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									BUDGET - SUMMARY OF VDSS FUNDS AND MATCH FUNDS                                      APPENDIX ??

FROM _________ TO __________                               CONTRACTOR NAME: ___________________




                                          2-1-1 PROGRAM        TOTAL VDSS        TOTAL MATCH
 BUDGET CATEGORY                           COMPONENT            REQUEST            AMOUNT
 SALARIES                                                 $0                $0             $0
 EMP. BENEFITS                                            $0                $0             $0
 POSTAGE                                                  $0                $0             $0
 RENT & UTILITIES                                         $0                $0             $0
 EQUIPMENT                                                $0                $0             $0
 PRINTING                                                 $0                $0             $0
 CONSUMABLE SUPPLIES                                      $0                $0             $0
 TRAVEL                                                   $0                $0             $0
 HARDWARE                                                 $0                $0             $0
 SOFTWARE                                                 $0                $0             $0
 OTHER (ITEMIZED)                                         $0                $0             $0
 TOTAL REQUESTED FROM VDSS                                $0                $0             $0

                                                                                 PERCENT OF
                                                                 AMOUNT            BUDGET

 TOTAL REQUESTED FROM VDSS                                                  $0          #DIV/0!
 SUPPLIED FROM MATCH                                                        $0          #DIV/0!
 TOTAL PROJECT BUDGET                                                       $0          #DIV/0!




                                                                                          PAGE 1
SALARIES AND EMPLOYEE BENEFITS                                              APPENDIX ??
FROM ________ TO _________                            CONTRACTOR NAME: _________________
                                                           TOTAL % OF    TOTAL       AMOUNT
                                              TOTALHOURS    TIME ON     ANNUAL      REQUESTED
                          SALARIES             PER WEEK     PROJECT     SALARY      FROM VDSS
STAFF POSITION
1
2
3
4
5
6
7
8
9
10
11
12
13
14
TOTAL SALARIES REQUESTED FROM VDSS                                            $0            $0

                                                                         TOTAL
                     EMPLOYEE BENEFITS          STAFF        % OR       ANNUAL        VDSS
NAME OF BENEFIT                               POSITION #     RATE        COST        REQUEST
FICA                                                            7.65%          $0           $0
WORKER'S COMPENSATION                                                          $0           $0
OTHER - GROUP LIFE & DISABILITY                                                $0           $0
HEALTH INSURANCE                                                               $0           $0
PENSION/RETIREMENT                                                             $0           $0
OTHER - PAID LEAVE                                                             $0           $0
OTHER - ADMIN. OF FLEXIBLE BENEFITS                                            $0           $0
OTHER - DISABILITY INSURANCE                                                   $0           $0
UNEMPLOYMENT                                                                   $0           $0
TOTAL EMPLOYEE BENEFITS REQUESTED FROM VDSS                                                 $0




                                                                                          PAGE 2
                                               PERSONNEL EXPENSE FORM                                                     APPENDIX ??
FROM: _________ TO _________
CONTRACTOR: ___________________                                                                             FEDERAL ID# ____________

                                                                                                                     TOTAL
                   % OF                                                                                            MONTHLY
                 TIME ON                                                                         TOTAL  BENEFITS   EXPENSES
                 PROJEC    GROSS                                                                ANNUAL MONTHLY     (SALARY +
NAME AND TITLE      T      SALARY    ANNUAL    FICA        WORK. COMP LIFE INS.    HEALTH INS. BENEFITS EXPENSES   BENEFITS

1                    0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

2                    0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

3                    0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

4                    0%         $0        $0          $0             $0       $0           $0       $0        $0          $0


5                    0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

                     0%         $0        $0          $0             $0       $0           $0       $0        $0          $0

TOTALS                          $0        $0          $0             $0       $0           $0       $0        $0          $0




                                                                                                                               PAGE 3
OTHER PROPOSED EXPENSES                                                        APPENDIX ??

FROM _________ TO __________                            CONTRACTOR NAME: _________________
 LINE ITEM                           JUSTIFICATION                    PROPOSED VDSS FUNDS
                               (How Costs Were Determined)
 POSTAGE TOTAL:                                                                       $0.00

  Administrative                                                                      $0.00

  Program                                                                             $0.00
 RENT AND UTILITIES TOTAL:                                                            $0.00

  Rent                                                                                $0.00

  Utilities                                                                           $0.00

  Telephone                                                                           $0.00
 EQUIPMENT TOTAL:                                                                     $0.00

  Equipment Purchase                                                                  $0.00

  Equipment Rental                                                                    $0.00
 PRINTING TOTAL:                                                                      $0.00

  Administrative                                                                      $0.00

  Program
 CONSUMABLE SUPPLIES TOTAL:                                                           $0.00

  Office                                                                              $0.00

  Program                                                                             $0.00
 TRAVEL TOTAL:                                                                        $0.00

  Administrative                                                                      $0.00

  Program                                                                             $0.00

 Sub-Total                                                                            $0.00


                                                                                      PAGE 4
OTHER PROPOSED EXPENSES                                                           APPENDIX ??

FROM ________ TO _________                                CONTRACTOR NAME: _________________

 LINE ITEM                           JUSTIFICATION (continued)          PROPOSED VDSS FUNDS
                                      Balance Brought Forward                            $0.00
                                    (How Costs Were Determined)
 OTHER TOTAL:                                                                            $0.00
 Audit                                                                                   $0.00
 Computer Maintenance                                                                    $0.00
 Conferences/Meetings                                                                    $0.00
 Employment Advertising                                                                  $0.00

 Indirect Costs                                                                          $0.00
 Insurance                                                                               $0.00

 Membership Dues                                                                         $0.00
 Professional Fees                                                                       $0.00
 Subcontracts                                                                            $0.00
 Website Audit                                                                           $0.00

 SOFTWARE TOTAL:                                                                         $0.00
  IRis License                                                                           $0.00
  Desktop Software                                                                       $0.00
  File Server Software                                                                   $0.00
  Norton Anti-Virus                                                                      $0.00
  Other (specify)                                                                        $0.00




 TOTAL AMOUNT REQUESTED FROM VDSS                                                        $0.00




                                                                                         PAGE 5
BUDGET - MATCH DOCUMENTATION                                                           APPENDIX ??

FROM _________ TO ___________                       CONTRACTOR NAME: ___________________


 BUDGET
 CATEGORY              BRIEF DESCRIPTION   SOURCE     CASH        IN-KIND VALUE        TOTAL MATCH

 Salaries                                                                                       $0
 Employee
 Benefits                                                                                       $0

 Postage                                                                                        $0

 Rent and
 Utilities                                                                                      $0

 Equipment                                                                                      $0

 Printing                                                                                       $0
 Consumable
 Supplies                                                                                       $0

 Travel                                                                                         $0


 Hardware                                                                                       $0

 Software                                                                                       $0



 Other                                                                                          $0

 TOTAL AMOUNT SUPPLIED FROM MATCH                            $0                   $0            $0




                                                                                              PAGE 6

								
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