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16 <br />STATE OF NORTH CAROLINA <br />DIVISION OF SOCIAL SERVICES <br />PURCHASE CONTRACT BUDGET <br />SUMMARY Effective <br />Provider ~*i-nlevment 4ecnrity ('emmissioriID # fRF01 P re-r~~ 7/1/'2003 through 6/30/2004 <br />Part I -Estimated Expenditures <br />Object of Expenditure <br />A. Salaries <br />B. Fringe Benefits <br />C. Staff Development-Services <br />D. Travel <br />E. Equipment Purchase-Tangible <br />Property <br />F. Transportation-Recipient <br />G. Medical Supplies and Expense <br />H. Cost of Space-Non-Residential <br />I. Room &Board-Residential Treatment <br />J. Service Payments <br />K. Other <br />L. Indirect Costs <br />Total Non- Matchable <br />Program Costs Costs <br />~1) ~2) <br />$20,649 <br />4,353 <br />360 <br />2,682 <br />M Totals ~ 28,044 ~ <br />Part II -Computation of Unit Cost or Individual Fixed Rate <br />A. 1. Total Matchable Costs <br />2. Less: Earned Income for Unit Cost Method <br />3. Net Matchable Costs <br />B. 1. Total Service Unit Capacity, or <br />2. Total Anticipated Utilization Capacity <br /> <br /> <br />Total Matchable <br />Costs <br /> <br />Method of Computation or Source of Data <br />