EXHIBIT A ITEMIZED SERVICE BUDGET.XLSX
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Exhibit A ITEMIZED SERVICE BUDGET Funding: Health Promotion Agency: Maricopa County Department of Public Health Service: CRD-RRP-HPR Agreement #: DI24-002413 Total Allocation: $99,108.33 Budget Period: 5/1/2024 - 4/30/2025 1. PERSONNEL & ERE Indirect Cost Eligible (dropdown) Cost Category (dropdown) FTE Level Position Title Total Salary for the Contract Period per FTE ERE Rate % Billed to this Contract Personnel Subtotal Employee Related Expenses Subtotal Total Cost Yes Admin 1 CHW Coordinator $26,946.40 15.00% 100% $26,946.40 $4,041.96 $30,988.36 Yes Other 1 CHW Supervisor $73,297.59 15.00% 10% $7,329.76 $1,099.46 $8,429.22 Yes Other 1 Program Supervisor $78,691.24 15.00% 10% $7,869.12 $1,180.37 $9,049.49 $0.00 $0.00 $0.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL PERSONNEL & ERE: $42,145.28 $6,321.79 $48,467.08 2. PROFESSIONAL AND OUTSIDE SERVICES Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Revised 3.26.13 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Fingerprint Clearance $80.00 1 Other $80.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Yes Other 1 Other Immunizations - Health and Safety checklist $100.00 1 Other $100.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL PROFESSIONAL AND OUTSIDE SERVICES: $2,520.00 3. TRAVEL Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost $0.00 Revised 3.26.13 TOTAL TRAVEL: $0.00 4. SPACE Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost $0.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL SPACE: $0.00 5. EQUIPMENT Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost $0.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL EQUIPMENT: $0.00 Please provide details on Indirect Cost Eligible where "No" was selected Revised 3.26.13 6. MATERIALS AND SUPPLIES Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost Yes Other 1 Other End of program recognition $300.00 1 Other $300.00 $0.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL MATERIALS AND SUPPLIES: $300.00 7. OPERATING SERVICES Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Rate of reoccurrence (dropdown) Total Cost Yes Other 90 Hour ACRO Temporary Services Biling Rate / Practicum $26.65 18 Year $43,173.00 $0.00 Please provide details on Indirect Cost Eligible where "No" was selected TOTAL OPERATING SERVICES: $43,173.00 9. INDIRECT COSTS Cost Category Total costs eligible for Indirect % Total Cost Not Applicable $ - $0.00 Revised 3.26.13 Case Management $ - $0.00 Employment $ - $0.00 Admin $ 30,988.36 15.00% $4,648.25 Other $ 63,471.72 $0.00 TOTAL INDIRECT COSTS: $4,648.25 10. CLIENT DIRECT SERVICES/VOUCHERS g y (dropdown) Total Units Unit (dropdown) Unit description Rate per Unit reoccurrences (dropdown) Total Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CLIENT DIRECT SERVICES: $0.00 Total Cost Personnel $42,145.28 ERE $6,321.79 Professional & Outside Services $2,520.00 Travel $0.00 Space $0.00 Revised 3.26.13 Equipment $0.00 Materials & Supplies $300.00 Operating Services $43,173.00 Indirect Costs $4,648.25 Client Direct Services/Vouchers $0.00 TOTAL COSTS: $99,108.33 Revenue: Total Cost ADES Refugee Program $99,108.33 TOTAL REVENUE: $99,108.33 Budget Check: Total Allocation $99,108.33 Total Revenue ADES Cost $99,108.33 (Should equal zero) $0.00 Revised 3.26.13 Funding: RRPCMA Service: CRD-RRP Total Allocation: $99,108.33 Select "Yes" or "No" if the cost is eligible for indirect costs Select a "Cost Category" from the drop down if applicable. This can be left b Input the information for all columns Total Cost for the Contract will calculate based on the inputs If more rows are needed in any Cost Category, add them above the last row If a line is not Indirect Cost Eligible, please provide the details in the box Please select "Yes" or "No" Indirect Cost Eligible (dropdown) Cost Category (dropdown) FTE Level Yes Admin 1 Yes Other 1 Yes Other 1 Box when "No" is selected Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Yes Other 1 Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Yes Other 1 Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Yes Other 90 Please provide detail Indirect costs are calculated based on the cost category selected. If no sele Input the indirect percentage for calculation to generate Client Direct Services/Vouchers section is not eligible for Indirect costs. Cost Category (dropdown) Total Units This section is the summary of all the totals There is a "Budget Check" section. It should equal zero if the budget is the Funding: Service: Original Allocation: #REF! Additional Allocation: $0.00 Total Allocation: #REF! Fill in for the Additional Allocation only Select "Yes" or "No" if the cost is eligible for indirect costs Select a "Cost Category" from the drop down if applicable. This can be left b Input the information for all columns Total Cost for the Contract will calculate based on the inputs If more rows are needed in any Cost Category, add them above the last row If a line is not Indirect Cost Eligible, please provide the details in the box Please select "Yes" or "No" Indirect Cost Eligible (dropdown) Cost Category (dropdown) FTE Level Box when "No" is selected Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail There must be a number in the "Total Units" and "Number of Recurrences" Please provide information of the unit in the column "Unit description" Indirect Cost Eligible (dropdown) Cost Category (dropdown) Total Units Please provide detail Indirect costs are calculated based on the cost category selected. If no sele Input the indirect percentage for calculation to generate Client Direct Services/Vouchers section is not eligible for Indirect costs. Cost Category (dropdown) Total Units This section is the summary of all the totals for the Additional Allocation an There is a "Budget Check" section. It should equal zero if the budget is the Information inserted here is simply an example for illustration purposes. Position Title Total Salary for the Contract Period per FTE ERE Rate % Billed to this Contract CHW Coordinator $26,946.40 15.00% 100% CHW Supervisor $73,297.59 15.00% 10% Program Supervisor $78,691.24 15.00% 10% TOTAL PERSONNEL & ERE: Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Original ISB Instructions ATTACHMENT ITEMIZED SERVICE BUDGET blank if inapplicable w already populated 1. PERSONNEL & ERE ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 2. PROFESSIONAL AND OUTSIDE SERVICES Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Fingerprint Clearance $80.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Other Immunizations - Health and Safety checklist $100.00 1 Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Information inserted here is simply an example for illustration purposes. ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 3. TRAVEL ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 4. SPACE Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Other End of program recognition $300.00 1 Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 5. EQUIPMENT ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 6. MATERIALS AND SUPPLIES ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 7. OPERATING SERVICES Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Hour ACRO / Practicum $26.65 18 Information inserted here is simply an example for illustration purposes. Cost Category Not Applicable Case Management Employment Admin Other Information inserted here is simply an example for illustration purposes. Unit (dropdown) Unit description Rate per Unit Number of reoccurrences ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 8. OTHER ls on Indirect Cost Eligible where "No" was selected ection was made, this will calculate under the "Not Applicable" section 9. INDIRECT COSTS 10. CLIENT DIRECT SERVICES/VOUCHERS exact amount allocated. Information inserted here is simply an example for illustration purposes. Position Title Total Salary for the Contract Period per FTE ERE Rate % Billed to this Contract Amendment Instructions ATTACHMENT ITEMIZED SERVICE BUDGET blank if inapplicable w already populated 1. PERSONNEL & ERE Additional Allocation Original Allocation TOTAL PERSONNEL & ERE: Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Unit (dropdown) Unit description Rate per Unit Number of reoccurrences ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 2. PROFESSIONAL AND OUTSIDE SERVICES ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 3. TRAVEL ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 4. SPACE Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Unit (dropdown) Unit description Rate per Unit Number of reoccurrences ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 5. EQUIPMENT ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 6. MATERIALS AND SUPPLIES ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 7. OPERATING SERVICES Unit (dropdown) Unit description Rate per Unit Number of reoccurrences Cost Category Not Applicable Case Management Employment Admin Other ls on Indirect Cost Eligible where "No" was selected for the formula to calculate. 8. OTHER ls on Indirect Cost Eligible where "No" was selected ection was made, this will calculate under the "Not Applicable" section 9. INDIRECT COSTS 10. CLIENT DIRECT SERVICES/VOUCHERS Unit (dropdown) Unit description Rate per Unit Number of reoccurrences nd Total Contract Ceilings exact amount allocated. Agency: Maricopa County Department of Public Health Contract #: Contract Period: 1/1/2024-12/31/2024 Personnel Subtotal Employee Related Expenses Subtotal Total Cost $26,946.40 $4,041.96 $30,988.36 Amanda $7,329.76 $1,099.46 $8,429.22 Julian $7,869.12 $1,180.37 $9,049.49 Reggie $42,145.28 $6,321.79 $48,467.08 Rate of reoccurrence (dropdown) Total Cost Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $80.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 Other $100.00 $0.00 $0.00 $0.00 $0.00 L PROFESSIONAL AND OUTSIDE SERVICES: $2,520.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 TOTAL TRAVEL: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 TOTAL SPACE: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 TOTAL EQUIPMENT: $0.00 Rate of reoccurrence (dropdown) Total Cost Other $300.00 $0.00 TOTAL MATERIALS AND SUPPLIES: $300.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 TOTAL OPERATING SERVICES: $0.00 Rate of reoccurrence (dropdown) Total Cost Year $43,173.00 TOTAL OTHER SERVICES: $43,173.00 Total costs eligible for Indirects Indirect % Total Cost $ - 12.00% $0.00 $ - 12.00% $0.00 $ - 12.00% $0.00 $ 30,988.36 15.00% $4,648.25 $ 63,471.72 $0.00 TOTAL INDIRECT COSTS: $4,648.25 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 TOTAL CLIENT DIRECT SERVICES: $0.00 Total Cost Personnel $42,145.28 ERE $6,321.79 Professional & Outside Services $2,520.00 Travel $0.00 Space $0.00 Equipment $0.00 Materials & Supplies $300.00 Operating Services $0.00 Other $43,173.00 Indirect Costs $4,648.25 Client Direct Services/Vouchers $0.00 TOTAL COSTS: $99,108.33 Revenue: Total Cost ADES Refugee Program $99,108.33 TOTAL REVENUE: $99,108.33 Budget Check: Total Allocation $99,108.33 Total Revenue ADES Cost $99,108.33 (Should equal zero) $0.00 Agency: Contract #: Contract Period: Personnel Subtotal Employee Related Expenses Subtotal Total Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 $0.00 $0.00 $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 L PROFESSIONAL AND OUTSIDE SERVICES: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL TRAVEL: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL SPACE: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL EQUIPMENT: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL MATERIALS AND SUPPLIES: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL OPERATING SERVICES: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL OTHER SERVICES: $0.00 Total costs eligible for Indirects Indirect % Total Cost $ - $0.00 $ - $0.00 $ - $0.00 $ - $0.00 $ - $0.00 Additional Allocation 0 Original Allocation 0 TOTAL INDIRECT COSTS: $0.00 Rate of reoccurrence (dropdown) Total Cost $0.00 $0.00 Additional Allocation 0 Original Allocation 0 TOTAL CLIENT DIRECT SERVICES: $0.00 Additional Allocation Total Cost Personnel 0 $0.00 ERE 0 $0.00 sional & Outside Services 0 $0.00 Travel 0 $0.00 Space 0 $0.00 Equipment 0 $0.00 Materials & Supplies 0 $0.00 Operating Services 0 $0.00 Other 0 $0.00 Indirect Costs 0 $0.00 Direct Services/Vouchers 0 $0.00 TOTAL COSTS: 0 $0.00 Revenue:Additional Allocation Total Cost ADES Refugee Program 0 $0.00 TOTAL REVENUE: $0.00 $0.00 Budget Check:Additional Allocation Total Allocation Total Allocation 0 0 Total Revenue ADES Cost 0 0 (Should equal zero) 0 0