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<br />. . ..... <br /> <br />County/Site ' <br /> <br />Form B /, <br /> <br />FACILITIES SPACE VALUATION WORKSHEET <br />(Must be co"mpleted to count the value ,of any 'space? <br /> <br />PROJECT: Family Nutrition Program <br /> <br />FACILITY: <br />(A separate worksheet must be completed for each <br />facilitY'(buifding) forwhichthe value of sp~ce ~e- <br />considered.) <br /> <br />, .CD Depreciation (Use Allowanc.e) : <br />(Choose a, b, or c) " <br /> <br />Gross Acquisition Cost <br />(Less) c9st of land <br />(Less) Federal Gov't.. Contribution <br />, ,(Le?s) <br />New Acquis:ticn Cost <br /> <br />$ <br />( <br />( <br />,{ , <br />"$ <br /> <br />) <br />) <br />) <br />(NAC) , <br /> <br />Date of Acquisition: <br /> <br />Usefu4 Life: <br /> <br />Years, (ULY <br /> <br />a. Annual Straight-Une Depreciation = (1.;. UL).x NAC <br />(If this method use~ check 0 here.)' <br /> <br />$ <br /> <br />OR <br /> <br />b. Where State, County, or other govemmentai agency has figures' available, in lieu of the above , <br />calculation, use that govemm~nt's d~preciation figure fromJts annual financial report, assuring that any <br />cost of land and any Federal Govemment contribution has been first deducted. ' <br />(Attach copy of financial statement and check 0 here.) $ <br /> <br />OR <br /> <br />c. Where building has been completely depreciated, calculate a reasonable use allowance according to ' . <br />criteria at 7 CF.R Part 227, Appendix A, A(11). When using a. "use al/owance", attach calculations and <br />check 0 here. <br /> <br />$ <br /> <br />~ Interest, <br />, A.nnual interest on debt associated with the facility; attach documentation. ~ <br /> <br /><IDOperation and Maintenance Expenses, . <br />Expenses incurred for the administration', supervision, operation, maintenance, preservation, and protection of the <br />building agency's physical plant as properly allocated to this facility. Includes janitorial and utility services; <br />, environmental saJety, hazardous waste disposal; property liability, and aI/ other insurance relating to property; <br />leasing costs; ,facility planning and m-anagement; central receiving. Salaries and wages should include aI/ properly <br />al/ocated fringe costs. Attach'documentation, itemization; and calculations. $ <br /> <br />Q) + ~ + @)= ~J Total Facilitie.~ Cost $ <br /> <br />Gross amount of interior space in entire facility/building . <br />(Less) common areas (hal/ways sta.ircases, r~strooms, lobbies, etc.) <br />Net. amount of usable interior space in entire facility/b~ifding <br /> <br />sq. ft. <br />sq. ft. <br />sq. ft. (Tot,al Space)' <br /> <br />0'~ ~ <br /> <br />= <br /> <br />~ <br /> <br />, Total Facility Cost .;. Total Space = Cost / Sq. Ft. = <br /> <br />$ <br /> <br />(Cost/Sq. Ft.) @J <br /> <br />I nVF>r\ ' <br />