| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 1 of 3)
BFM-8 (11/98)
| Contractor Name: | |
| Contractor Contract Person: | Telephone: |
| Expenditure Item | Amount | |
|---|---|---|
| Line 1 | Personal Service |
$ |
| Line 2 | Fringe Benefits |
|
| Line 3 | General Operating |
|
| Line 4 | (Sum of Lines 1,2 and 3) TOTAL DIRECT COSTS –> | $ |
| Line 5 | Indirect Cost Rate |
% |
| Line 6 | Indirect Cost |
|
| Line 7 | Equipment |
|
| Line 8 | Purchased Services |
|
| Line 9 | (Sum of Lines 4, 6, 7 and 8) TOTAL EXPENSES –> | $ |
| Revenue | Amount |
|
| 1. | $ | |
| 2. | ||
| Line 10 | TOTAL REVENUE –> | $ |
| Net Budgeted Operating Costs | Amount | |
| Line 11 | (Line 9 minus Line 10) NET BUDGETED OPERATING COSTS –> |
$ |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 2 of 3)
Contractor Name: _______________________________________
| Section 1: Direct Operating Personal Service Listing | |||||||||||||
| Title | Social Security Number (if available) |
Annual Salary | % Time Allocated to Program | Salary Allocated to Program | |||||||||
|
|||||||||||||
| Section II: General Operating Expenses | |||||
| Item | Cost Item | Amount | Item | Cost Item | Amount |
| 1. | Insurance | $ | 10. | Travel-Staff Out/State | $ |
| 2. | Building Main. & Repair | 11. | Utilities | ||
| 3. | Office Supplies | 12. | Vehicles-Oper. Expenses | ||
| 4. | Program Supplies | 13. | Staff Training | ||
| 5. | Telephone | 14. | Advertising | ||
| 6. | Rent | 15. | Printing | ||
| 7. | Travel-Staff in State | 16. | |||
| 8. | Contractual Svcs | 17. | |||
| 9. | Dues & Subscriptions | 18. | Total
G/O Expenses –> (To Budget Summary, Line 3) |
$ | |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 3 of 3)
Contractor Name: _______________________________________
| Section III: Equipment Purchases | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Equipment Purchases (To Budget Summary, Line 7) –> |
$ | |
| Section IV: Purchased Services | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Purchased Services (To Budget Summary, Line 8) –> |
$ | |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 1 of 3)
BFM-8 (11/98)
| Contractor Name: | |
| Contractor Contract Person: | Telephone: |
| Expenditure Item | Amount | |
|---|---|---|
| Line 1 | Personal Service |
$ |
| Line 2 | Fringe Benefits |
|
| Line 3 | General Operating |
|
| Line 4 | (Sum of Lines 1,2 and 3) TOTAL DIRECT COSTS –> | $ |
| Line 5 | Indirect Cost Rate |
% |
| Line 6 | Indirect Cost |
|
| Line 7 | Equipment |
|
| Line 8 | Purchased Services |
|
| Line 9 | (Sum of Lines 4, 6, 7 and 8) TOTAL EXPENSES –> | $ |
| Revenue | Amount |
|
| 1. | $ | |
| 2. | ||
| Line 10 | TOTAL REVENUE –> | $ |
| Net Budgeted Operating Costs | Amount | |
| Line 11 | (Line 9 minus Line 10) NET BUDGETED OPERATING COSTS –> |
$ |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 2 of 3)
Contractor Name: _______________________________________
| Section 1: Direct Operating Personal Service Listing | |||||||||||||
| Title | Social Security Number (if available) |
Annual Salary | % Time Allocated to Program | Salary Allocated to Program | |||||||||
|
|||||||||||||
| Section II: General Operating Expenses | |||||
| Item | Cost Item | Amount | Item | Cost Item | Amount |
| 1. | Insurance | $ | 10. | Travel-Staff Out/State | $ |
| 2. | Building Main. & Repair | 11. | Utilities | ||
| 3. | Office Supplies | 12. | Vehicles-Oper. Expenses | ||
| 4. | Program Supplies | 13. | Staff Training | ||
| 5. | Telephone | 14. | Advertising | ||
| 6. | Rent | 15. | Printing | ||
| 7. | Travel-Staff in State | 16. | |||
| 8. | Contractual Svcs | 17. | |||
| 9. | Dues & Subscriptions | 18. | Total
G/O Expenses –> (To Budget Summary, Line 3) |
>$ | |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 3 of 3)
Contractor Name: _______________________________________
| Section III: Equipment Purchases | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Equipment Purchases (To Budget Summary, Line 7) –> |
$ | |
| Section IV: Purchased Services | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Purchased Services (To Budget Summary, Line 8) –> |
$ | |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 1 of 3)
BFM-8 (11/98)
| Contractor Name: | |
| Contractor Contract Person: | Telephone: |
| Expenditure Item | Amount | |
|---|---|---|
| Line 1 | Personal Service |
$ |
| Line 2 | Fringe Benefits |
|
| Line 3 | General Operating |
|
| Line 4 | (Sum of Lines 1,2 and 3) TOTAL DIRECT COSTS –> | $ |
| Line 5 | Indirect Cost Rate |
% |
| Line 6 | Indirect Cost |
|
| Line 7 | Equipment |
|
| Line 8 | Purchased Services |
|
| Line 9 | (Sum of Lines 4, 6, 7 and 8) TOTAL EXPENSES –> | $ |
| Revenue | Amount |
|
| 1. | $ | |
| 2. | ||
| Line 10 | TOTAL REVENUE –> | $ |
| Net Budgeted Operating Costs | Amount | |
| Line 11 | (Line 9 minus Line 10) NET BUDGETED OPERATING COSTS –> |
$ |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 2 of 3)
Contractor Name: _______________________________________
| Section 1: Direct Operating Personal Service Listing | |||||||||||||
| Title | Social Security Number (if available) |
Annual Salary | % Time Allocated to Program | Salary Allocated to Program | |||||||||
|
|||||||||||||
| Section II: General Operating Expenses | |||||
| Item | Cost Item | Amount | Item | Cost Item | Amount |
| 1. | Insurance | $ | 10. | Travel-Staff Out/State | $ |
| 2. | Building Main. & Repair | 11. | Utilities | ||
| 3. | Office Supplies | 12. | Vehicles-Oper. Expenses | ||
| 4. | Program Supplies | 13. | Staff Training | ||
| 5. | Telephone | 14. | Advertising | ||
| 6. | Rent | 15. | Printing | ||
| 7. | Travel-Staff in State | 16. | |||
| 8. | Contractual Svcs | 17. | |||
| 9. | Dues & Subscriptions | 18. | Total
G/O Expenses –> (To Budget Summary, Line 3) |
>$ | |
| Orig Agency Code | Contract Number | |
| 11000 |
Appendix B
Budget Summary (Page 3 of 3)
Contractor Name: _______________________________________
| Section III: Equipment Purchases | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Equipment Purchases (To Budget Summary, Line 7) –> |
$ | |
| Section IV: Purchased Services | ||
|---|---|---|
| Item / Description | Amount | |
| A. | $ | |
| B. | ||
| C. | ||
| Total
Purchased Services (To Budget Summary, Line 8) –> |
$ | |
| Budget Totals Year 1 |
Projected Budget Totals YEAR 2 |
Projected Budget Totals YEAR 3 |
Three Year Totals |
|
|---|---|---|---|---|
| Personal Service | ||||
| Fringe Benefits | ||||
| General Operating Expenses | ||||
| Total Direct Costs | ||||
| Indirect Cost Rate | ||||
| Indirect Costs | ||||
| Equipment Purchases | ||||
| Purchased Services | ||||
| GRAND TOTAL |
| Vendor Signature | Date: |
| Printed Name | |
| Title | |
| Contractor Name | |
| Contractor Address |