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PROGRAM YEAR 2005-2006 <br />PUBLIC SERVICE PROGRAM BUDGET PROPOSAL <br />Organization Name: SHARE OURSELVES <br />Program Name: SOS Free Medical and Dental Clinic <br />Program Year: 2005-2006 <br />EXPENDITURES <br />CATEGORY <br />SANTA ANA CDBG <br />OTHER <br />TOTAL PROGRAM <br />GRANT REQUESTED <br />RESOURCES <br />BUDGET <br />Administrative Staff <br />$ <br />$90,000 <br />$90,000 <br />Salaries & Benefits <br />Program Staff Salaries & <br />$10,000 <br />992,416 <br />1,002,416 <br />Benefits <br />Office Supplies <br />11,300 <br />11,300 <br />Rent/Lease <br />6,000 <br />6,000 <br />Communications <br />10,500 <br />10,500 <br />Utilities <br />13,150 <br />13,150 <br />Contractual/Professional <br />Services <br />46,000 <br />46,000 <br />Please Specify) <br />Insurance <br />150,000 <br />150,000 <br />Other (Please Specify) <br />296,980 <br />296,980 <br />1. Pharm/Lab/Pt. Supplies <br />2. In kind <br />250,000 <br />250,000 <br />3. Taxes/Licenses/Permits <br />2,350 <br />2,350 <br />4. Repairs/Maintenance <br />43,000 <br />43,000 <br />5. Equipment <br />20,000 <br />20,000 <br />6. Other <br />47,120 <br />47,120 <br />TOTAL <br />$10,000 <br />$1,978,816 <br />$1,988,816 <br />LIST OTHER PROGRAM RESOURCES <br />SOURCE <br />AMOUNT <br />Hoag Hospital <br />$805,572 <br />Grants <br />573,000 <br />Donations <br />305,244 <br />In kind <br />250,000 <br />CDBG Santa Ana <br />10,000 <br />Interest/Reimbursements <br />20,000 <br />TOTAL <br />$1,988,816 <br />Wcu:1r11111� <br />