Provided here is a sample of how to complete a budget justification for the construction of a new facility when applying for Fiscal Year (FY) 2023 Capital Assistance for Hurricane Response and Recovery Efforts (CARE).
Organization Name: Family Medical Center (FMC)
Project Type: Construction of a New Facility
Project Name: FMC New Facility
Total CARE Funding Request = $490,000
Total Project Cost = $8,302,100
Family Medical Center’s proposed CARE project will construct a new 3-story building on an existing site. The building will provide examination rooms, a waiting area, records rooms, patient services, provider offices, a special purpose room, restrooms, health care support function areas, communications, and mechanical spaces. The building will comply with all accessibility requirements of the Americans with Disabilities Act and local building codes. An FMC sign will be installed at the entrance of the facility, and moveable medical and office equipment will be purchased. The resulting facility will result in a larger and better organized facility, well suited to deliver services to the patient population.
The total FMC project cost is $8,302,100. This application requests $490,000 to support the total construction and equipment cost. The balance of $7,812,100 will be using a loan backed by the loan guarantee program through HRSA. Should the loan guarantee program application not be approved, we will use $4,500,000 of program income. In addition, we will use venture capital financing from local investors for the remaining $3,312,100, for which we have already received letters of support.
The project is anticipated to begin within 30 days of award and be completed with the facility occupied by August 2025.
| LINE NUMBER | ALLOWABLE COSTS - CARE | UNALLOWABLE COSTS |
|---|---|---|
| Line 1—Administrative and legal expenses |
$63,100 is the total administrative cost. $23,600 is allocated to pay a portion of FMC’s staff / project manager (for work directly related to the construction project). $39,500 is allocated for an environmental analysis and costs associated with evaluation of the environmental effects of proposed activities and producing an Environmental Statement to the local authorities. Total: $63,100 |
|
| Line 2—Land, structures, right- of-way, appraisals, etc. | The current land is owned by FMC. No additional land is required for this project. | |
| Line 3—Relocation expenses and payments | Although temporary relocation will be required for this project, no costs are anticipated for this classification. | |
| Line 4— Architectural and engineering fees |
$739,000 for the architectural and engineering fees, which will cover the following: mechanical and electrical design; bid renovation/construction documents (plans and specifications); and assistance during the construction bidding (answer questions presented by the contractors). Total: $739,000 |
|
| Line 5—Other architectural and engineering fees | No other architectural or engineering fees are anticipated for this project. | |
| Line 6—Project inspection fees |
$23,437 for inspections by the local department of building construction, shop drawing and Total = $23,437 |
|
| Line 7—Site work |
$375,000 is the total site work, which includes: Total: $375,000 |
|
| Line 8—Demolition and removal | None | |
| Line 9—Alteration/ Renovation (Construction) |
$6,067,563 is the total construction cost to build the new building on the existing site. The total square footage is 17,358 square feet on 3 levels. The master format divisions costs are: General Requirements total $540,012:
Facility Construction total $4,963,266:
Facility Services total $345,852:
Process Equipment total $169,891:
Other Project Costs total $48,542:
Grand Total Construction = $6,067,563 |
$10,000 is an allowance for a wall mural in the waiting room. |
| Line 10— Equipment |
$704,000 is the total for equipment. $38,750 will be used to purchase office equipment: 7 desks @ $1,000 ($7,000), 7 computers (4GB RAM, 160 GB HD, 22" monitor, Intel Core Duo 2 Processor) @ $2,500 each (7 @ $2,500=$17,500) would be purchased for each of the new exam rooms, and 114 chairs would be procured (i.e., 100 chairs for the waiting room and 14 chairs for the offices) (114 @ $125=$14,250). $569,250 of clinical equipment. See equipment list for other equipment purchased. Total = $704,000 |
|
| Line 11— Miscellaneous | No miscellaneous costs are anticipated for this project |
|
| Line 12—SUBTOTAL (Allowable and Unallowable Costs) |
$7,972,100 total allowable costs (Sum of Lines 1 through 11) |
$10,000 total unallowable costs (Sum of Lines 1 through 11) |
| Line 13— Contingencies | $320,000, which is less than 5% of the sum of Lines, 7, 8, and 9 will be included for contingency. | |
| Line 14— SUBTOTAL | $8,292,100 total allowable costs (Sum of Lines 12 and 13) |
$10,000 total unallowable costs (Sum of Lines 12 and 13) |
| Line 15—Project (program) income | Not Applicable | |
| Line 16—TOTAL PROJECT COSTS (Allowable and Unallowable) |
$8,302,100 (Sum of allowable and unallowable costs from Line 14) |
|
| Line 17— GRANT funding requested (Note: round to the nearest whole dollar amount) |
$490,000 |
SEE APPENDIX B: Allowable and Unallowable Costs in the Notice of Funding Opportunity