AM .. , 1 of 22 <br />