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DocuSign Envelope ID: F7F335BA-8B6B-4DF4-825C-8C793AOA9C6F <br /> EXHIBIT"A" <br /> Scope of Services—FY 2015-16 <br /> Outside Agency Performance Agreement <br /> Agency Name: Club Nova Community, Inc. <br /> Program Name: Club Nova Community, Inc. <br /> Funding Award: $75,000 <br /> Outline how the agency will spend Orange County's funding award. <br /> Expense Description Amount <br /> Personel Salaries, FICA $25,000 <br /> Transportation(fuel,travel, etc..) $26,000 <br /> Other Expenses (clubhouse PSR services for members with ACTT) $10,000 <br /> Other Expenses (Employment Coordinator; Salary, FICA, Fringe) $14,000 <br /> Program Services <br /> For assistance with this or the following section, please reference the Exhibit A instructions and example, located within the <br /> contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes <br /> below,by June 30,2016. <br /> • Transportation: Maintain a high-quality transportation program so our members have the <br /> opportunity to attend and engage in our program and continue in the recovery process. <br /> • Members Receiving ACTT Services: Provide opportunities and support to our members who are <br /> also receiving Assertive Community Treatment Team services. <br /> • Employment: Continue to support and assist members who desire to return to paid employment in <br /> the community. The Transitional and Supported Employment Programs will maintain and strive <br /> to increase the number of placements available to members and the number of members who <br /> work in the community. <br /> Anticipated Outcomes <br /> The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange <br /> County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants <br /> within that measure's description or for an earlier performance measure. <br /> Performance Measures Anticipated <br /> Results <br /> Number of drivers certified in CPR, AED, Ist Aid, Blood Borne Pathogens, Seisure 3 <br /> Management <br /> Number of members who receive ACTT services 21 <br /> Number of members supported in their effort to return to paid employment in the 32 <br /> community <br /> F ocuSigned by: <br /> Certified by: G,, 16\1� LL, Title: Executive Director Date: 8/21/2015 <br /> r°ovic s`�gnature) <br />