Independent Medical Education Program Budget Proposal by LeePenny

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									        Home                                       Definitions                      Detailed Summary


                         Bristol Myers Squibb Global Grant Request Budget Tem



                                          Project Total      BMS Total
Program Costs - ESTIMATE                                                      Program Costs - RECONCILIATION
                                         $          -        $     -




  Please click on the Program Costs - ESTIMATE button to input the detailed       To qualify for final payment, reconciliatio
   budget breakdown. Workbook is protected. Please only edit text in blue.                                        after prog
ailed Summary                           Detailed Instructions


uest Budget Template



                                                BMS Total Variance
     RECONCILIATION
                                           $                                -




y for final payment, reconciliations must be submitted by the provider 90 days
                       after program completion
                                                                            INDEPENDENT MEDICAL EDUCATION PROGRAM
                                                                                      BUDGET PROPOSAL

                               Home                              Definitions                              Detailed Summary                           Detailed Instructions

ONLY EDIT TEXT IN BLUE


                                                                              Estimated Program Costs
Date of Grant Request:                                   (Enter Date)
Grant Requestor:                                         (Enter Name)                                         (Enter Contact Name)                               (Enter Phone Number)
Logistics Provider/Educational Partners:                 (Enter Name)                                         (Enter Contact Name)                               (Enter Phone Number)
Program Name:                                            (Enter Name)

Program Type (Select from Drop down list)                                                         if Other:


Program Objective:                                       (Enter Program Objective)


Audience:                                                (Enter Audience)
Program Location:                                        (Enter Location)
Program Dates:                                           Start Date:               (Enter Date)                                                                             End Date: (Enter Date)


                     Total Participants                     # of Attendees            # of Speakers                           # of Staff                                       Other (Please Specify)
                              0                                    0                         0                                       0                                            (Enter # of Other)
Note: Please complete only those line items relevant for this program
                                                                               US Program Development Costs
MANAGEMENT FEES                                               Hourly Rate                 Hours                      Total Cost            % BMS to Fund           BMS Total Cost           Description of Services
Program Development                                                           $0                         0                           $0              100%                           $0
Program Materials Development                                                 $0                         0                           $0              100%                           $0
Multimedia Development                                                        $0                         0                           $0              100%                           $0
Speaker Management                                                            $0                         0                           $0              100%                           $0
Speaker/Moderator Training                                                    $0                         0                           $0              100%                           $0
Recruiting Database/Telecommunication Setup                                   $0                         0                           $0              100%                           $0
Audience Generation Materials Development                                     $0                         0                           $0              100%                           $0
Audience Generation                                                           $0                         0                           $0              100%                           $0
On Site Content Project Management                                            $0                         0                           $0              100%                           $0
On Site Editorial Services                                                    $0                         0                           $0              100%                           $0
Logistic Management Fee                                                       $0                         0                           $0              100%                           $0
Writing/Editorial/Literature Review                                           $0                         0                           $0              100%                           $0
Other: (MUST specify in Column I, Description)                                $0                         0                           $0              100%                           $0
TOTAL MANAGEMENT FEES                                                    Project                         0                           $0               BMS                           $0
DIRECT PROGRAM EXPENSES                                        Unit Cost                 Units(#)                    Total Cost            % BMS to Fund           BMS Total Cost           Description of Services
Recruitment List Fee                                                          $0                         0                           $0              100%                           $0
Certification Fee                                                             $0                         0                           $0              100%                           $0
Accreditation Fee                                                             $0                         0                           $0              100%                           $0
Association Fee                                                               $0                         0                           $0              100%                           $0
Attendee Communications                                                       $0                         0                           $0              100%                           $0
Program Materials                                                             $0                         0                           $0              100%                           $0
Meeting Room                                                                  $0                         0                           $0              100%                           $0
Other Rooms (MUST specify in Column I, Description)                           $0                         0                           $0              100%                           $0

Attendee Breakfast                                                            $0                         0                           $0                   100%                      $0
Attendee Lunch                                                                $0                         0                           $0                   100%                      $0
Attendee Dinner                                                               $0                         0                           $0                   100%                      $0
Attendee Breaks                                                               $0                         0                           $0                   100%                      $0

Audio Visual (Equipment and Staff)                                            $0                         0                           $0                   100%                      $0

Speaker Travel                                                                $0                         0                           $0                   100%                      $0
Speaker Lodging                                                               $0                         0                           $0                   100%                      $0
Speaker Ground Transfers                                                      $0                         0                           $0                    25%                      $0
Faculty Meal (example Slide Review) Indicate Meal Type                        $0                         0                           $0                   100%                      $0

Staff Travel                                                                  $0                         0                           $0                   100%                      $0
Staff Lodging                                                                 $0                         0                           $0                   100%                      $0
Staff Ground Transfers                                                        $0                         0                           $0                   100%                      $0
Other Travel (MUST specify in Column I, Description)                          $0                         0                           $0                   100%                      $0

Printed Materials (/slide kits/CD-Rom, etc.)                                  $0                         0                           $0                   100%                      $0
Online Hosting/ Maintenance Fee                                               $0                         0                           $0                   100%                      $0
BRC / Invitations (If applicable include printing and
                                                                              $0                         0                           $0                   50%                       $0
postage)
Other (MUST specify in Column I, Description)                                 $0                         0                           $0                   100%                      $0
TOTAL DIRECT PROGRAM EXPENSES                                            Project                         0                           $0                    BMS                      $0
HONORARIA (MUST specify in Column I, Description)                 Fees             # of Speaker/Faculty              Total Cost            % BMS to Fund           BMS Total Cost           Description of Services
Speaker/Author/Editor Honorarium                                              $0                      0                              $0              100%                           $0
Other Honorarium                                                              $0                      0                              $0              100%                           $0
TOTAL HONORARIA                                                          Project                      0                              $0               BMS                           $0

TOTALS                                                                                                                                    Project Total                                  BMS Total
Total Management Fee                                                                                                                                                                $0                                      $0
Total Direct Program Expenses                                                                                                                                                       $0                                      $0
Total Honoraria                                                                                                                                                                     $0                                      $0

ESTIMATED REVENUE FROM FEES OR OTHER CHARGES                                             Unit Cost               Units (#)       Project Total                                              Description of Services
Registration Fees Charged for Participation                                                          $0                        0                                                    $0
                                                                         Worksheet is protected to keep users from removing formulas.
TOTAL ESTIMATED PROGRAM COST                                                                                                                                                        $0                                      $0


                                                                                                   METRICS
Cost Per Attendee                                                                                                             Project                                            BMS               Comments
MANAGEMENT FEES                                                                                                                 Calc                                             Calc
DIRECT PROGRAM EXPENSES                                                                                                         Calc                                             Calc
HONORARIA (MUST specify in Column I, Description)                                                                               Calc                                             Calc
TOTAL ESTIMATED PROGRAM COST                                                                                                    Calc                                             Calc



       US - Estimated Cost                                                                              Page 3of13                                                               46211e12-528f-433b-8d45-1cfc435a62e0.xls
      Home                Definitions          Detailed Summary


                             Program Development Costs
                                                Project Total
                          Totals
Management Fee
Direct Program Expenses
Honoraria

ESTIMATED PROGRAM COST
      Detailed Summary         Detailed Instructions


opment Costs
      Project Total           BMS Total

        $             -   $                 -
        $             -   $                 -
        $             -   $                 -

        $             -   $                 -
                                                                         INDEPENDENT MEDICAL EDUCATION PROGRAM
                                                                                FINAL COST RECONCILIATION

                                                            Reconciliation - Actual Program Costs
INSTRUCTIONS: Form is to be completed at program COMPLETION. Enter Actuals (highlighted in BLUE) and Reason for Variance only, except
where noted. The remainder of the form will self populate from the "Estimated Program Cost" Worksheet.
Grant ID#:                                              (Located on LOA)               Amount Awarded            (Located on LOA)

                                                    Attendees           Speakers             Staff            Other (Specify)                     Total
               Estimated Totals                         0                   0                  0                    0                              0
                  Actual Totals                                                                                                                    0
                    Variance                            0                   0                  0                    0                              0

MANAGEMENT FEES
Program Development                                 Hourly Rate        Actual Hours       Total Actual        Estimated Cost     Variance          Reason for Variance
Program Development                                               $0                  0                  $0               $0                $0
Program Materials Development                                     $0                  0                  $0                $0               $0
Multimedia Development                                            $0                  0                  $0                $0               $0
Speaker Management                                                $0                  0                  $0                $0               $0
Speaker/Moderator Training                                        $0                  0                  $0                $0               $0
Recruiting Database/Telecommunication Setup                       $0                  0                  $0                $0               $0
Audience Generation Materials Development                         $0                  0                  $0                $0               $0
Audience Generation                                               $0                  0                  $0                $0               $0
On Site Content Project Management                                $0                  0                  $0                $0               $0
On Site Editorial Services                                        $0                  0                  $0                $0               $0
Logistic Management Fee                                           $0                  0                  $0                $0               $0
Writing/Editorial/Literature Review                               $0                  0                  $0                $0               $0
Other: (MUST specify in Column I, Description)                    $0                  0                  $0                $0               $0
TOTAL MANAGEMENT FEES                                                                                    $0                $0               $0

DIRECT PROGRAM EXPENSES                              Unit Cost           Units(#)         Total Actual        Estimated Cost     Variance          Reason for Variance
Recruitment List Fee                                              $0                  0                  $0               $0                $0
Certification Fee                                                 $0                  0                  $0               $0                $0
Accreditation Fee                                                 $0                  0                  $0               $0                $0
Association Fee                                                   $0                  0                  $0               $0                $0
Attendee Communications                                           $0                  0                  $0               $0                $0
Program Materials                                                 $0                  0                  $0               $0                $0
Meeting Room                                                      $0                  0                  $0               $0                $0
Other Rooms (MUST specify in Column I,
                                                                  $0                  0                  $0                $0
Description)                                                                                                                                $0

Attendee Breakfast                                                $0                  0                  $0                $0               $0
Attendee Lunch                                                    $0                  0                  $0                $0               $0
Attendee Dinner                                                   $0                  0                  $0                $0               $0
Attendee Breaks                                                   $0                  0                  $0                $0               $0

Audio Visual (Equipment and Staff)                                $0                  0                  $0                $0               $0

Speaker Travel                                                    $0                  0                  $0                $0               $0
Speaker Lodging                                                   $0                  0                  $0                $0               $0
Speaker Ground Transfers                                          $0                  0                  $0                $0               $0
Faculty Meal (example Slide Review) Indicate
                                                                  $0                  0                  $0                $0
Meal Type                                                                                                                                   $0

Staff Travel                                                      $0                  0                  $0                $0               $0
Staff Lodging                                                     $0                  0                  $0                $0               $0
Staff Ground Transfers                                            $0                  0                  $0                $0               $0
Other Travel (MUST specify in Column I,
                                                                  $0                  0                  $0                $0
Description)                                                                                                                                $0

Printed Materials (/slide kits/CD-Rom, etc.)                      $0                  0                  $0                $0               $0
Online Hosting/ Maintenance Fee                                   $0                  0                  $0                $0               $0
BRC / Invitations (If applicable include printing
                                                                  $0                  0                  $0                $0
and postage)                                                                                                                                $0
Other (MUST specify in Column I, Description)                     $0                  0                  $0                $0
                                                                                                                                            $0
TOTAL DIRECT PROGRAM EXPENSES                                                                            $0                $0               $0

HONORARIA                                            Unit Cost           Units (#)        Total Actual        Estimated Cost     Variance          Reason for Variance
Speaker/Author/Editor Honorarium                                  $0                  0                  $0                $0               $0
Other Honorarium                                                  $0                  0                  $0                $0               $0
TOTAL HONORARIA                                                                                          $0                $0               $0

ESTIMATED REVENUE FROM FEES OR OTHER CHARGES                            Unit Cost          Units (#)                              Project Total   Description of Services
Registration Fees Charged for Participation                                          $0                   0                                 $0

TOTALS                                                                                    Total Actual         Original Cost     Variance
Total Management Fee                                                                                     $0                $0               $0
Total Direct Program Expenses                                                                            $0                $0               $0
Total Honoraria                                                                                          $0                $0               $0
TOTAL PROGRAM COST                                                                                       $0                $0 Incomplete
                                                                                                     Page 2 of 2                                                  ZN-I0095 Revised on 01/16/06
         Home   Definitions   Detailed Summary   Detailed Instructions




1 of 2




2 of 2
         Home                          Definitions



Management Fee Definitions
Program Development




Program Materials Development




Multimedia Development

Speaker Management




Speaker/Moderator Training



Recruiting Database/Telecommunication Setup

Audience Generation Materials Development
Audience Generation




On Site Content Project Management




On Site Editorial Services

Logistic Management Fee



Writing/Editorial/Literature Review

Other: (Please Specify)

Direct Program Expenses Definitions
Certification Fee

Accreditation Fee
Association Fee
               Detailed Summary                      Detailed Instructions




• Develop Program objectives with research and opinion leader consultation
• Develop clinical/ Program content
• Write, edit and update clinical content
• Conduct literature searches as necessary
• Liaise with faculty for purposes of content development


• Develop and design Program workbook, Speaker, moderator and field instruction
guides and evaluation form. It does not include logistics items such as name
badges, tent cards, welcome kits, copies of agenda, attendee lists, departure
notices, etc., which should be included in the Logistics Management Fee


• Develop and design program materials

• Recommend Speakers & other Participants
• Recruit Speakers & negotiate honorarium
• Moderation
• Schedule, confirm, & coordinate involovement of Speakers

• Recruit, schedule, confirm and coordinate involvement of Speakers
• Develop and execute training sessions with Speakers or moderators. Training
cost does NOT include Speaker fees
• Develop, manage and maintain Speaker and attendee database

• Develop and design invitation letters and brochures 

• Develop and design of invitation letters and brochures
• Develop Speaker and attendee list Company and B-MS sources and purchase of
additional lists, as required
• Manage and execute invitation mailing or other type of audience generation
materials Execution of mailings should be administrative
• Manage and execute confirmation and follow-up mailing and/or tele-recruiting
Execution of mailings should be administrative

• Manage production of program materials; coordinate effectively to ensure
successful & timely execution within budget
• Ensure set-up, coordination & payment of venue
• Manage & coordinate AV needs
• Coordinate overall event

• Editorial assistance on-site to coordinate any required on-site editorial input

• Management of Logistics items such as name badges, tent cards, welcome
kits, copies of agenda, attendee lists, departure notices, etc.


• Medical Editor executes reviews

• Any other Management Fee not represented by the provided categories


Printing and mailing costs for preparation and distribution of CME certificates.

CME accredited provider's expenses for managing program in accordance with the
requirements and guidelines of the applicable accrediting body, including
management of faculty disclosures, review of program materials, preparation and
maintenance of required records, etc.
Hosting fee charged by a medical or professional association in connection with a
satellite symposium or similar educational activity to be held during a meeting or
conference sponsored by the association

								
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