|
11111.
<br /> DocuSign Envelope ID:AB039DC1-8309-4D41-B525-6E84F973FAA6
<br /> EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION CONTINUED
<br /> MAIN APPLICATION
<br /> b.) Program Budget Detail
<br /> What is the cost to deliver your projectiprogram? List each project/program element in the table below,
<br />■
<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 Counselin! Class , ,,, , ,,,, , ,
<br /> . ,....,,,fif, 41,.. t,, Itilrawi:imif 4,, ,,, M ,,,"01'''.;:t.-,reA447,,,,,,y,x' ,?, . , _..,,,,,,,
<br /> PoskeleFein4.-*,- 1,,kv IN'' 3wr. ''-. ,,,, ".... 14f. , 4(41,0 ji -11 )41‘ *..''' ! -• Pre''''. 4! i I gl4uwial1N,'
<br /> :',1; ..':::'''' C; a' W"a ' ,,,t_.,, ..:htl!:;4 .4 "1 a .S 1"...Lirat,&Li& 1 13p,: ,I., ,
<br /> Credit Counseling Teacher in class $25 96 hours(8 hrs/mth x 12 months) $2,400
<br /> Credit Counseling Teacher—class prep $25 1 48 hours(4hrsImth x 12 mths)
<br /> ._....._ $1,200
<br /> Credit Counselor--one-on-one $20 120 hours(10 hrs/mth x12 mills $2,400
<br /> Materials $25 120 course packets/credit reports $3,000
<br /> Total $9,000
<br /> _ 11
<br /> Com 0 lete the table below for the .rciectioro•ram for which ou are res uestin• funds.
<br /> Attach additional rows/pages, as needed.
<br /> Program: Parent Aide Services
<br /> -o.t t,Elements''''','%"t,,7;','`..4 0jpoilMFtrf;
<br /> tiMPPOPt rheasure,',,' ;(4 'Sliblvtgli ($)
<br /> Home Visit $63.64 4 per mth X 18 families $49,900
<br /> -
<br /> . __
<br /> ' Total , $49,900
<br /> .
<br /> C.) Cost per Unit
<br /> .,i-_ , , ° ° , ° , ,,T 'wi,'
<br /> : 4
<br /> ' O''qa111 ' A''191'''', g - .,,,- ,,' i, i.„,O. ., •4,Fi.piecteli ,20M17
<br /> Total Cost of Program $6,327 $10,500 $49,900
<br /> Total #of Units 121 194 784
<br /> Cost Per Unit $52.29 $54.12 $63.64
<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 112412016 4:55:46 PM Page 1 9 o f 2 1
<br />
|