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HV12-009 Columbus NFP - Approved Budget by zhangyun


									COMMUNITY: Columbus, Georgia/Muscogee County

                                                  APPROVED BUDGET
                                               NURSE FAMILY PARTNERSHIP
PERSONNEL COSTS AND FRINGE BENEFITS: For each position, enter monthly wage and monthly fringe
benefits (health insurance, taxes, unemployment, life insurance, retirement plans). Enter %FTE (full time equivalent             BUDGET
applied to grant). Green cells will auto calculate for 12 months and then auto populate "Grant Request" amount.
                                                                          MONTHLY COST                 12 Months     12 Months
                  Name and Position Title                   Total Wages       Fringe   % FTE (Enter                   FRINGE
                                                              Earned         Benefits  as decimal)                   BENEFITS
1.   Nurse Supervisor                                         6,500            625         1.00         78,000       7,500       346,368
2.   4 Nurse Home Visitors                                    4,658            433         4.00        223,584       20,784
3.   Data Entry/Support                                       2,500            250         0.50         15,000       1,500
                                                                                Sub-Total              316,584       29,784
TRAVEL: List separately local and long distance travel. List staff person/consumer traveling, mileage rate, # of miles,
common carrier, reason for travel. List travel expenses associated with meetings, trainings, workshops.
                                                        Description                                                                Total
 1. Nurse Supervisor: required training anf travel out-of-town; NFP training, technical assistance, national training             11,100
 2. 4 Nurse Home Visitors: required training and travel out-of-town; NFP training, technical assistance, national training        23,200
 3. Administrator: required training and travel out-of-town; NFP training, technical assistance, national training                 5,100
 4. Professional development training and travel at state rate mileage/lodging/meals; NFP national training                        9,260
                                                                                                      Sub-Total                   48,660
SUPPLIES: List separately, office supplies, medical supplies, educational supplies. List how cost item contributes to
program's objectives/goals.
                                                          Description                                                               Total
1.   Office supplies including printing, postage, all types consumable materials used in operations for persons above             10,775
2.   Education supplies: NFP home visiting materials/support services                                                             11,050
3.   Medical supplies: for nurse supervisor and 4 nurse home visitors as required for NFP start-up                                 4,000
4.   NFP training materials and implementation supplies purchased from NFP vendor or national office                               2,145
5.   NFP techncial assistane and training                                                                                         14,310
                                                                                     Sub-Total                                    42,280
CONTRACTUAL: Provide explanation of purchase of each contract, how cost were estimated, deliverables, and how
contract contributes to program's objectives/goals.
                                                        Description                                                                Total
                                                                                              Sub-Total                             0
OTHER: All other costs that do not fit in any other budget category. For each cost provide justification and                     BUDGET
explanation of costs. If applicant does not have an approved federal indirect rate, rent, utilities and insurance.
                                                       Description                                                                 Total
 1.  IT Expenditures: 6 computers, 2 printer/scanner/copiers for NFP personnel                                                    9,400
2. NFP Measurement Tools                                                                                                          7,853
                                                                                                      Sub-Total                   17,253
INDIRECT COST: Applicable to applicants that have an approved federal direct cost rate                                           BUDGET
                                                        Description                                                                Total
1. Administrative Costs                                                                                                           43,000

                                                                                                                   TOTAL         497,561
                                                         Governor's Office for Children and Families
                                                               Contract Adjustment Notice
Contract #:
    GOCF Financial Review:                         Approved                Not-Approved
    GOCF Program Review:                           Approved                Not-Approved                            Contractor Authorizing Official:
    GOCF Financial Director:                       Approved                Not-Approved                                                               Signature   Email      Date
    GOCF Executive Director:                       Approved                Not-Approved

INSTRUCTIONS : Budget CAN should be submited by Email and U.S. mail to Financial Officer assigned to this grant. Program CAN should be submitted by Email and U.S. mail to the
Program Coordinator assigned to this contract. Notice must be given no less than 30 days before the proposed change(s) would be implemented. Provide description of change and
justification for change under "Description and Justification". GOCF will notify the grantee of its decision by email.

BUDGET ADJUSTMENT: Enter description and justification below. Prior approval of Budget Adjustment is required before implementation of Budget Adjustment. Email Approved Budget
with request for changes indicated in BLUE font.
                  Greater than 5% adjustment between budget categories
                  Change in percent of time applied (FTE%) to contract for staff; this action also requires a Program adjustment
                  Adding new contractual services; this action also requires a Program adjustment
                  Equipment or computer purchases exceeding $1,500 for a single item not approved in the original budget
                  But changes will not be allowed if the change would increase administrative cost greater than 10%

PROGRAM ADJUSTMENT: Enter description and justification below. Prior approval of Program Adjustment is required before implementation of Program Adjustment.
            Altering performance standards description or requirements
            Altering Program participant numbers
            Altering service delivery activities or changing the site of a service delivery activity
            Change in staff job description and/or percent of time applied (FTE %) to the program; this action also requires a budget adjustment
            Adding new contractual services; this action also requires a budget adjustment

                  Explain below. Change to administrative information: contact person, address, email, telephone, etc.

                                                                    ALLOWED COSTS
* Prorated share by program activity
          Budget Category                                                    Description
Personal Services                Regular salaries, FICA, Employee Benefits; permanent hourly labor, temporary/casual labor
                                 Supplies and materials, printing, publications, small equipment and furniture not on inventory, IT equipment and software, repairs and
Regular Operating                maintenance, rents other than real estate, insurance and bonding, lease of office equipment; meeting room expenses, travel (mileage,
                                 meals, lodging, transportation costs)
Equipment                        Office equipment, furniture, capitol >$5,000. Equipment is not an approved budget category for this grant program
IT Expenditures                  IT equipment, desktop computers, laptop, printer, scanner, IT supplies and materials, etc
Real Estate Rentals              *Pro-rated share of office space and utilities.
Voice/Data Communications        *Pro-rated share of telephone, internet charges, pagers, cell phones.
Contractual Services             Written formal agreements for purchase of services with consultants, state/local governments, private and non-profit agencies paid by
                                 per diem, fixed rate, cost reimbursement
          Type of Expense                                           Includes but not limited to                                                      Category
Advertising                      Cost to advertise, market program                                                                       Regular Operating
Audit                            *Pro-rated share of fees associated with performance of an audit                                        Regular Operating
Background Investigation         Background investigations (GCIC) on program staff and volunteers                                        Regular Operating
Client Benefits/Transportation   Child care services, cost to transport participants to direct service activities, etc.                  Regular Operating
Computer Software                Expense for prepackaged software                                                                        IT Expenditures
Computers, Laptops, Printers     Computers, laptops, printers, etc. If justified by grantee and approved by GOCF                         IT Expenditures
IT supplies and materials        Supplies and materials for IT                                                                           IT Expenditures
Consumer Support                 Consumer meetings/planning                                                                              Regular Operating
Contracts                        Agreements for delivery of services evidenced by a written agreement                                    Contractual Services
Equipment >$5,000                Equipment or capitol >$5,000 is an unallowed expense for the grant program                              Equipment >$5,000 (not allowed)
Equipment (office)               Equipment <$5,000 each item if justified and approved by GOCF                                           Regular Operating
Equipment Maintenance/Repairs    Contracts for maintenance of equipment and costs of repairs                                             Regular Operating
Evaluation                       Evaluation evidenced by written agreement (may not exceed 10% of base budget)                           Contractual Services
Fringe Benefits                  Benefits associated with employees, health insurance, FICA, etc.                                        Personal Services
Furniture                        Purchase of office furniture <$5,000 each item if justified by grantee and approved by GOCF             Regular Operating
Insurance/Bonding                Fidelity bonds on employees and hazard coverage on property                                             Regular Operating
Meetings                         Rental of meeting room, audio visual equipment, charts, etc and food/drinks for meeting.                Regular Operating
Per Diem and Fees                Fee for services, direct service provider fees                                                          Contractual Services
Postage                          Costs incurred in mailing materials                                                                     Regular Operating
Printing                         Letterhead stationery, imprinted envelopes, material for participants                                   Regular Operating
Salaries                         Employee wages; hourly or salaried; permanent or temporary                                              Personal Services
Scholarships                     Educational assistance                                                                                  Regular Operating
Subscriptions/Memberships        Subscription to job-related publications, memberships in organizations                                  Regular Operating
Supplies (Operations)            All types of consumable materials used in operations                                                    Regular Operating
Supplies (Program)               Curricula, workbooks, videos                                                                            Regular Operating
Telecommunications/Telephone     * Pro-rated share of telephone, internet charges, pagers, cell phones                                   Voice/Data Communications
Training/Conferences             Registration fees or tuition                                                                            Regular Operating
Travel                           Lodging, meals, use of vehicle for job-related activities mileage                                       Regular Operating
Rent and Utilities               *Pro-rated share of real estate rental and utilities (rent cannot be paid if the building is owned or   Real Estate Rentals
                                 have substantial financial interest by grantee or subgrantee)
                           UNALLOWED COSTS AND ACTIVITIES
                                           UNALLOWED COSTS

Acquisition of land
Bonus or commissions
Cost incurred outside the award period
Construction costs including capital improvements
Corporate formation
Grant preparation fee
Imputed interest charges (late fees)
Equipment or capitol exceeding $5,000
Federal employees' compensation and travel
Organized fundraising activities (e.g., campaigns, endowment drives, and solicitation of gifts), which
includes salary of any individual(s) engaged in direct fundraising activity for the organization. An
organization may engage in activity to "institutionalize" the GOCF-funded project for sustainability
purposes; however, GOCF funds may used for the purpose of raising funds to finance non-related grant
programs and/or complementary program activities.
Mileage rate may not exceed the travel policy as published by the State Accounting Office.,2095,39779022_138756285,00.html
Military-type equipment

                                         UNALLOWED ACTIVITIES

Direct services may not teach or promote religion
Supplanting funds: Federal funds must be used to supplement existing funds for direct service activities
and must not replace those funds that have been appropriated for the same purpose.

Commingling of funds: Physical segregation of cash depositions are not required, however, the accounting
system of all contractors and sub-contractors must ensure that agency funds are not commingled with
funds from other federal agencies. Each award must be accounted for separately. Commingling of funds
is prohibited on either a program-by-program or project-by-project basis.

Political activities including endorsement of any political candidate or party, use of machinery, equipment,
postage, stationary, or personnel on behalf of any candidate or any question of public policy subject to
referendum, in accordance with O.C.G.A.. 50-20-3(f)

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