HUD 424 cbw Grant Application Detailed Budget Worksheet

Application for Healthly Homes and Lead Hazard Control Grant Programs and Quality Assurance Plans

424-cbw.xls

Application for Healthy Homes and Lead Hazard Control Program Grants

OMB: 2539-0015

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Overview

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OMB Approval No. 2501-0017


Grant Application Detailed Budget Worksheet (Exp. 01/31/2008)

Name and Address of Applicant:









































































Category Detailed Description of Budget (for full grant period)
1. Personnel (Direct Labor)
Estimated Hours Rate per Hour Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income
Position or Individual




















































































































































Total Direct Labor Cost













2. Fringe Benefits
Rate (%) Base Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income









































































































Total Fringe Benefits Cost













3. Travel













3a. Transportation - Local Private Vehicle
Mileage Rate per Mile Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income


























































































Subtotal - Trans - Local Private Vehicle


















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form HUD-424-CBW (2/2003)



Grant Application Detailed Budget Worksheet

Detailed Description of Budget
3b. Transportation - Airfare (show destination)
Trips Fare Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income


























































































Subtotal - Transportation - Airfare













3c. Transportation - Other
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income


























































































Subtotal - Transportation - Other













3d. Per Diem or Subsistence (indicate location)
Days Rate per Day Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Subtotal - Per Diem or Subsistence













Total Travel Cost













4. Equipment (Only items over $5,000 Depreciated value)
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income




























































Total Equipment Cost


















2




form HUD-424-CBW (2/2003)
















































Grant Application Detailed Budget Worksheet

Detailed Description of Budget
5. Supplies and Materials (Items under $5,000 Depreciated Value)













5a. Consumable Supplies
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income









































































































Subtotal - Consumable Supplies













5b. Non-Consumable Materials
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income


























































































Subtotal - Non-Consumable Materials













Total Supplies and Materials Cost













6. Consultants (Type)
Days Rate per Day Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income


























































































Total Consultants Cost













7. Contracts and Sub-Grantees (List individually)
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Total Subcontracts Cost


















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form HUD-424-CBW (2/2003)



Grant Application Detailed Budget Worksheet

Detailed Description of Budget
8. Construction Costs













8a. Administrative and legal expenses
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Subtotal - Administrative and legal expenses













8b. Land, structures, rights-of way, appraisal, etc
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income




























































Subtotal - Land, structures, rights-of way, …













8c. Relocation expenses and payments
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Subtotal - Relocation expenses and payments













8d. Architectural and engineering fees
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Subtotal - Architectural and engineering fees













8e. Other architectural and engineering fees
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income











































































Subtotal - Other architectural and engineering fees


















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form HUD-424-CBW (2/2003)



Grant Application Detailed Budget Worksheet
8f. Project inspection fees
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Project inspection fees













8g. Site work
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Site work













8h. Demolition and removal
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Demolition and removal













8i. Construction
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Construction













8j. Equipment
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income




























































Subtotal - Equipment













8k. Contingencies
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Contingencies













8l. Miscellaneous
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income













































Subtotal - Miscellaneous













Total Construction Costs


















5




form HUD-424-CBW (2/2003)



Grant Application Detailed Budget Worksheet
9. Other Direct Costs
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income

Item















































































































































































































Total Other Direct Costs




























Subtotal of Direct Costs




























10. Indirect Costs
Rate Base Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income

Type



















































































































































Total Indirect Costs













Total Estimated Costs


















6




form HUD-424-CBW (2/2003)


Sheet 2: Sheet2





OMB Approval No. 2501-0017
Grant Application Detailed Budget Worksheet (Exp. 01/31/2008)
Public reporting burden for this collection of information is estimated to average 3 hours 12 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. Information collected will provide proposed budget data for multiple programs. HUD will use this information in the selection of applicants. Response to this request for information is required in order to receive the benefits to be derived. The information requested does not lend itself to confidentiality.




Detailed Description of Budget
Analysis of Total Estimated Costs


Estimated Cost Percent of Total







1 Personnel (Direct Labor)




2 Fringe Benefits




3 Travel




4 Equipment




5 Supplies and Materials




6 Consultants




7 Contracts and Sub-Grantees




8 Construction




9 Other Direct Costs




10 Indirect Costs





Total:











Federal Share:





Match (Expressed as a percentage of the Federal Share):














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form HUD-424-CBW (2/2003)

File Typeapplication/vnd.ms-excel
AuthorEric C. Gauff
Last Modified ByHUD
File Modified2007-01-16
File Created2001-12-11
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