National State-based Tobacco Control Programs Budget Tem

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Overview

Home Page
Summary
Personnel Salary and Fringe
Contracts
Consultants
Equipment
Supplies
Travel
Other
In-Kind

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Sheet 1: Home Page

							Form Approved OMB No. ####-#### Exp. Date M/D/YYYY
				National State-Based Tobacco Control Programs (DP15-1509)
				Budget Template
			[Choose your state name…]
				The following navigation bar is available on all worksheets
				Click a tab to jump to the corresponding sheet:
	Instructions:
	You may use this template to prepare a budget. The budget template is a suggested tool to help states prepare a complete and accurate budget.
	It does not replace SF424A. Please refer to the supplemental guidance document for more information.
	Awardees who received Competitive funding should enter their budget information for both the Core and Competitive Components.
	If you received only Core funding, disregard the Competitive Component column.
	Notes on Data Entry:
	All light yellow cells are available for user input.
	Conditional formatting may highlight cells red if values are missing, not valid, or violate program rules.
	Technical Support:
	If you need technical support at any time, please send an email with a detailed description of your need to the following address:
	OSHMISTA@CDC.GOV
	Public reporting burden of this collection of information is estimated to average 2 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.
	An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a
	currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of
	information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74,
	Atlanta, Georgia 30333; ATTN:PRA ([OMB#]).

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Sheet 2: Summary

	[Choose your state name…] - Budget Summary
	Object Class	Component		Total
		Core	Competitive
	Salary and Wages	$-	$-	$-
	Fringe Benefits	$-	$-	$-
	Contractual Costs	$-	$-	$-
	Consultant Costs	$-	$-	$-
	Equipment	$-	$-	$-
	Supplies	$-	$-	$-
	Travel	$-	$-	$-
	Other	$-	$-	$-
	Direct Costs	$-	$-	$-
	Indirect Costs	$-	$-	$-
	TOTAL	$-	$-	$-
	Target	$-	$-	$-
	Balance	$-	$-	$-
	Indirect Cost Justification

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Sheet 3: Personnel Salary and Fringe

	Personnel Salary and Fringe
1	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
2	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
3	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
4	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
5	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
6	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
7	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
8	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
9	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
10	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
11	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
12	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
13	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
14	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
15	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
16	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
17	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
18	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
19	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
20	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
21	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
22	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
23	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
24	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
25	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
26	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
27	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
28	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
29	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
30	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
31	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
32	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
33	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
34	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
35	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
36	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
37	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
38	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
39	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification
40	Personnel Cost
	Name	Position Title	Annual Salary and Wages	% Paid by This Grant	Months	Salary and Wages
						$-
		Fringe	Fringe (%)	Fringe ($) if not %	Fringe	Total Planned
					$-	$-
	Allocation of Cost by Service Type
		Core %	Competitive %	Core $	Competitive $	Total Allocated
	Allocation	100.0%	0.0%	$-	$-	$-
	Justification

---

Sheet 4: Contracts

Contracts

1

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

2

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

3

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

4

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

5

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

6

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

7

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

8

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

9

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

10

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

11

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

12

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

13

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

14

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

15

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

16

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

17

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

18

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

19

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

20

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

21

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

22

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

23

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

24

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

25

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

26

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

27

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

28

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

29

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

30

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

31

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

32

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

33

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

34

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

35

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

36

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

37

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

38

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

39

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

40

Basic Information

Itemized Costs

Justification

Name of Contractor

Salary and Wages

$-

Method of Selection

Fringe Benefits

$-

Justification for Sole Source Selection

Consultant Costs

$-

Period of Performance

Equipment

$-

Scope of Work

Supplies

$-

Travel

$-

Method of Accountability

Deliverable Cost

<enter description>

$-

Other

<enter description>

$-

Allocation of Cost by Service Type

Other

<enter description>

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Other

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Subcontract Costs

$-

Total Direct Costs

$-

Indirect Costs

$-

TOTAL FOR CONTRACT

$-

---

Sheet 5: Consultants

Consultants

1

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

2

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

3

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

4

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

5

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

6

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

7

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

8

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

9

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

10

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

11

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

12

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

13

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

14

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

15

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

16

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

17

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

18

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

19

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

20

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

21

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

22

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

23

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

24

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

25

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

26

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

27

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

28

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

29

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

30

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

31

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

32

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

33

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

34

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

35

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

36

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

37

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

38

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

39

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

40

Basic Information

Itemized Costs

Justification

Name of Consultant

Number of Days of Consultation

Organizational Affiliation

Expected Daily Rate of Compensation

$-

Nature of Services to Be Rendered

BASE COMPENSATION SUBTOTAL

$-

Relevance of Service to the Project

Travel

$-

Method of Accountability

Per Diem (total for all days consultation)

$-

Allocation of Cost by Service Type

Supplies

$-

Core %

Competitive %

Core $

Competitive $

Total Allocated

Deliverable Cost

<enter description>

$-

Allocation

100.0%

0.0%

$-

$-

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

Other

<enter description>

$-

EXPENSES SUBTOTAL

$-

TOTAL FOR CONSULTANT

$-

---

Sheet 6: Equipment

	Equipment				Must Total 100%
	Equipment costs are for items with a Unit Cost over $5,000. Most Grantees will not have Equipment Costs. Select "Yes" to acknowledge this and begin entering Equipment					No
Line #	Item Requested	Number Needed	Unit Cost	Amount Planned	Core %	Competitive %	Core $	Competitive $	Justification
1				$-	100.0%	0.0%	$-	$-
2				$-	100.0%	0.0%	$-	$-
3				$-	100.0%	0.0%	$-	$-
4				$-	100.0%	0.0%	$-	$-
5				$-	100.0%	0.0%	$-	$-
6				$-	100.0%	0.0%	$-	$-
7				$-	100.0%	0.0%	$-	$-
8				$-	100.0%	0.0%	$-	$-
9				$-	100.0%	0.0%	$-	$-
10				$-	100.0%	0.0%	$-	$-
11				$-	100.0%	0.0%	$-	$-
12				$-	100.0%	0.0%	$-	$-
13				$-	100.0%	0.0%	$-	$-
14				$-	100.0%	0.0%	$-	$-
15				$-	100.0%	0.0%	$-	$-
16				$-	100.0%	0.0%	$-	$-
17				$-	100.0%	0.0%	$-	$-
18				$-	100.0%	0.0%	$-	$-
19				$-	100.0%	0.0%	$-	$-
20				$-	100.0%	0.0%	$-	$-
21				$-	100.0%	0.0%	$-	$-
22				$-	100.0%	0.0%	$-	$-
23				$-	100.0%	0.0%	$-	$-
24				$-	100.0%	0.0%	$-	$-
25				$-	100.0%	0.0%	$-	$-
26				$-	100.0%	0.0%	$-	$-
27				$-	100.0%	0.0%	$-	$-
28				$-	100.0%	0.0%	$-	$-
29				$-	100.0%	0.0%	$-	$-
30				$-	100.0%	0.0%	$-	$-
31				$-	100.0%	0.0%	$-	$-
32				$-	100.0%	0.0%	$-	$-
33				$-	100.0%	0.0%	$-	$-
34				$-	100.0%	0.0%	$-	$-
35				$-	100.0%	0.0%	$-	$-
36				$-	100.0%	0.0%	$-	$-
37				$-	100.0%	0.0%	$-	$-
38				$-	100.0%	0.0%	$-	$-
39				$-	100.0%	0.0%	$-	$-
40				$-	100.0%	0.0%	$-	$-
	Total						$-	$-	Total Allocated = $0

---

Sheet 7: Supplies

	Supplies
Line #	Item Requested	Type (if appropriate)	Number Needed	Unit Cost	Amount Planned	Core %	Competitive %	Core $	Competitive $	Justification
1					$-	100.0%	0.0%	$-	$-
2					$-	100.0%	0.0%	$-	$-
3					$-	100.0%	0.0%	$-	$-
4					$-	100.0%	0.0%	$-	$-
5					$-	100.0%	0.0%	$-	$-
6					$-	100.0%	0.0%	$-	$-
7					$-	100.0%	0.0%	$-	$-
8					$-	100.0%	0.0%	$-	$-
9					$-	100.0%	0.0%	$-	$-
10					$-	100.0%	0.0%	$-	$-
11					$-	100.0%	0.0%	$-	$-
12					$-	100.0%	0.0%	$-	$-
13					$-	100.0%	0.0%	$-	$-
14					$-	100.0%	0.0%	$-	$-
15					$-	100.0%	0.0%	$-	$-
16					$-	100.0%	0.0%	$-	$-
17					$-	100.0%	0.0%	$-	$-
18					$-	100.0%	0.0%	$-	$-
19					$-	100.0%	0.0%	$-	$-
20					$-	100.0%	0.0%	$-	$-
21					$-	100.0%	0.0%	$-	$-
22					$-	100.0%	0.0%	$-	$-
23					$-	100.0%	0.0%	$-	$-
24					$-	100.0%	0.0%	$-	$-
25					$-	100.0%	0.0%	$-	$-
26					$-	100.0%	0.0%	$-	$-
27					$-	100.0%	0.0%	$-	$-
28					$-	100.0%	0.0%	$-	$-
29					$-	100.0%	0.0%	$-	$-
30					$-	100.0%	0.0%	$-	$-
31					$-	100.0%	0.0%	$-	$-
32					$-	100.0%	0.0%	$-	$-
33					$-	100.0%	0.0%	$-	$-
34					$-	100.0%	0.0%	$-	$-
35					$-	100.0%	0.0%	$-	$-
36					$-	100.0%	0.0%	$-	$-
37					$-	100.0%	0.0%	$-	$-
38					$-	100.0%	0.0%	$-	$-
39					$-	100.0%	0.0%	$-	$-
40					$-	100.0%	0.0%	$-	$-
	Total							$-	$-	Total Allocated = $0

---

Sheet 8: Travel

	Travel
Line #	Description and Number of People	Cost of Mileage or Airfare	Cost of Per Diem or Lodging	Cost of Ground Transport	Other Costs	Amount Planned	Core %	Competitive %	Core $	Competitive $	Justification
1						$-	100.0%	0.0%	$-	$-
2						$-	100.0%	0.0%	$-	$-
3						$-	100.0%	0.0%	$-	$-
4						$-	100.0%	0.0%	$-	$-
5						$-	100.0%	0.0%	$-	$-
6						$-	100.0%	0.0%	$-	$-
7						$-	100.0%	0.0%	$-	$-
8						$-	100.0%	0.0%	$-	$-
9						$-	100.0%	0.0%	$-	$-
10						$-	100.0%	0.0%	$-	$-
11						$-	100.0%	0.0%	$-	$-
12						$-	100.0%	0.0%	$-	$-
13						$-	100.0%	0.0%	$-	$-
14						$-	100.0%	0.0%	$-	$-
15						$-	100.0%	0.0%	$-	$-
16						$-	100.0%	0.0%	$-	$-
17						$-	100.0%	0.0%	$-	$-
18						$-	100.0%	0.0%	$-	$-
19						$-	100.0%	0.0%	$-	$-
20						$-	100.0%	0.0%	$-	$-
21						$-	100.0%	0.0%	$-	$-
22						$-	100.0%	0.0%	$-	$-
23						$-	100.0%	0.0%	$-	$-
24						$-	100.0%	0.0%	$-	$-
25						$-	100.0%	0.0%	$-	$-
26						$-	100.0%	0.0%	$-	$-
27						$-	100.0%	0.0%	$-	$-
28						$-	100.0%	0.0%	$-	$-
29						$-	100.0%	0.0%	$-	$-
30						$-	100.0%	0.0%	$-	$-
31						$-	100.0%	0.0%	$-	$-
32						$-	100.0%	0.0%	$-	$-
33						$-	100.0%	0.0%	$-	$-
34						$-	100.0%	0.0%	$-	$-
35						$-	100.0%	0.0%	$-	$-
36						$-	100.0%	0.0%	$-	$-
37						$-	100.0%	0.0%	$-	$-
38						$-	100.0%	0.0%	$-	$-
39						$-	100.0%	0.0%	$-	$-
40						$-	100.0%	0.0%	$-	$-
	Total								$-	$-	Total Allocated = $0

---

Sheet 9: Other

	Other
Line #	Item Requested	Number Needed	Unit Cost	Amount Planned	Core %	Competitive %	Core $	Competitive $	Justification
1				$-	100.0%	0.0%	$-	$-
2				$-	100.0%	0.0%	$-	$-
3				$-	100.0%	0.0%	$-	$-
4				$-	100.0%	0.0%	$-	$-
5				$-	100.0%	0.0%	$-	$-
6				$-	100.0%	0.0%	$-	$-
7				$-	100.0%	0.0%	$-	$-
8				$-	100.0%	0.0%	$-	$-
9				$-	100.0%	0.0%	$-	$-
10				$-	100.0%	0.0%	$-	$-
11				$-	100.0%	0.0%	$-	$-
12				$-	100.0%	0.0%	$-	$-
13				$-	100.0%	0.0%	$-	$-
14				$-	100.0%	0.0%	$-	$-
15				$-	100.0%	0.0%	$-	$-
16				$-	100.0%	0.0%	$-	$-
17				$-	100.0%	0.0%	$-	$-
18				$-	100.0%	0.0%	$-	$-
19				$-	100.0%	0.0%	$-	$-
20				$-	100.0%	0.0%	$-	$-
21				$-	100.0%	0.0%	$-	$-
22				$-	100.0%	0.0%	$-	$-
23				$-	100.0%	0.0%	$-	$-
24				$-	100.0%	0.0%	$-	$-
25				$-	100.0%	0.0%	$-	$-
26				$-	100.0%	0.0%	$-	$-
27				$-	100.0%	0.0%	$-	$-
28				$-	100.0%	0.0%	$-	$-
29				$-	100.0%	0.0%	$-	$-
30				$-	100.0%	0.0%	$-	$-
31				$-	100.0%	0.0%	$-	$-
32				$-	100.0%	0.0%	$-	$-
33				$-	100.0%	0.0%	$-	$-
34				$-	100.0%	0.0%	$-	$-
35				$-	100.0%	0.0%	$-	$-
36				$-	100.0%	0.0%	$-	$-
37				$-	100.0%	0.0%	$-	$-
38				$-	100.0%	0.0%	$-	$-
39				$-	100.0%	0.0%	$-	$-
40				$-	100.0%	0.0%	$-	$-
	Total						$-	$-	Total Allocated = $0

---

Sheet 10: In-Kind

	In-Kind
	Total non-Federal Funds (if not using table below)
	Estimated In-Kind Funding
	Object Class	Applicant Funds	State Funds	Local Funds	Other	Program Income	TOTAL
	Salary and Wages						$-
	Fringe Benefits						$-
	Consultant Costs						$-
	Equipment						$-
	Supplies						$-
	Travel						$-
	Other						$-
	Contractual Costs						$-
	TOTAL	$-	$-	$-	$-	$-	$-
	You may use the space below to provide additional detail on in-kind and matching funds provided. (Hint: press Alt+Enter to add a line break)