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Docusign Envelope ID: 50565F21-A738d303BD3F-60841076ED5E <br /> Contract Number 000481451 Page 22 of 30 <br /> Budget Detail - Year, 1 <br /> Category item Narrative ' Amount <br /> Operational Other Not Otherwise Classified Drug screens reimbursement, up to $1 ,500. Average of 100 per $1 ,500,00 <br /> year / $15.00 each. Total (100 x $15 = $11500) <br /> Operational Other Not Otherwise Classified Substance Use Disorder Assessment reimbursement, up to $600. $600,00 <br /> Average 2 per year 1 $300 Total (2 x $300 = $600) <br /> Operational Other Not Otherwise Classified Treatment Services reimbursement, up to $14,000 includes $14,000,00 <br /> uncoveredluninsured treatments, (For uncovered treatments, <br /> assume 10% Uninsured/Unable to access State funded (Medicaid) <br /> Services) Total $ 14 ,000 <br /> Subcontracts and Grants $0,00 <br /> Match $0,00 <br /> Cost Per Service $0,00 <br /> Sub Tota) ! $3201480.00 <br /> Indirect Cost $0.00 <br /> Totet Budget $320,480,00 <br /> Subi %oriiraci ing aci% d Grants 8i;ojot Detail -^Yeiie I <br /> Category Iterrr Na, "rrative Amount <br /> Line Item Budget Detail (08/11 ) <br />