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New Position Request Form <br />EXPENSES <br />Personnel <br />salary, hiring range (Grade 69, S1 -5D) <br />Fringes <br />sub -total <br />operatina & Canital <br />Travel & training <br />Mileage <br />Desk <br />Chair <br />Filing cabinet <br />Bookcase <br />Equipment <br />sub -total <br />TOTAL <br />Consolidated contract <br />PHN I <br />$ 26,879 - $ 32,672 <br />6,471 - 7,224 <br />---- - - - - -- ---- - - - - -- <br />$ 33,350 $ 39,896 <br />S 150 <br />70 <br />370 <br />200 <br />155 <br />175 <br />150 <br />$ 1,270 <br />$ 34,620 <br />Family Planning $ 16,263 <br />Child service Coordination 15,466 <br />sub -total $ 31,729 <br />Projected Medicaid Reimbursement <br />( 13 CSC cases X $60 /month x 12 months) $ 9,360 <br />TOTAL $ 41,089 <br />$ 150 <br />70 <br />370 <br />200 <br />155 <br />175 <br />150 <br />$ 1,270 <br />$ 41,166 <br />13 <br />