Dental @ X% Unemployment & Workers Compensation @ X% Disability @ X% TOTAL FRINGE @ X% TRAVEL Provider Training: 2 trainings in QI/QA @ $X per person x 2 FTEs 5 hotel nights @ $X per night x 2 FTEs x 2 trainings Outreach (X,XXX miles @ $0.XX per mile) TOTAL TRAVEL EQUIPMENT Include items of moveable equipment that cost $5,000 or more and with – a useful life of one year or more. Ultrasound machine 3 dental chairs @ $X,XXX each TOTAL EQUIPMENT SUPPLIES 4 laptop computers @ $X each Office Supplies ($X per month x 12 months) Printing Costs ($X.XX per brochure x 4 brochures x X,000 copies) TOTAL SUPPLIES CONTRACTUAL Include sufficient detail to justify costs. – Pharmacy Services ($X per contract) Laboratory Services ($X per sample x X,XXX samples) Housekeeping Services ($X per month x 12 months) Waste Removal ($X per month x 12 months) TOTAL CONTRACTUAL
Dental @ X% Unemployment & Workers Compensation @ X% Disability @ X% TOTAL FRINGE @ X% TRAVEL Provider Training: 2 trainings in QI/QA @ $X per person x 2 FTEs 5 hotel nights @ $X per night x 2 FTEs x 2 trainings Outreach (X,XXX miles @ $0.XX per mile) TOTAL TRAVEL EQUIPMENT – Include items of moveable equipment that cost $5,000 or more and with a useful life of one year or more. Ultrasound machine 3 dental chairs @ $X,XXX each TOTAL EQUIPMENT SUPPLIES 4 laptop computers @ $X each Office Supplies ($X per month x 12 months) Printing Costs ($X.XX per brochure x 4 brochures x X,000 copies) TOTAL SUPPLIES CONTRACTUAL – Include sufficient detail to justify costs. Pharmacy Services ($X per contract) Laboratory Services ($X per sample x X,XXX samples) Housekeeping Services ($X per month x 12 months) Waste Removal ($X per month x 12 months) TOTAL CONTRACTUAL
fy2015samplebudgetjustify.docx