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The University of the State of New YorkPROPOSED AMENDMENT FOR A
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THE STATE EDUCATION DEPARTMENTFEDERAL OR STATE PROJECT
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FS-10-A (03/15)
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 = Required Field
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Agency Name:Gorham - Middlesex Central SchoolOntario
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Mailing Address:4100 Baldwin RdCounty
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Rushville, NY 14544
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Agency Code:430901060000004
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Amendment #:
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Project Number:5891-21-2190
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Contract #:
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Contact Person:Erica HasselstromTel:585-554-4848
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E-mail Address:ehasselstrom@mwcsd.org
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INSTRUCTIONS
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● Submit the original and two copies directly to the same State Education Department office where budget was mailed. DO NOT submit this form to Grants Finance.
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● This form need only be submitted for budget changes that require prior approval as follows:
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● Personnel positions, number and type
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● Equipment items having a unit value of $5,000 or more, number and type
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● Minor remodeling
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● Any increase in a budget subtotal (professional salaries, purchased services, travel, etc.) by more than 10 percent or $1,000, whichever is greater
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● Any increase in the total budget amount.
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● Amendment # at top of this page must be completed.
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● If extra room is needed for explanations, expand the rows using the row breaks on the left.
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● Do not use the FS-10-A for requesting a project extension.
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CHIEF ADMINISTRATOR'S CERTIFICATION
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By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, & accurate, & the expenditures, disbursements, & cash receipts are for the purposes& objectives set forth in the terms & conditions of the Federal (or State) award. I am aware that any false,fictitious, or fraudulent information, or the omission of any material fact may subject me to criminal, civil, or administrative penaltiesfor fraud, false statements, false claims, or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
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Date:4/24/2023Signature:
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FOR DEPARTMENT USE ONLY
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Program Approval:Date:
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Finance:
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LoggedApproved
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SUBTOTALEXPLANATION (Provide same detail as required in
FS-10 Budget)
SUBTOTAL INCREASESUBTOTAL DECREASE
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15 - Professional Salaries
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16 - Support Staff Salaries
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40 - Purchased ServicesTwo things need to happen within the Purchased Services Code. As part of a soft amendment, $8,987 that is in purchased services for instructional needs, will need to be reallocated to the facilities code to cover remaining work needed to add new entry doors to support ventilation. This will be represented as a $0 change in the 40 line. To continue to cover the additional costs for doors and phone systems, $10,576 will be used from 80-Employee Benefits for safe and healthy schools.$10,576
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45 - Supplies & Materials
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46 - Travel Expenses
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80 - Employee BenefitsEmployee benefits for ERS and Health Insurance will be picked up within the general budget. $8,081 and $2,495 will be moved to the 40 code.
$10,576
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90 - Indirect Cost
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49 - Boces Services
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30 - Minor Remodeling
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20 - Equipment
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Total Increase or Decrease:(+) $10,576(-) $10,576
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Net Increase or Decrease:$0
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ENTER BUDGET >Previous Budget Total:$1,273,281
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Proposed Amended Total:$1,273,281
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