ACTIVITY BUDGET REQUEST FORM

Person organizing Event DonoDIGNA Sumari Request Date:15/08/2022

Event or activity title LTBI GUIDELINE
Event or Activity dates 16-19 August 2022
Project /Activity Code 3.TZ.015.5
Location Morogoro

Payment Method: Mobile Wallet

Activity GL
Expenses items Code Code Item Description Days QTY Rates Total Amount
Perdiem 4.3.2 70210 PM NLTP 5.5 1 220,000.00 1,210,000.00
Officers(NTLP,NACP,HANDENI TC,DSM
Perdiem 4.3.2 70210 RHMT,DCS&KINONDONI MC) 5.5 18 170,000.00 16,830,000.00
Perdiem 4.3.2 70210 Drivers 5.5 2 150,000.00 1,650,000.00
Transportation 4.3.1 70210 Bus fair 2 17 35,000.00 1,190,000.00
Transportation 3.5.2 70313 Fuel 2 126 3,468.00 873,936.00
Subtotal 21,753,936.00
Payment to be direct to vendor/ Beneficiary
Venue&Refreshments 4.3.2 70210 Coference package 4 21 40,000.00 3,360,000.00
Subtotal 3,360,000.00

Total Payment to Participants 21,753,936.00

Total Payment to Vendor 3,360,000.00
Total Amount for activity 25,113,936.00

Approved by Project Manager/

Requester Checked by Finance Officer : Verified by Finance & Adm OfficeRepresentative Officer
Name :…………………………. Name :……………………… Name:……………………………… Name :.....................................

Signature:……………………… Signature:…………………. Signature:………………………… Signature:………………………………

Date:………………………………Date:……………….……….. Date:………………………………….
Date:…………………………………….
LTBI ACTIVITY BUDGET
Description of Assumptions Measure- No of Unit Cost

Input ment Unit units of Input

(TSh)
Per diem –220,000 PM for 5.5 days (16-19 August, 2022) Person 1 220000
Per diem – 18 officers for 5.5 days of June (16-19 Person 18 170,000
August, 2022)
Per diem – 2 drivers for 3 days of June (16-19 Person 2 150,000
August, 2022)
Fuel 2 vehicles x Tshs 3,200 x 140 ltrs (5.5 Litres 140 3,200
days)
Bus fare 11 people x Tshs 70,000 Bus ticket 18 70,000
Conference package 15 people x Tshs 40,000/person Person 24 40,000
TOTAL
Days Freq Total

5.5 1 1,210,000
5.5 1 16,830,000

5.5 1 1,650,000

2 1 896,000

1 1 1,260,000
4 1 3,840,000
25,686,000
Participants-LTBI Guideline
SN Name Position Organisation
1 Riziki Kisonga PM-NTLP NTLP
Emmanuel Matechi TB Advisor
2 NTLP
3 Peter Neema TB/HIV Coordinator NTLP
4 Allan Tarimo Head-Care and Prevention NTLP
5 Deus Kamara Quality FP NTLP
6 Adeline Supportive staff NTLP
7 Balama M & E officer NTLP
8 Judith Nyaboe DTHO Handeni TC
9 Maliwaza Mganga DTLC-Mnyamala Kinondoni MC
10 Isaya Jelly TB/HIV Coordinator NACP
11 Robert Pharmacist NTLP
12 Digna Riwa Physician DSM RHMT
13 Isaac Lekule DR TB coordinator NTLP
14 Julius Mtemahanji ACSM Coordinator NTLP
15 John Msaki Community TB Coordinator NTLP
16 Bahati Mfaki 5 Lab scientist DCS
17 DRV PM DRV PM NTLP
18 DRV NTLP DRV NTLP NTLP
19 Patric Mchami HS/Admini NTLP
20 Patrice HEU NTLP
21 Isaac Kiduma 5 BMH NTLP
22 Lilian Mtei KNCV NTLP