120-26 LEAP - Challenge Application - Supplemental Forms.pdf

Identify the consultant and describe the service(s) to be provided. (Continue on the back of this form if additional space is needed) Activity/Task Consultant Staff Level Assigned Rate Per Hour/Per Day Est. Time for Completion (hours/days) (A) Cost Per Activity/Task 1. $ $ 2. 3. 4. 5. 6. TOTAL $ OTHER EXPENSES (Itemize) (B) COST $ TOTAL Column (B) Costs $ TOTAL Columns (A) and (B) Costs (Also enter this amount on Form LEAP-4 next to “Consulting”) $