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Name Service Rate Other SS/HS Costs Project LAUNCH Costs Grand Total *Travel at 3,124 @ .50 per mile = $1,562 *Training course $175 (3) John Smith (Editor) Copy Editing 1FTE @ $27,000 + Fringe Benefits of $6,750 = $33,750 *Supplies @ $47.54 x 12 months or $570 *Telephone @ $60 x 12 months = $720 $46,167 $46,167 $92,334 *Indirect costs = $9,390 (negotiated with contractor) (4) Jane Smith GBG Consultant $250 per hour x 400 hours 12 month period $50,000 $50,000 $100,000 (5) To Be Announced Marketing Coordinator Annual salary of $50,000 x 50% level of effort TOTAL $25,000 $25,000 $50,000 $217,334 JUSTIFICATION: Explain the need for each contractual agreement and how it relates to the overall project. (1) Certified trainers are necessary to carry out the purpose of the SS/HS State Program and Project LAUNCH by providing state level training, development of systems change policies, and educating the public and local communities on how to effectively implement changes at the state level. 50
(2) Consultant is needed to provide training on health disparaties. (3) Editor is needed for development of all written products. (4) Consultant is needed for Good Behavior Game Training. (5) Marketing Coordinator will develop a plan to include public education and outreach efforts to engage state and community leaders , provide presentations at public meetings and community events to stakeholders, community civic organizations, churches, agencies, family groups and schools. *Represents separate/distinct requested funds by cost category FEDERAL REQUEST – (enter in Section B column 1 line 6f of form SF-424A) $86,997 G. Construction: NOT ALLOWED – Leave Section B columns 1& 2 line 6g on SF- 424A blank. H. Other: expenses not covered in any of the previous budget categories FEDERAL REQUEST Item Rate SS/HS Costs Project LAUNCH Costs Grand Total (1) Rent* $50/sq.ft x 2,500 sq. feet $62,500 $62,500 $125,000 (2) Telephone $600/mo. x 12 mo. $ 7,200 $ 7,200 $ 14,400 (3) Teleconferences (SS/HS) (4) Teleconferences (Project LAUNCH) (5) Brochures (SS/HS) (5) Brochures (Project LAUNCH) 18 sites x $8/hr x 1.5 hours x 40 events 34 sites x $8/hr x 1.5 hours x 30 events 1.50/brochure X 1500 brochures 1.50/brochure X 1500 brochures $ 8,640 $ 8,640 $12,240 $ 12,240 $2,250 $ 2,250 $2,250 $ 2,250 TOTAL $80,590 $84,190 $164,780 JUSTIFICATION: Break down costs into cost/unit (e.g. cost/square foot). Explain the use of each item requested. 51
Page 1 and 2: Department of Health and Human Serv
Page 3 and 4: Appendix B - Guidance for Electroni
Page 5 and 6: Cost Sharing/Match Required: No Len
Page 7 and 8: programming and policies will be ac
Page 9 and 10: • Assist grantees with developing
Page 11 and 12: • Participate in state, regional,
Page 13 and 14: Freedom (OIF), and Operation New Da
Page 15 and 16: and performance assessment, e.g., a
Page 17 and 18: Tribal organization means the recog
Page 19 and 20: (demographics and clinical characte
Page 21 and 22: Your application must be received b
Page 23 and 24: Section B: Proposed Approach (35 po
Page 25 and 26: • Demographics - race, ethnicity,
Page 27 and 28: Note: There should be separate colu
Page 29 and 30: termination of the grant award, or
Page 31 and 32: Appendix A - Checklist for Formatti
Page 33 and 34: Appendix B - Guidance for Electroni
Page 35 and 36: that these issues will be resolved
Page 37 and 38: • Name, telephone number, and e-m
Page 39 and 40: o Documentation of nonprofit status
Page 41 and 42: grant applications submitted by com
Page 43 and 44: prevention provider may also provid
Page 45 and 46: Appendix F - Sample Budget and Just
Page 47 and 48: FEDERAL REQUEST Purpose of Travel L
Page 49: Item(s) Rate SS/HS Costs Project LA
Page 53 and 54: FEDERAL REQUEST - (enter in Section
Page 55 and 56: Appendix G - Confidentiality and SA
Page 57 and 58: Appendix H- Addressing Behavioral H
Page 59 and 60: You can learn more about the CLAS m
Page 61 and 62: Appendix I - Sample Logic Model A l
Page 63 and 64: Sample Logic Model 63

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