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DocuSign Envelope ID:FO3CBAC2-B7E2-4CDB-AFA6-CB52A071BA00 t A- continued <br /> Provider's Outside Agency Application <br /> MAIN APPUCATIKA <br /> Complete the table below for the project/program for which you are requesting <br /> funds. Attach additional rows/pages, as needed, <br /> Program: Burwell School Visitor Services — Ex•ansion/Da time Histo <br /> Teas for Older Pa,oulation:Yea, la <br /> Cot Elements I C0 1:(4 Quantity/Unit of measure Subtotal($) <br /> Speaker Honoraria $50,00 3 events $150 00 <br /> Planning, Marketing $27 00 10 staff hours $270,00 <br /> Site Preparation $105 00 3 events $315 00 <br /> Staffing AdemnistrafR)n Evahu)tIon $37 00 2 his x Exec Director, docent $333 00 <br /> time x 3 events <br /> 1 Total $1068.00 <br /> C.) Cost per Unit <br /> ( t d 2015- <br /> Projecteh 201 -i 7 <br /> Actual 21.14-15 <br /> 16 <br /> Total Cost of Program NA NA $1,068.00 <br /> Total # of Units NA NA $140.00 <br /> Cost Per Unit NA NA $7.63 <br /> Program. Bq, ell Sehppl Historic Site "Bu eli Volu tjf Comfpurlit — <br /> Buildin• YEAR ONE <br /> Cost Elements I Col(4 . Quantity/Unit of measure Subtotal(;) <br /> Administration $27 00 4 hours/month staff x 12 months $1,296.00 <br /> Printing & Mailing for marketing, record $325.00 60 volunteer packets, files, $650,00 <br /> keeping, applications and record forms mailings x 2/year <br /> Community Volunteer events $250 00 2 x year $500 00 <br /> Total $2,446.00 <br /> d.) Cost per Unit <br /> ,,t1,„,.:1 2011445 1 Estimated 2015- 11 <br /> 16 Proj,ct,cl 201*-17 <br /> Total Cost of Program NA A $2, 6.00 <br /> Total # of Units NA NA 5,000 visitors <br /> $0.50/visitor <br /> Cost Per Unit NA NA <br /> Main Application 1/25/2016 1 :26:31 PM 6 6 { 1 6 <br />