Art3_County_FY17_BikePed_WalkBikeSB_Inv01 www.SB(ounty.gov
Public Health Trudy Raymundo
SAN BERNARDINO Director
COUNTYAdministration Corwin Porter
Assistant Director
Maxwell Ohikhuare,M.D.
Health Officer
IN-KIND MATCH REPORT
Email In-Kind Report to: Date: 4/16/2019
nguyenkt@scag.ca.gov SCAG OWP#: 225.3564.1
Kana Sato-Nguyen In-Kind Match Report#: 5
Senior Budget&Grants Analyst Reporting Period: January 1,2019-March 31,2019 Ql
Southern California Association of Governments
900 Wilshire Blvd, I7th Floor
Los Angeles,CA 90017 Project Title: San Bernardino County Safe Routes to School
Cost Categories Hourly Hours Amount Fringe Rate Fringe IDCRate• IDC Amount
Rate
Direct Labor Classi tcation s
Cont SRTS Project Coordinator 1 $33.02 1 272,001 1 48.36%1 $0.001 16.330%1 $0.00 $0.00
Health Education Specialist 11 $0.00 I 1 1 48.36%1 $0.001 16.330%1 $0.00 $0.00
PH Program Manager $62.57 1 40.001 1 48.36%1 $0.001 16.330%1 $0.00 $0.00
48.36% $0.001 16.330%1 $0.00 $0.00
48,36% $0.001 16,330% $0.00 $0.00
Subtotal- Direct Labor 312.00 S0.00 $0.00 $0.00 $0.00
Other Direct Costs ODCs
Printing Services $479.82 $479.82
HS Admin Charges $0.00
County Counsel Charges $0.00
CEHW Charges $0.00
Email Costs
$0.00
Promotional Items $0.00
Travel Costs
$0.00
Subtotal-ODCs: 5479.82 $479.82
TOTAL for IN-KIND MATCH $479.82 $479.82
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.I further certify that our agency is not using any
federal funds to mVADV.
Chief Financial Officer
Signature Title
Joshua Dugan L4 d-s- /9
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
(ICAP)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).
McBrideHl�'District Si,cmd District 7hiril District Vic,.Ch.k.fifth Div.,,
San Bernardino Associated Governments
Claim Form
Article 3 Grant Program
Project Name: Walk and Bike SB Grant Allocation No: L18-0702-0754-01
Claimant: County of San Bernardino
Address: 340 N. Mountain View Avenue
San Bernardino,CA 92415-0010
Attention: Joshua Dugas
Phone No: (909) 387-6222
E-mail Address: Joshua.Dugas@dph.sbcounty.gov
Amount Requested
for Reimbursement: $ 22,278.75
Purpose: Please check one purpose.
(X) Article 3 Bicycle/Pedestrian Facilities,Public Utilities Code(PUC)99233.3
( ) Transit Stop Access Improvements,PUC 99233.3
Authorizing Signature:
(Claimant's Chief dminstrator or Financial Officer)
J/
Date:
Signature
Joshua Dugas,Chief Financial Officer
Type Name&Title
Condition of Approval:
Approval of this claim and payment by the County Auditor to this claimant are subject to monies being available and
to the provision that such monies will be used only in accordance with the approved allocation instruction.
A3 Claim County of San Bernardino SRTS ATP Cycle 3 5316BOD-4.19.19
Claim Form
Page 1
San Bernardino Associated Governments
Reimbursement Request
Article 3 Grant Program
Claimant: County of San Bernardino
Grant Information com letedb SANBAG)
Article 3
Total Project Award Percent
Project Name Cost Amount Article 3 Local Match ATP Funds
Walk and Bike SB $ 2,000,000 $ 320,000 16.0% $ 50,000 $ 1,600,000
Instructions: Please complete 1 through 4 below.
Amount
1)Article 3 Cost(amount being requested for
reimbursement) $ 22,279
2) Local Match/ATP Funds Cost $ 480
Total $ 22,759
Project Costs to Date include amount requested above)
Local Match/ATP Funds
3)Article 3 $ 22,279 Remainin 1,600,000
4)Local Match/ATP Funds $ 80,000 Article 3 Balance Remaining297,721
Total $ 102,279 Total Amount Remaining 1,897,721
1 certify that the information on this Financial Reporting form is true and accurate to the best of my knowledge.
The same authority that signs the Claim Form must sign this form.
Signed: 4e Date:
1r-vv\ L fl F )tcl
A3 Claim County of San Bernardino SRTS ATP Cycle 3_5 16BOD-4.19.19
Reimbursement Request
Page 1
EMACS Salaries
LD Program Id 2903
Prod Time y
,Sum of Sum 1 Amount Pay Period End2 Pay
I PeriodJan Feb Mar (;jmidTot;fl
arne
Friis,Mark 4,653.52 3,771.80 4,898.48 13 323.80
Ri sb Scott 1 670.94 129962 742.64 3,713.20
Grand Total 6,324.46 5,071.42 5,641.12 17,037.00 r
Salary 11,483.55
Benefits 48.36% 5,553.45
17,037.00
Indirect 16.33% 2,782.14 '
LD Program Id 2903
Prod Time y
Pay Period End2 Pay Period End
Jan — Feb — Mar Grand TotaW
Sum of Sum Hours
Frus,Mark 95.00 77.00 100.00 272.00
Ri sb Scott 18.00 14.00 8.00 40.00
Grand Total 113.00 91.00 108.00 312.00
Hours Rate Salary Benefits Total Indirect Cotal Amoum
272.00 33.02 8,980.72 4,343.08 13,323.80 2,175.77 15,499.57
40.00 62.57 2,502.83 1,210.37 3,713.20 606.37 4,319.57
11,483.55 5,553.45 17,037.00 2,782.14 19,819.14
cOVnty of San Bernardino - RMACS
Report ID: SBLD030 LABOR OISTRIBOTION - MAJOR PROGRAM BY PROGRAM BY JOBCODE Page NO. 144
Pay Period end: 03/29/1, Run in: U00 Run Date 04/06/19
MJ Program
PNLTH - Public Health
gram 29 Run Time 39:24:40
WORK _ NON-WORK ___________
PROGRAM WITS AMOUNT
WITS Y-T-O
JOBCD UNITS AMOUNT WITS AMOUNT UNITS AMODMP UNITS AMOUNT
2903 Safe Routes t0 School 16398 PH Program Manager 4 $3]1 105 $9,712
20]3] Cent JETS Project Coordinator 50 $2,449 838 $41,049 5 $195
PROGRAM (2503) TOTALS 54 $2,821 943 $50,]61 5 $1]5
133)-12--o /
1 1 0 -T le
County of San Bernardino - SMACK
Report ID: KBLD030 LABOR DISTRIBUTION - MAJOR PROGRAM BY PROGRAM BY JODCOD6 Page NO. 129
LDGRONP : PHLTH - Public Health Pay Period End: 12/21/18 Run ID: O01 Run Date 12/29/18
NO Program: ]9 Run Time 14:29:03
- WORK - - T=O T-D Y-T-D
- NON-WORK
PROORTN' JOBCD UNIT$ AMOUNT UNITS AMOUNT UNITS AMOUNT UNITS AMOUNT
2903 Safe Routes to School 16370 PH Program Manager 5 $464 65 $51999
20039 Cent SETS Project Coordinator 45 $2,204 566 $20,725 5 $105 5 $175
PROGRAM (2903) TOTALS 50 $2,668 631 $33,724 5 $175 5 $195
Services&Supplies
Description of Funded Program (Multiple Items) Value ... Description of F...
Budget Period 2019 52 ^ 2900-COMMUNI... ^
Fund Mul 54 ...
000
Value Type (Multiple
(Multiple Items) 2901-HEALTHY
Sum of Amount to be checked against payment bud lan Feb Mar 60 2902-CALIFORNColumn Labels ...
Row Labels 7 8 9 Grand Total 66 2903-SAFE ROU...
2904-NEW HOP...
PHL CAL CARD DECEMBER 2018 1,400.00 1,400.00 50 2905-REENTRY
1530 P. CASTILLO UT 9/22/18 15.07 15.07 ..51 w 291.0-STATISTIC...
28668-CAMPAIGN 25 340,20 340.20 2930-COMMUNI...
29542-Calendars 2 Year 3 Month 2019-20 11.00 11.00 NOT RELEVAN...
December 2018 Postage 48.48 48.48
31180-CAMPAIGN 25 340.20 340.20
2902 —GY 17/18-...
Dec 2018 Emails 113.02 113.022903-GY1718-SA...
Jan 2019 Emails 110.20 110.20 20
Feb 2019 Emails 110.54 110.54 2905-GY1718-RE...
v
_ "Trip from 10/10/18 To 12/14/18 to San Bernardi 450.72 450.72
Grand Total 1,912.70 901.12 125.62 2,939.43
Query 1,912.70 901.12 12S.61 2,939.43
Less: Printing service applied to in-kind match (479.82) - - (479.82)
1,432.88 901.12 125.61 2,459.61
Category Grant In-Kind Match Total
S&B 17,037.00 - 17,037.00
S&S 2,459.61 479.82 2,939.43
Indirect 2,782.14 - 2,782.14
f
22,278.75 479.82 22,758.57
_ Indirect Cost Rate Proposal
_ San Bernardino County
Department of Public Health
For Use in Fiscal Year 2018119
(Using Auditad Financials for FY 201512016)
Total Cost ComporreMa I Allowable Dim&Cost
Total Costs Toml Total
(Based on Amuld Unallowable Allowable Total Allowable Dim" All Other
De:,:,2 ion pt Costs Co..lncurtetl) Excludable Costs Indirect p Cps Direct Costs Program Costs Direct m Oos
a Is c tl=(a-trc) a f=(d.)
s.Lrlm a aerwma:
9alenesWa9ee 39.3M.I39.53 008.018.09 2,181,5M89 M875,15299 35,975,152.98
6+eltime.ComO Tvne 209,08098 289,390.40 208,fiW.eB
Boom W.022.191 161 45179019 1,420.24o.W 1 m,50.1e0.11 I19.1W,1W 11
Total salaries a BercRs 69,666,W8.91 1A39.80B04 4.211,80335 N.115.193.59 54,115,193.59
Services 3 Supplies:
A LbMMB4Pem^el5upplke 13,10841 12M 1J,W551
mmunml 13.OE5.51
B Tekcoon r. 854.5Y2.53 45,951.64 BC0.590.89 BCB,SW89
C I... 1,193.553.00 850.60,.00 233,94903 233.948W
D Moom.DeMtl5 Lab Supplies 12BZ389W 60185 1,288]Ii9.32 1,208]BB J2
E Equpmeslas.... 138689.05 2251.all 13IA38.66 13]A38.85
F Of.Expelm 2,163,314.57 41.95025 6n,824.02 1p as.540.30 1,498,54030
G Postage 28373264 2,912.73 2W,019.81 280.819.81
H Prime ALouxl 283]N.93 12422.39 2]131254 T131354
I M.rrx s 84,529.39 18,390.39 48,131W 40,131 W
1 Too, 31,8251" 6,11485 .510.94 20.510W
K Subec'fons,.WPub1.xox 1,8.Ill .12 1.60)95 1.W1.BS
L Pumo RebliaN AcNarmn0 33,21376 33,213.76 1 33,213M
M Julks 2J0)8401 52030 2JU 24461 230,24461
N Prof-argil Serams 18,]SB.OM.W _ 3I1.554.3] 18322,45252 18,]2 al5 52
O CouMy Swa(LOWCAP)
P InbrmaOon T.6r.y 1.067878.19 1]2]1568 1 ,M5, eM.OW 51
Q Ramal Coo-BWH seMEqupnem 4.225,11lit 42,4I342 29,f053] 9,158.2]553 9d59.2]5.52
R FeoMes MaMNmnea,Opomrom O Rep e]1,40538 291.555.25 3...50131 3weso 13
5 MMw PM 1,142,3W37 1269718 1.12B.BW.1B 1,129.BO6.te
T Tlml 381,'2564 39.W3.25 J2],OB2.59 R],092.59
U AuOi i5.39381 15.393.Bf 15,393.81
V CouMy Coumel 98,5W.W 32,14988 G7].12 88411.13
W ONer
x Human Resources 189.43TW 183.43IW
Z Rembumamers' _
Revenue 17.M 88 I17280081
Tot"
Servkn83uPPlln 31,0117.741.82 161,71456 1 2,776A67.50 1 38,149.1%A 1 2a,149,159st
Coital balrenditems(Im ovement) 802,22'W BIZ 486 p
Caphal Expenditures(Fixed Assets) 52a,970W 528.670.00 _
TamIB !airy FXpenditums 91,885.642.76 2.632.618.55 6,968.671.05 82,2M.M 16 M2N,353,18
Coif M.cons
M specs Use t96,]8800 =- -
pumlosim88.W
M Lompuler 8onware BEquip Use 293.]6100 61.00
RUM uselm 453,742.00 - 42W
FE AWXorLbrJroNr 313,5290D 34,T12.W57W
Be Ceunry asmin.gryre 21r,579.00 40.M.W5300
UU Counry[aunnl 44,62300 23.11 - -
RR FxIliw ManmemeM coawdol (3424001 400) _RR FvotlryMa^ryammlGrods (1 Bfi900I 900) - _RR m..W Manveamen<Ma.. 16.B1100 11.00W W 359,73E W 90,4W W3 WpurcMsim9cer 130,01900 8,04].002.Wo"Itrrtesamoo 23,06BW 00Pp ISM1ems Dewkpmmt 89.265W 14,633W2,00
DD coat Enimervon 9a,255 oD - 9825s.W
DD pull hrwaM (138.15300) (139.15300
Total Cen Nm 2,034.M900 1W,T10.W, 184R01900
Tonal AlbwffiIe Irldrecf Costs(MC) 8,83I.6B0.85
Dial.Df Al C...dpn5AA Mares In,83],890051
Tptils 93.=37175 281032a 1 02.264,35316 82,2643531fi
INDIRECT COST PATE(AIC I Total Direct Salaries a eanenlB):
AdMill/Department Overnead 1 6,988,fi]1.05 12.914%
Counry Ovemeetl 1,649,01e00 3A17%; 20,022,191.18
Allowable lndImat Cost(AID) 8,837,690.0E 16.331% 39,354,734.53 50.88%
Total Direct Salaries 8 Benefits 54,115.193.59 5%376,925.69
=AdM1W[)epMMq
COST RATE(AIC I Toed Allowable disc[Costs)
t Oveenead 69886]105 8.485%019002d48%
Cost(AIC) 8,837,690 05 10.743%
ct Costs 82,264,353.161
Excluded to cakulate FINAL BILLABLE ICRP for PHL ONLY
241E COUNTY SERVICES(INCL COWCAP) 185)10.00
I445 Sperafa,LNG 60,O0[).00 1 Per 011Vs email 12/15/17 aL
FINAL ICRP(PHL ONLY);2/8/2018 A