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U.S. Department of Justice Office of Community Oriented Policing Services COPS in Schools Grant Program udget Information ~--. `.~~ . Applicant Name: San Leandro Police Department ORI Code (Assigned by FBI): CA0011200 state: California This worksheet will assist you in properly organizing and estimating your costs and providing the necessary details for financial review Complete Part 1 if you are request- ing funds for full-time officers, Part 2 if you are requesting part-time officers, and both parts if you are requesting full- and part-time officers. Everyone must complete a Budget Summary. The budget information you provide will be used to calculate your grant amount. Assistance in completing this information is available from the U.S. Department of Justice Response Center at 1-800-421-6770, or by writing the COPS Office, 1100 Vermont Avenue, NW, Washington, DC 20530. Also, you can refer to the sample budget included in this application kit. OMB Approval Number: 1103-0027 Part 1 Complete if ou are requesting Full ime Officers 1. Cost Per Full-Time Officer -Year 1 Instructions: Please indicate the Law Enforcement Agency's cost for each of the following categories. Please do not include employee contribution Current Annual Entry-Level Base Salary $ ~ 1 , 648 % of base salary Enter the base annual salary that your department currently Pays a new, entry-level officer. Annual Fringe Benefits: *Social Security $ Q % Cost for Social Security may not exceed 6.2% *Medicare $ 749 % '~„ 4F Cost for Medicare may not exceed 1.45 Health Insurance $ 6.300 % 12% Costs toward health insurance coverage, please indicate if this is for Family Coverage ()Yes () No Life Insurance $ _ _ 0 % Costs toward life insurance coverage. Vacation $ 2 ,152 % Vacation costs, if not included in base salary. Sick Leave $ 2 , 152 % Sick leave costs, if not included in base salary. Retirement $ 11, 879 % 23% Contribution to retirement benefits. *Worker's Comp. $ 9 % Costs of worker's compensation. *Unemployment Ins. $ Q % Costs of unemployment insurance. Other Denta 1 $ R5~ % _ ~ 1 Fi% Costs of equipment, training, uniforms, vehicles and overtime Other $h i ft $ 1 , ^~00_ % . 0~ are not permitted. Rotation Pay Total Fringe Benefits $ 25 , 282 Sum of department fringe benefit costs for Year 1. Total Year 1 Salary and Benefits $ 76 , 930 Year 1 base salary plus Year 1 fringe benefits Previous editions are obsolete and should not be used. (02/08/2001) Page 1