**Appendix C -Sample Budget and Justification**

**ILLUSTRATION OF A SAMPLE DETAILED BUDGET AND NARRATIVE JUSTIFICATION
FOR COMPLETING SF 424A: SECTION B FOR 01 BUDGET PERIOD**

**(Sample for 1^st^ year of the funding cycle)**

[**A. Personnel**:]{.underline} an employee of the applying agency whose
work is tied to the application

# FEDERAL REQUEST

  -------------- ----------- ------------------- ------------- -----------
  Position       Name        Annual Salary/Rate  Level of      Cost
                                                 Effort        

  Executive      John Doe    \$64,890            5%            \$3,245
  Director                                                     

  Coordinator    To be       \$46,276            25%           \$11,569
                 selected                                      

  Development    Sarah Smith \$35,000            25%           \$8,750
  Specialist                                                   

                                                 TOTAL         \$23,564
  -------------- ----------- ------------------- ------------- -----------

**JUSTIFICATION**: **Describe the role and responsibilities of each
position.**

# 

# NON-FEDERAL MATCH

  -------------- ----------- ------------------- ------------- -----------
  Position       Name        Annual Salary/Rate  Level of      Cost
                                                 Effort        

  Peer Helper    Ron Jones   \$23,000            15%           \$3,450

  Clerical       Susan       \$13.38/hr x 100                  \$1,338
  Support        Johnson     hr.                               

                                                 TOTAL         \$4,788
  -------------- ----------- ------------------- ------------- -----------

**JUSTIFICATION:** **Describe the role and responsibilities of each
position.**

**FEDERAL REQUEST** (enter in Section B column 1 line 6a of form SF424A)
**\$23,564**

# NON-FEDERAL MATCH (enter in Section B column 2 line 6a of form SF424A) \$4,788 

**[B. Fringe Benefits]{.underline}**: List all components of fringe
benefits rate

# FEDERAL REQUEST

  --------------------- ------------------ ------------------- -----------
  Component             Rate               Wage                Cost

  FICA                  7.65%              \$23,564            \$1,803

  Workers Compensation  2.5%               \$23,564            \$589

  Insurance             10.5%              \$23,564            \$2,474

                                           TOTAL               \$4,866
  --------------------- ------------------ ------------------- -----------

# NON-FEDERAL MATCH

  --------------------- ------------------ ------------------- -----------
  Component             Rate               Wage                Cost

  FICA                  7.65%              \$4,788             \$366

  Workers Compensation  2.5%               \$4,788             \$120

  Insurance             10.5%              \$4,788             \$503

                                           TOTAL               \$989
  --------------------- ------------------ ------------------- -----------

**JUSTIFICATION**: **Fringe reflects current rate for agency.**

**FEDERAL REQUEST** (enter in Section B column 1 line 6b of form SF424A)
**\$4,866**

# NON-FEDERAL MATCH (enter in Section B column 2 line 6b of form SF424A) \$989

[**C. Travel:**]{.underline} Explain need for all travel other than that
required by this application. Local travel policies prevail.

# 

# FEDERAL REQUEST

  -------------- --------------- ------------- ------------------ ---------
  Purpose of     Location        Item          Rate               Cost
  Travel                                                          

  SAMHSA         Washington, DC  Airfare       \$200/flight x 6   \$1,200
  Meetings                                     persons            

                                 Hotel         \$180/night x 6    \$2,160
                                               persons x 2 nights 

                                 Per Diem      \$46/day x 6       \$828
                                 (meals)       persons x 3 days   

                                                                  

                                                                  

  Local travel                   Mileage       3,000              \$1,140
                                               miles@.38/mile     

                                               TOTAL              \$6,453
  -------------- --------------- ------------- ------------------ ---------

JUSTIFICATION: Describe purpose of travel and how costs were determined.

**NON-FEDERAL MATCH**

  -------------- --------------- ------------- ------------------ ---------
  Purpose of     Location        Item          Rate               Cost
  Travel                                                          

  Meetings       Chicago, IL     Airfare       \$150/flight x2    \$750
                                               persons            

                                 Hotel         \$155/night x 5    \$1,550
                                               persons x 2 nights 

                                 Per Diem      \$46/day x 5       \$460
                                 (meals)       persons x 2 days   

  Local Travel   Group meetings  Mileage       3,000miles x       \$1,140
                                               .38/mile           

                                               TOTAL              \$3,900
  -------------- --------------- ------------- ------------------ ---------

**JUSTIFICATION: Describe purpose of travel and how costs were
determined.**

**FEDERAL REQUEST** (enter in Section B column 1 line 6c of form SF424A)
**\$6,453**

# NON-FEDERAL MATCH (enter in Section B column 2 line 6c of form SF424A) \$3,900

[**D. Equipment**:]{.underline} an article of tangible, nonexpendable,
personal property having a useful life of more than one year and an
acquisition cost of \$5,000 or more per unit -- federal definition.

> **List Individually**

**FEDERAL REQUEST** -- (enter in Section B column 1 line 6d of form
SF424A) **\$ 0**

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6d of form
SF424A) **\$ 0**

**[E. Supplies:]{.underline}** materials costing less that \$5,000 per
unit and often having one-time use

# FEDERAL REQUEST

  ----------------------- ----------------------- -----------------------
  Item(s)                 Rate                    Cost

  General Supplies                                \$360

  Postage                 \$37/mo. x 12 mo.       \$444

  Meeting supplies        \$10/meeting x 26       \$260
                          meetings                

  Copies                  8000 copies x .10/copy  \$800

                          TOTAL                   \$1,864
  ----------------------- ----------------------- -----------------------

**JUSTIFICATION: Describe need and include explanation of how costs were
estimated.**

# NON-FEDERAL MATCH

  ----------------------- ----------------------- -----------------------
  Item(s)                 Rate                    Cost

  Postage                                         \$2,220

                          TOTAL                   \$2,220
  ----------------------- ----------------------- -----------------------

**JUSTIFICATION: Describe need and include explanation of how costs were
estimated.**

**FEDERAL REQUEST** -- (enter in Section B column 1 line 6e of form
SF424A) **\$ 1,864**

**NON-FEDERAL MATCH** - (enter in Section B column 2 line 6e of form
SF424A) **\$ 2,220**

**[F. Contract:]{.underline}** generally amount paid to non-employees
for services or products. A consultant is a non-employee who provides
advice and expertise in a specific program area.

**FEDERAL REQUEST** (Consultant)

  -------------- ---------------- ----------- -------------- --------------
  Name           Service          Rate        Other          Cost

  To be selected Evaluator        \$150/day   15 days        \$2,250

                 Travel           .38/mile    462 miles      \$176

                                              TOTAL          \$2,426
  -------------- ---------------- ----------- -------------- --------------

**JUSTIFICATION:** **Explain the need for each consultant agreement and
how they relate to the overall project.**

**FEDERAL REQUEST** (Contract)

  ----------------------- ---------------------------------- ------------
  Entity                  Product/Service                    Cost

  To be selected          Evaluation                         \$10,000

  To be selected          Travel (Per diem-\$52 per day x 2  \$844
                          days; hotel -\$120/per day x 2     
                          days; airfare - \$500 RT           

                          TOTAL                              \$10,844
  ----------------------- ---------------------------------- ------------

**JUSTIFICATION: Explain the need for each contractual agreement and how
they relate to the overall project.**

**NON-FEDERAL MATCH** (Consultant)

  --------------- -------------- ------------- -------------------- ----------
  Name            Service        Rate          Other                Cost

  To Be selected  Evaluation     \$17.50/hr.   5 days x 8 hrs/day x \$3,500
                                               5 participants x     
                                               \$17.50/hr.          

                                                                    

                                                                    

                                                                    

                                               TOTAL                \$ 3,500
  --------------- -------------- ------------- -------------------- ----------

**JUSTIFICATION:** **Explain the need for each agreement and how they
relate to the overall project.**

**NON-FEDERAL MATCH** (Contract)

  ----------------------- ----------------------- -----------------------
  Entity                  Product/Service         Cost

  To be selected          \$300 x 5 groups        \$1,500

                          TOTAL                   \$1,500
  ----------------------- ----------------------- -----------------------

**JUSTIFICATION:** **Explain the need for each agreement and how they
relate to the overall project.**

# FEDERAL REQUEST -- (enter in Section B column 1 line 6f of form SF424A) \$ 13,270

(combine the total of consultant and contact)

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6f of form
SF424A) **\$ 5,000**

(combine the total of consultant and contact)

**[G. Construction:]{.underline}** **NOT ALLOWED -** Leave Section B
columns 1&2 line 6g on SF424A blank

**[H. Other:]{.underline}** expenses not covered in any of the previous
budget categories

# FEDERAL REQUEST

  ----------------- ------------------------ -----------------------------
  Item              Rate                     Cost

  telephones        \$200 x 12 months        \$ 2,400

  Brochures         .89/brochure X 10,000    \$ 8,900
                    brochures                

                    TOTAL                    \$ 11,300
  ----------------- ------------------------ -----------------------------

JUSTIFICATION: Breakdown cost requested. Explain the use of each item
requested.

# 

# NON-FEDERAL MATCH

  ----------------- ------------------------ -----------------------------
  Item              Rate                     Cost

  Printing          \$300/run x 5 runs       \$1,500

                                             

                                             

                                             

                                             

                    TOTAL                    \$ 1,500
  ----------------- ------------------------ -----------------------------

**JUSTIFICATION:** **Breakdown costs**. **Explain the use of each
item.**

# FEDERAL REQUEST -- (enter in Section B column 1 line 6h of form SF424A) \$ 11,300

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6h of form
SF424A) **\$ 1,500**

**[Indirect cost rate:]{.underline}**

**FEDERAL REQUEST** (enter in Section B column 1 line 6j of form SF424A)

**15% of Salary and Wages (copy of negotiated indirect cost rate
agreement attached) \$3,534**

**NON-FEDERAL MATCH** (enter in Section B column 2 line 6j of form
SF424A)

15% Salary and Wages **\$718**

**[BUDGET SUMMARY]{.underline}**

  ----------------- ----------------- ----------------- -----------------
  **Category**      **Federal         **Non-Federal     **Total**
                    Request**         Match**           

  Personnel         \$23,564          \$4,788           \$28,352

  Fringe            \$4,866           \$989             \$5,855

  Travel            \$5,328           \$3,900           \$10,353

  Equipment         0                 0                 0

  Supplies          \$1,864           \$2,220           \$4,084

  Contractual       \$13,270          \$5,000           \$18,270

  Other             \$11,300          \$1,500           \$12,800

  Total Direct      \$60,192          \$18,397          \$78,589
  Costs\*                                               

  Indirect Costs    \$2,274           \$462             \$2,736

  Total Project     \$62,466          \$18,859          \$81,325
  Costs                                                 
  ----------------- ----------------- ----------------- -----------------

## TOTAL PROJECT COSTS : Sum of Total Direct Costs and Indirect Costs

**FEDERAL REQUEST** (enter in Section B column 1 line 6k of form SF424A)
**\$62,466**

**NON-FEDERAL MATCH** (enter in Section B column 2 line 6k of form
SF424A) **\$18,859**

**[CALCULATION OF FUTURE BUDGET PERIODS]{.underline}**

**[(based on first 12-month budget period)]{.underline}**

Input, review and verify the accuracy of your 2^nd^ and 3^rd^ year
budget estimates. Increases or decreases in the future years must be
explained and justified.

Total federal share is not to exceed \$75,000in any year.

+-----------------------+----------+-----------+---------+-----------+
|                       | **F      | **Match** | **Fe    | **Match** |
|                       | ederal** |           | deral** |           |
+-----------------------+----------+-----------+---------+-----------+
| **Personnel**         |          |           |         |           |
+-----------------------+----------+-----------+---------+-----------+
| -   Executive         | \$3,245  | \$3,450   | \$3,245 | \$3,450   |
|     Director          |          |           |         |           |
|                       | \$11,569 | \$1,338   | \       | \$1,338   |
| -   Coordinator       |          |           | $11,569 |           |
|                       | \$8,750  | \$4,788   |         | \$4,788   |
| -   Development       |          |           | \$8,750 |           |
|     Specialist        | \$23,564 |           |         |           |
|                       |          |           | \       |           |
| -   Peer Helper       |          |           | $23,564 |           |
|                       |          |           |         |           |
| -   Clerical Support  |          |           |         |           |
|                       |          |           |         |           |
| TOTAL                 |          |           |         |           |
+-----------------------+----------+-----------+---------+-----------+
| **Fringe Benefits**   | \$4,866  | \$989     | \$4,866 | \$989     |
+-----------------------+----------+-----------+---------+-----------+
| **Travel**            | \$6,453  | \$3,900   | \$6,453 | \$3,900   |
+-----------------------+----------+-----------+---------+-----------+
| **Equipment**         | 0        | 0         | 0       | 0         |
+-----------------------+----------+-----------+---------+-----------+
| **Supplies**          | \$1,864  | \$4,000   | \$1,864 | \$4,000   |
+-----------------------+----------+-----------+---------+-----------+
| **Contract**          | \$4,500  | \$1,500   | \$4,500 | \$1,500   |
|                       |          |           |         |           |
| -   Evaluation        | \$10,000 | \$37,500  | \       | \$37,500  |
|                       |          |           | $10,000 |           |
| -   Public Awareness  | \$14,500 | \$39,000  |         | \$39,000  |
|                       |          |           | \       |           |
| -   Coalition members |          |           | $14,500 |           |
|                       |          |           |         |           |
| > TOTAL               |          |           |         |           |
+-----------------------+----------+-----------+---------+-----------+
| **Other**             | \$21,479 | \$21,855  | \       | \$21,855  |
|                       |          |           | $21,479 |           |
+-----------------------+----------+-----------+---------+-----------+
| **Total Direct        | \$72,726 | \$74,532  | \       | \$74,532  |
| Costs**               |          |           | $72,726 |           |
+-----------------------+----------+-----------+---------+-----------+
| **Total Indirect      | \$2,274  | \$468     | \$2,274 | \$468     |
| Costs**               |          |           |         |           |
+-----------------------+----------+-----------+---------+-----------+
| **Total Costs**       | **\$     | **\       | **\$7   | **\       |
|                       | 75,000** | $75,000** | 5,000** | $75,000** |
+-----------------------+----------+-----------+---------+-----------+

**Year 2 Year 3**

Personnel: Percentage of effort to remain the same

Fringe: Based on current rates

Travel: Based on POV rate for current year and anticipated training
requirements

Supplies: Based on projected needs and retail costs for current year

Contract: Based on current year costs.

Other: All other costs are based on current and anticipated expenses.

Indirect Costs: Based on current negotiated rate