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t <br /> CEBH@IRMW CWAdolescent psydil8triC Medal Health C& k <br /> UNIFORM GRANT APPLICATION <br /> BUDGET NARRATIVE WORKSHEET <br /> /MPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your <br /> program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder specific <br /> Budget Forms. <br /> AGENCY/PROGRAM NAME : CE13H@lRMH/ Child/Adolescent Psychiatric Mental Health Clinic <br /> FUNDER: IRC=CSAC <br /> CA UTION : Do not enter any figures where a cell is colored In dark blue - Formulas and/or links are In place, Gray areas should <br /> Lbe used for calculations and to write Information oniv,OWN -a- <br /> I <br /> :.: . .. . . . ::#.fid . ; •::: . <br /> . . . . . . . . . . . . . . .. . . . . . . . . . . .. .. . r. .. .. . :: . . . . . . . v.;iii:•i:•i.:ti{:}.i::i�F;:i::r•:i}:�i:;:::;.}:.;-•� <br /> . .. . . <br /> 1 <br /> 1 Children's Services CouncilSt. Lucie <br /> 2 Children's Services Council-Martin <br /> 3 Advisory Committee-Indian River <br /> 76000.00 <br /> 4 United WaySt. Lucie County76 000. 152,605.0 <br /> 5 United Way-Martin County <br /> 6 United Way-Indian River County , :^ <br /> f <br /> 7 Department of Children & Families <br /> 8 County Funds <br /> 9 Contributions-Cash .... . ,. <br /> 10 Program Fees 7500000 <br /> 11 Fund Raisin Events-Net 6.700.000• <br /> . . . . .. . . . . . . . <br /> 12 Sales to Public - Net :::>: : >:•>:;;>: <br /> 13 Membership Dues > >. <br /> 14 Investment Income <br /> 15 Miscellaneous : • •. :• • .• <br /> 16 Legacies & Bequests <br /> 17 Funds from Other Sources 29000 <br /> 18 Reserve Funds Used for Operating <br /> 19 In-Kind Donations - IRMH j ` <y' 101 777.00 <br /> 20 TOTAL REVENUES ::`•: % % <br /> downy include tine 19 $151 ,000.00 576,000.00 56,854,605.0 <br /> Ss, <br /> .. .. . .�::.�:.::,-.�:::::.:�: -::•i:�:•i:•::•:i;:}'i::::r.:•:::.;r:.:::::::::•:: l.•:�:L?>:i::}:?:i>::. .,:i:5:;•i:�:•i::::i:;•}:.� ..: <br /> .�:.v:::::::.:.:,•. •:r:::•:•i:iiia•};i; <br /> ;.}::;::•:::::::•::•i:{•:-iii' . : . . . . . . . . . .. . . . . . . . . . . . ..:. . .: }� <br /> . . . :;;:.;•:::. ::::::;vii;.}•: , . . . . ::. :... .::.�:Ri:•:;;: i:•:i;::, . . . . .. .v : . .. . . . . ... . ... <br />.... . :�•:. :. <br /> :;;:;;;;;<::.i:;•;ilii:.i:;;;.i:<;.;iiiom ::::::::::::: . . .. . . . . . . . <br /> •i:•i..�.•..•.•�-.- .-.-i�.iiii i:•;:.i:•i:;.:;;•i:;•::•:;- �i : :; .;;:}•;:«:;•i:.;::.;�.;::.ii••i:•;:: :: :; :.::::::. <br /> 21 Salaries - <br /> (must complete chart on next page) . ��:•:r:=� <br /> :;< ;:» : >:; :.>: >:;•<: >:: >:.:<.: : s>s:.> i;:::<:»>::»:>::;::<ii:<:.,;i: •ii:;;•i;i::: ::.:: . 184 67.00 7 3,551 <br />,447.21 <br /> �:::::x�:::.;ilii:-iii>•ri;;<::< <: :• <br /> :. :::::ilii::'^:::;•ii;:•i:-:;•:;: ;:-::;.: . ::.. . .: .,. . :.:•. ,. : <br /> . . . . . . . . . ... . . ..�: :; ::. . .:. . . . .;: ., . .: . r. . . .... ., ,;. .;. . . .: •:.:;:; : : ::;:;: : :.; : <br />: : : ::i;> . i::-::••i:iii;-:.,, :: -. ::.:._ . . ,�: .; . .; . . . . . . <br /> . . . . . . . .. . .. . ..,.. . :. . . . . .. .. . . :. :::. # ::;•;•::; . ..:.�;i:-iii•:.,::.: . ... <br /> ;;;:, . . :. . . :.. :::.... :.: •:::::. :::.:::.._::::.:::.:�;;•.:<?..: iii: » a:•iii:S: _: : :oa>.::a::;;:::;S:r:::v::,:r:•ixii <br /> +: <br /> 22 FICA - Total salaries x 0.0765 :::;... ... i:<:: .. :.: . . .. . <br /> e Yemen - Hua q 7• •� <br /> pension or ua I I Sj400.84 271 ,685.71 <br /> 23 staff <br /> Life/Heal : . Ica affil 8863.24 0.00 1709824.61 <br /> 24 Disab. <br /> Workers ompensa ion - employees x— :' 29g943.39 0.00 577,110.17 <br /> 25 rate 3 261 .53 <br /> n <br /> oa Hemp oymen - pr 0.001 62,860.62 <br /> 26 employees x $7,000 x UCT-6 rate ' #:' "lilt 884.48 <br /> 0.00 17,046.95 <br /> 05242004 <br /> U-1 <br />