Page Community and Economic Development Programs Community Services Block Grant Budget Summary
1. Applicant Agency 5. a. Number 2. Date Submitted 3. Contract End Date
of
Pages
4. Contract No.
PROGRAM ACCOUNT
b. Name 6. COST CATEGORY Contact Person c. Beginning d. Ending PROJECTED EXPENDITURES (c) (d) Second Quarter Third Quarter
Number 1. 1.1 1.2 1.3 2. 2.1 2.2 2.3 2.4 2.5
Name Personnel Costs Salaries and Wages Fringe Benefits Consultants and Contract Services Non-Personnel Costs Travel Space Costs and Rental Consumable Supplies Rental, Lease of Equipment Other Costs
(a) Total
(b) First Quarter
(e) Fourth Quarter
TOTAL COSTS
CS Form 25
Total Contract Amount
(P.A. 01+ P.A. 05) ____________________________
ADECA/CSBG Revised 2006
Page Community and Economic Development Programs Community Services Block Grant Budget Summary
of
Pages
Program Account No._________________ Name ___________________________ Beginning ____________ Ending ____________
Cost Category Number 1.3 Cost Category DESCRIPTION OF ITEM AND BASIS FOR VALUATION CONSULTANTS and (1) Audit fees (estimates by CPA) CONTRACT SERVICES (2) Computer Services – Payrolls, etc. (1) Staff Local Miles@__________¢ per mile TRAVEL (2) Out-of-Area: Per Diem days@$______per day (3) Board – Local___________Miles@_________¢ per mile (4) Out - of -Area: days @$_________ per day (5) Staff: Public Transportation Fares (plane, train, bus, etc.) (6) Board: Public Transportation Fares (plane, train, bus, etc.) SPACE COST (1) Office space $__________ per month x__________months and RENTALS (2) Other (list) CONSUMABLE (1) Office supplies and postage $___________per month x_________ months SUPPLIES (2) Printing and reproduction $____________per month x_________months RENTAL PURCHASE LEASE (1)________Office machines, typewriters, etc.@ OF EQUIPMENT per month x_________ months (2) Copiers@$_________per month x_________months Amount Total
2.1
2.2 2.3
2.4
2.5
OTHER(1) Telephones $____________per month x____________months COSTS (2) Utilities $___________per month x___________months (3) Insurance and Bonding $_________per month x_______ months (4) Transportation (participants) $______per month x_______months
TOTALS (Transfer Category Totals to Budget Summary Sheet)
CSBG Form 25 N
ADECA/CSBG Revised 2006
Community and Economic Development Programs Community Services Block Grant Budget Support Sheet Salaries and Fringe Benefits 1. Applicant Agency
5.
2. Date Submitted
PROGRAM ACCOUNT
Page _______ of _______ Pages 3. Contract End Date 4. Contract No.
a. Number
b. Name
BUDGET SUPPORT DATA Circle Circle % Monthly or No. of of Hourly Months Time Rate or Hours
c. Beginning
Contract Amount (Nearest $)
d. Ending
No. Persons
Title or Position
Annualized Salary
Fringe Benefits (Employer’s Share Only)
Cost Basis for FICA Computation $ __________ FICA _______ FICA _______ UC Actual Ins. Actual Ret. Actual Other: List __________ __________ __________ __________ __________ __________ __________ __________
__________ __________ __________
Total Fringe Benefits $ __________ Cost Category 1.2 Budget Summary
TOTAL SALARIES (COST CATEGORY 1.1 BUDGET SUMMARY) CS Form 25-P
ADECA/CSBG Revised 2006
Page _____ of _____ Pages Community and Economic Development Programs Community Services Block Grant Budget Summary This form should be used for items which cannot be adequately explained On CS Form 25-N (For example: 2.5 Emergency Assistance). DESCRIPTION OF ITEM AND BASIS FOR VALUATION
Cost Category Number
Cost Item Amount
Cost Category Total
CS Form 25-P
ADECA/CSBG Revised 2006