### Sample Budget and Justification (match required)

> THIS IS AN ILLUSTRATION OF A SAMPLE DETAILED BUDGET AND NARRATIVE.
> WITH GUIDANCE FOR COMPLETING SF 424A: SECTION B FOR THE BUDGET PERIOD.

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

FEDERAL REQUEST

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

  Executive     John Doe       \$64,890         10%            \$6,489
  Director                                                     

  Coordinator   To be selected \$46,276         100%           \$46,276

                                                TOTAL          \$52,765
  ------------- -------------- ---------------- -------------- -------------

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

The executive director will provide oversight of grant, including fiscal
and personnel management, community relations and project implementation
and evaluation. The coordinator will coordinate project services and
activities, including training, communication, data collection and
dissemination.

NON-FEDERAL MATCH

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

  Executive     John Doe       \$64,890         7%             \$4,542
  Director                                                     

  Prevention    Sarah Smith    \$26,000         25%            \$6,500
  Specialist                                                   

  Peer Helper   Ron Jones      \$23,000         40%            \$9,200

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

                                                TOTAL          \$21,580
  ------------- -------------- ---------------- -------------- -------------

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

The executive director will provide oversight of grant, including fiscal
and personnel management, community relations and project implementation
and evaluation. The development specialist will provide staffing support
to the working council. The peer helper will be responsible for peer
recruitment, coordination and support. The clerical support will process
paperwork, payroll, and expense reports.

**FEDERAL REQUEST** (enter in Section B column 1 line 6a of form SF424A)
**\$52,765**

**NON-FEDERAL MATCH** (enter in Section B column 2 line 6a of form
SF424A) **\$21,580**

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

FEDERAL REQUEST

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

  FICA              7.65%             \$52,765          \$4,037

  Workers           2.5%              \$52,765          \$1,319
  Compensation                                          

  Insurance         10.5%             \$52,765          \$5,540

                                      TOTAL             \$10,896
  ----------------- ----------------- ----------------- -----------------

NON-FEDERAL MATCH

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

  FICA              7.65%             \$21,580          \$1,651

  Workers           2.5%              \$21,580          \$ 540
  Compensation                                          

  Insurance         10.5%             \$21,580          \$2,266

                                      TOTAL             \$4,457
  ----------------- ----------------- ----------------- -----------------

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

**FEDERAL REQUEST** (enter in Section B column 1 line 6b of form SF424A)
**\$10,896**

**NON-FEDERAL MATCH** (enter in Section B column 2 line 6b of form
SF424A) **\$4,457**

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                                                        

  Conference (be Washington, DC Airfare        \$200/flight x 2 \$400
  as specific as                               persons          
  possible)                                                     

                                Hotel          \$180/night x 2  \$720
                                               persons x 2      
                                               nights           

                                Per Diem       \$46/day x 2     \$184
                                (meals)        persons x 2 days 

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

                                               TOTAL            \$2,444
  -------------- -------------- -------------- ---------------- --------------

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

Cost for two members to attend a grantee meeting in Washington. Local
travel is needed to attend local meetings, project activities, and
training events. Local travel rate is based on agency's privately owned
vehicle (POV) reimbursement rate.

**NON-FEDERAL MATCH**

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

  Regional       Chicago, IL    Airfare        \$150/flight x \$300
  Training                                     2 persons      
  Conference                                                  

                                Hotel          \$155/night x  \$620
                                               2 persons x 2  
                                               nights         

                                Per Diem       \$46/day x 2   \$184
                                (meals)        persons x 2    
                                               days           

  Local Travel   Outreach       Mileage        350 miles x    \$133
                 workshops                     .38/mile       

                                               TOTAL          \$1,237
  -------------- -------------- -------------- -------------- --------------

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

Coalition agencies will provide funding for two members to attend the
regional technical assistance workshop (our closest location is Chicago,
IL). Local travel rate is based on agency's POV reimbursement rate.

**FEDERAL REQUEST** (enter in Section B column 1 line 6c of form SF424A)
**\$2,444**

# NON-FEDERAL MATCH (enter in Section B column 2 line 6c of form SF424A) \$1,237

**[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.

**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 office supplies \$50/mo. x 12 mo.       \$600

  Postage                 \$37/mo. x 8 mo.        \$296

  Laptop Computer\*       \$900                   \$900

  Printer\*               \$300                   \$300

  Projector\*             \$900                   \$900

  Copies                  8000 copies x .10/copy  \$800

                          TOTAL                   \$3,796
  ----------------------- ----------------------- -----------------------

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

Office supplies, copies and postage are needed for general operation of
the project. The laptop computer is needed for both project work and
presentations. The projector is needed for presentations and outreach
workshops. All costs were based on retail values at the time the
application was written. \*Provide justification for purchases,
especially if they were requested and purchased under a previous budget.

**NON-FEDERAL MATCH**

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

  General office supplies \$50/mo. x 12 mo.       \$600

  Bookcase\*              \$75                    \$75

  Digital camera\*        \$300                   \$300

  Fax machine\*           \$150                   \$150

  Computer\*              \$500                   \$500

  Postage                 \$37/mo. x 4 mo         \$148

                          TOTAL                   \$1,773
  ----------------------- ----------------------- -----------------------

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

The local television station is donating the bookcase, camera, fax
machine, and computer (items such as these can only be claimed as match
once during the grant cycle and used for the project). The "applying
agency" is donating the additional costs for office supplies and
postage.

**FEDERAL REQUEST** -- (enter in Section B column 1 line 6e of form
SF424A) **\$ 3,796**

**NON-FEDERAL MATCH** - (enter in Section B column 2 line 6e of form
SF424A) **\$ 1,773**

**[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 Coalition        \$150/day   15 days        \$2,250
                 Building                                    

                 Travel           .38/mile    360 miles      \$137

                                              TOTAL          \$2,387
  -------------- ---------------- ----------- -------------- --------------

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

This person will advise staff and coalition members of ways to maintain,
increase membership, and develop a Strategic Prevention Framework for
the local coalition. The rate is based on the average consulting rate in
this area. Consultant is expected to make up to 6 trips (each trip a
total of 60 miles) to meet with staff and the coalition. Mileage rate is
based on POV reimbursement rate. A request for proposal will be issued
to secure a competitive bid before final selection is made.

**FEDERAL REQUEST** (Contract)

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

  To be selected          1.5 minute Public       \$2,300
                          Service Announcement    
                          (PSA)                   

  To be selected          Evaluation Report       \$4,500

                          TOTAL                   \$6,800
  ----------------------- ----------------------- -----------------------

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

A local media outlet will produce a 1.5-minute PSA from the youth drug
awareness video for the local television market. Tasks will include
cutting and editing the tape, preparing introductory statement,
inserting music and/or narrative, and synchronizing the sound track. A
local evaluation specialist will be contracted to produce the year-end
results of the coalition efforts. A request for proposal will be issued
to secure a competitive bid before final selection is made.

**NON-FEDRAL MATCH** (Consultant)

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

  Coalition       Outreach       \$17.5/hour   6 members x \$17.50  \$25,200
  members         meeting                      x20 hr./mo. x 12 mo. 
                  facilitation                                      

                  Travel         .38/mile      12 members x 148     \$675
                  Expenses                     miles x .38/mile     

                                               TOTAL                \$25,875
  --------------- -------------- ------------- -------------------- ----------

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

Twelve (12) coalition members are volunteering their time to facilitate
the youth prevention and outreach sessions outlined in the strategic
plan. Hourly rate is based on average salaries of the volunteers. Travel
is based on average distance between volunteer's location and the
meeting sites. Mileage rate is based on POV reimbursement rate.

**NON-FEDERAL MATCH** (Contract)

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

  West Bank School        Student Assistance      \$15,000
  District                Program                 

                          TOTAL                   \$15,000
  ----------------------- ----------------------- -----------------------

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

West Bank School District is donating their contracted services to
provide drug testing, referral and case management for 50 non-school
attending youth. Average cost is \$300/person. (MOU attached to
application)

# FEDERAL REQUEST -- (enter in Section B column 1 line 6f of form SF424A) \$ 9,187

(combine the total of consultant and contact)

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6f of form
SF424A) **\$ 40,875**

(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

  Rent              \$15/sq.ft x 700 sq.     \$10,500
                    feet                     

  Telephone         \$100/mo. x 12 mo.       \$1,200

  Student Surveys   \$1/survey x 2784        \$2,784

  Brochures         .89/brochure X 1500      \$1,335
                    brochures                

                    TOTAL                    \$15,819
  ----------------- ------------------------ -----------------------------

JUSTIFICATION: Breakdown costs into cost/unit: i.e. cost/square foot.
Explain the use of each item requested.

Rent and telephone is necessary to operate the project. Monthly
telephone costs reflect the % of effort for the personnel listed in this
application. Survey copyright requires the purchase of the ATOD surveys.
Brochures will be used at various community functions (health fairs and
exhibits).

# NON-FEDERAL MATCH

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

  Space rental      Varies between           \$11,500
                    \$75/event to over       
                    \$300/event              

  Television time   \$250/spot x 50 spots    \$12,500

  Food and          \$2.50/meeting x 40      \$300
  beverages         attendees x 3 meetings   

  Internet services \$26/mo. x 12 mo.        \$312

  Student surveys   \$1/survey x 1583        \$1,583
                    surveys                  

  Printing          \$300/run x 6 runs       \$1,800

                    TOTAL                    \$27,995
  ----------------- ------------------------ -----------------------------

**JUSTIFICATION:** **Breakdown costs into cost/unit: i.e. cost/square
foot. Explain the use of each item requested**.

Various coalition and community organizations donate space for the
various activities outlined in the scope of work, such as teen night
out, after-school programs, and parent education classes. The prices
range from\$75/event for the West Bank School District to over
\$300/event for the Holiday Inn. The local ACME market is donating the
food for three meetings. The local television station is donating
airtime for the PSA (MOU attached to application). The applying agency
is donating the internet services for the full-time coordinator. The
West Bank School District is donating the cost of 1,583 student surveys.
All costs are the value placed on the service at the time of this grant
application. A coalition member is donating the printing for the
bi-monthly newsletter.

# FEDERAL REQUEST -- (enter in Section B column 1 line 6h of form SF424A) \$ 15,819

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6h of form
SF424A) **\$ 27,995**

**[Indirect cost rate:]{.underline}** Indirect costs can only be claimed
if your organization has a negotiated indirect cost rate agreement. It
is applied only to direct costs to the agency as allowed in the
agreement.

For information on applying for the indirect rate go to: samhsa.gov then
click on grants -- grants management -- HHS Division of Cost Allocation
-- Regional Offices.

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

8% of personnel and fringe (.08 x \$63,661) **\$5,093**

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

8% of personnel and fringe (.08 x \$26,037) **\$2,083**

**JUSTIFICATION:** The indirect costs rate was approved by the Dept. of
Health and Human Services in 200X and is applied to the personnel and
fringe, per the negotiated agreement. A copy of the fully executed,
negotiated, indirect cost agreement is attached.

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

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

  Personnel         \$52,765          \$21,580          \$74,345

  Fringe            \$10,896          \$4,457           \$15,353

  Travel            \$2,444           \$1,237           \$3,681

  Equipment         0                 0                 0

  Supplies          \$3,796           \$1,773           \$5,569

  Contractual       \$9,187           \$40,875          \$50,062

  Other             \$15,819          \$27,995          \$43,814

  Total Direct      \$94,907          \$97,917          \$192,824
  Costs\*                                               

  Indirect Costs    \$5,093           \$2,083           \$7,176

  Total Project     \$100,000         \$100,000         \$200,000
  Costs                                                 
  ----------------- ----------------- ----------------- -----------------

# \* [TOTAL DIRECT COSTS:]{.underline} 

# FEDERAL REQUEST -- (enter in Section B column 1 line 6i of form SF424A) \$94,907

**NON-FEDERAL MATCH** -- (enter in Section B column 2 line 6i of form
SF424A) **\$97,917**

## [TOTAL PROJECT COSTS]{.underline}: Sum of Total Direct Costs and Indirect Costs

**FEDERAL REQUEST** (enter in Section B column 1 line 6k of form SF424A)
**\$100,000**

**NON-FEDERAL MATCH** (enter in Section B column 2 line 6k of form
SF424A) **\$100,000**