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SAN BERNARDINO Public Health Trudy Raymundo
Director
COUNTYAdministration Corwin Porter
._ Assistant Director
Maxwell Ohikhuare,M.D.
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date: 8/26/2018
nguvenki4scaa.ca.eov SCAG OWP#: 225.3564.1
Kana Sato-Nguyen In-Kind Match Report#:
Senior Budget&Grants Analyst Reporting Period: Jan. I,2018-Mar.31,2018 QI
Southern California Association of Governments
900 Wilshire Blvd, 17th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Categories HR�y Hours Amount Fringe Rate Fringe 7DC Rate* !DC Amount
Direct Labor Classi Ication s :
Cont SRTS Project Coordinator $32.33 244.00 $7,887.37 49.28% $3,886.89 15.307% $1,802.29 $13,576.55
Health Education Specialist II $0.00 $0.00 $0.00 $0.00
PH Program Manager $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
Subtotal- Direct Labor 244.00 $7,887.37 $3,886.89 $1,802.29 $13,576.55
Other Direct Costs LYACyl
Printing Services $0.00
HS Admin Charges $0.00
County Counsel Charges $102.00 $102.00
CEHW Charges $0.00
$0.00
$0.00
Subtotal-ODCs: $102.00 S102.00
TOTAL for IN-KIND MATCH S7,989.37 513,678.55
I,Kelly Welty,certify that this in-kind match report and the information attached is true and correct.1 also certify that all eligible and required documentation is on
file for this report and that I am the person duly authorized to sign this certification on behalf of my agency.I further certify that our agency is not using any federal
funds to match expenditure funds.
4 k� 60 �iPN �ll� �Istl al r
Signature Tide
Kelly Welter
Print Name Date
-If applicable,for credit of indirect costs for work provided as in-kind contribution,a sub-recipient must submit an approved Indirect Cost Allocation Plan(ICAP)or Indirect Cost Rate Proposal
(ICRP)to SCAG on an annual basis for SCAG's review.1f a sub-recipient has not received a negotiated indirect cost rate previously,then the sub-recipient may elect to charge a de minimis rate of
10%of modified total direct costs(MTDC).
BOARD OF •
••
LID Program Id 2903
Prod Time Y
Sum of .• End2 Pay Period End
FebruaryJanuary . Total
Descr Name January
ContSRTS Project •• • Friis,Mark $ 2 412.76 $ 4,535.99 $ 4,825.51 $ 11,774.26
Grand Total $ 2,412.76 $ 4,535.99 $ 4,825.51 $ 11,774.26
January February March Total Hours Hourly Rate Salary Rate
Cont SRTS Project Coordinator Friis,Mark $ 2,412.76 $ 4,535.99 $ 4,825.51 244 $ 48.26 $ 32.32527
Health Education Specialist II Beltran,Bernadette
PH Program Manager Rigsby Scott
Total 00
Total •
Indirect Rate 15.307% $ 1,802.29
Total •
www.SB(ounty.yov
Public Health Trudy Raymundo
cra
ERNARDINODirector
UNTYAdministration Corwin Porter
Assistant Director
Maxwell Ohikhuare,M.D.
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date: 8/26/2018
nguvenk(@scae.ca.gov SCAG OWP#: 225.3564.1
Kana Sato-Nguyen In-Kind Match Report#:
Senior Budget&Grants Analyst Reporting Period: April I,2018-June 30,2018 Q2
Southern California Association of Governments
900 Wilshire Blvd, 17th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Categories Hourly Rate Hours Amours! Fringe Rate Fringe IDC Rate a IDC Amount
Direct Labor Classi rcation s :
Cont SRTS Project Coordinator $41,31 244.50 $10,099.23 49.28% $4,976.91 15.307% $2.307.70 $17,383.84
Health Education Specialist II $36.59 0.12 $4.42 49.28% $2.18 15.307% $1.01 $7.61
PH Program Manager $98.62 18.00 $1,775.08 49.28% $874.76 15.307% $405.61 $3,055.45
$0.00 49.28% $0.00 15.307% $0.00 $0.00
$0.00 49.28% $0.00 15.307% $0,001 $0.00
Subtotal- Direct Labor 262.62 $11,878.73 $5,853.85 52,714.33 $20,446.91
Other Direct Costs ODCs
Printing Services $25.92 $25.92
HS Admin Charges $553.20 $553.20
County Counsel Charges $0.00
CEHW Charges $205.62 $205.62
$0.00
$0.00
Subtotal-ODCs: $784.74 $784.74
TOTAL for IN-KIND MATCH $12,663.47 1S21,231.65
1,Kelly Welty,certify that this in-kind match report and the information attached is true and correct.I also certify that all eligible and required documentation is on
file for this report and that I am the person duly authorized to sign this certification on behalf of my agency.I further certify that our agency is not using any federal
funds to match expenditure funds.
Signature Title
Kelly Welty OL -s -IY
Print Name Date
-if applicable,for credit of indirect costs for work provided as in-kind contribution,a sub-recipient must submit an approved Indirect Cost Allocation Plan(ICAP)or Indirect Cost Rate Proposal
(ICRP)to SCAG on an annual basis for SCAG's review.If sub-recipient has not received a negotiated indirect cost rate previously,then the sub-recipient may elect to charge a de minimis rate of
10%of modified total direct costs(MTDC).
BOARD OF •
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www.SB(olinty.gov
CeNBERNARDINO Public Health TrudyRayolundoUNTY rector
Administration Corwin Porter
_ Assistant Director
Maxwell Ohikhuare,M.D..
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date: 10/I 1/2018
neuvenk@scaR.ca.Rov SCAG OWP#: 225.3564.1
Kana Sato-Nguyen In-Kind Match Report#:
Senior Budget&Grants Analyst Reporting Period: July 1,2018-September 30,2018 Q3
Southern California Association of Governments
900 Wilshire Blvd, 17th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Categories HourlyHours Amount Fringe Rate Fringe IDCRate* RIC Amount
Raatete
Direct Labor GlassiRcation/s):
Cont SRTS Project Coordinator $33.02 301.00 $9,938.22 48.36% $4,806.13 16.330% $2,407.75 $17,152.10
Health Education Specialist 11 $0.00 $0.00 48.36% $0.00 16.330% $0.00 $0.00
PH Program Manager $61.83 32.00 $1,978.61 48.36% $956.85 16.330% $479.36 $3,414.82
Subtotal- Direct Labor 333.00 $11,916.83 S5,762.98 S2,887.11 $20,566.92
Other Direct Costs(ODCs)
Printing Services $64.82 $64.82
HS Admin Charges $0.00
County Counsel Charges $0.00
CEHW Charges $0.00
Email Charges $341)67 $349.67
$0.00
Subtotal-ODCs: $414.49 -fi - - $414.49
TOTAL for IN-KIND MATCH $12,331.32 S20,981.41
1.Kelly Welty,certify that this in-kind match report and the information attached is true and correct.I also certify that all eligible and required documentation is on
file for this report and that I am the person duly authorized to sign this certification on behalf of my agency.I further certify that our agency is not using any federal
funds to match expenditure funds.
Chief Financial Officer
Signature Title
Kelly Welty 10/11/2018
Print Name � Date_ lo�nrzely
-if applicable,for credit of indirect costs for work provided as in-kind contribution,a sub-recipient must submit an approved Indirect Cost Allocation Plan(ICAP)or Indirect Cost Rate Proposal
(ICRP)to SCAG on an annual basis for SCAG's review.If a sub-recipient has not received a negotiated indirect cost rate previously,then the sub-recipient may elect to charge a de minimis rate of
10%of modified total direct costs(MTDC)-
BOARD OF • '
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www.SBCounty.gov
SAN BERNARDINO Public Health Trudy Raymundo
Director
COUNTYAdministration Corwin Porter
Assistant Director
Maxwell Ohikhuare,M.D.
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date: 1/11/2019
nRuYenk(@scag.ca.gov SCAG OWP#: 225.3564.1
Kano Sato-Nguyen In-Kind Match Report#: 4
Senior Budget&Grants Analyst Reporting Period: October 1,2018-December 31,2018 Q4
Southern California Association of Governments
900 Wilshire Blvd, 17th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Categories Rarlute y Hours Amount Fringe Rate Fringe IDCRate• HIC Amount
Direct Labor Classification(s):
Cont SRTS Project Coordinator $33.02 1 265.00 $8,749.601 48.36%1 $4,231.31 16.330%1 $2,119.781 $15,100.69
Health Education Specialist fI $0.00 $0.011 48.36% $0.00 16.330% $0.00 $0.00
PH Program Manager $62.57 33.00 $2,064.84 48.36% $998.55 16.330% $110.25 $3,563.64
$0.00 48.36% $111 16.330%1 $0.001 $0.00
$0.00 48.36%1 $0.001 16.330%1 $0.00 $0.00
Subtotal- Direct Labor 298.00 $10,814.44 S5,229.86 $2,620.03 $18,664.33
Other Direct Costs(ODCs)
Printing Services $0.00
HS Admin Charges $1,165.28 $1,165.28
County Counsel Charges $0.00
CEHW Charges �/ $0.00
Email Costs $226.40
$226.40
Promotional Items $3,307.67 $3,307.67
Travel Costs $264.90
$264.90
Subtotal-ODCs: $4,964.25 $4,964.25
TOTAL for IN-KIND MATCH S15,778.691 1523,628.58
1,Joshua Dugas,certify that this in-kind match report and the information attached is true and correct.I also certify that all eligible and required documentation is
on file for this re ort and that I am the person duly authorized to sign this certification on behalf of my agency.I further certify that our agency is not using any
federal fund t Hatch expenditure funds.
/ Chief Financial Officer
Signature Title
Joshua Dusts `/I///1
Print Name Date
-if applicable,for credit of indirect costs for work provided as in-kind contribution,a sub-recipient must submit an approved Indirect Cost Allocation Plan(ICAP)or Indirect Cost Rate Proposal
(ICRP)to SCAG on an annual basis for SCAG's review.If a sub-recipient has not received a negotiated indirect cost rate previously,then the sub-recipient may elect to charge a de minimis rate of
10%of modified total direct costs(MTDC).
www.SBCounty.gov
C(56
ERNARDINO (Public Health Trudy Raymundo
UNTY Director
orter
Administration
Corwin Porter
Assistant Director
Maxwell Ohlkhuare,M.D.
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date:
nguyenkfascae ca gov SCAG OWP#:225.3564.1
Kana Sato-Nguyen In-Kind Match Report#:
Senior Budget&Grants Analyst Reporting Period: January I,2018-December 31 2018
Southern California Association of Governments
900 Wilshire Blvd, 17th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Cot odes Hourly
e8 Rate Hours AmouN Fringe Rae Fringe lL1C Rote' IDC Amount
Direct Labor Classifrcalion/sl:
Cont SRTS Project Coordinator 1054.50 $36,674.42 49.28% $17,901.24 15,307% $8,637.53 $63,213.18
Health Education Specialist II 0.12 S4.42 49.28% $2.18 15.307% $1 1 $7.61
PH Program Manager 8300 $5,818.53 49.28% $2,830.16 15.307% $1,385.22 $10,033.91
Subtoal- Direct Labe, 1,137.62 $42,497.37 S20,733.58 " $10,023.76
Costs/ 573,254.70
Other Direct ODCsJ
Printing Services S90.74
HS Admin Charges $1,718 48
$90.74
$1,718A8
County Counsel Charges $102,00Ioz.00 $IO2.00
CEHW Charges $205.62
Email Costs $205.62
$576 0] $576.07
Promotional Items $3,307.G] $3,307.67
Travel Costs $264 911
$264.90
Subtotal-ODC= 36,265.48 $6,265.48
TOTAL for IN-KIND MATCH $48,762.851 1 1 $79,520.18
1,Joshua Dugas,certify that this in-kind match report and the information attached is true and correct.I also certify that all eligible and required documentation is on
file for this report and that I am the person duly authorized to sign this certification on behalf of my agency.1 further certify that our agency is not using any federal
funds to match expenditure funds.
Signature Title
Print Name
Daze
'Ifapplicable,for credit of indirect costs for work provided as in-kind contribution,a sub-recipient must submit an approved Indirect Cost Allocation Plan(ICAP)or Indirect Cost Rate Proposal
(ICRP)to SCAG on an annual basis for SCAG's review.If a sub.recipient has not eceived a negotiated indirect cost rate previously,then the sub-recipient may elect to charge a de minions rate of
10%of modified total direct costs(MTDC).
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