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DocuSign Envelope ID: EB541A3B-1E01-49AB-9E09-7987ECAEC1C4 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Food (water, Gatorade, snacks 6 months) $600.00 $600.00 <br /> Gas and oil $100.00 2.50 per gallon(40 gallons) $100,00 <br /> Total $2200.00 <br /> b) Cost per Unit <br /> Actual 2014-15 Estimated 2015-16 Projected 2016-17 <br /> Total Cost of Program $2,000 $2200.00 _$3000.00 <br /> Total # of Units _ 1= 1/4 acres 1=1/4 acres 1=1/2 acres <br /> Cost Per Unit $2000.00 $2200.00 $3000.00 <br /> Program: Summer Enrichment Camp <br /> Cost Elements Cost($) Quantity/Unit of measure Subtotal (SI <br /> Classes (instructors) $200.00 200x4 classes $800.00 <br /> Food $5.00 5x60 students x25 days $1500.00 <br /> Field trips $300.00 2 field trips x300 $600.00 <br /> Teachers $1000.00 2 teachers x1000 $2000.00 <br /> Counselors (RENA) _ $500.00 500x 4 counselors x 5 weeks $2000.00 <br /> Administrators $2000.00 3 x 2000 $6,000.00 <br /> Total $12,900.00 <br /> b) Cost per Unit <br /> Actual 2014-15 Estimated 2015-16 Projected 2016-17 <br /> Total Cost of Program $11,000.00 18,000.00 $20,000.00 <br /> Total # of Units 40 60 60 <br /> Cost Per Unit $275.00 per $315.00 per <br /> student student $333.00 per student <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 Application1/25/20161° a g e 28 o f 32 <br />