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IOW <br /> Appendix <br /> COMMITMENT nV WoN-FauEPAL MATCHING SUPPORT <br /> FOR SOCIAL SERVICE BLOCK GRANT PROJECT <br /> A separate copy of this agr.: ment should be completed for <br /> each commitment of support axcept volunteer in-kind match. <br /> • <br /> Agency: County Dept. of Social Services State Agency <br /> Address: 300 West Tryon Street ❑ Local Agency <br /> Hillsborough, NC 27278 • El Public Agency <br /> ❑ Private Agency <br /> ❑ Individual <br /> Type of support or activity (give brief description) : A) If <br /> support is in the form of staff, describe duties and <br /> relation- ship to the project, B) if space, attach two <br /> appraisals of rental <br /> value. Space, equipment and staff contributions which are pro- <br /> • posed as match for SSBG funds cannot have been derived from <br /> Federal funds. <br /> $500 - Indirect cost. (Tel, ,Space, Adm.-calculated at <br /> • 1100 •er full time equivalent em-lo ee) <br /> _ - = o a o a_ree county prof. sta££_ _ <br /> • - 510 - Cash contribution <br /> Type of Commitment: ❑ Tentative NI Final ® Cash 5 Inkind <br /> Value to this Budget Year (if applicable) : S 3 ,292 <br /> Certification by official authorized to make Commitment: <br /> It is understood that these committed non-Federal resources will <br /> be used to match Social Service Block Grant Federal funds, and <br /> will not be used to match any other Federal funds during the <br /> period of the SSBG project. <br /> Shirley E. Marshall Date: 12-1-86 <br /> Typewritten Name <br /> Chair, Orange County Board of. Commissioners <br /> Tit e <br /> Signature <br /> 20 <br />