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<br />ExLibit F
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<br />BUDGET FORM
<br />
<br />All costs related to the program activities described in the proposal must be included on the Budget Form. A budget
<br />narrative must be attached on a sep.lra1e sheet of paper 1'01 all line items marked with an * asterisk.
<br />
<br />~
<br /> Administratiw Pro ram Total WIA, Kind . Total .
<br />I Salaries*:~
<br />. J. FYLP Peer Mentors (4 at . '"
<br /> .25 FTE at $ 12.62/hL I $26.250 $26.250 . ..'$26,250):
<br /> 1 FYLP Supervisor 1.25 FTE I $10,675 $10.675 , $10.000 $20,675'
<br /> 3. Staff Accountant (.05 FTE I $2,200 $5,200 $5;200 T
<br /> Use separate sheet ifnecessar:y .,
<br />, Benefits* .
<br /> ] FYLP SupeTVIsor (20%>1 $2.135 $2,135 $2,135 ,
<br /> 2. Staff Accountant (20(~u) $440 I $440 '$440"
<br /> Use separate sheet if necessary. I '.
<br /> ,
<br /> Rent or user fee* 0 $9.000 .$9;000....
<br />· Utilities $4,000 , $4,000 $2.000 $6,000
<br /> Phone & Internet fees $5,000 $5.000 $1.000 $6,000
<br />I Parking fees '.
<br /> Security
<br /> Maintenance . ';
<br /> Insurance $4.000 $4.000 $3.000 $7,000,j
<br /> baulument rental fees* , I
<br />I Veliicle Iease* ,
<br /> Office expenses $5,000 S5,000 $2,000 $7,000
<br /> I consumables) I.
<br /> Accounting Services ...
<br /> l~egal services . <,
<br /> Auditing services
<br /> lndirect costs* ...... "C
<br /> Total Ooeratio~ Expenses 1: 18% $18.000 $17,000 S35,000 ,
<br /> Staff training $1,000 $1,000 $2.000 $3,000 5'
<br /> Stafftrave 1:rnileage $600 $600 $600 ."'
<br /> Participant Wa~es* '''./'. ..
<br /> SUODort services* $30,000 , $30,000 $30,000 .;)1
<br /> Particioant Incentives* $10,000 $10,000 $1O;()Q0 . ."
<br /> Other (1ist)* . '''.' "i~
<br /> Total Oneratin~ Expenses 2: mill $2.000 $43,600
<br /> ~~ '.. ... .'. ". CJ?":~2:.. ' , .;, ", ~~~C:,i~~~~~1;r . I~"~ ~^~:.;
<br /> .
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<br /> . I,...... "" [",,', .... I. "
<br />
<br />*See Budget Form Instructions
<br />
<br />Note: Audit Requirements
<br />States, local governments and non-profit institutions who receive $500,000 or more in federal funds in a fiscal
<br />year shall meet the audit requirements of the OMB Circular A-133, "Audits of States. and Local Govemmenb
<br />and Non-Profit Institutions."
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