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["Federal Identifying Information"]
["CFDA Title: Community Services Block Grant (CSBG)"]
["Assistance Listing (CFDA) Number 93.569"]
["Federal agency: U.S. Department of Health and Human Services (HHS) \nAdministered by: Office of Community Services (OCS), Administration for Children and Families (ACF)"]
["Purpose: Reduce poverty, revitalize low-income communities, and empower low-income families and individuals to become self-sufficient"]
["Primary recipients: States, territories, and tribes, which then fund Eligible Entites, often know as Community Action Agencies (CAAs)"]
["Applicant Information"]
["Entity Legal Name: "]
["Entity DBA, if any:"]
["Physical Address:"]
["Mailing Address (if different):"]
["City, State, Zip+4: ","     "]
["County of Headquarters Office:","     "]
["Current Geographic Service Area:  "]
["Social media handles/platforms (if any):"]
["Entity Email:"]
["Entity Phone:"]
["Entity Fax:","     "]
["Type of Entity - Response: Yes or No or Explain"]
["a. Private Non-Profit"]
["b. Public Organization"]
["c. Other","     "]
["           Authorized Representative Information "]
["First and Last Name:"]
["Title:"]
["Email:"]
["Direct phone number:"]
["           Finance Chief Information"]
["First and Last Name:","     "]
["Title:","     "]
["Email:"]
["Direct phone number:"]
["Contact Person for Matters Involving this Application"]
["First and Last Name:","     "]
["Title:","     "]
["Email:"]
["Direct phone number:"]
["Entity Details"]
["Approved Negotiated Indirect Cost Rate Agreement (NICRA) with a cognizant agency (if any)","     "]
["List the dates of the entity’s current Fiscal Year:  (Provide Mo/Yr to Mo/Yr)"]
["Data Universal Numbering System (DUNS):","     "]
["Sam.gov Unique Entity Identification (UEI):"]
["Employer Identification Number (EIN):","     "]
["NOTE: To draw funds, Subrecipient must be registered in the System for Award Management. If you are not registered, go to https://sam.gov to renew, update or create a new registration."]
[]
["Certification"]
["Executive Director Typed Name"]
["Executive Director Signature & Date","     "]
["Board Chair Typed Name"]
["Board Chair Signature & Date","     "]
["This application to become a Kansas CSBG Eligible Entity and provide services within some or all of the 35 County Kansas service area has been authorized by the governing body of the organization named above. "]
[]
["Entity Mission Statement:"]
[]
[]
["Brief Entity Overview"]
[]
[]
["Geographic Location - The Applicant is:     Answer either A. or B., NOT both."]
["A) geographically located in the county(ies) for which the applicant is applying and is providing a range of services designed to eliminate poverty and foster self-sufficiency in same county(ies).  If yes, also explain the services currently provided that eliminate poverty and foster self-sufficiency."]
["B) in an area that is contiguous to or within reasonable proximity to the county(ies) for which applicant is applying and is already providing related services in the same county(ies). If yes, explain if your entity is already providing a related service in the county(ies) and explain what those related services are."]
[null,"     "]
["Entity Experience"]
["Is the applicant currently administering any of the following Kansas Housing Resources Corporation (KHRC) grants provided directly by KHRC? Yes or No"]
["Community Services Block Grant (CSBG)"]
["Emergency Solutions Grant (ESG)"]
["Tenant Based Rental Assistance (TBRA)","     "]
["Weatherization Assistance Program (WAP)","     "]
[]
["List all other current state or federally funded grant programs greater than $50,000 administered:",null,"State Funds (Y/N)","Federal Funds (Y/N)","# of Years Administered"]
["Grant Name","Funding Entity and Purpose of Award"]
[{"$nulls":4},"     "]
[{"$nulls":4},"     "]
[{"$nulls":4},"     "]
[{"$nulls":4},"     "]
[{"$nulls":4},"     "]
[]
["In the table below, provide information on the types of services and activities provided during FFY 2024-2025 (Oct.-Sept).  For any yes response, include a brief narrative description of those services and the number of unduplicated persons served with these services in FFY 2024-2025 (Oct.-Sept) in the table below.  "]
["Community Services Block Grant Annual Report"]
["Type of Service or Activity","Brief Narrative Description",null,null,"(Y/N)"]
["Employment Services (SRV 1)"]
["Education and Youth Development Services (SRV 2)"]
["Income and Asset Building Services (SRV 3)"]
["Housing Services (SRV 4)"]
["Health and Nutrition Services (SRV 5)"]
["Civic Engagement and Community Involvement Services (SRV 6a-d)"]
["Transportation Domain (SRV 7)"]
["Please complete the Logic Model within this workbook. [Copy and extend the form, as necessary.]"]
[]
["Case Management - For the county(ies) for which your entity is applying, describe how your organization will provide case management services to persons who want to work towards transitioning out of poverty into self-sufficiency and information related to how education and employment needs will be addressed and what type of direct assistance will be provided.  "]
[]
[]
["Provide a description of the proposed project. The project summary should include a description of how CSBG funds will be used to support the project. Is this a new project or continuance of an existing project? "]
[]
[]
["Provide a brief 25-word or less project description to use in a press release or contract."]
[]
[]
["Briefly define how the proposed project relates to the purposes of the CSBG authorizing legislation and any Community Needs Assessments for the geographical service area. Include how the project will assist people or communities of below 125% Federal Poverty Income Limits (currently 200%) and how this will be documented."]
[]
[]
["Briefly identify key personnel to be involved in the proposed project, including the project director. Identify the percentage of time that each key position will devote to the project. Provide information that will allow reviewers to make an informed judgment on the capabilities and experience of key personnel."]
[]
[]
["Discuss other resources (volunteers, in-kind, agency personnel, partnerships, additional funding, etc.) that will support the project."]
[]
[]
["Timeline for implementing the proposed project. *Kansas CSBG regular grant agreements are April 1 to September 30 (18-months)."]
[]
[]
["Briefly describe entity attributes that contribute to its ability to successfully execute the project. The description should include the applicant’s experience with providing similar services as described in the RFP."]
[]
[]
["Briefly describe applicant’s experience with the Community Services Block Grant or similar federal grants. "]
[]
[]
["How will project performance be assessed, analyzed, reported, and adjusted throughout the project?"]
[]
[]
["Provide a brief summary of all existing projects/programs that are funded by an earlier CSBG grant. The summary should include progress made toward the project/program’s goals. "]
[]
[]
["Application of Results Oriented Management Accountability (ROMA): In the table below, indicate if your entity has a formal process to evaluate program results and to evaluate the accomplishment of performance and expenditures targets or benchmarks. "]
["Formal Process","Description",null,null,"Yes or No"]
["Client Surveys:","     "]
["Regular monitoring of meeting expenditure targets/benchmarks","     "]
["Regular monitoring of meeting performance targets/benchmarks","     "]
["Process for taking evaluation data and making improvements to programs and services","     "]
[]
["Provide information on the amount and percentage of the CSBG grant request that will be utilized for Direct Client Support, excluding any funds that will be used for salaries and overhead costs of Programmatic staff."]
[]
[]
["I agree to submit the Center for Excellance Organizational Standards documentation once each year. (Yes or No) - https://kshousingcorp.org/wp-content/uploads/2025/08/State-of-Kansas-Org-Standards-Guidance-UPDATED-JAN-2024-Section-10-Added-8-20-25.pdf "]
["Organizational Standards"]
[]
["Community Needs Assessment for Counties Applying"]
["Do you currently have a Community Needs Assessment?"]
["If not, are you willing to prepare and implement a Community Needs Assessment within a reasonable time?"]
[]
["Governance"]
["How many board seats does your organization have per the Bylaws?  "]
["How many board vacancies are currently vacant in excess of 90 days? "]
["Describe frequency of board meetings."]
["Do you currently have a Tripartite Board of Directors?"]
["If not, are you willing to implement a Tripartite Board of Directors within reasonable time?"]
[]
["Provide an explanation of how your entity will implement the CSBG program in the county(ies) for which you have applied.  Include 1) a timeline (# days after award notification) for when a) staff will be hired, b) offices open for business, c) what type of community outreach conducted, and d) and estimated date by when applications for assistance will be accepted, 2) a description of the the type of assistance and services that will be provided with CSBG, and 3) a  description of the types of programs/grants to be supported with CSBG.     "]
[]
[]
["Describe: How many full time service sites (open M-F full time 40 hours per week) will be open and how many part-time service sites (open half days or open less than 40 hours weekly) will be open in each county for which applicant is applying. If full or part-time service sites will not be operated, but instead applications will be accepted by applicant staff at outreach sites on a regularly planned weekly schedule, provide information on the planned schedule (# days a week and in what city(ies)). If applicant does not plan to have service sites or outreach sites, provide a detailed plan on a separate page how the county (ies) will be served with CSBG funds.   "]
[]
[]
["Indicate if your entity coordinates or plans to coordinate services in the county for which your organization is applying for and describe the planned working relationship with the organization, the process to refer individuals, and if you plan to or have entered into a written agreement.  Note:  CSBG funds can be utilized to collaborate with other entities on projects and/or to subcontract for client services.  This question is not related to subcontracting.\n"]
["Entity","List and describe intended linkages and coordination of services for counties applying, if applicable."]
["Department for Children anf Families (DCF) field office for Food (SNAP), Cash Assistance (TANF),  Low Income Energy Assistance Program (LIEAP), Child Care (CC) Assistance, Child Support Services (CSS), https://www.dcf.ks.gov/Pages/contacts.aspx; "]
["Medicaid/KanCare                                                                                                                                     https://www.kancare.ks.gov/apply-now/health-plans"]
["WIC https://www.kdhe.ks.gov/DocumentCenter/View/41530/State-Agency-Contacts-for-Local-Agencies."]
["KANSASWORKS, the state's public workforce system, managed by the Kansas Department of Commerce, Workforce Development Boards, or Workforce Centers https://ksworksstateboard.org and https://www.kansasworks.com/contact"]
["School Districts https://www.ksrevenue.gov/pdf/schooldistricts.pdf and https://www.ksde.gov/Portals/0/School%20Bus/Documents-Forms/2025-USD-County-Map%20green.pdf?ver=2025-09-09-145358-107 "]
["Local Governments https://www.lkm.org/page/DirectorySearch "]
["For Profit Businesses or Corporations https://allthingskansas.k-state.edu/build-your-business-in-kansas "]
["Utility Providers"]
["Low-Income Housing Providers"]
["Financial Institutions"]
["Health Service Institutions https://communitycareks.org/page/member-clinics "]
["Institutions for post secondary education/training"]
["Other non-profit organization serving low-income persons"]
["Faith Based organizations"]
[]
["Budget Narrative – CSBG Direct Expense - Provide a detailed description of the proposed use of CSBG funds"]
[]
[]
["Required Attachments"]
["Information",null,"Within workbook"]
["Counties",null,"Within workbook"]
["CSBG Logic Model [Copy and extend the form, as necessary.]",null,"Within workbook"]
["CSBG Budget Workbook (4 pages)",null,"Within workbook"]
["CSBG Assurances & Certifications",null,"Word Document"]
["Single Audit Certification",null,"Word Document"]
["501c3 Letter (preferrably dated in last 2 years)",null,"From Entity"]
["Most Recent Single Audit or Independent Audit, (if no audit, Recent Financial Statement)",null,"From Entity"]

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["Applicant Name:",null,{"$f":"Information!B8","v":0}]
["Counties Applicant is Applying For"]
["County","Population for whom poverty status is determined","Percent of Population","Weight 1%","125 percent of poverty level","Percent of Poverty","Weight 90%","Land area in square miles, 2010 - (Square Miles)","Percent of Land Area","Weight 9%","Total Weight Percent or Percent of Allocation Based on 125% FPL","Estimated FFY 2026 90% Funds $5,633,845.20","Applying For: \nYes or No"]
["Barton",24591,8.5948558786213842E-3,8.5948558786213845E-5,4698,1.1037003798815484E-2,9.9333034189339354E-3,895.4,1.0951731655421388E-2,9.8565584898792488E-4,1.1004907826708075E-2,61999.947135941722]
["Cheyenne",2592,9.0593576663765718E-4,9.0593576663765718E-6,589,1.3837367470205023E-3,1.2453630723184522E-3,1019.89,1.247438195001979E-2,1.122694375501781E-3,2.37711680548661E-3,13392.308104430072]
["Decatur",2662,9.3040162453296427E-4,9.3040162453296421E-6,425,9.9845181236623681E-4,8.9860663112961313E-4,893.52,1.0928737177520794E-2,9.8358634597687134E-4,1.8914969933518141E-3,10656.40125680955]
["Ellis",27466,9.5997036136072113E-3,9.5997036136072117E-5,6340,1.4894551742122215E-2,1.3405096567909993E-2,899.91,1.1006893940172282E-2,9.906204546155054E-4,1.4491714058661571E-2,81644.073689163022]
["Finney",37313,1.3041350794965625E-2,1.3041350794965625E-4,5852,1.3748094131687571E-2,1.2373284718518814E-2,1301.97,1.592453212353025E-2,1.4332078911177225E-3,1.3936906117586191E-2,78518.371633413597]
["Ford",33089,1.1565011027111665E-2,1.1565011027111665E-4,6247,1.4676066992592662E-2,1.3208460293333396E-2,1098.27,1.3433055980790316E-2,1.2089750382711284E-3,1.4533085441875641E-2,81877.15365790097]
["Gove",2765,9.6640138686463037E-4,9.664013868646304E-6,204,4.7925686993579366E-4,4.313311829422143E-4,1071.67,1.310770858070744E-2,1.1796937722636696E-3,1.6206889690745302E-3,9130.7107691134897]
["Graham",2346,8.1995575174843502E-4,8.1995575174843497E-6,411,9.6556163501770192E-4,8.6900547151593172E-4,898.52,1.0989892703852163E-2,9.8909034334669459E-4,1.8662953723801107E-3,10514.419225465899]
["Grant",7158,2.5018087259229744E-3,2.5018087259229746E-5,803,1.8864866007766781E-3,1.6978379406990104E-3,574.79999999999995,7.03043930705407E-3,6.3273953763486632E-4,2.3555955655931065E-3,13271.060770358008]
["Gray",5562,1.9439871659099727E-3,1.9439871659099729E-5,738,1.7337822059441948E-3,1.5604039853497752E-3,868.87,1.0627240432707151E-2,9.5645163894364353E-4,2.5362954959525187E-3,14289.096205653717]
["Greeley",1280,4.4737568722847266E-4,4.4737568722847264E-6,92,2.161354511475148E-4,1.9452190603276332E-4,778.45,9.5213038945306909E-3,8.5691735050776215E-4,1.0559130134128103E-3,5948.8504622332966]
["Hamilton",2460,8.598001488922209E-4,8.5980014889222088E-6,223,5.2389353919451954E-4,4.7150418527506762E-4,996.51,1.2188418708894314E-2,1.0969576838004882E-3,1.5770598705644782E-3,8884.9111818923066]
["Haskell",3519,1.2299336276226525E-3,1.2299336276226525E-5,575,1.3508465696719675E-3,1.2157619127047708E-3,577.52,7.0637079133783346E-3,6.3573371220405005E-4,1.8637949611850476E-3,10500.332295856568]
["Hodgeman",1628,5.6900595219371367E-4,5.6900595219371369E-6,184,4.3227090229502961E-4,3.8904381206552663E-4,859.99,1.051862821794264E-2,9.4667653961483754E-4,1.3414104112023013E-3,7557.2986063821118]
["Kearny",3795,1.326399010181292E-3,1.3263990101812921E-5,497,1.1676012958729875E-3,1.0508411662856888E-3,870.54,1.0647666378501827E-2,9.5828997406516444E-4,2.0223951304526662E-3,11393.861098204128]
["Lane",1453,5.0784130745544595E-4,5.0784130745544594E-6,262,6.1551617609400947E-4,5.5396455848460849E-4,717.46,8.7753287843406642E-3,7.8977959059065971E-4,1.3488225621498227E-3,7599.057517419481]
["Logan",2681,9.3704235739026193E-4,9.3704235739026203E-6,490,1.1511562071987202E-3,1.0360405864788481E-3,1072.99,1.3123853639658919E-2,1.1811468275693027E-3,2.2265578376220534E-3,12544.082186009386]
["Meade",3795,1.326399010181292E-3,1.3263990101812921E-5,639,1.5012016661224126E-3,1.3510814995101714E-3,978.09,1.1963121749889555E-2,1.0766809574900599E-3,2.4410264471020444E-3,13752.365132078907]
["Morton",2545,8.8950869062223671E-4,8.8950869062223668E-6,395,9.279728609050907E-4,8.3517557481458163E-4,729.73,8.9254044459578415E-3,8.032864001362057E-4,1.6473570618570096E-3,9280.9546756292166]
["Ness",2583,9.0279015633683193E-4,9.0279015633683198E-6,385,9.044798770847086E-4,8.140318893762378E-4,1074.75,1.314538038492756E-2,1.1830842346434805E-3,2.0061440255830865E-3,11302.30488903995]
["Norton",4348,1.5196792875542182E-3,1.5196792875542182E-5,621,1.458914295245725E-3,1.3130228657211526E-3,878.13,1.0740500467472843E-2,9.6664504207255586E-4,2.2948647006692507E-3,12928.912478514894]
["Phillips",4719,1.6493483343993458E-3,1.6493483343993457E-5,922,2.1660531082392243E-3,1.949447797415302E-3,885.88,1.0835291533286464E-2,9.7517623799578174E-4,2.9411175187550771E-3,16569.800815674203]
["Rawlins",2474,8.6469332047128236E-4,8.6469332047128239E-6,233,5.4738652301490164E-4,4.9264787071341145E-4,1069.42,1.3080188593858323E-2,1.1772169734472491E-3,1.6785117773653732E-3,9456.4755200533764]
["Rooks",4577,1.5997175940974371E-3,1.5997175940974371E-5,400,9.3971935281528176E-4,8.4574741753375355E-4,890.53,1.0892166172774637E-2,9.802949555497173E-4,1.8420395490244452E-3,10377.765671481537]
["Rush",2873,1.0041487104745328E-3,1.0041487104745327E-5,567,1.3320521826156618E-3,1.1988469643540956E-3,717.76,8.7789981159205454E-3,7.9010983043284911E-4,1.9989982818916902E-3,11262.046875243746]
["Scott",4874,1.7035227340246686E-3,1.7035227340246687E-5,400,9.3971935281528176E-4,8.4574741753375355E-4,717.54,8.7763072727619646E-3,7.8986765454857678E-4,1.6526502994225769E-3,9310.7759566804471]
["Seward",21131,7.3855434740819183E-3,7.385543474081918E-5,3802,8.9320324485092535E-3,8.0388292036583289E-3,639.5,7.8217918177819722E-3,7.0396126360037744E-4,8.8166459019995251E-3,49671.618195079696]
["Sheridan",2397,8.3778087678644455E-4,8.3778087678644452E-6,232,5.4503722463286337E-4,4.90533502169577E-4,895.96,1.0958581074370503E-2,9.862722966933453E-4,1.4851836076307868E-3,8367.2945389693923]
["Sherman",5513,1.9268610653832576E-3,1.9268610653832577E-5,793,1.862993616956296E-3,1.6766942552606664E-3,1056.07,1.2916903338553569E-2,1.1625213004698212E-3,2.8584841663843201E-3,16104.257300060304]
["Stanton",2008,7.0182060933966653E-4,7.0182060933966655E-6,418,9.8200672369196931E-4,8.8380605132277242E-4,680.35,8.3214324679092497E-3,7.4892892211183247E-4,1.6397531795280017E-3,9238.1155796685707]
["Stevens",5060,1.768532013575056E-3,1.7685320135750562E-5,881,2.069731874575658E-3,1.8627586871180922E-3,727.29,8.8955605491081325E-3,8.0060044941973184E-4,2.6810444566735744E-3,15104.589443217026]
["Thomas",7472,2.611555574196209E-3,2.6115555741962089E-5,757,1.7784188752029207E-3,1.6005769876826286E-3,1074.69,1.3144646518611585E-2,1.1830181866750427E-3,2.8097107300996335E-3,15829.475310160316]
["Trego",2717,9.4962479859356263E-4,9.4962479859356264E-6,273,6.4135845829642974E-4,5.7722261246678677E-4,889.48,1.087932351224505E-2,9.7913911610205437E-4,1.5658579765547766E-3,8821.8014450948413]
["Wallace",1392,4.8652105986096402E-4,4.8652105986096402E-6,193,4.5341458773337344E-4,4.0807312896003613E-4,913.65,1.1174949326530882E-2,1.0057454393877794E-3,1.4186837789464252E-3,7992.6447983351791]
["Wichita",2063,7.2104378340026489E-4,7.2104378340026489E-6,426,1.0008011107482751E-3,9.0072099967344757E-4,718.57,8.7889053111862275E-3,7.9100147800676042E-4,1.6989329155142107E-3,9571.525051191742]
["Total",244901,8.5595900920265811E-2,8.5595900920265751E-4,40967,9.624370681695911E-2,8.6619336135263195E-2,30933.670000000002,0.37835297404216989,3.4051767663795286E-2,0.12152706280826114,684664.6594724207,{"$f":"COUNTIF(M4:M38,\"=yes\")","v":0}]

{"sheet":"Logic Model","index":2,"n_rows":24,"n_cols":11,"rows_kept":24,"cut":false,"hidden":false,"merged":[[1,1,1,6],[3,1,3,6],[0,0,0,1],[0,2,0,12]]}
["Applicant Name:",null,{"$f":"Information!B8","v":0}]
["Entity Mission:",{"$f":"Information!A54","v":0}]
[]
["Program Description:"]
["Family, Agency, or Community:"]
["Proxy Outcome: Yes or No"]
["Remember to keep it simple and not duplicate."]
["Identified Problem, Need, Situation (CARSP Statement from CSG Org Info)","Service Domain (#1-#7)",null,"Service or Activity\n(Output)\nIdentify the timeframe.\nIdentify the # of clients served or the # of units offered. (CARv3.0 Services)","Outcome\n(General statement of results expected) (CARv3.0 NPIs)","Outcome Indicator\nProjected # and % of clients who will achieve each outcome.","Actual Results\nActual # and % of clients who achieve each outcome.",null,"Measurement Tool","Data Source, Collection Procedure, Personnel (Inputs / Resources)","Frequency of Data Collection and Reporting"]
["(1) Planning","(1) Planning",null,"(2) Intervention","(3) Benefit","(4) Benefit","(5) Benefit",null,"(6) Accountability","(7) Accountability","(8) Accountability"]
["EXAMPLE: Individuals are being evicted due to lack of stable income.","SRV 4 Housing Services",null,"The number of individuals that received rental payment assistance (e.g.: emergency rental payments and deposits).","The number of individuals who avoided eviction","40 of 50 individuals or 90% will achieve this outcome.","45 of 50 individuals or 95% achieved this outcome.",null,"Attendance and sign in records, Follow-up Calls, Follow-up Surveys, Client Information System (software)","CSBG funds; Staff; Community partners, Case Managers, Workforce partners","Daily, Weekly, Monthly, Quarterly"]
{"$rows_empty":13}
["[Copy and extend the form, as necessary.]"]

{"sheet":"Budget Instructions","index":3,"n_rows":44,"n_cols":1,"rows_kept":44,"cut":false,"hidden":false,"merged":[]}
["Kansas CSBG Budget"]
["Workbook  Instructions"]
[]
["Contract / Funding Cycle is April 1 through September 30 each year."]
["Data / ROMA Cycle is October 1 through September 30 each year."]
[]
[]
["Budget Summary Page"]
["Applicants are to develop a 12-month budget (April to March), based upon the allocation listed for their agency in the “Available Funds” section of the grant guide.  The budget summary will reflect three-line items: "]
[]
["1. Personnel – Non-administrative salaries and fringe benefits to be charged as direct costs to CSBG."]
["2. Non-Personnel – All other non-administrative, direct program costs."]
["3. Administration – Direct and indirect administrative costs, including:"]
[]
["1)  CSBG’s “Fair Share” of Indirect Costs & Direct Costs, including:"]
[]
["Administrative costs as a part of an indirect cost rate agreement (note – a copy of the rate agreement with the Federal cognizant agency must be uploaded into CSG eGov to support the application and the basis of the computation), and"]
["Any direct administrative costs not included in the indirect cost rate (such costs are uncommon and may only be charged when the applicant uses an objective basis for calculation of the costs, such as a consistent and thorough time study of the impacted individuals). "]
[]
["2)  Other Indirect Costs Charged to CSBG (as a result of “Shortfall” in other program budgets).  "]
["OMB Circulars place strict limits on the allocation of costs to grants using Federal funds.  These requirements usually prohibit agencies from assigning administration costs to a grant in excess of that grant’s “fair share” as determined by a cost allocation plan.  However, as administered by the State of Kansas, CSBG allows agencies to leverage other funds and to maintain programs and activities that could not be otherwise supported.  The ability to leverage additional program resources for local communities is considered one of the unique strengths of the CSBG program.  Such shortfall costs, however, must be justified as necessary.  Shortfall costs will only be allowable when applicants demonstrate that other cost objectives are unable to pay for their fair shares.  Applicants requesting to use CSBG funds to pay for “shortfall” from other cost objectives must submit a completed Worksheet for Calculation of Shortfall.  The requested costs must be thoroughly justified."]
[]
["Direct Expense Worksheet"]
["Applicants must submit a detailed explanation of all proposed costs.  Information provided in the worksheet should clearly define what expenses are anticipated in the Personnel and Non-Personnel lines.  Applicants should supply sufficient detail to explain how specific costs were derived in order to demonstrate that requested expenditures are justified and reasonable.  All costs should clearly relate to the proposed service delivery approach described in the Community Action Plan (CAP).  Budget categories are provided to assist in planning and to elicit the detail required. "]
[]
["Administrative Cost Pool Worksheet"]
["Applicants must submit detail of all costs identified as administrative costs, whether or not these costs are supported with CSBG funds.  This information is an essential element of the justification for the fair share element of the Administration line item.  It is requested to further demonstrate the role that CSBG plays in maintaining operations of subgrantee organizations.  Budget categories are provided to assist in planning and to elicit the detail required.  Delete instructions/sample content and expand cells, add lines and adjust formulas within the worksheet as necessary."]
[]
["Shortfall Worksheet"]
["The information derived from this worksheet is essential to documenting the basis for assigning administrative costs to CSBG beyond its fair share.  "]
[]
["Total Administrative Costs – The amount entered here should match the total from the administrative cost pool worksheet (KS-CSBG Budget c).  This figure should include all costs connected with agency-wide administration regardless of the funding source that pays these costs.  For agencies having indirect cost rate agreements, this figure should equal the total of all costs associated with the indirect cost pool."]
[]
["Program Title – Enter the name of each program or funding source for the agency.  All sources of funding, including private donations and CSBG that are anticipated to be active April 1, 2026 – March 31, 2027, are to be included.  Donations do not need to be itemized; simply use one line for all private donations.  "]
[]
["Funding Source – Enter identifying information for the originating source of the funding.  This may include the names of Federal or State agencies or local units of government.  It may also include the names of private foundations or grant-making bodies. "]
[]
["Pass-Through Entity – The purpose of this column is to distinguish the pass-through entity from the appropriator of funds.  Specifically, this section distinguishes funding received from a Federal program, using Federal dollars, from funding received from the State, using State resources.  Certain funding originates at a source different from the actual grant-making body.  CSBG is a prime example, as it originates from the Federal Department of Health and Human Services but passes to KHRC for disbursement.    "]
[]
["Grant Amount – Enter the total amount of funds to be received from this funding source."]
[]
["Fair Share – Enter each program’s or funding source’s fair share of the administrative costs for the period April 1, 2026 – March 31, 2027.  The fair share is the amount each program would pay into the administrative cost pool during this timeframe, if it could.  The figure for fair share must be objective and verifiable.  Applicants with questions regarding how to figure each program’s fair share can contact the CSBG Program Manager for technical assistance. "]
[]
["Actual Contribution – Enter the actual contribution that each program/funding source will make to the administrative cost pool.  CSBG’s fair share amount and contribution amount should be equal. "]

{"sheet":"Budget Summary","index":4,"n_rows":18,"n_cols":6,"rows_kept":18,"cut":false,"hidden":false,"merged":[[17,0,18,3],[6,0,7,0],[6,1,7,1],[6,2,7,2],[6,3,7,3],[14,0,14,3],[15,0,15,1],[5,0,5,3],[0,0,0,3],[1,0,1,3],[2,0,2,3],[3,0,3,3],[4,0,4,3]]}
["KS-CSBG Budget a."]
["COMMUNITY SERVICES BLOCK GRANT"]
["FFY 2026 Non-Discretionary "]
["Budget Summary"]
["APPLICANT ORGANIZATION:"]
["  April 1, 2026 - March 31, 2027"]
["1. ALLOWABLE EXPENSES",null,"FFY 2026"]
[]
["   A. PERSONNEL",null,null,{"$f":"IFERROR(C9/$C$14,\"-\")","v":"-"}]
["   B. NON-PERSONNEL COSTS",null,null,{"$f":"IFERROR(C10/$C$14,\"-\")","v":"-"}]
["   C. ADMINISTRATION",null,{"$f":"SUM(C12:C13)","v":0},{"$f":"IFERROR(C11/$C$14,\"-\")","v":"-"}]
["      1. CSBG FAIR SHARE",null,null,{"$f":"IFERROR(C12/$C$14,\"-\")","v":"-"},null,"Please remember to input your indirect cost rate and send any applicable documentation."]
["      2. SHORTFALL",null,null,{"$f":"IFERROR(C13/$C$14,\"-\")","v":"-"}]
["   D. TOTAL EXPENSE",null,{"$f":"SUM(C9:C11)","v":0},{"$f":"SUM(D9:D11)","v":0}]
[]
["   E.  CSBG Fair Share as a % of FFY 2026 Personnel Line",null,{"$f":"IFERROR(C12/C9,\"-\")","v":"-"},"(If a cost basis other than \"personnel\" is authorized, please adjust the formula and the fair share descriptor.)"]
["If indirect cost rate, please note timeframe."]
["2.  Fair Share Comments: "]

{"sheet":"Direct Expense Worksheet","index":5,"n_rows":122,"n_cols":13,"rows_kept":122,"cut":false,"hidden":false,"merged":[[18,1,18,8],[19,1,19,10],[15,1,15,8],[0,0,0,12],[2,0,2,12],[3,0,3,12],[4,0,4,12],[6,0,6,12],[7,0,7,12],[16,1,16,8],[17,1,17,8],[20,1,20,9],[21,1,21,8],[8,1,8,8],[8,9,8,12],[9,1,9,8],[22,1,22,8],[23,0,23,11],[24,1,24,8],[25,0,33,0],[25,1,25,8],[26,1,26,8],[27,1,27,8],[28,1,28,8],[29,1,29,8],[30,1,30,8],[31,1,31,8],[32,1,32,8],[33,1,33,8],[10,0,19,0],[10,1,10,8],[11,1,11,8],[12,1,12,8],[13,1,13,8],[14,1,14,8],[34,0,41,0],[34,1,34,8],[35,1,35,8],[36,1,36,8],[37,1,37,8],[38,1,38,8],[39,1,39,8],[40,1,40,8],[41,1,41,8],[42,0,50,0],[42,1,42,8],[43,1,43,8],[44,1,44,8],[45,1,45,8],[46,1,46,8],[47,1,47,8],[48,1,48,8],[49,1,49,8],[50,1,50,8],[51,0,59,0],[51,1,51,8],[52,1,52,8],[53,1,53,8],[54,1,54,8],[55,1,55,8],[56,1,56,8],[57,1,57,8],[58,1,58,8],[59,1,59,8],[60,0,68,0],[60,1,60,8],[61,1,61,8],[62,1,62,8],[63,1,63,8],[64,1,64,8],[65,1,65,8],[66,1,66,8],[67,1,67,8],[68,1,68,8],[69,0,77,0],[69,1,69,8],[70,1,70,8],[71,1,71,8],[72,1,72,8],[73,1,73,8],[74,1,74,8],[75,1,75,8],[76,1,76,8],[77,1,77,8],[78,0,86,0],[78,1,78,8],[79,1,79,8],[80,1,80,8],[81,1,81,8],[82,1,82,8],[83,1,83,8],[84,1,84,8],[85,1,85,8],[86,1,86,8],[87,0,95,0],[87,1,87,8],[88,1,88,8],[89,1,89,8],[90,1,90,8],[91,1,91,8],[92,1,92,8],[93,1,93,8],[94,1,94,8],[95,1,95,8],[96,0,104,0],[96,1,96,8],[97,1,97,8],[98,1,98,8],[99,1,99,8],[100,1,100,8],[101,1,101,8],[102,1,102,8],[103,1,103,8],[104,1,104,8],[105,1,105,10],[106,0,114,0],[106,1,106,8],[107,1,107,8],[108,1,108,8],[109,1,109,8],[110,1,110,8],[111,1,111,8],[118,1,118,8],[119,1,119,8],[120,1,120,11],[121,0,121,11],[112,1,112,8],[113,1,113,8],[114,1,114,8],[115,0,115,11],[116,1,116,8],[117,1,117,8]]}
["KS-CSBG Budget b."]
[]
["COMMUNITY SERVICES BLOCK GRANT"]
[" Worksheet for CSBG Direct Expense"]
["Applicants must submit a detailed explanation of all proposed costs.  Information provided should clearly and completely define the anticipated expenses in each listed category.  Applicants should supply sufficient detail to explain how specific costs were derived in order to demonstrate that the expenditures are justified and reasonable.  All costs should clearly relate to the proposed projects.  Applicants are guided to add schedules to provide the detail needed to support budgeted costs."]
[]
["APPLICANT ORGANIZATION:"]
["  April 1, 2026 - March 31, 2027"]
["Object Class Categories","Detail"]
["   Personnel","Non-administrative salaries and fringe benefits to be charged as direct costs to the CSBG program.  Add lines, adjust formula as necessary.  Please remove sample entries.",{"$nulls":7},"Annual Salary","% This Budget","Sub-Total ▼"]
["Salaries          Position - Hours per Week  Each funded position is to have its own line.",{"$nulls":10},{"$f":"SUM(K11*J11)","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[null,"Sub-Total Salaries  ►",{"$nulls":9},{"$f":"SUM(L11:L19)","v":0}]
[{"$nulls":10},"% Fringe▼"]
["Fringe","As a percentage of Salary Sub-Total - ___ %",{"$nulls":9},{"$f":"SUM(K22*J22)","v":0}]
["Other Personnel","Detailed Description - Add lines, adjust formula if necessary.",{"$nulls":9},{"$f":"SUM(K23*J23)","v":0}]
["Personnel Sub-Total",{"$nulls":11},{"$f":"SUM(L20:L23)","v":0}]
["  Non-Personnel","All other non-administrative, direct program costs.  Add lines, adjust formula as necessary.",{"$nulls":7},"Unit Cost","Quantity","Sub-Total ▼"]
["1. Operating Expense            Detail rent/use allowance, electricity/water/natural gas, etc., maintenance of building & grounds, trash/exterminating, building/contents insurance, property taxes, liability insurance and other operating expenses.  Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},{"$f":"SUM(J26)*K26","v":0}]
[{"$nulls":11},{"$f":"SUM(J27)*K27","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["2. Contractual Services        Describe contractual expenses planned including accounting services, audit expense, computer services, etc.  Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["3. Professional Fees/Services   Detail anticipated expenses related to legal and consulting services, bonding and other professional fees and services anticipated.  Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["4. Office Costs        Describe budgeted costs related to general office supplies/stationery, printing, advertising, furnishings and equipment (<$1000), maintenance agreements, . . ..   Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["5. Equipment           Describe all supply and equipment purchases planned for which the purchase price, individually or in aggregate, will equal/exceed $1,000.  Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["6. Computer/Data Processing    Describe all budgeted hardware, devices, software, computer supplies, maintenance and repair, . . ..   Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["7. Communication  Detail budgeted amounts for postage/delivery service, telephone, telephone equipment/repair, internet connectivity/repair, . . ..   Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[" 8.  Training   Describe training expenses, internal and external.  Consider registration fees for events, professional publications/resources, organizational dues/subscription, in-service speakers and activities.  Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},{"$f":"SUM(J90)*K90","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["Training",{"$nulls":10},0]
["9.  Travel       Describe planned travel expenditures for attendance or participation in conferences, meetings or symposia of organizations.  Include specific information about travel to planned events/destinations, who will attend and an itemization of anticipated, related costs.   Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["10.  Construction","Construction is NOT an allowable cost in the Community Services Block Grant Program"]
["11.  Other               Describe other budgeted costs not applicable to the categories above including set-asides for direct service activities.   Each item to have its own line; add lines, adjust formula as necessary.",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["Non-Personnel Sub-Total",{"$nulls":11},{"$f":"SUM(L25:L115)","v":0}]
["CSBG Fair Share Admn./In-Direct   Charges","Direct and indirect administrative costs. (fair share) charged to CSBG  Add lines, adjust formula as necessary.  ",{"$nulls":7},"Unit Cost","Quantity/%","Sub-Total ▼"]
["Indirect Detail",{"$nulls":10},{"$f":"SUM(J118)*K118","v":0}]
[{"$nulls":11},{"$f":"SUM(J119)*K119","v":0}]
[{"$nulls":11},{"$f":"SUM(J120)*K120","v":0}]
[null,"CSBG Fair Share Admn./Indirect Charges Sub-Total ",{"$nulls":10},{"$f":"SUM(L118:L120)","v":0}]
["Worksheet Total",{"$nulls":11},{"$f":"SUM(M11:M121)","v":0}]

{"sheet":"Cost Pool Worksheet","index":6,"n_rows":112,"n_cols":13,"rows_kept":112,"cut":false,"hidden":false,"merged":[[0,0,0,12],[2,0,2,12],[3,0,3,12],[4,0,4,12],[5,0,5,12],[6,0,6,12],[15,1,15,10],[16,1,16,9],[17,1,17,8],[18,1,18,8],[19,0,19,11],[20,1,20,8],[7,1,7,8],[7,9,7,12],[8,1,8,8],[9,0,14,0],[9,1,9,8],[10,1,10,8],[11,1,11,8],[12,1,12,8],[13,1,13,8],[14,1,14,8],[21,0,29,0],[21,1,21,8],[22,1,22,8],[23,1,23,8],[24,1,24,8],[25,1,25,8],[26,1,26,8],[27,1,27,8],[28,1,28,8],[29,1,29,8],[39,0,45,0],[39,1,39,8],[40,1,40,8],[41,1,41,8],[42,1,42,8],[43,1,43,8],[44,1,44,8],[45,1,45,8],[30,0,38,0],[30,1,30,8],[31,1,31,8],[32,1,32,8],[33,1,33,8],[34,1,34,8],[35,1,35,8],[36,1,36,8],[37,1,37,8],[38,1,38,8],[46,0,54,0],[46,1,46,8],[47,1,47,8],[48,1,48,8],[49,1,49,8],[50,1,50,8],[51,1,51,8],[52,1,52,8],[53,1,53,8],[54,1,54,8],[55,0,63,0],[55,1,55,8],[56,1,56,8],[57,1,57,8],[58,1,58,8],[59,1,59,8],[60,1,60,8],[61,1,61,8],[62,1,62,8],[63,1,63,8],[64,0,72,0],[64,1,64,8],[65,1,65,8],[66,1,66,8],[67,1,67,8],[68,1,68,8],[69,1,69,8],[70,1,70,8],[71,1,71,8],[72,1,72,8],[73,0,81,0],[73,1,73,8],[74,1,74,8],[75,1,75,8],[76,1,76,8],[77,1,77,8],[78,1,78,8],[79,1,79,8],[80,1,80,8],[81,1,81,8],[82,0,90,0],[82,1,82,8],[83,1,83,8],[84,1,84,8],[85,1,85,8],[86,1,86,8],[87,1,87,8],[88,1,88,8],[89,1,89,8],[90,1,90,8],[91,0,99,0],[91,1,91,8],[92,1,92,8],[93,1,93,8],[94,1,94,8],[95,1,95,8],[96,1,96,8],[97,1,97,8],[98,1,98,8],[99,1,99,8],[109,1,109,8],[110,0,110,11],[111,0,111,11],[100,1,100,11],[101,0,108,0],[101,1,101,8],[102,1,102,8],[103,1,103,8],[104,1,104,8],[105,1,105,8],[106,1,106,8],[107,1,107,8],[108,1,108,8]]}
["KS-CSBG Budget c."]
[]
["COMMUNITY SERVICES BLOCK GRANT"]
["Subgrantee Worksheet for Administrative Cost Pool"]
["Applicants must submit a detail of all of the costs identified as administrative costs, whether or not these costs are supported with CSBG funds.  This information is an essential element of the justification of the Fair Share - Administration line item.  It is requested to further demonstrate the role that CSBG plays in maintaining operations within subgrantee organizations."]
["APPLICANT ORGANIZATION:"]
["  April 1, 2026 - March 31, 2027"]
["Object Class Categories","Detail"]
["   Personnel","Salaries and fringe benefits charged to cost pool.  ",{"$nulls":7},"Annual Salary","% This Budg.","Sub-Total ▼"]
["Salaries                     Position - Hours per Week.  Each funded position is to have its own line; add lines, adjust formula if necessary.  ",{"$nulls":10},{"$f":"SUM(K10*J10)","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[null,"Sub-Total Salaries  ►",{"$nulls":9},{"$f":"SUM(L10:L15)","v":0}]
[{"$nulls":10},"% Fringe▼"]
["Fringe","As a percentage of Salary Sub-Total - ___ %",{"$nulls":9},{"$f":"SUM(K18*J18)","v":0}]
["Other Personnel","Detailed Description - Add lines, adjust formula if necessary.",{"$nulls":9},{"$f":"SUM(K19*J19)","v":0}]
["Administrative Cost Pool Personnel Sub-Total",{"$nulls":11},{"$f":"SUM(L16:L19)","v":0}]
["  Non-Personnel","All other costs charged to the cost pool.  ",{"$nulls":7},"Unit Cost","Quantity","Sub-Total ▼"]
["1. Operating Expense",{"$nulls":10},{"$f":"SUM(K22*J22)","v":0}]
[{"$nulls":11},{"$f":"SUM(K23*J23)","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["2. Contractual Services",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["3. Professional Fees/Services",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["4. Office Costs",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["5.  Equipment",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["6.  Computer/Data Processing",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["7. Communication",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[" 8.  Training",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},{"$f":"SUM(K87*J87)","v":0}]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["9.  Travel",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["10. Construction","Construction is NOT an allowable cost in the Community Services Block Grant Program"]
["11. Other",{"$nulls":10},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
[{"$nulls":11},0]
["Administrative Cost Pool Non-Personnel Sub-Total ",{"$nulls":11},{"$f":"SUM(L21:L110)","v":0}]
["Worksheet Total",{"$nulls":11},{"$f":"SUM(M4:M111)","v":0}]

{"sheet":"Shortfall Worksheet","index":7,"n_rows":31,"n_cols":10,"rows_kept":31,"cut":false,"hidden":false,"merged":[[0,0,0,9],[2,0,2,9],[3,0,3,9],[5,0,5,9],[7,0,7,5],[7,6,8,9],[8,0,8,5],[20,1,20,3],[9,0,9,9],[10,0,10,9],[11,1,11,3],[12,1,12,3],[13,1,13,3],[14,1,14,3],[15,1,15,3],[16,1,16,3],[17,1,17,3],[18,1,18,3],[19,1,19,3],[27,0,27,5],[28,0,29,9],[30,0,33,9],[21,1,21,3],[22,1,22,3],[23,1,23,3],[24,1,24,8],[25,1,25,3],[26,0,26,8]]}
["KS-CSBG Budget d."]
[]
["COMMUNITY SERVICES BLOCK GRANT"]
["Worksheet for Calculation of Shortfall"]
[]
["APPLICANT ORGANIZATION:"]
[]
["Total Administrative Costs "]
["(From Worksheet for Subgrantee Administrative Cost Pool)"]
["Note:  For agencies with indirect cost rate agreements, this total should equal the total of all costs associated with the indirect cost pool."]
["Programs/Funding Sources Anticipated to be Active   April 1, 2026 - March 31, 2027"]
[null,"Program Title",null,null,"Funding Source","Pass-Through Entity","Grant Amount","A - Fair Share of Admin Cost Pool Expenses","B - Actual Contribution to be Made to Admin Cost Pool","Shortfall (A minus B)"]
[1,"CSBG",null,null,"HHS","KHRC",null,null,null,{"$f":"H13-I13","v":0}]
[2,{"$nulls":8},0]
[3,{"$nulls":8},0]
[4,{"$nulls":8},0]
[5,{"$nulls":8},0]
[6,{"$nulls":8},0]
[7,{"$nulls":8},0]
[8,{"$nulls":8},0]
[9,{"$nulls":8},0]
[10,{"$nulls":8},0]
[11,{"$nulls":8},0]
[12,{"$nulls":8},0]
[13,"Add lines, adjust formulas as necessary.  Please remove sample entries."]
[14,{"$nulls":8},{"$f":"H26-I26","v":0}]
["Shortfall Sub-Total",{"$nulls":8},{"$f":"SUM(J13:J26)","v":0}]
["Worksheet Totals",{"$nulls":5},{"$f":"SUM(G13:G27)","v":0},{"$f":"SUM(H13:H27)","v":0},{"$f":"SUM(I13:I27)","v":0},{"$f":"H28-I28","v":0}]
["Agencies without an indirect cost rate MUST document the basis for the calculation of fair share."]
[]
["Applicant Comments:"]

{"sheet":"Scoring","index":8,"n_rows":35,"n_cols":10,"rows_kept":35,"cut":false,"hidden":false,"merged":[[31,6,31,7],[4,1,12,1],[13,1,18,1],[19,1,24,1],[25,1,28,1],[29,1,30,1]]}
["For State Use Only - 35 County Application Score Sheet"]
["Only applications submitted before the proposal deadline are scored."]
[{"$f":"Information!B7","v":0}]
[]
["1. The entity followed application instructions. (Weighted at 20%)","20% Weight","3 Completely","2 Neutral","1 Low","0 Not At All","Score","Factor","Final Score","Notes"]
["Information Pages Complete & 2 Signatures",null,3,2,1,0,null,2.5,{"$f":"G6*H6","v":0}]
["Counties Page Complete",null,3,2,1,0,null,2.5,{"$f":"G7*H7","v":0}]
["CSBG Assurances & Certifications and Single Audit Certification Complete/Signed (Attachments)",null,3,2,1,0,null,2.5,0]
["CSBG Logic Model Page Complete [Copy and extend the form, as necessary.]",null,3,2,1,0,null,2.5,0]
["The budget worksheets are complete. (Budget Pages)",null,3,2,1,0,null,2.5,0]
["The costs in the budget are realistic and seem appropriate.  (Budget Pages)",null,3,2,1,0,null,2.5,0]
["The budget narrative explains all of the proposed costs. (Information Page)",null,3,2,1,0,null,2.5,0]
["501c3 Letter, Secretary of State, Single Audit or Indpendent Audit or if no audit - Recent Financial Statement (Attachments)",null,3,2,1,0,null,2.5,0]
["2. The proposed project represents addressing needs within the counties applying. (Weighted 20%)","20% Weight","3 Completely","2 Neutral","1 Low","0 Not At All","Score","Factor","Final Score","Notes"]
["The activities, programs/services or interventions are responsive to the problem/need statement.  (Logic Model)",null,3,2,1,0,null,4,{"$f":"G15*H15","v":0}]
["The needs statement is data driven. (Logic Model)",null,3,2,1,0,null,4,{"$f":"G16*H16","v":0}]
["The proposed outcomes are logical given the activities. (Logic Model)",null,3,2,1,0,null,4,0]
["The timeline for implementation is realistic and achievable. (Information Page)",null,3,2,1,0,null,4,0]
["The applicant demonstrates, through its efficacy statement, that the planned activities will measurably impact the problem / need.  (Logic Model)",null,3,2,1,0,null,4,0]
["3. The proposed project, activity or service is directly related to the purposes of the CSBG authorizing legislation (CSBG Act). (Weighted at 25%)","25% Weight","3 Completely","2 Neutral","1 Low","0 Not At All","Score","Factor","Final Score","Notes"]
["The project summary decribes how the proposed project relates to the purposes of the CSBG authorizing legislation.  (Information Page)",null,3,2,1,0,null,5,{"$f":"G21*H21","v":0}]
["To what extent will the  project  help individuals and families with low incomes become stable and achieve economic security.  (Information Page)",null,3,2,1,0,null,5,{"$f":"G22*H22","v":0}]
["To what extent will the project mobilze the  communities where people with low income live to become healthy and offer economic opportunity. (Information Page)",null,3,2,1,0,null,5,0]
["To what extent will the project help people with low incomes become engaged and active in building opportunities in their communities. (Information Page)",null,3,2,1,0,null,5,0]
["Services for below 125% of Poverty Guidelines",null,3,2,1,0,null,5,0]
["4. Applicant entity has demonstrated that it has the capacity to effectively implement the project, produce the planned results, and meet reporting requirements. (Weighted at 20%)","20% Weight","3 Completely","2 Neutral","1 Low","0 Not At All","Score","Factor","Final Score","Notes"]
["Key personnel to be involved with the project have been identified, including percent of time devoted to the project. (Information Page)",null,3,2,1,0,null,6.67,{"$f":"G27*H27","v":0}]
["The applicant has described other resources that will support the project.  (Information Page)",null,3,2,1,0,null,6.67,{"$f":"G28*H28","v":0}]
["The description of the applicant's attributes clearly describes the entity's ability to successfully implement the project.  (Information Page)",null,3,2,1,0,null,6.67,0]
["5. Applicant has described a plan to sustain the project or sustain the gains of the project. (Weighted at 15%)","15% Weight","3 Completely","2 Neutral","1 Low","0 Not At All","Score","Factor","Final Score","Notes"]
["The project's sustainability plan describes the applicant's plan to continue the project and/or sustain gains made in the counties applied for, as a result of the project and is feasible.  (Information Page)",null,3,2,1,0,null,15,{"$f":"G31*H31","v":0}]
[{"$nulls":6},"Total Score",null,{"$f":"SUM(I6:I31)","v":0}]
[]
["*Factor = 100 based on weight percent",{"$nulls":6},{"$f":"SUM(H31,H27:H29,H21:H25,H15:H19,H6:H13)","v":100.01}]
["2026-01-26"]