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Name of Organization: <br />Name of Program <br />2015 -2016 Funded Personnel <br />Interval <br />NOTE: Please remember that this is only a budget and that reimbursement should be based on actual service. <br />* Only direct hours charged to the grant will be reimursable. Timecards must demonstrate direct hours charged <br />to the grant. Benefits (Vacation, sick and holiday) are paid for program staff who work 100% in the ESG program. <br />PROGRAM STAFF <br />Position Title <br />Annual <br />Salary <br />Annual <br />Benefits <br />Total <br />Compensation <br />ESG Funds <br />Requested <br />Percentage of <br />time in the <br />program serving <br />SA residents <br />DV Advocate <br />$ 15,600 <br />$ <br />$ 15,600 <br />$ 15,600 <br />100% <br />Clinical Supervisor <br />$ 12,480 <br />$ <br />$ 12,480 <br />$ 9,346 <br />75% <br />$ <br />Total Amount Re uested <br />$ - <br />Total Amount Requestedl Requested <br />$ 24,946 <br />175% <br />CONTRACTUAL /PROFESSIONAL SERVICES <br />Type of Service <br />Annual Contract Amount <br />Total <br />ESG Funds <br />Percenta e of <br />Total Amount Re uested <br />$ - <br />Exhibit. B <br />Page 2 0l'2 <br />