Org Chart for Profit Organizations by njf11265

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									        Name of Organization:                                                                               Exhibit A
               Project Name:

                                         Other Funding Sources
   Identify all sources of funding by organization or donor and amount of funds that are
   anticipated to be utilized for this program. These funding sources should correspond with your
   proposed budget (Exhibit B). Leveraging and matching funds are not required but are highly
   encouraged as CDBG funds are not intended to provide ongoing support.


Source of Funds                      Type of Funds:               Amount of Funds            Funding Status
(organization/agency name)           (i.e., CDBG, HOME, ESG,      (list amount received or   (i.e., cash on hand, grant
                                     HOPWA, Other Federal         anticipated)               awarded, etc.) Committed,
                                     Funds, State/Local, Private,                            Pending, and Not yet
                                     fees, contributions, special                            requested
                                     events, volunteers, Other…)


City of Turlock
                                    Federal CDBG funds                                       Pending
Public Service Grant funds




Total funding sources for this project should                      $                  -      This total should equal your
match detailed budget (Exhibit B)                                                            program budget total.




City of Turlock-Housing Program Services                                                            Other Funding Sources
CDBG Public Service Grant Application Fiscal Year 2011-2012                                                      Exhibit A
Name of Organization:                                                                                Exhibit B
Project Name:
                                                          Budget
Please fill out the form below noting the total amount of funding requested for each line item. The amounts
indicated should equal the funding requested. The total amount in the "Other Funding" column should equal the
total funding required to carry out the program as listed under "Other Funding Sources" Exhibit A. Specific details
of Project Costs are required. You will be required to follow each line item amount detailed in this budget in your
draw requests.

Do not add or change any line items listed

                           Line Item                                CDBG           Other Funding       Program Total
1. Personnel Costs:
 a. Salaries-List Positions below:                                                                                    -




                                                                                                                      -
 b. Benefits and taxes (Fringe)                                                                                       -
                                                         Subtotal           -                   -                     -
2. Non-Personnel Costs:
 a. Rent/Lease of Space (for program only):                                                                           -
 b. Janitorial: (Cleaning supplies, toilet paper, ...)                                                                -
 c. Utilities: (gas, electric, water)                                                                                 -
 d. Telephone/Internet Services:                                                                                      -
 e. Insurance-Specify types:                                                                                          -
 f. Supplies (office only):                                                                                           -
 g. Postage/Shipping:                                                                                                 -
 h. Rental/Maintenance Equipment:                                                                                     -
 i. Audit:                                                                                                            -
 j. Automobile/Transportation/Mileage:                                                                                -
 k. Staff Training/Conferences:                                                                                       -
 l. Subcontracts (be specific):________________                                                                       -
 m. Professional Fees: _______________________                                                                        -
 n. Other (be specific):_______________________                                                                       -
 o. Other (be specific):_______________________                                                                       -
                                                         Subtotal           -                   -                     -
3. Project costs (not already listed above):
 a. Project costs description: Food

                                                                                                                      -
 b. Project costs description: Supplies (non-office):
Example: Paper plates/cups, paper napkins, plastic utensils,
plastic servig gloves, ...                                                                                            -
 c. Project costs description (be specific):

                                                                                                                      -
                                                         Subtotal           -                   -                     -

                                                  Grant Totals              -                   -                     -


City of Turlock-Housing Program Services                                                                         Budget
CDBG Public Service Grant Application Fiscal Year 2011-2012                                                   Exhibit B
      Name of Organization:                                                                               Exhibit C
               Project Name:

                                          Personnel Information
Complete the following personnel chart, including volunteers and contracted employees. Attach copies of job
descriptions of the individuals that will be involved with the implementation of the project to this exhibit. Each of these
components must be present for Exhibit C to be considered complete.


                                 Position Type                      Total Hours
                                                     Pay Rate                        Total Cost to        Total Cost of
         Position Title
                                  (direct service,                   Per Month
                                                     (Hourly with                    Program (per         CDBG Funds
                                  admin support,                       (for the
                                                       Fringe)                           month)             (per month)
                                        etc.)                         program)
 1                                                                                                $0.00
 2                                                                                                $0.00
 3                                                                                                $0.00
 4                                                                                                $0.00
 5                                                                                                $0.00
 6                                                                                                $0.00
 7                                                                                                $0.00
 8                                                                                                $0.00
 9                                                                                                $0.00
10                                                                                                $0.00
11                                                                                                $0.00
12                                                                                                $0.00
13                                                                                                $0.00
14                                                                                                $0.00
15                                                                                                $0.00
16                                                                                                $0.00
17                                                                                                $0.00
18                                                                                                $0.00
19                                                                                                $0.00
20                                                                                                $0.00
                                                                                                  $0.00
                                                              Monthly Totals:                   $0.00               $0.00

                                                         (Monthly Totals above multiplied by 12 months-auto calculated)
                                   Yearly Totals Year Round Program:                            $0.00               $0.00


                                                                    (If your program is seasonal enter revised totals here)
                     Adjusted Yearly Totals for Seasonal Program:                              $0.00               $0.00




     City of Turlock-Housing Program Services                                                          Personnel Information
     CDBG Public Service Grant Application Fiscal Year 2011-2012                                                 Exhibit C

								
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