Final - 424CBW.xlsx

Eviction Protection Grant Program

Final - 424CBW.xlsx

OMB: 2528-0331

Document [xlsx]
Download: xlsx | pdf

Overview

Worksheet
Summary
PRA and Instructions


Sheet 1: Worksheet

Grant Application Detailed Budget Worksheet









OMB Number 2501-0044



Expiration: 2/28/2027



Applicant Name:













Applicant Address:

























































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













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













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)













7a. Contracts
Quantity Unit Cost Estimated Cost
HUD Share Applicant Match Other HUD Funds Other Federal Share State Share Local/Tribal Share Other Program Income









































































































Subtotal - Contracts













7b. 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


























































































Subtotal - Sub-Grantees













Total Contracts and Sub-Grantees Cost













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













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













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














Sheet 2: Summary





form HUD-424-CBW




OMB Number 2501-0044
Grant Application Detailed Budget Worksheet Expiration: 2/28/2027






Detailed Description of Budget
Analysis of Total Estimated Costs

Estimated Cost Percent of Total
1 Personnel (Direct Labor)
0.00 0.0%
2 Fringe Benefits
0.00 0.0%
3 Travel
0.00 0.0%
4 Equipment
0.00 0.0%
5 Supplies and Materials
0.00 0.0%
6 Consultants
0.00 0.0%
7 Contracts and Sub-Grantees
0.00 0.0%
8 Construction
0.00 0.0%
9 Other Direct Costs
0.00 0.0%
10 Indirect Costs
0.00 0.0%

Total:
0.00 0.0%
Federal Share:



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































































Sheet 3: PRA and Instructions

Public Reporting Act Statement


The public reporting burden for this collection of information is estimated to average 3 hours 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. Comments regarding the accuracy of this burden estimate and any suggestions for reducing this burden can be sent to: U.S. Department of Housing and Urban Development, Office of the Chief Data Officer, R, 451 7th St SW, Room 8210, Washington, DC 20410-5000. Do not send completed HUD 424-CBW forms to this address. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection displays a valid OMB control number. The Department of Housing and Urban Development is authorized to collect this information under the authority cited in the Notice of Funding Opportunity for this grant program. The information collected will provide proposed budget data for multiple programs. HUD will use this information in the selection of applicants. This information is required to obtain the benefit sought in the grant program. This information will not be held confidential and may be made available to the public in accordance with the Freedom of Information Act (5 U.S.C. §552).


Instructions for Completing the Grant Application Detailed Budget Worksheet


This form is to be used to provide detailed budget information regarding your proposed program. If your program requires you to provide program activity information you should use a separate HUD-424-CBW to provide information related to each program activity. The detailed information provided on this form can be summarized on the HUD-424-CB form by checking the “All Years” box at the top of the form and inputting the summary information.
Item Discussion
1 - Personnel (Direct Labor) This section should show the labor costs for all individuals supporting the grant program effort (regardless of the source of their salaries). The hours and costs are for the full life of the grant. If an individual is employed by a contractor or sub-grantee, their labor costs should not be shown here.

Please include all labor costs that are associated with the proposed grant program, including those costs that will be paid for with in-kind or matching funds.

Do not show fringe or other indirect costs in this section.

Please use the hourly labor cost for salaried employees (use 2080 hours per year or the value your organization uses to perform this calculation). An employee working less than full time on the grant should show the numbers of hours they will work on the grant.
2 - Fringe Benefits Use the standard fringe rates used by your organization. You may use a single fringe rate (a percentage of the total direct labor) or list each of the individual fringe charges. The spreadsheet is set up to use the Total Direct Labor Cost as the base for the fringe calculation. If your organization calculates fringe benefits differently, please use a different base and discuss how you calculate fringe as a comment.
3 - Travel
3a - Transportation - Local Private Vehicle If you plan on reimbursing staff for the use of privately owned vehicles or if you are required to reimburse your organization for mileage charges, show your mileage and cost estimates in this section.
3b - Transportation - Airfare Show the estimated cost of airfare required to support the grant program effort. Show the destination and the purpose of the travel as well as the estimated cost of the tickets.

Each program notice of funding opportunity (NOFO) discusses the travel requirements that should be listed here.
3c - Transportation - Other If you or are charged monthly by your organization for a vehicle for use by the grant program, indicate those costs in this section.

Provide estimates for other transportation costs that may be incurred (taxi, etc.).
3d - Per Diem or Subsistence For travel which will require the payment of subsistence or per diem in accordance with your organization’s policies. Indicate the location of the travel.

Each program NOFO discusses the travel requirements that should be listed here.
4 – Equipment “Equipment” means tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost that equals or exceeds the lesser of the capitalization level established by the non-Federal entity for financial statement purposes, or $5,000.

Each program NOFO describes what equipment may be purchased using grant funding.
5 - Supplies and Materials “Supplies” means all tangible personal property other than those described in the definition of equipment. A computing device is a supply if the acquisition cost is less than the lesser of the capitalization level established by the non-Federal entity for financial statement purposes or $5,000, regardless of the length of its useful life.

List the proposed supplies and materials as either Consumable Supplies or as Non-Consumable Materials.
5a - Consumable Supplies List the consumable supplies you propose to purchase. General office or other common supplies may be estimated using an anticipated consumption rate.
5b - Non-consumable materials List furniture, computers, printers, and other items that will not be consumed in use. Please list the quantity and unit cost.
6 – Consultants Indicate the consultants you will use. Indicate the type of consultant (skills), the number of days you expect to use them, and their daily rate.
7 - Contracts and Subgrantees
7a - Contracts
7b - Subgrantees
List the contractors and sub-grantees that will help accomplish the grant effort. Examples of contracts that should be shown here include contracts with Community Based Organizations; liability insurance; and training and certification for contractors and workers.

If any contractor, sub-contractor, or sub-grantee is expected to receive over 10% of the total Federal amount requested, a separate Grant Application Detailed Budget (Worksheet) should be developed for that contractor or sub-grantee and the total amount of their proposed effort should be shown as a single entry in this section.

Unless your proposed program will perform the primary grant effort with in-house employees (which should be listed in section 1), the costs of performing the primary grant activities should be shown in this section.

Types of activities which should be shown in this section:
·        Contracts for all services
·        Training for individuals not on staff
·        Contracts with Community Based Organizations or Other Governmental Organizations (note the 10% requirement discussed above)
·        Insurance if your program will procure it separately

Please provide a short description of the activity the contractor or subgrantee will perform, if not evident.
8 – Construction Costs
8a – Administrative and legal expenses Enter estimated amounts needed to cover administrative expenses. Do not include costs that are related to the normal functions of government.
8b – Land, structures, rights-of way, appraisal, etc. Enter estimated site and right(s)-of-way acquisition costs (this includes purchase, lease, and/or easements).
8c – Relocation expenses and payments Enter estimated costs related to relocation advisory assistance, replacement housing, relocation payments to displaced persons and businesses, etc.
8d – Architectural and engineering fees Enter estimated basic engineering fees related to construction (this includes start-up services and preparation of project performance work plan).
8e – Other architectural and engineering fees Enter estimated engineering costs, such as surveys, tests, soil borings, etc.
8f – Project inspection fees Enter estimated engineering inspection costs.
8g – Site work Enter the estimated site preparation and restoration costs that are not included in the basic construction contract.
8h – Demolition and removal Enter the estimated costs related to demolition activities.
8i – Construction Enter estimated costs of the construction contract.
8j - Equipment Enter estimated cost of office, shop, laboratory, safety equipment, etc. to be used at the facility, if such costs are not included in the construction contract.
8k – Contingencies Enter any estimated contingency costs.
8l – Miscellaneous Enter estimated miscellaneous costs.
9 - Other Direct Costs Other Direct Costs include a number of items that are not appropriate for other sections.

Other Direct Costs may include:
·        Staff training
·        Telecommunications
·        Printing and postage
Relocation, if costs are paid directly by your organization (if relocation costs are paid by a subgrantee, it should be reflected in Section 7)
10 - Indirect Costs Indirect costs (including Facilities and Administration costs) are those costs that have been incurred for common or joint purposes. These costs benefit more than one cost objective and cannot be readily identified with a particular final cost objective without effort disproportionate to the results achieved.

Indicate your approved Indirect Cost Rate (if any) and calculate the indirect costs in accordance with the terms of your approved indirect cost rate and enter the resulting amount. Also show the applicable cost base amount and identify the proposed cost base type.
Total Estimated Costs Enter the grand total of all the applicable columns.
The eight rightmost columns allow you to identify how the costs will be spread between the HUD Share and other contributors (including Match funds and Program Income). This information will help the reviewers better understand your program and priorities.
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy