If yes, include the person for whom the potential conflict exists as well
as the nature of the potential conflict of interest and the relationship to any
current or former board member, current or former aging advisory committee
member, or current or former employee.
(1000 text character limit)
D. Budget Information
Proposal Budgets should be prepared using the reduced Title III planning allocation shown in the notification letter sent to you on: July 27, 2015.
Each proposed service must have its own budget workbook completed. Only Cost Reimbursement Budgets should be uploaded into the proposal submission. Fixed Unit Rate Budgets have been previously submitted to DAAA. The Cost Areas and Cost Categories overview provides narrative outlining allowable line item budget costs (Appendix A). It is not all-inclusive of allowable/disallowable costs, but addresses commonly questioned costs.
Cost Reimbursement Budgets
(Attachment D) include:
(Caregiver Information Service;
Information, Referral and Assistance; Instruction and Training; Ombudsman;
Senior Center Operations)
Cost reimbursement Appendix A
· Project Staff Allocation: This worksheet should be completed first to determine total proposed Personnel expenses for the program for FY 2016. List each staff member necessary to providing the proposed service and the percentage of time they will be allocated to the project. This form self calculates the total personnel cost to the project. Total Personnel expense on the Cost Reimbursement Budget must not exceed the total allocated cost on this form.
· Cost Reimbursement Budget: These worksheets are to be used to breakdown total budget cost areas to specific allowable expense categories.
· Expense Category Explanation: This worksheet must be used to provide explanations to justify all expenses allocated to Title III, Local Cash, and Other Resources, noting all sources of match and/or in-kind. The Budget Amount column will self-populate from amounts entered into the Cost Reimbursement Budget worksheets (CR Budget 1-4).
· Cost Reimbursement Budget Summary: This worksheet self populates from Cost Reimbursement Budget worksheets 1-4
· In-Kind Forms (if applicable): This workbook is available upon request to those entities planning to utilize the value of in-kind items/services to offset local cash match requirements.
Fixed Unit Rate Budgets:
(Congregate Meals; Home Delivered Meals; Transportation)
· FY 2016 Rate Setting workbooks for Title III funding requests for unit rate funded services have been previously submitted to DAAA. A final copy of the workbook, signed by a person authorized to commit the agency to any eventual Service Contract must be on-file with the DAAA. If a fully-signed, original copy of the Rate Setting workbook has not been filed, it must be submitted with the FY 2016 written proposal to be considered for funding.
Please print your completed form: