Fill and Sign the Form B Medical Certificate Fin 74

eGrants Application Budget Worksheets REV. 1-6-2011 Worksheet Page 1 Grant ID Number :______________________ Budget Estimate– You will only be able to enter information into those fields specific to the type of grant you selected. These will be indicated by the presence of “Edit” Buttons in the line item area. Personnel Costs: Enter classifications to be utilized, the monthly or hourly salary rate, and percentage of work time related to the grant. Reasonable cost of living increases or incentive increases should be estimated and included. A listing of applicable benefits and their % of salary are needed. Overtime Costs must be broken out separately and are based on operations rather than positions. Applicable overtime benefits and their %’s are needed. See Budget Pages 3 and 4. Position Name:_____________________ (For each FT or HRLY position desired) Brief description_______________________________________________ If Full-time: Pay rate:__________________ Avg. per month, % time grant related____________ If Hourly: Pay rate:______________per hour, # of hours:____________ Position Name:_____________________(For each FT or HRLY position desired) Brief description_______________________________________________ If Full-time: Pay rate:___________________Avg. per month, % time grant related____________ If Hourly: Pay rate:______________per hour, # of hours:____________ Position Name:_____________________ (For each FT or HRLY position desired) Brief description_______________________________________________ If Full-time: Pay rate:___________________Avg. per month, % time grant related____________ If Hourly: Pay rate:______________per hour, # of hours:____________ Benefits: (Social Sec, FICA, OASDI, SDI, Worker’s Comp, Unemp, Retire., Health, etc.) Type_______________________________________%__________ Type_______________________________________%__________ Type_______________________________________%__________ Type_______________________________________%__________ Type_______________________________________%__________ Type_______________________________________%__________ REV. 1-6-2011 1 Worksheet Page 2 Overtime : Type of Operation:______________________________________________ Hourly pay range employees involved: Min. _____________Max.____________ Type of Operation:______________________________________________ Hourly pay range employees involved: Min. _____________Max.____________ Type of Operation:______________________________________________ Hourly pay range employees involved: Min. _____________Max.____________ Type of Operation:______________________________________________ Hourly pay range employees involved: Min. _____________Max.____________ Type of Operation:______________________________________________ Hourly pay range employees involved: Min. _____________Max.____________ Benefits: (Social Sec, FICA, OASDI, SDI, Worker’s Comp, etc.) Type_______________________________________%__________ Type_______________________________________%__________ Type_______________________________________%__________ Travel Expenses: Enter estimated cost of travel related to the grant, such as the Training and Leadership Seminar, Vehicular Homicide or other OTS training attendance. Costs include transportation, lodging, and per diem incurred by personnel identified in the budget, and must be segregated into “in-state” and “out-of-state” travel. In-State: Cost:______________________ Anticipated Travel:______________________________________________ Justification:________________________________________________________ _____________________________________________________ Out-of -State Cost:______________________ Anticipated Travel:______________________________________________ Justification:________________________________________________________ ___________________________________________________ REV. 1-6-2011 2 Worksheet Page 3 Equipment: Enter the estimated cost of each item of equipment to be purchased. Items that have a useful life of more than one year and cost $5,000 or more should be included in this category. The total cost of equipment includes modifications, attachments, accessories, or auxiliary apparatus necessary to make it usable for grant purposes including tax, shipping, and installation, excluding any discounts. Item Title:___________________________________________________ Quantity:______________Unit Cost:_______________________ Justification:__________________________________________________ _ __________________________________________________________ Item Title:___________________________________________________ Quantity:_______________Unit Cost:________________ Justification:__________________________________________________ _ __________________________________________________________ Item Title:___________________________________________________ Quantity:_________________Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Item Title:___________________________________________________ Quantity:_________________Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Contractual Services: You must prepare a sub-budget for this item which will autopopulate the line item on the Budget Page. The sub-budget will mirror this budget layout exactly, however, it will be for the items provided or charged for by a vendor under contract. There should be no Equipment costs in a Contractual Services sub-budget. REV. 1-6-2011 3 Worksheet Page 4 Other Direct Costs: This category should include the line item titles of any other direct grant expenses not covered in previous categories including services not requiring contractual agreements and minor equipment. The following are examples of line item titles that may apply: office supplies, printing/duplication, educational materials, radar device, child safety seats, bicycle helmets, and checkpoint supplies. Item Title:_________________________________ Quantity:___________ Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Item Title:_________________________________ Quantity:___________ Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Item Title:_________________________________ Quantity:___________ Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Item Title:_________________________________ Quantity:___________ Unit Cost:________________ Justification:_________________________________________________ __________________________________________________________ Depending on the type of your grant, the Budget should now be complete! Uploads : Your grant application must include a Problem Statement and Method of Procedure document. You must complete and upload a Problem Statement and Method of Procedure (PSMOP) document from a link on the UPLOADS Page. You will select type of document to be uploaded from drop-down menu based on the type of grant for which you are applying. Save the document to your computer, so that you can complete the required statistical information and questions prior to completing the application. When you get to the Upload section you will upload the completed document from your computer into the eGrants Application. REV. 1-6-2011 4