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County/site <br /> <br />FACILITIES SPACE VALUATION WORKSHEET <br />(Must be completed to count the value of any 'space') <br /> <br />Form B <br /> <br />PROJECT: <br /> <br />Family Nutrition Program <br /> <br />FACILITY: "["a) ~ J <br />(A separate worksheet must be completed for each <br /> <br />facility (building) for which the value of space will be considered.) <br /> <br />Depreciation (Use Allowance) <br /> (Choose a, b, or c) <br /> <br />Gross Acquisition Cost $ ..~/, ~O--~-O/ <br />(Less) cost of land ( ' ~ ~'// <br />(Less) Federal Gov't. Contribution ( ~. ~-o. <br />(Less) ( <br />New Acquisition Cost $ .2. ~/.z G <br /> / / <br />Date of AcqUisition: ~/,/~/~ ~"Z'-Useful Life: <br /> a. Annual Straight-line Depreciation.~(l+ UL) <br /> (If this method used check I~'flere.) <br /> <br />Years, (UL) <br /> <br />OR <br /> <br />b. Where State, County, or other governmental agency' has figures available, in lieu of the above <br /> calculation, use that government's depreciation figure from its annual financial report, assuring that any <br />cost of land and any Federal Government contribution has been first deducted. <br /> (Attach copy of financial statement and check [3 here.) $ <br /> <br />OR <br /> <br /> c. Where building has been completely depreciated, calculate a reasonable use allowance according to <br /> criteda at 7 CFR Part 227, Appendix A, A(11). When using a "use allowance", attach calculations and <br />check Q here. <br /> $ <br /> <br />(~ Interest <br />Annual interest on debt associated with the facility; attach documentation. <br /> <br />(~) Operation 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 safety, hazardous waste disposal; property liability, and all other insurance relating to property; leasing <br />costs; facility planning and management; central receiving. Salaries and wages should include all properly allocated <br />fringe costs. Attach documentation, itemization, and calculations. $ ~.~ O~/ dc'-~J, c~o <br /> <br /> (~D -t- (~) -!- (~) = [~] Total Facilities Cost $ '~/.~, ~ ? <br /> <br />Gross amount of intedor space in entire facility/building <br />(Less) common areas (hallways staircases, restrooms, lobbies, etc.) <br />Net amount of usable intedor space in entire facility/building <br /> <br />Total Facility Cost + Total Space = Cost / Sq. Ft. = $ ..f"~. /0 <br /> (Over) <br /> <br />/'~Y'~., ~'~""~ sq. ft. <br /> sq. ft. <br /> sq. ft. (Total Space) <br /> <br />(Cost/Sq. Ft.) <br /> <br /> <br />