FEDERAL REQUEST Sample Contracts Narrative – Name (1) Service (2) Rate (3) Other Cost (4) (1) State $250/individual x 3 Department of Training 5 days $ 750 staff Human Services (2) Treatment Services 1040 Clients $27/client per year $28,080 *Travel at 3,126 @ .50 per mile = $1,563 *Training course $175 *Supplies @ $47.54 x 12 1FTE @ $27,000 + (3) John Smith Treatment months or $570 Fringe Benefits of $46,168 (Case Manager) Client Services $6,750 = $33,750 *Telephone @ $60 x 12 months = $720 *Indirect costs = $9,390 (negotiated with contractor) $40 per hour x 225 (4) Jane Smith Evaluator 12 month period $9,000 hours Marketing Annual salary of (5) To Be Coordinator $30,000 x 10% level $3,000 Announced of effort FEDERAL REQUEST (enter in Section B column 1, line 6f of-424A) $86,998 – *Represents separate/distinct requested funds by cost category FEDERAL REQUEST Sample Justification for Contracts – Certified trainers are necessary to carry out the purpose of the statewide Consumer Network by providing recovery and wellness training, preparing consumer leaders statewide, and educating the public on mental health recovery. Client treatment services to be provided are based on organizational history of expenses.
FEDERAL REQUEST – Sample Contracts Narrative Name (1) Service (2) Rate (3) Other Cost (4) (1) State Department of Human Services Training $250/individual x 3 staff 5 days $ 750 (2) Treatment Services 1040 Clients $27/client per year $28,080 (3) John Smith (Case Manager) Treatment Client Services 1FTE @ $27,000 + Fringe Benefits of $6,750 = $33,750 *Travel at 3,126 @ .50 per mile = $1,563 *Training course $175 *Supplies @ $47.54 x 12 months or $570 *Telephone @ $60 x 12 months = $720 *Indirect costs = $9,390 (negotiated with contractor) $46,168 (4) Jane Smith Evaluator $40 per hour x 225 hours 12 month period $9,000 (5) To Be Announced Marketing Coordinator Annual salary of $30,000 x 10% level of effort $3,000 FEDERAL REQUEST – (enter in Section B column 1, line 6f of-424A) $86,998 *Represents separate/distinct requested funds by cost category FEDERAL REQUEST – Sample Justification for Contracts Certified trainers are necessary to carry out the purpose of the statewide Consumer Network by providing recovery and wellness training, preparing consumer leaders statewide, and educating the public on mental health recovery. Client treatment services to be provided are based on organizational history of expenses.
act-final-foa-revised_4-20.18.docx