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{"sheet":"Sheet1","index":0,"n_rows":148,"n_cols":12,"rows_kept":148}
[null,"North Carolina Division of Aging"]
[null,"Service Cost Computation Worksheet  c:732A.xls",{"$nulls":8},"DAAS-732A"]
[null,"Provider: ",{"$nulls":8},"PTRC 03/2019"]
[null,"County:   "]
[null,"Budget Period:  7-1-2020  through  6-30-2021"]
[null,"Date ____________  Revision ____ Yes"]
[]
[]
[{"$nulls":4},"Service","Service","Service","Service","Service","Service","Service","Service"]
[null,null,"Grand",null,"Name of","Name of","Name of","Name of","Name of","Name of","Name of","Name of"]
[null,"I.  Projected Revenues","Total",null,"Service","Service","Service","Service","Service","Service","Service","Service"]
[null," A. Fed/State Funding From the Division of Aging",{"$f":"SUM(E12:L12)","v":0},"///////////////"]
[null,"        Required Minimum Match - Cash","////////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"        1)  ",{"$f":"SUM(E14:L14)","v":0},"///////////////"]
[null,"        2)",{"$f":"SUM(E15:L15)","v":0},"///////////////"]
[null,"        3)",{"$f":"SUM(E16:L16)","v":0},"///////////////"]
[null,"        Total Required Minimum Match - Cash",{"$f":"SUM(E17:L17)","v":0},"///////////////",{"$f":"SUM(E14:E16)","v":0},{"$f":"SUM(F14:F16)","v":0},0,0,0,0,0,0]
[null,"        Required Minimum Match - In-Kind","////////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"        1)",{"$f":"SUM(E19:L19)","v":0},"///////////////"]
[null,"        2)",{"$f":"SUM(E20:L20)","v":0},"///////////////"]
[null,"        3)",{"$f":"SUM(E21:L21)","v":0},"///////////////"]
[null,"        Total Required Minimum Match - In-Kind",{"$f":"SUM(E22:L22)","v":0},"///////////////",{"$f":"SUM(E19:E21)","v":0},0,0,0,0,0,0,0]
[null," B. Total Required Minimum Match  (cash + in-kind)",{"$f":"C17+C22","v":0},"///////////////",{"$f":"E17+E22","v":0},{"$f":"F17+F22","v":0},0,0,0,0,0,0]
[null," C. Subtotal, Fed/State/Required Match Revenues",{"$f":"C12+C23","v":0},"///////////////",{"$f":"E12+E23","v":0},{"$f":"F12+F23","v":0},0,0,0,0,0,0]
[null," D. NSIP Cash Subsidy/Commodity Valuation",{"$f":"SUM(E25:L25)","v":0},"///////////////"]
[null," E. OAA Title V Worker Wages, Fringe Benefits and Costs",{"$f":"SUM(E26:L26)","v":0},"///////////////"]
[null," Local Cash, Non-Match","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  ",{"$f":"SUM(E28:L28)","v":0},"///////////////"]
[null,"  2)  ",{"$f":"SUM(E29:L29)","v":0},"///////////////"]
[null,"  3)",{"$f":"SUM(E30:L30)","v":0},"///////////////"]
[null,"  4)",{"$f":"SUM(E31:L31)","v":0},"///////////////"]
[null," F. Subtotal, Local Cash, Non-Match",{"$f":"SUM(E32:L32)","v":0},"///////////////",{"$f":"SUM(E28:E31)","v":0},{"$f":"SUM(F28:F31)","v":0},0,0,0,0,0,0]
[null," Other Revenues, Non-Match","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  ",{"$f":"SUM(E34:L34)","v":0},"///////////////"]
[null,"  2)",{"$f":"SUM(E35:L35)","v":0},"///////////////"]
[null,"  3)",{"$f":"SUM(E36:L36)","v":0},"///////////////"]
[null," G. Subtotal, Other Revenues, Non-Match",{"$f":"SUM(E37:L37)","v":0},"///////////////",{"$f":"SUM(E34:E36)","v":0},{"$f":"SUM(F34:F36)","v":0},0,0,0,0,0,0]
[null," Local In-Kind Resources (Includes Volunteer Resources)","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  ",{"$f":"SUM(E39:L39)","v":0},"///////////////"]
[null,"  2)",0,"///////////////"]
[null,"  3)",0,"///////////////"]
[null," H. Subtotal, Local In-kind Resources, Non-Match",0,"///////////////",{"$f":"SUM(E39:E41)","v":0},{"$f":"SUM(F39:F41)","v":0},0,0,0,0,0,0]
[null,"  I. Consumer Contribution",0,"///////////////"]
[null," J. Total Projected Revenues (Sum I C,D,E,F,G,H, & I)",0,"///////////////",{"$f":"SUM(E24+E25+E26+E32+E37+E42+E43)","v":0},{"$f":"SUM(F24+F25+F26+F32+F37+F42+F43)","v":0},0,0,0,0,0,0]
[null," K. Revenue Excess/(Shortage)(Cannot be negative #, must be \"0\")",{"$f":"SUM(E45:L45)","v":0},"///////////////",{"$f":"SUM(E44-E96)","v":0},0,0,0,0,0,0,0]
[null,"     Note:  Revenue must Equal Expenses (Section I, line j = Section II, line j)"]
[]
[null,"Division of Aging "]
[null,"Service Cost Computation Worksheet  732A",null,null,"Service","Service","Service","Service","Service","Service","Service","Service"]
[null,null,"Grand ","Admin.",{"$f":"E10","v":"Name of"},"Name of","Name of","Name of","Name of","Name of","Name of","Name of"]
[null,"II.  Line Item Expense","Total","Cost","Service","Service","Service","Service","Service","Service","Service","Service"]
[null," Staff Salary From Labor Distribution Schedule","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  Full-time Staff",{"$f":"SUM(D53:L53)","v":0}]
[null,"  2)  Part-time staff   (do not include Title V workers)",{"$f":"SUM(D54:L54)","v":0}]
[null,"A.  Subtotal, Staff Salary",{"$f":"SUM(D55:L55)","v":0},{"$f":"SUM(D53:D54)","v":0},{"$f":"SUM(E53:E54)","v":0},0,0,0,0,0,0,0]
[null," Fringe Benefits","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  FICA @ .0765%",{"$f":"SUM(D57:L57)","v":0}]
[null,"  2)  Health Ins. @ ",0]
[null,"  3)  Retirement  @ ",0]
[null,"  4)  Unemployment Insurance",0]
[null,"  5)  Worker's Compensation",0]
[null,"  6)  Other",0]
[null,"B.  Subtotal, Fringe Benefits",{"$f":"SUM(D57:L62)","v":0},{"$f":"SUM(D57:D62)","v":0},{"$f":"SUM(E57:E62)","v":0},0,0,0,0,0,0,0]
[null,"Local In-Kind Resources, Non-Match ","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1) ",{"$f":"SUM(D65:L65)","v":0}]
[null,"  2)",{"$f":"SUM(D66:L66)","v":0}]
[null,"  3)",{"$f":"SUM(D67:L67)","v":0}]
[null,"C.  Subtotal, Local In-Kind Resources  Non-Match",{"$f":"SUM(D68:L68)","v":0},{"$f":"SUM(D65:D67)","v":0},0,0,0,0,0,0,0,0]
[null,"D.  OAA Title V Worker Wages, Fringe Benefits and Costs",{"$f":"SUM(D69:L69)","v":0}]
[null," Travel","//////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1) Per Diem  ",{"$f":"SUM(D71:L71)","v":0}]
[null,"  2) Mileage Reimbursement ",{"$f":"SUM(D72:L72)","v":0}]
[null,"  3) Other Travel Cost:  ",{"$f":"SUM(D73:L73)","v":0}]
[null,"E.  Subtotal, Travel",{"$f":"SUM(D74:L74)","v":0},{"$f":"SUM(D71:D73)","v":0},0,0,0,0,0,0,0,0]
[null," General Operating Expenses","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"  1)  ",{"$f":"SUM(D76:L76)","v":0}]
[null,"  2)  ",0]
[null,"  3)  ",0]
[null,"  4)  ",0]
[null,"  5) ",0]
[null,"  6)",0]
[null,"  7)",0]
[null,"  8)",0]
[null,"  9)",0]
[null,"10)",0]
[null,"11)",0]
[null,"12)",0]
[null,"13)",0]
[null,"14)",0]
[null,"15)",0]
[null," F.  Subtotal, General Operating Expenses",0,{"$f":"SUM(D76:D90)","v":0},{"$f":"SUM(E76:E90)","v":0},0,0,0,0,0,0,0]
[null,"G.   Subtotal, Other Administrative Cost Not Allocated","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"       in Lines II.A through F  ","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"H.  Total Proj. Expenses Prior to Admin. Distribution",{"$f":"C55+C63+C68+C69+C74+C91","v":0},{"$f":"D55+D63+D68+D69+D74+D91","v":0},{"$f":"E55+E63+E68+E69+E74+E91","v":0},{"$f":"F55+F63+F68+F69+F74+F91","v":0},{"$f":"G55+G63+G68+G69+G74+G91","v":0},0,0,0,0,0]
[null," I.  Distribution of Admininistrative Cost (\"Manual Entries\")","///////////////"]
[null,"J.  Total Proj. Expenses After Admin. Distribution",{"$f":"SUM(E96:L96)","v":0},"///////////////",{"$f":"E55+E63+E68+E69+E74+E91+E95","v":0},0,0,0,0,0,0,0]
[null,"Note:  If costs appear in the Administrative Column, you must include an explanation for distributing these costs to the various services.  This is a requirement for budget approval."]
[null,"Division of Aging"]
[null,"Service Cost Computation Worksheet  732A"]
[{"$nulls":4},"Service","Service","Service","Service","Service","Service","Service","Service"]
[null,null,"Grand ",null,{"$f":"E10","v":"Name of"},"Name of","Name of","Name of","Name of","Name of","Name of","Name of"]
[null,"III.  Computation of Rates","Total",null,"Service","Service","Service","Service","Service","Service","Service","Service"]
[null,"   A. Computation of Unit Cost Rate:","////////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////","///////////////"]
[null,"       1.  Total Expenses (equals line II.J)",{"$f":"SUM(E104:L104)","v":0},"///////////////",{"$f":"E96","v":0},0,0,0,0,0,0,0]
[null,"       2.  Total Projected Units","////////////////","///////////////"]
[null,"       3.  Total Unit Cost Rate","////////////////","///////////////",{"$f":"E104/E105","v":{"$error":"#DIV/0!"}},{"$f":"F104/F105","v":{"$error":"#DIV/0!"}},{"$f":"G104/G105","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"   B.  Computation of Reimbursement Rate:","////////////////","////////////////","////////////////","////////////////","////////////////","////////////////","////////////////","////////////////","////////////////","///////////////"]
[null,"       1.  Total Revenues  (equals line I.J)",{"$f":"SUM(E108:L108)","v":0},"///////////////",{"$f":"E96","v":0},0,0,0,0,0,0,0]
[null,"       2.  Less:    USDA   (equals line I.D)",{"$f":"SUM(E109:L109)","v":0},"///////////////",{"$f":"E25","v":0},0,0,0,0,0,0,0]
[null,"                        Title V   (equals line I.E and II.D)",{"$f":"SUM(E110:L110)","v":0},"///////////////",0,0,0,0,0,0,0,0]
[null,"                         Non Match In-Kind  (equals line I.H and II.C)",{"$f":"SUM(E111:L111)","v":0},"///////////////",{"$f":"E42","v":0},0,0,0,0,0,0,0]
[null,"       3.  Expenses Subject to Unit Reimbursement",{"$f":"C108-SUM(C109:C111)","v":0},"///////////////",{"$f":"E108-SUM(E109:E111)","v":0},{"$f":"F108-SUM(F109:F111)","v":0},0,0,0,0,0,0]
[null,"       4.  Total Projected Units (equals line III.A.2)","///////////////","///////////////",{"$f":"E105","v":0},0,0,0,0,0,0,0]
[null,"       5.  Total Reimbursement Rate","////////////////","///////////////",{"$f":"IF(E124<=E129,E124,E129)","v":{"$error":"#DIV/0!"}},{"$f":"IF(F124<=F129,F124,F129)","v":{"$error":"#DIV/0!"}},{"$f":"IF(G124<=G129,G124,G129)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"   C.  Units Reimbursed Through HCCBG ","////////////////","///////////////",{"$f":"ROUND(E24/E124,0)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"   D.  Units Reimbursed Through Program Income*","////////////////","///////////////",{"$f":"TRUNC(E43/E114,0)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"   E.  Units Reimbursed Through  Remaining Revenues","////////////////","///////////////",{"$f":"TRUNC((E32+E37)/E114,0)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"   F.  Total Units Reimbursed/Total Projected Units","////////////////","///////////////",{"$f":"SUM(E115:E117)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(F115:F117)","v":{"$error":"#DIV/0!"}},{"$f":"SUM(G115:G117)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[]
[]
[{"$nulls":4},{"$f":"ROUND(VALUE(E112),0)","v":0},0,0,0,0,0,0,0]
[{"$nulls":4},0,0,0,0,0,0,0,0]
[]
[{"$nulls":4},{"$f":"ROUND(E121/E122,4)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[]
[{"$nulls":4},{"$f":"ROUND(VALUE(E24),0)","v":0},0,0,0,0,0,0,0]
[{"$nulls":4},{"$f":"VALUE(E115)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[]
[{"$nulls":4},{"$f":"ROUND(E126/E127,4)","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"}]
[null,"*  The Division of Aging ARMS deducts reported program"]
[null,"    income from reimbursement paid to providers.  Line III.D"]
[null,"    indicates the number of units that will have to be produced"]
[null,"    in addition to those stated on line III.C in order to earn the"]
[null,"    net revenues stated on line I.C."]
[]
[]
[null,"Information on this form (DAAS-732A) corresponds with "]
[null,"information stated on the Provider Services Summary"]
[null,"(DAAS-732) as follows:"]
[null,null,"DAAS-732A","DAAS-732",null,null,"________________________________________________"]
[null,"Block Grant Funding","Line I.A","Col. A",null,null,"(Signature)"]
[null,"Required Local Match-Cash & In-Kind","Line I.B","Col. B"]
[null,"Net Service Cost","Line I.C","Col. C",null,null,"________________________________________________"]
[null,"USDA Subsidy","Line I.D","Col. D",null,null,"(Date)"]
[null,"Total Funding","L. I.C+I.D","Col. E"]
[null,"Projected HCCBG Reimbursed Units","Line III.C","Col. F"]
[null,"Total Reimbursement Rate","Line III.B.5","Col. G"]
[null,"Projected Total Service Units","Line III.F","   Col. I  "]