Spreadsheet: e657ead9-aaf5-4b3a-9caf-4851977ebfa9
Sheet: Sheet1

Grantee: | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12
Address:
Phone:
 |  |  |  |  | Total Agency Budget:  __________________ |  |  |  |  | Total Program Budget:  ________________
Line | Budget Item |  |  |  |  | SOMA Stabilization Fund Request | CDBG | City Funding (General Fund) | State | Federal | Private Funding | Total Funding for Program
Salaries & Wages |  |  | Personnel Time |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
 | Name  -  Title | Rate/Hr. | # of [NAME] | # of Hrs Pgm | Total # of Hrs
1 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
2 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
3 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
4 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
5 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
6 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
7 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
8 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
9 | Total Salaries & Wages (Lines 1 thru 8) |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Fringe Benefits (Cannot exceed 25% CDBG/ESG Salaries & Wages) |  |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
 | Item |  |  |  | Rate
10 | FICA (7.65%) |  |  |  |  |  |  |  |  |  |  | 0
11 | SUI |  |  |  |  |  |  |  |  |  |  | 0
12 | Workers Compensation |  |  |  |  |  |  |  |  |  |  | 0
13 | Medical Insurance |  |  |  |  |  |  |  |  |  |  | 0
14 | Retirement |  |  |  |  |  |  |  |  |  |  | 0
15 | Other |  |  |  |  |  |  |  |  |  |  | 0
16 | Total Fringe Benefits (Lines 10 thru 15) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
Contractual Services - Consultants |  |  | Consultant Time |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
 | Item | Rate/Hr. | # of [NAME] | # of Hrs Pgm | Total # of Hrs
17 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
18 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
19 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
20 |  |  |  |  | 0 | 0 |  |  |  |  |  | 0
21 | OMB A-133 Audit ($500,000 in Federal Funds) |  |  |  | 0 | 0 |  |  |  |  |  | 0
22 | Total Contractual Services (Lines 17 thru 21) |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Equipment |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
23 |  |  |  |  |  |  |  |  |  |  |  | 0
24 |  |  |  |  |  |  |  |  |  |  |  | 0
25 |  |  |  |  |  |  |  |  |  |  |  | 0
26 | Total Equipment (Lines 23 thru 25) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
Insurance |  |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
27 | General Liability |  |  |  |  |  |  |  |  |  |  | 0
28 | Fidelity Bond |  |  |  |  |  |  |  |  |  |  | 0
29 | Property |  |  |  |  |  |  |  |  |  |  | 0
30 | Auto |  |  |  |  |  |  |  |  |  |  | 0
31 | Other |  |  |  |  |  |  |  |  |  |  | 0
32 | Total Insurance (Lines 27 thru 31) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
Travel & Conferences |  |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
33 |  |  |  |  |  |  |  |  |  |  |  | 0
34 |  |  |  |  |  |  |  |  |  |  |  | 0
35 |  |  |  |  |  |  |  |  |  |  |  | 0
36 | Total Travel & Conferences (Lines 33 thru 35) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Space Rental (Office/Program Space) |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
37 | [NAME] |  |  |  |  |  |  |  |  |  |  | 0
38 | Total Space Rental |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Office Supplies |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
39 | Office Supplies |  |  |  |  |  |  |  |  |  |  | 0
40 | Total Office Supplies |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Telecommunications (Phone) |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
41 | Telecommunications |  |  |  |  |  |  |  |  |  |  | 0
42 | Total Telecommunications |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Utilities |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
43 | Utilities |  |  |  |  |  |  |  |  |  |  | 0
44 | Total Utilities |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Other |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
45 |  |  |  |  |  |  |  |  |  |  |  | 0
46 |  |  |  |  |  |  |  |  |  |  |  | 0
47 |  |  |  |  |  |  |  |  |  |  |  | 0
48 |  |  |  |  |  |  |  |  |  |  |  | 0
49 | Total Other (Lines 45 thru 48) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | TOTAL |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
50 | Total (Line 9+16+22+26+32+36+38+40+42+44+49) |  |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0
 | Program Income |  |  |  |  | Column A | Column B | Column C | Column D | Column E | Column F | Column G
51 | Program Income |  |  |  |  |  |  |  |  |  |  | 0
APPROVALS
GRANTEE |  |  |  |  |  |  | MOH
_________________________________________________ |  |  |  |  |  |  | ___________________________________________________
Executive Director |  | Date |  |  |  |  | Director |  |  | Date
_________________________________________________ |  |  |  |  |  |  | ___________________________________________________
Board Chair |  | Date |  |  |  |  | Program Director |  |  | Date
 |  |  |  |  |  |  | ___________________________________________________
 |  |  |  |  |  |  | Fiscal Director |  |  | Date