Indian Environmental General Assistance Program (GAP)

General Performance Reporting for Assistance Programs (NEW)

GAP_Performance Work Plan_Budget Worksheet_July 2024

Indian Environmental General Assistance Program (GAP)

OMB:

Document [pdf]

Download: pdf | pdf

OMB Control Number: 2090-NEW
Expira;on Date: xx/xx/xxxx

Indian Environmental General Assistance Program
Detailed Budget Worksheet
The detailed budget worksheet is an op4onal planning tool and should be emailed to your EPA GAP
Project Oﬃcer. It should not be submiAed in Grants.gov as part of the ﬁnal applica4on package.
For guidance on construc4ng a budget please visit:
hAps://www.epa.gov/sites/produc4on/ﬁles/2019-05/documents/applicant-budget-developmentguidance.pdf
Revised 02/13/24

This collec*on of informa*on is approved by OMB under the Paperwork Reduc*on Act, 44
U.S.C. 3501 et seq. OMB Control Number: 2090-NEW. Responses to this collec*on of
informa*on is op*onal [40 CFR Part 35, 2 CFR Parts 200 and 207]. An agency may not conduct
or sponsor, and a person is not required to respond to, a collec*on of informa*on unless it
displays a currently valid OMB control number. The public repor*ng and recordkeeping burden
for this collec*on of informa*on is 2 hours. Send comments on the Agency’s need for this
informa*on, the accuracy of the provided burden es*mates and any suggested methods for
minimizing respondent burden to Director, Informa*on Engagement Division; U.S.
Environmental Protec*on Agency (2821T); 1200 Pennsylvania Ave., NW; Washington, D.C.
20460. Include the OMB control number in any correspondence. Do not send the completed
form to this address.

Indian Environmental General Assistance Program
Detailed Budget Worksheet
he detailed budget wor sheet is an optional planning tool and
should be emailed to our
ro ect fficer. t should not
be submitted in rants.gov as part of the final application
pac age. For guidance on constructing a budget please visit:
https://www.epa.gov/sites/production/files/2019-05/documents/
applicant-budget-development-guidance.pdf
Revised 02/13/2

form
rintring
Form
Budget Year

Date Submitted/Revised:

Name of Grant Recipient:

PERSONNEL - List all staff positions for the project by title. Enter hourly salary rate and the number of hours

allotted to the project for the project period. The total personnel costs should be entered on Standard Form
424A, Section B, Line 6.a.
Position/Title

Hourly Rate

No. of Hours

Estimated
Work Years

*Total
Estimated
Work Years

Subtotal

0
0

* Total Estimated Work Years is a
measurement of staff time
spent on work plan activities.
Calculate by adding the annual hours
for each staff position together, then
dividing this total by 2080 hours. (One
full-time work year is 2080 hours.) In
the work plan, divide the Total
Estimated Work Years among all work
plan components.

PERSONNEL TOTAL:
FRINGE BENEFITS - Enter the r n e enefits that are included and

re e t e

r r n e rate a a de
a n
The r n e tot l should be entered on Standard Form 424A, Section B, Line 6.b.

1. Please provide the
benefits that are
included in your fringe
rate. For example,
Retirement, Health Care,
Annual and Sick Leave,
Life Insurance, etc.

2. Please provide fringe
rate percentage in
decimal format. For
example, .25, .40, etc.

3. lease enter any
miscellaneous or lump
sum benefits not a
fringe amount added to
ersonnel total .

FRINGE TOTAL:

NOTE: To convert a percentage to a decimal,
move the decimal point two spaces to the left.
For example, 17.5% would convert to .175

Page 1 of 7

and

TRAVEL - Salaried employees only. Indicate the travel's purpose, the destination of each trip, the duration, and the
number of travelers. Specify the mileage, per diem, and other costs for each trip, such as lodging, transportation,
etc. Refer to htt
a
tra e an
er d e rate for federal rates (optional); tribes may use
rates specified in their own policies.This amount will be entered on Standard Form 424A, Section B, Line 6.c.
Trip A - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip A

Trip B - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip B

Trip C - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip C

Trip D - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip D

* Rental Car, Taxi, Shuttle, Rail, etc.
Page 2 of 7

TRAVEL - CONTINUED: Indicate the budgeted travel's purpose, the destination of each trip, the duration of the trip
and the number of travelers. Specify the mileage, per diem, and other costs for each trip, such as lodging, common
carrier transportation, etc. Tot l or tr el should be entered on Standard Form 424A, Section B, Line 6.c.
Trip E - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip E

Trip F - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip F

Trip G - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip G

Trip H - Purpose, Location,
Attendees, Component #
and/or Travel Justification

Expense

Cost
(or rate/mile)

# of Days
(or # of miles)

# of
Travelers

# of Trips

Amount

Round Trip Airfare

Lodging

Per Diem (Meals &
Incidental Expenses)

* Ground Transportation

POV Mileage Cost

0
Subtotal for Trip H

* Rental Car, Taxi, Shuttle, Rail, etc.
Page 3 of 7

TRAVEL TOTAL:

EQUIPMENT - List each item to be purchased that ha an estimated acquisition cost (including shipping) of more

than ,000 per unit and a useful life of more than one year. lternati ely, you may list shippin costs separately
under ther Items with a unit cost of ,000 or less may be entered under upplies or ther. Please provide a
detailed justification, identify the appropriate work plan component number, and explain how you arrived at
your estimates. If applicable, indicate why it is more cost effective to purchase rather than lease. u p ent
tot l should be entered on Standard Form 424A, Section B, Line 6.d.
Item Description

Component #

Cost Per Item

How Many?

Amount

Equipment Justification/Cost
Estimates (e.g., vendor quotes,
catalog searches, etc.):

EQUIPMENT TOTAL:
SUPPLIES - Supplies means tangible property other than equipment. The detailed budget wor sheet should

identify categories of supplies to be procured (e.g., laboratory supplies or office supplies) and their cost. If
requesting items previously purchased, explain why they are being purchased again. Explain how you arrived at
your estimates. uppl es tot l should be entered on Standard Form 424A, Section B, Line 6.e.
Item Description

Component #

Cost Per Item or
Month

How Many Items or
Months?

Explanation of cost estimates
and previous purchases (e.g.,
based on previous year's
expenses, vendor quotes,
catalog searches, etc.):

SUPPLIES TOTAL:
Page 4 of 7

Amount

CONTRACTUAL - Identify each proposed contract and specify its purpose and estimated cost. Provide information on how the
costs were estimated. ontr ctu l amount should be entered on Standard Form 424A, Section B, Line 6.f.
NOTE: or uidance that e plains each ob ect class cate ory includin sole source procurement, please isit https
www epa o sites production files
documents applicant bud et de elopment uidance pdf f your project requires
hiring consultants (individuals providing expert service, managed directly by the grantee, not managed by a company/
firm/contractor), the maximum allowable consultant rate cannot exceed the maximum daily rate for Level IV of the Executive
Schedule, adjusted annually. Find the rates at: https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salarytables/pdf/202 /EX.pdf. Select "Salary and Wages," then "Executive Schedule." Divide the annual salary by
hours to
determine the ma imum hourly rate ultiply by to determine the ma imum daily rate

Contracts
Item Description

Purpose/Basis for Estimates

Component

Amount

Contractual Subtotal

Consultants
Consultant A - Purpose,
Location, and Component
and/or Commitment #

Expense

Cost
(or rate/mile)

# of Hours,
Days, or Miles

# of People

# of Trips

Amount

# of People

# of Trips

Amount

Hourly or Daily Wage
Travel (RT Airfare or
Mileage Cost)
Lodging
Per Diem (Meals &
Incidental Expenses)

Subtotal for Consultant A
Consultant B - Purpose,
Location, and Component
and/or Commitment #

Expense

Cost
(or rate/mile)

# of Hours,
Days, or Miles

Hourly or Daily Wage
Travel (RT Airfare or
Mileage Cost)
Lodging
Per Diem (Meals &
Incidental Expenses)

Subtotal for Consultant B

Page 5 of 7

CONTRACTUAL
TOTAL:

OTHER - Include items here which do not fit in the other specific budget categories. Give a brief description of the

expense and how you arrived at the estimate. Participant support costs (e.g., council travel) are entered here.
Do not include items contained in the Tribe's Indirect Cost Rate Proposal. *Grantees who own their building
are not entitled to reimbursement for rent; however, they may directly charge for utilities and maintenance costs
using a cost allocation plan. If an expense is being shared with other programs, please provide the cost share
formula. This amount should be entered on Standard Form 424A, Section B, Line 6.h.
Item Description

How Did You Arrive at Cost?

Cost Per Item
or Month

How Many Items
or Months?

Building Lease/Rent *
Explanation of Cost Sharing Formula

Explanation of Cost Sharing Formula
or Cost Allocation

OTHER TOTAL:
Page 6 of 7

Amount

INDIRECT COSTS - If indirect charges are budgeted, indicate the approved rate and base. The base amount is usually
total direct costs, less capital expenditures and pass through funds. Pass through funds are normally defined as major
subcontracts, payments to participants, stipends to eligible recipients, and subgrants, all of which normally require
minimal administrative effort. However, please refer to your negotiated agreement for specific guidance. This
amount should be entered on Standard Form 424A, Section B, Line 6.j.
NOTE: If you plan to propose indirect costs as part of your grant budget, you must
t ne the
n t
r r e t
er: (a) a current approved Indirect Cost Rate Agreement or (b) documentation that a current
indirect cost rate proposal has been submitted to the Department of Interior's National Business Center (DOI/NBC)
or other co ni ant a ency f you do not ha e (a) or (b), you may choose one of the followin options

1. You may use a provisional/final indirect cost rate used on a current grant with the DOI. The DOI grant must correspond
to the same project period as the EPA grant. You must provide a copy of the DOI grant agreement with your EPA
application package.
2. e uest a default indirect cost rate of
at the time of application The recipient must use the 10 de minimis rate
throughout the life of the assistance agreement, unless the recipient negotiates and receives approval for an IDC rate
with its cogni ant Federal agency during the life of the agreement.

Approved or
Proposed Indirect
Cost Rate (Enter as
a decimal):

INDIRECT TOTAL:

Base Amount:

NOTE: To convert a percentage to a decimal,
move the decimal point two spaces to the left.
For example, 17.5% would convert to .175

TOTAL BUDGET:

Estimated Program Income - amount and planned
use of funds:

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Page 7 of 7

File Type	application/pdf
Author	Aarti Iyer
File Modified	2024-05-30
File Created	2024-05-30