Emergency Medical services
Grant No. / TBD
Budget Narrative / Page 1
Personnel Costs[OTS1]
None
Travel Expense
In-State - Costs are included for appropriate staff to attend conferences and training events supporting the grant goals and objectives and/or traffic safety. Funds may be used to attend OTS approved training. Anticipated travel and events include local mileage for grant activities and meetings, OTS Summit, and, (Enter known conferences or required travel). All conferences, seminars or training not specifically identified in the Schedule B-1, must be approved by OTS. All travel claimed would be at the agency approved rate. Per diem may not be claimed for meals provided at conferences when registration fees paid with OTS grant funds.
Out-Of-State - Appropriate staff will attend (enter the name of the event and location if known) in support of the grant goals and objectives. All out-of-state travel trips not included in the grant agreement must receive written approval from OTS.
Contractual Services[so2]
Equipment
(Grantee Name) will purchase and distribute fully equipped extrication systems for (Agencys to recieve Equipment). The system includes every piece of extrication equipment, modifications, attachments, accessories, and auxiliary apparatus necessary to make it usable for the purpose it was acquired, and costs $5,000 or more (including tax, shipping, and installation).
Each location will receive up to $______for a fully equipped extrication system that includes a hydraulic spreader and hydraulic power unit. Other dependent extrication items purchased may include, rams, hydraulic hoses, ram attachment and extension sets, cutters and mini spreaders
The (Agency to receive system) Fire Department will receive up to $ for a fully equipped extrication system that includes a hydraulic spreader and hydraulic power unit. Other dependent extrication items purchased may include, rams, hydraulic. hoses, ram attachment and extension sets, cutters and mini spreaders.
The (Agency to receive system) Fire Department will receive up to $ for a fully equipped extrication system that includes a hydraulic power unit. Other dependent extrication items purchased may include, rams and supports, hydraulic hoses, ram attachment and extension sets, cutters, and mini spreaders.
[OTS3]
Other Direct Costs[so4]
Extrication Items: (Grantee Name)may distribute to various locations the following extrication items: portable lights, sawzalls, rescue saws, rescue struts and plates, step chocks, portable lights, driver side air bag covers, cribbing, airbags and accessories, extrication gloves, rams and supports, cutters, axes, ropes, and combi-tool (add additional items).
NOTE: Each item must have a unit cost of less than $5,000 (which includes tax, shipping, and installation). Additionally, each extrication item purchased must operate independent of the grant funded power unit.
Indirect Costs
Program Income
None
[OTS5]
OTS-38f EMS
(Rev. 11/07)
[OTS1]
[so2]1Describe the work each consultant firm, agency, or person that will provide services.
[OTS3]Add additional distribution information as needed.
[so4]1Describe each line item identified in the Schedule B and its intended purpose. Enter the number of each item requested.
[OTS5]Printing Instructions: In the print window, change the “Print what?” to Document.