Contract Summary FormEarly Intervention Services Agreement • October 15th, 2018
ADMINISTRATIVE COSTS PERIOD ONE PERIOD TWO PERIOD THREE TOTAL Indirect Costs $ 21,475 $ 42,950 $ 42,950 $ 107,375 SUBTOTAL ADMIN COSTS $ 21,475 $ 42,950 $ 42,950 $ 107,375 PROGRAM COSTSSalaries $ 124,275 $ 248,550 $ 248,550 $ 621,375 Benefits 29,874 59,748 59,748 149,370 Services & Supplies 7,460 28,732 28,732 64,924 Start-up Costs 6,906 0 0 6,906 Subcontractors 10,000 20,000 20,000 50,000 SUBTOTAL PROGRAM COSTS $ 178,515 $ 357,030 $ 357,030 $ 892,575 TOTAL GROSS COSTS $ 199,990 $ 399,980 $ 399,980 $ 999,950 REVENUEMHSA $ 199,990 $ 399,980 $ 399,980 $ 999,950 TOTAL REVENUE $ 199,990 $ 399,980 $ 399,980 $ 999,950
Model Municipal Contract ForEarly Intervention Services Agreement • March 9th, 2009
This Agreement (Agreement) is between (insert county or City of New York), acting through its duly constituted Department of
