2016-754-E Finance - A Helping Hand performance agreement

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DocuSign Envelope ID: E7F88FC1-7C61-4E68-8AF9-5870F711DEBC it A continued Provider's Outside Agency Application MAIN APPLICATION b.) Program Budget detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Example Program: Credit Counseling Class Cost Elements Cost Quantity/Unit of Measure Subtotal($) Credit Counseling Teacher--in class $25 96 hours(8 hrslmth x 12 months) $2,400 Credit Counseling Teacher—class,prep $25 48 hours(4hrslmth x 12 mths) $1,200 Credit Counselor—one-on-one $20 120 hours(10 hrsl'mth x12 mths $2,400 Materials $25 120yw�course packets/credit reports $3,000 Total $9,000 Complete the table below for the ro'ectl ro ram for which you are requesting funds. Attach additional rows/pages, as needed. Program: Senior Companion Care Cost Elements Cast $ Quanti lllnit of measure Subtotal Partial Salary For Program Assistant $14,555 50%of role-scheduling,etc. $14,555 Advertising and recruitment of companions $500 Using both pay and free ads $500 Training of companions $165 Materials and staff time $165 Background checks $780 $26 perbackground check $780 Total 16,000 c.) Cost per Unit Actual 2014-15 Estimated 2015-16 Projected 2016-17 Total Cost of Program 523,365 535,260 551,260 Total # of Units 26,168 26,763 27,563 Cost Per unit 20.00 20.00 20.00 This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/25/2016 1:23:46 PM Page 23 of 26