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Attachment C
<br />BUDGET FORM
<br />(October 1 , 201 1 - December 31 , 201 1 )
<br />All costs related to the program activities described in the proposal must be included on the Budget Form. A budge
<br />narritive must be attached on a separate sheet of paper for all line items marked with an � astrisk.
<br />"'See Budget Form Instructions
<br />Note: Audit Requirements
<br />States, local governments and non - profit institutions who receive $500,000 or more in federal funds in a fiscal year
<br />shall meet the audit requirements of the OMB Circular A -1 33, "Audits of States, and Local Governments and Non-
<br />profit Institutions."
<br />Administrative
<br />No more than 1 O%
<br />allowed.
<br />Program
<br />Total WIA
<br />Match /In -Kind
<br />Total
<br />,.. � Personnel
<br />,,.,,:
<br />:.
<br />. � .
<br />Salaries'
<br />1 _ FYLP Peer Mentors
<br />(4 at .450 FTE at $14.00 /hr.)
<br />2. FYLP Supervisor (.50 FTE)
<br />3. Senior Accountant (.10 FTE)
<br />Use separate sheet if necessary.
<br />$70,061
<br />$70,061
<br />$70,061
<br />$17,768
<br />$17,768
<br />$17,768
<br />$5,300
<br />$4,71 O
<br />$4,71 O
<br />Benefits'
<br />1 . FYLP Supervisor (23 %)
<br />2. Senior Accountant (23 %)
<br />Use separate sheet if necessary_
<br />$3,684
<br />$3,684
<br />$3,684
<br />$1,219
<br />$1,083
<br />$1,083
<br />Total Personnel
<br />$6,519
<br />$91,513
<br />$97,306
<br />$97,306
<br />..... __
<br />O_perating"lE�jie"nse "s �
<br />_ _.
<br />, .
<br />_,
<br />�.� � "i. -`'
<br />r ,�
<br />�^ �,{
<br />x, .� a- s�,r�,,.
<br />Rent or user fee"
<br />$9,000
<br />$9,000
<br />Utilities
<br />$7,200
<br />$3,600
<br />$3,600
<br />$7,200
<br />Phones
<br />$4,800
<br />$2,400
<br />$2,400
<br />$4,800
<br />Internet fees
<br />$2,000
<br />$1,000
<br />$1,000
<br />$2,000
<br />Parking fees
<br />Securit
<br />Maintenance
<br />Insurance
<br />$6,000
<br />$3,000
<br />$3,000
<br />$6,000
<br />Equipment rental fees'
<br />Vehicle lease"
<br />Office expenses
<br />consumables)
<br />$7,000
<br />$3,500
<br />$3,500
<br />$7,000
<br />Accounting Services
<br />Legal services
<br />Auditing services
<br />$1,000
<br />$500
<br />$500
<br />$1,000
<br />Indirect costs
<br />Staff training
<br />$1,300
<br />$1,300
<br />$1,300
<br />Staff travel /mileage
<br />$275
<br />$275
<br />$275
<br />Participant Wa es•
<br />Support services
<br />$16,913
<br />$16,913
<br />$16,91 3
<br />Participant Incentives'
<br />$2,595
<br />$2,595
<br />$2,595
<br />Other list "
<br />Total O erating Expenses
<br />$O
<br />$49,083
<br />$33,508
<br />$24,575
<br />$58,083
<br />� ,��.m aa�:�� ri. , a r. v
<br />G f ,;,GRAND TOT�4L �'� >F
<br />T�"otal -Perso -_ el +'Total,
<br />1 �d. y �Il`�'.�T 7
<br />OpeYatmg,E�penses � �
<br />�� $6 519 �,,
<br />� ' �
<br />Oj'!f..V �
<br />:��_
<br />b�5f s* ze�'�d G
<br />��`$140�,596 >F
<br />� �� a < <" " k�
<br />� S
<br />,,,
<br />.r r "Y � 2
<br />� $130 894 +af
<br />p ra` �' `°
<br />try d §
<br />'" y
<br />"' $24`575 �'
<br />� �_�, �
<br />� J. _•
<br />v , :: c
<br />� $155 389 ''+
<br />t
<br />V.(
<br />"'See Budget Form Instructions
<br />Note: Audit Requirements
<br />States, local governments and non - profit institutions who receive $500,000 or more in federal funds in a fiscal year
<br />shall meet the audit requirements of the OMB Circular A -1 33, "Audits of States, and Local Governments and Non-
<br />profit Institutions."
<br />
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