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CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT BLOCK GRANT <br />FINAL PROGRAM BUDGET <br />Organization Name: SHARE OUR SELVES <br />Program Name: SOS Free Medical and Dental Clinic <br />Program Year: 2004-2005 <br />FXPFNDITURES <br />SANTA ANA CDBG <br />OTHER <br />TOTAL PROGRAM <br />CATEGORY <br />GRANT <br />RESOURCES <br />BUDGET <br />Administrative Staff <br />$ <br />$300,000 <br />$300,000 <br />Salaries & Benefits <br />Program Staff Salaries & <br />10,000 <br />840,000 <br />850,000 <br />Benefits <br />11,000 <br />11,000 <br />Office Supplies <br />6,200 <br />6,200 <br />Rent/Lease <br />24,200 <br />24,200 <br />Communications <br />17,000 <br />17,000 <br />Utilities <br />Contractual/Professional <br />Services <br />40,000 <br />40,000 <br />Pharmacist, Dentist <br />170,000 <br />170,000 <br />Insurance <br />1. Pharm/Lab/Pt. Supplies <br />300,000 <br />300,000 <br />2.Taxes/Licenses/Permits <br />92,905 <br />92,905 <br />3. Repairs/Maintenance <br />34,000 <br />34,000 <br />4.Inkind <br />250,000 <br />250,000 <br />5. Other <br />71,000 <br />71,000 <br />TOTAL <br />$10,000 <br />$2,156,305 <br />$2,166,305 <br />OTHER PROGRAM RESOURCES <br />ACTUAL FUNDING SOURCE <br />AMOUNT <br />Donations <br />$ <br />410,505 <br />Hoag Hospital <br />$ <br />825,800 <br />Grants <br />$ <br />600,000 <br />Inkind <br />$ <br />250,000 <br />Interest/Reimbursements/Other <br />$ <br />70,000 <br />TOTAL <br />1 $2,156,305 <br />EXHIBIT B <br />