HUD-91186-A Multifamily Housing Service Coordinator One Year Budget

Multifamily Housing Service Coordinator
One-Year Budget

OMB Approval No. 2502-0447
(exp 09/30/2013)

U.S. Department of Housing
and Urban Develpment
Office of Housing

The public reporting burden for this collection of information for the Multifamily Housing Service Coordinator Programs is es
and maintaining the data needed, and completing and r
not required to respond to, a collection of information unless the collection displays a valid control number.

Name and Address of Grantee/Owner:

1. Project Information: Please provide the information for every project included in your request; add more rows if needed.
c. FHA or Project
b. Project Type (I.e.Sec. 202, 236,
a. Project Name and Address
Number:
221(d)(3)BMIR, or Sec. 8)

f. Resident Information
Estimate # of Frail Elderly:
Estimate # of at Risk Elderly:
Estimate # Non-Elderly People w/ Disabilities
Remaining Residents
Total

Number of Residents
______
______
______
______

% of Total Residents
______ %
______ %
______ %
______ %

0

d. Section 8 Number e. # of Subsidized
Rental Units

g. If the SC will serve multiple eligible projects, give
proportionate amount of time planned for each site.
Project Name(s)
# of Hours per week

0.0

2. Budget Information**
a. Personnel (Direct Labor/Salary)
Identify Position - SC or Aide

Hours

Rate per Hour

Year1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.0

Total Direct Labor Cost
b. Fringe Benefits

Rate (%)

Base

Year1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Fringe Benefits Cost

Page 1 of 7

Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

c. Quality Assurance/Program Evaluation
(cap - 10% of line "a", Personnel)

OMB Approval No. 2502-0447
(exp 3/31/2007)

U.S. Department of Housing
and Urban Develpment
Office of Housing

Hours

Rate per Hour

Year1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Quality Assurance
d. Training

Hours

Rate per Hour

Year1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Training
e. Travel (Indicate local private vehicle, (mileage and rate per mile) airfare (trips and fare), other (quantity and unit cost), per diem (days
and rate per day).

Year 1

Total Travel
f. Supplies and Materials

$0.00
Quantity

Unit Cost

Year 1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Supplies and Materials
g. Other Direct Costs

Quantity

Unit Cost

Year 1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Other Direct Costs
Subtotal of Direct Costs

Page 2 of 7

Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

OMB Approval No. 2502-0447
(exp 3/31/2007)

U.S. Department of Housing
and Urban Develpment
Office of Housing

Quantity

h. Indirect Costs

Unit Cost

Year 1

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

Total Indirect Costs
i. Total Estimated Costs
** Please note: You may increase costs from year to year by no more than 3%.
j. Contracts: If you plan to contract out for a Service Coordinator or for Quality Assurance, list related cost. Give item and related cost

k. Quality Assurance is _______% of line a, "Personnel (Direct Labor)". (Cannot exceed 10%.)
3. Funding Sources and Time Periods (Indicate all that apply.)

Grant

# of Years

# of Months

- N/A -

12

$ Amount

# of Years

Residual Receipts

$ Amount

Excess Income

$ Amount

Section 8 Operating Funds
Budget-based)

$ Amount

From Date

To Date

# of Months

From Date

To Date

# of Years

# of Months

From Date

To Date

# of Years

# of Months

From Date

To Date

(i.e.

Page 3 of 7

Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

U.S. Department of Housing
and Urban Develpment
Office of Housing

Signature: ___________________________________________

Contact Name: _________________________

OMB Approval No. 2502-0447
(exp 3/31/2007)

Date: _______________

Phone #: ____________________

Page 4 of 7

Email: _______________________________

Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

OMB Approval No. 2502-0447
(exp 3/31/2007)

U.S. Department of Housing
and Urban Development
Office of Housing

Project Information: Please provide the information for every project included in your request; add more rows if needed.
c. FHA or Project
2. a. Project Name and Address
b. Project Type (I.e. Sec. 202, 236,
Number
221(d)(3)BMIR, or Sec. 8)

f. Resident Information
Estimate # of Frail Elderly
Estimate # of at Risk Elderly
Estimate # Non-Elderly People w/ Disabilities
Remaining Residents

Number of Residents % of Total Residents
______
______ %
______
______ %
______
______ %
______
______ %

0

Total

d. Section 8 Number e. # of Subsidized
Rental Units

g. If the SC will serve multiple eligible projects, give
proportionate amount of time planned for each site.
Project Name(s)
# of Hours per week

0.0

Project Information:

3. a. Project Name and Address

f. Resident Information
Estimate # of Frail Elderly
Estimate # of at Risk Elderly
Estimate # Non-Elderly People w/ Disabilities
Remaining Residents
Total

b. Project Type (I.e. Sec. 202, 236,
221(d)(3)BMIR, or Sec. 8)

Number of Residents % of Total Residents
______
______ %
______
______ %
______
______ %
______
______ %

0

c. FHA or Project
Number

d. Section 8 Number e. # of Subsidized
Rental Units

g. If the SC will serve multiple eligible projects, give
proportionate amount of time planned for each site.
Project Name(s)
# of Hours per week

0.0

Page 5 of 7

More Projs Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

OMB Approval No. 2502-0447
(exp 3/31/2007)

U.S. Department of Housing
and Urban Development
Office of Housing

Project Information:

4. a. Project Name and Address

f. Resident Information
Estimate # of Frail Elderly
Estimate # of at Risk Elderly
Estimate # Non-Elderly People w/ Disabilities
Remaining Residents

b. Project Type (I.e. Sec. 202, 236,
221(d)(3)BMIR, or Sec. 8)

Number of Residents % of Total Residents
______
______ %
______
______ %
______
______ %
______
______ %

0

Total

c. FHA or Project
Number

d. Section 8 Number e. # of Subsidized
Rental Units

g. If the SC will serve multiple eligible projects, give
proportionate amount of time planned for each site.
Project Name(s)
# of Hours per week

0.0

Project Information:

5. a. Project Name and Address

Estimate # of Frail Elderly
Estimate # of at Risk Elderly
Estimate # Non-Elderly People w/ Disabilities
Remaining Residents
Total

b. Project Type (I.e. Sec. 202, 236,
221(d)(3)BMIR, or Sec. 8)

Number of Residents % of Total Residents
______
______ %
______
______ %
______
______ %
______
______ %

0

c. FHA or Project
Number

d. Section 8 Number e. # of Subsidized
Rental Units

g. If the SC will serve multiple eligible projects, give
proportionate amount of time planned for each site.
Project Name(s)
# of Hours per week

0.0

Page 6 of 7

More Projs Form HUD-91186-A
(5/2004)

Multifamily Housing Service Coordinator
One-Year Budget

OMB Approval No. 2502-0447
(exp 3/31/2007)

U.S. Department od Housing
and Urban Development
Office of Housing

Instructions for completing the One-Year Budget, HUD-91186-A
Section 2: Budget Information
a. Personnel (Direct Labor)

b. Fringe Benefits

c. Quality Assurance

d. Training
e. Travel

f. Supplies and Materials

g. Other Direct Costs

h. Indirect Costs

This section should show the labor costs for The Service Coordinators and/or
aides. Use the hourly labor cost for salaried employees (use 2080 hours per
year or the value your organization uses to perform this calculation). Do not
show fringe or other indirect costs in this section.
Use the same standard fringe rate 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. Use the Total Direct Labor Cost as the base for the
fringe calculation. If your organization calculates fringe benefits differently, use
a different base and discuss how you calculate fringe as a comment.
Give the title of the professional (e.g. MSW) who will be performing QA, the
number of hours over the year you expect to use them, and their hourly rate.
Quality Assurance is limited to program evaluation activities and cannot
exceed 10% of line a, Personnel.
Give fees and rates for appropriate training programs, to the extent known.
Otherwise estimate and provide basis for the anticipated cost.
Provide mileage and cost estimates for use of private vehicles or public
transportation; show the estimated cost of airfare required to attend training
programs, and list necessary per diem rates in accordance with your
organization’s policies. Give travel destinations if known.
List the supplies you propose to purchase. You can use an anticipated
consumption rate to estimate the cost of office or other common supplies, (e.
g. 1 box paper clips every 3 months). Include replacement of office
equipment. List items individually along with the quantity and their anticipated
cost.
Include costs such as telephone and Internet Service, printing, postage, and
maintenance of office equipment, when such costs are attributable to the SC
program only.
OMB Circular A87 defines indirect costs as those that have been incurred by
multiple programs for common or joint purposes. Indirect costs are associated
with the centralized services distributed throughout your agency and cannot be
readily identified with one particular program. Additionally, the costs should
not be otherwise treated as direct costs. If your organization already has an
established indirect cost rate, use this rate and explain how it is calculated.

i. Grand Total
j. Contracts (Sub-Grantees)

Sum lines “a” through “h” to get your one-year total request amount.
If you will contract with a public or private agency to provide the Service
Coordinator or Quality Assurance, list the activities and costs included in the
contract in this section.
k. Quality Assurance percent of Quality Assurance costs cannot exceed ten percent (10%) of your total
line a, Personnel
Personnel/Direct labor cost. Calculate your percentage and include on this
line, to ensure you are within the 10% cap.
Section 3: Funding Sources and Time Periods
Housing owners can use any of the four funding sources to pay the costs of a Service Coordinator program.
You may use these resources individually or in combination with each other. Indicate which funding sources
you propose to use, by giving the dollar amount, the number of years and months during which you will use the
funds, and the exact time period, (e.g. from May 1, 2004 to April 30, 2005).

Page 7 of 7

Instructions Form HUD-91186-A (5/2004)