FY15 Smart Start RAR amendmentSmart Start of New Hanover County
Amendment/Revision Reuuest Form
Section I. Basic Information Contract 4: 3- 15 -3 -03 -0431
Direct Services Provider: New Hanover County Public Library Amendment #: I
Smart Start Activity Name: Smart Start Raising A Reader Revision #:
Purpose Svc Code -ID #: 5512
Section II. Change Requested
Change existing activity description X Amend budget
❑ Revise budget ❑ Initiate Contract
❑ Terminate ❑ Other Changes (dates, provisions, etc.)
"Requested effective date: December 31, 2014
"Accurate and complete revision requests received between the Is' and the Loth of the month will be
effective no later than the last day of the month. Those received between the Ilth and the end of the
month will be effective no later than the 15th of the following month. Amendment requests will follow
NCPC's effective date policy.
Section III. Justification (If additional space is needed, please attach a separate sheet.)
Amend budget to 100% allocation
Section IV. DSP Authorizing Signature(s)
Signature of Co ar ct Adnin` rator, Direct Services Provider Date
(iivvUdj -eta .�� �v:� --
Signature ofNHC Assist Manager Date
Section V. Local Smart Start Agency Approval /Denial /Acceptance
The contract/budget revision /amendment is approved as submitted effective
The contract /budget revision /amendment is denied for the reason(s) stated below:
SS of NHC Executive Director Date
SS of NHC Programming & Evaluation Director Date
SSNHC -DSP Rev -AMD Request Form Amd I with corrected contract #s.doc
Smart Start of
New Hanover County
Budget Change Sheet
Direct Service Provider: NHCPL Fiscal Year: 2015 Amendment #: 1 I Revision #:
Activity: Smart Start Raising A Reader Effective Date: 12/31/14
Contract #: 3- 15 -3 -03 -0431
Purpose Service Code: 5512 Current Amount Amount Changed New Amount
51 X 11) Personnel
52XX 12) Contracted Services
13) Total Personnel /Contracted Services
531X 14) Office Supplies & Materials
538X 15) Service Related Supplies
16) Total Supplies & Materials
$58,945.00
$0.00
$17,000.00
$0.00
$75,945.00
$0.00
$58,945.00
$17,000.00
$75,945.00
$75.00 $135.00 $210.00
$3,000.00 $3,505.00 $6,505.00
$3,075.00 $1640.00 $6,715.00
541X
17) Travel
$750.00
$250.00
$1,000.00
542X
18) Communications & Postage
$0.00
$0.00
$0.00
5430
19) Utilities
$0.00
$0.00
$0.00
5440
20) Printing & Binding
$50.00
$0.00
$50.00
5450
21) Repair and Maintenance
$0.00
$0.00
$0.00
546X
22) Meeting /Conference Expense
$0.00
$0.00 .
. _ $0.00
5470
23 Employee Training ( not travel )
$235.00
($235.00)
$0.00
5480
24) Advertising & Outreach
$0.00
$0.00
$0.00
5.49X
25) Not Available for Use
$0.00
$0.00
$0:00
$1,035.001
$15.00
$1,050.00
26) Total Non -Fixed Operating Expenses
5510
27) Office Rent (Land, Buildings, etc.)
$0.00
$0.00
$0.00
5520
28) Furniture Rental
$0.00
$0.00
$0.00
5530
29) Equipment Rental (Phones, Computer, etc.)
$0.00
$0.00
$0.00
5540
30) Not Available for Use
$100.00
$0.00
$100:00
5550
31) Dues, Subscriptions, & Fees
$0.00
$0.00
$0.00
5560
32) Insurance & Bonding
$0.00
$0.00
$0.00
5570
33) Books /Library Reference Materials
$0.00
$0.00
$0.00
5580
34) Not Available for Use
$0.00
$0.00
$0:00
5590
......
35) Other Expenses
...... . ..
$0;00
$0.00
$0:00
$100.001
$0.00
$100.00
36 ) Total Fixed Charges & Other Expenses
5610
5620
5630
5640
5650
61XX
62XX
66XX
67XX
69XX
37) Not Available for Use
38} Not Available for Use
39) Furniture /Non - Computer Eqpt., $500+ per item
40) Computer Equipment/Printers, $500+ per item
41) Furniture /Eqpt., under $500 per item
42) Total Property & Equipment Outlay
43) Purchases of Services
44} Not Available for Use
45) Scholarships /Stipends
46) Cash Grants & Awards
47) Non -Cash Grants & Awards
48) Total Services /Contracts /Grants
$0;00
$0100
$0.00
$ 0.00
$0:00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0700
$0:00.
$0.00
$0.00
$2,000.00
$0.00
$0.00
$0.00
$0.00
$0.00
$2,000.00
$2,000.00
$0.00
$2,000.00
res
,155.001 $20,655.00
.001
Local Partnership Name: SMART START OF NEW HANOVER COUNTY
rf 1W Fiscal Year: 2014-2015
Activity Title: Smart Start Raising A Reader
Purpose/Service Code: 5512
BUDGET NARRATIVE BUDGETAM
Budget Narrative Form 712012
.. .. .. .. .. c
1 Program Manager/Coordinator @ approx 25 hours week & I Literacy
11) Personnel
ConsultantlCoordinator @ approx 20 hours /week
$75,945.00
12) Contracted Professional Services
13) Total Person nel/Contracted Services
$75,945.00
14) Office Supplies and Materials
general office supplies
$21000
Purchase infant toddler materials & replacement materials, iPod & speaker for
15) Service Related Supplies
use in programs
$6,505.00
16) Total Supplies & Materials
$6,715.00
17) Travel
travel to sites
$1,000m
18) Communications & Postage
$0.00
19) Utilities
20) Printing and Binding
$50.00
21) Repair and Maintenance
22) Meeting/Conference Expense
$0.00
23) Employee Training (no travel)
$0.00
24) Advertising & Outreach
25) Not Available for Use
26) Total Non-Fixed Operating Expenses
$1,050.00
27) Office Rent (Land, Buildings, etc.)
28) Furniture Rental
29) Equipment Rental (Phone, Computer, etCr)
30) Vehicle Rental
rental to travel to RAR training in Raleigh
$100,00
31) Dues, Subscriptions, & Fees
32) Insurance & Bonding
33) Books / Library Reference Materials
34) flat :Availablef,orUse:
35) Other Expenses
........
36) Total Fixed Charges & Other Expenses
$100.00
37) Not Availa-6e for Use
U) Not Available for Use
39) Furniture/Non-computer Eqpt.. $500+ per item
40) Computer Equipment/Printers.$500+ per item
41) Furniture/Eqpt., under $500 per item
$0.00
42) Total Property and Equipment Outlay
c
$0,00
43) Purchase of Services
44): Cornsacts with Service Providers
45) Stipends & Scholarships
46) Cash Grants and Awards
47) Non-Cash Grants and Awards
purchase blue begs & parent awards
$2,000.00
48) Total Services/Contracts/Grants
$2,0
4
ted Expenditures
kai Total kd ;� -
1
$85,810.00
Budget Narrative Form 712012