2020 MCDAC Grant Application Outline
Section I. MCDAC Application Cover Sheet
Section II. Project Plan Narrative
A. Detailed description of project.
B. Letters of Support
Section III. Project Budget
A. Personnel
Annual Salary Calculation - 8 hours per day, 40 hours per week, 173.33 hours per month or 2,080 hours per year.
Position Equivalents: Full-time = 1.0; half-time = .50; Indicate % of time spent in position per funding source.
Benefits - MCDAC does not pay any portion of the employee's share of benefit costs, sick leave, vacation pay, etc.,
benefits shall accrue at the same rate and in accordance with the same policies used by the Grantee for its other regular
employees. All employee benefits are to be based on the employer's share only.
PERS/STRS - Total wage dollar amount is eligible at the current rate. Use State of Ohio formula for determining costs.
FICA - Use base wage amount to calculate amount payable. Use State of Ohio formula fordetermining costs.
Pensions - Allowable expense if it is an established private pension plan for implementingagency of the project. Use
State of Ohio formula for determining costs.
Health Insurance - MCDAC funds will not pay for individual private policies. Refers onlyto the employer's share of an
established group policy. Use State of Ohio formula fordetermining costs.
BWC - Rate can be obtained from the Industrial Commission of Ohio. Applicable rate per $100 of payroll and covers all
regular employees. Use State of Ohio formula for determining costs.
Unemployment Insurance - An allowable expense to the project only if the implementingagency is a contributing
agency, or has applied to the Ohio Bureau of Employment Servicesfor a contribution rate. This rate is then applied up
to $8,000 per person on their payroll.Agencies on a reimbursement basis for employment compensation do not qualify
forunemployment compensation
B. Equipment
Include all expenses associated with equipment purchase or lease.
C. Other
Include any needed expenditure, which does not fit into any category listed.
In order for your application to be considered:
You must submit a full p
roposal including one original and one electronic copy typed
on 8 1/2 x 11 paper.
Forms are provided and may be copied as needed.
Late applications will not be accepted.
NOTE: REPORTING AND PAYMENT OF EMPLOYEE BENEFITS TO THE APPROPRIATE AGENCIES SHOWN ON
PROJECT BUDGETS IS THE SOLE RESPONSIBILITY OF THE GRANTEE AND IT'S IMPLEMENTING AGENCY.
Section I. Cover Sheet
Implementing Agency Name:
Federal Tax ID Number:
Contact Person’s Name
and Title:
Mailing Address:
Telephone Number:
Email:
Authorized Fiscal Officer’s Name/Title:
Mailing Address:
Telephone Number: Email:
Email:
Project Director Name/Title:
Project Title:
Mailing Address:
Telephone Number:
Project Type:
List each Project Location address, contact person, title and phone number:
Application Prepared by:
Signature:
Date:
click to sign
signature
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Section II. Project Plan Narrative
Describe the project in detail. Include a general description of the project, the problems you are
facing in your community, the needs of your organization, the target population of your project
and any project goals and objectives you may have. Please include how you will evaluate the
project and any outcome measures you will use at the completion of the project. Attach letter(s)
of support from the organizations you collaborate with and your government officials.
Total Cost of Project:
Section III. Project Budget
Total MCDAC Requested Amount of Funding:
Applicant Cost Share of Project:
Type of Cost Total Project Cost
MCDAC Requested
Amount
Other Source
Amount
Salary
Benefits
Equipment
Purchase/Lease
Other (Please detail
any other project
costs here):
Total:
The above financial report reflects true and accurate information to the best of our knowledge
and belief.
Fiscal Officer: Date:
click to sign
signature
click to edit
Section III: Project Budget
A. Personnel
Position:
Name/Vacant:
Total Hours: Hourly Rate: Total Wages:
Employers Share of Monthly Rate
(Fringe Benefits or % Rate)
Eligible Wage Amount
or # of Months
Employer’s
Share of Fringes
PERS or STRS
X
=
Medicare
X
=
FICA
X
=
Other Pension
(PERS Additional)
X =
Health Insurance
X
=
BWC
X
=
Unemployment
X
=
Other
X
=
Subtotal Fringes
=
Subtotal Salary
+
Personnel Total
=
Position:
Name/Vacant:
Total Hours: Hourly Rate: Total Wages:
Employers Share of Monthly Rate
(Fringe Benefits or % Rate)
Eligible Wage Amount
or # of Months
Employer’s
Share of Fringes
PERS or STRS
X
=
Medicare
X
=
FICA
X
=
Other Pension
(PERS Additional)
X =
Health Insurance
X
=
BWC
X
=
Unemployment
X
=
Other
X
=
Subtotal Fringes
=
Subtotal Salary
+
Personnel Total
=
Section III: Project Budget
B. Equipment
Purpose
Expense
Total Equipment Expense:
Section III: Project Budget
C. Other Expenses
Please detail any expenses that are not include in the personnel or equipment sections.
Purpose
Expense
Total Other Expense:
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