sample budget by s60fx45Y


									                             SAMPLE BUDGET & BUDGET NARRATIVE

XYZ Hospital                                                        Type of Grant
Contact Person                                                             RFP#
Address                                                                    Date
Phone Number

Itemized List                 Support Requested             Other Contributions

1. Staff                      $10,000                       $ 5,000
2. Fringe benefits @15%       $ 1,500                       $ 750
3. 2 computers/1 printer                                    $ 6,500
4. Professional dev/travel    $ 2,500
Sub totals:                   $14,000                       $12,250

Total project cost:                                         $26,250

Budget Narrative:
The _________ hospital is making application to The North Dakota Rural Hospital Flexibility Program for the
funding period ______________ to _________________ and the budget is in the amount of $26,250.

Mary Jones, BSW, community organizer, will coordinate the implementation of community meetings, survey
development and dissemination, and fundraising activities. She will provide .5 FTE based on an annual salary
of $30,000. Funds in the amount of $15,000 are requested.

Fringe benefits:
Fringe benefits for the above mentioned position are estimated at 15 percent. Actual benefits will be charged to
the project. The amount of $1,500 is requested for fringe benefits.

Funds are not requested to cover supplies but will be provided as the hospital’s in-kind contribution toward this
project. Two computers (2@$2,500) and one printer ($1,500) will be purchased for a total of $6,500. This
equipment will be used by the community organizer and her administrative assistant.

Professional development/travel:
Funds in the amount of $2,500 are requested for training and travel purposes. The community organizer will
travel to Washington, DC in October, 2006 to attend a 3-day national training event for community
development specialists. Air travel, registration, lodging, meals and material total $2,500.

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