Project Management forms

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Form preview Tv program proposal sample pdf... UNC-TV PROGRAM PROPOSAL QUESTIONNAIRE Name Title Organization / Company Street Address City / County / State / Zip Daytime Telephone Evening Telephone Fax Number E-mail Address Web Address Project Information These questions will help us understand your program idea. Program Title Brief Description A two- or three-sentence description that could appear in our monthly program guide CenterPiece Intended Audience Who is the primary audience in terms of age gender education socioeconomic level and ethnicity -1- Program s Purpose To educate inform enlighten entertain etc. UNC-TV s Mission Television has the power to change lives. Please note funding for these services must be provided by the producer. Will you require a press kit If so indicate items you wish to include Photo sheets Program Descriptions Press Releases Bios Fact Sheets Fliers Poster Postcard Brochure Giveaway Items featuring program and UNC-TV logos national distribution Consultation with producers to develop and coordinate national strategies Development of contacts and promotional materials designed to interest PBS in your program or series public television station program directors in your program or series Secure carriage of your program or series on other public television stations across the country Ongoing promotion of your program or series in syndicated markets Secure media coverage of the host and/or talent of your program or series Develop promotions and merchandising opportunities for the program or series -7- Statewide Print trade journals magazines newspapers Statewide Broadcast radio television Internet Statewide Direct Mail Statewide Outdoor billboards bus shelters National Print trade journals magazines newspapers National Broadcast radio television Internet National Direct Mail National Outdoor billboards bus shelters Web page design and development Web page maintenance Audio or video streaming Consultation and event management Budget development and management Site surveys and selection Invitation list development Food and beverage selection Vendor selection and supervision Event staffing Event-specific media relations -8- Education and Outreach Questions program. Please note funding for these services must be provided by the producer. How will you extend the value of your program through educational and outreach materials and activities such as extended off-air rights teachers and viewers guides distribution to schools libraries and special interest groups and Web sites Sample Material Please do not send a DVD with your proposal. If your proposal is accepted for further consideration samples of your previous work will be requested. At that time please send a DVD of work samples that demonstrate the program genre you intend to produce and if possible are directly attributable to either the producer or director of your project. Treatment Please provide a three to five page narrative treatment of your program. Help us visualize your program by describing what the program will look like who will be in it the content the format and how it will be paced. Furnish as much detail as possible to help us understand the concept themes and presentation of your program. Budget A production budget will help us know if your program s costs are realistic appropriate and reasonable. Have you determined the cost of music and song licensing for broadcast outside of public television including home video cable and foreign distribution other visuals materials -6- Promotion Questions advertising needs. Please note funding for these services must be provided by the producer. Will you require a press kit If so indicate items you wish to include Photo sheets Program Descriptions Press Releases Bios Fact Sheets Fliers Poster Postcard Brochure Giveaway Items featuring program and UNC-TV logos national distribution Consultation with producers to develop and coordinate national strategies Development of contacts and promotional materials designed to interest PBS in your program or series public television station program directors in your program or series Secure carriage of your program or series on other public television stations across the country Ongoing promotion of your program or series in syndicated markets Secure media coverage of the host and/or talent of your program or series Develop promotions and merchandising opportunities for the program or series -7- Statewide Print trade journals magazines newspapers Statewide Broadcast radio television Internet Statewide Direct Mail Statewide Outdoor billboards bus shelters National Print trade journals magazines newspapers National Broadcast radio television Internet National Direct Mail National Outdoor billboards bus shelters Web page design and development Web page maintenance Audio or video streaming Consultation and event management Budget development and management Site surveys and selection Invitation list development Food and beverage selection Vendor selection and supervision Event staffing Event-specific media relations -8- Education and Outreach Questions program. Please note funding for these services must be provided by the producer. How will you extend the value of your program through educational and outreach materials and activities such as extended off-air rights teachers and viewers guides distribution to schools libraries and special interest groups and Web sites Sample Material Please do not send a DVD with your proposal. If your proposal is accepted for further consideration samples of your previous work will be requested. At that time please send a DVD of work samples that demonstrate the program genre you intend to produce and if possible are directly attributable to either the producer or director of your project.
Form preview Deloitte technical proposalreq... Vendor/ Provider Name REQUEST FOR REIMBURSEMENT- DIRECT SERVICE ND DEPARTMENT HUMAN SERVICES OF FISCAL ADMINISTRATION PAYEE CERTIFICATION Address Line 1 SFN 1763 Rev. 09-2005 Clear Fields Line 2 See reverse for instructions on completing this form. City CONTRACT INFORMATION State Column A Total Expenditures Previously Claimed This Billing Period Cumulative To Date Contract Award Including all Amendments Description of Service Total Matching In-Kind if Allowable Reported Zip Code Matching Salaries Fringe Benefit Employees I hereby certify that this request accurately reflects expenditures for services rendered in accordance with an agreement between the above and the North Dakota Department of Human Services that fund requirements have been complied with and that such compliance is documented for audit purposes. Is this the final reimbursement request Payee Signature Columns E F Date Only Payee Telephone Number Travel DHS Contract Number Consultation Services DEPARTMENT APPROVAL Equipment Program Director By Supplies Training Other List Separately Division Director Administration/Indirect Costs Contract Period Sub-Total From Billing Period To Less Advances/Program Income DHS FINANCE USE ONLY REF LINE Accounting Period Date Liaison Accountant Received To Date Total Amount Requested for Reimbursement This billing period Speed Chart Dept. ID Class Expended To Date Remaining Balance Program Income Fund Project Activity Resource Type Category TRANSACTION AMOUNT DISTRIBUTION White/Canary - Finance Canary - returned to vendor/provider with check Pink - retained by vendor/provider N*D. Department of Human Services/Fiscal Administration GENERAL INFORMATION BOXES City State Zip Enter a short description of the services provided by your organization under this contract. Enter the 8-digit Contract Number - assigned to the contract by DHS on the line provided please refer to your organization s finalized copy of the contract. Enter the beginning date and ending date of this contract - including all extension periods by amendment. Please note If the contract number has changed it is not an extension or amendment - it would then be a new contract - refer to your contract for this information. Enter the name for your organization as it should appear on the reimbursement check. Enter the full mailing address for your organization as it should be to mail the reimbursement check. Enter the City State and Zip Code for your organization as it should be to mail the reimbursement check. SPECIFIC INFORMATION BOXES Enter the total amounts claimed by Expenditure Classification as recorded on the most recently submitted SFN 1763 Column C. Enter the amount being claimed for reimbursement by Expenditure Classification on this SFN 1763. Enter the sum of Expenditures for each column A through C. Total the amounts recorded in Column A and B in Column C. Enter the Sum of the rows Sub-Total and Less Advances/Income for Columns A through C. to Further Project request for this contract Enter the Program Income Received Expended and the Remaining Balance when the vendor has been given specific approval from DHS to add Program Income to funds committed to further program objectives.
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