PIN: Budget Code: Fiscal Conduit: Subcontractor: Address: Tel #: Fax #: Operating Period: Through: Budget Amount Program Centrally Amount Administered Account Code Budget Category 1100 Salaries and Wages 1200 Fringe Benefits 1300 Central Insurance 2000 Non Staff Services 3000 OTPS 4000 Fiscal Conduit Fee TOTAL BUDGET AMOUNT ` Code Category Description: Salaries and 1100 Wages Employed staff Includes Employers FICA, Unemployment Insurance, Medical and other 1200 Fringe Benefits related cost Includes cost allocated to the Fiscal Conduit for enrollment in the 1300 Central Insurance Central Insurance Program. This is not reimbursable to Subcontractor
PIN: Budget Code: Fiscal Conduit: Subcontractor: Address: Tel #: Fax #: Operating Period: Through: Account Code Budget Category Budget Amount Program Amount Centrally Administered 1100 Salaries and Wages 1200 Fringe Benefits 1300 Central Insurance 2000 Non Staff Services 3000 OTPS 4000 Fiscal Conduit Fee TOTAL BUDGET AMOUNT ` Code Category Description: 1100 Salaries and Wages Employed staff 1200 Fringe Benefits Includes Employers FICA, Unemployment Insurance, Medical and other related cost 1300 Central Insurance Includes cost allocated to the Fiscal Conduit for enrollment in the Central Insurance Program. This is not reimbursable to Subcontractor
FY_2018_Discretionary_FC_100K_and_Under_Protected.docx