FEDERAL REQUEST – Sample Contracts Narrative Name (1) Service (2) Rate (3) Other Cost (4) (1) State Department of Human Services Training $250/individual x 3 staff 5 days $ 750 (2) Treatment Services 1040 Clients $27/client per year $28,080 (3) John Smith (Case Manager) Treatment Client Services 1FTE @ $27,000 + Fringe Benefits of $6,750 = $33,750 *Travel at 3,126 @ .50 per mile = $1,563 *Training course $175 *Supplies @ $47.54 x 12 months or $570 *Telephone @ $60 x 12 months = $720 *Indirect costs = $9,390 (negotiated with contractor) $46,168 (4) Jane Smith Evaluator $40 per hour x 225 hours 12 month period $9,000 (5) To Be Announced Marketing Coordinator Annual salary of $30,000 x 10% level of effort $3,000 FEDERAL REQUEST – (enter in Section B column 1, line 6f of-424A) $86,998 *Represents separate/distinct requested funds by cost category FEDERAL REQUEST – Sample Justification for Contracts Certified trainers are necessary to out the purpose of the statewide Consumer Network by providing recovery and wellness training, preparing consumer leaders statewide, and educating the public on mental health recovery. Client treatment services to be provided are based on organizational history of expenses. The Case Manager is vital to providing client services related to the program and leading to successful outcomes.
Item − List items by type of material or nature of expense. In the justification, explain the necessity of each cost for successful implementation and completion of the project. Rate − Break down costs by quantity and cost per unit as applicable. NOTE: Rent costs must be submitted with the following information: The individual cost that make up the total cost of the building The methodology used to allocate the costs to the programs or activities operating in the building Rent Questions Worksheet Supporting documentation Costs Charged to the Award – provide the costs charged to the award. FEDERAL REQUEST – Sample Narrative for “Other” Item Rate Cost (1) Rent* $15/sq. ft. x 700 sq. feet $10,500 (2) Telephone $100/mo. x 12 mo. $1,200 (3) Client Incentives $10/client follow-up x 278 clients $2,780 (4) Brochures .89/brochure X 1500 brochures $1,335 FEDERAL REQUEST (enter in Section B column 1, line 6h of SF-424A) $15,815 FEDERAL REQUEST – Sample Justification for Other Costs related to office space are typically included in the indirect cost rate agreement. However, if other rental costs for service site(s) are necessary for the project, they may be requested as a direct charge. The rent is calculated by square footage or FTE and reflects SAMHSA’s fair share of the space. *If rent is requested (direct or indirect), provide the name of the owner(s) of the space/facility. If anyone related to the project owns the building which is less than an “arms’ length arrangement”, provide the cost of ownership/use allowance calculations. Additionally, the lease and floor plan (including common areas) are required for all projects allocating rent costs. The monthly telephone reflect the percent of effort for the personnel listed in this application for the SAMHSA project only. The $10 incentive is needed to meet program goals in order to encourage attendance and follow-up with 278 clients.
7. Program Income Standard Form 424A SECTION C – NON-FEDERAL RESOURCES (a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS 8. Title of FOA 9. 10. 11. 12. TOTAL (sum of lines 8-11) $ $ $ $ SECTION D – FORECASTED CASH 13. Federal Totals for 1st Year $184,303 1st Quarter $46,075 2nd Quarter $46,076 3rd Quarter $46.076 4th Quarter $46,076 14. Non-Federal 15.TOTAL (sum of lines 13 and 14) $184,303 $46,075 $46,076 $46,076 $46,076 SECTION E – BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT (a) Grant Program FUTURE FUNDING PERIODS (a) First (b) Second (c) Third (d) Fourth 16. Title of FOA $184,498 $185,531 $185,762 $186,001 17. 18.