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w <br />w <br />RF"PT� CARR PROr i N <br />Contractor: Orange County DSS <br />PROPOSED OPERATING OUDGET <br />AND Attachment N -B <br />CAPITAL REQUEST FORM <br />f" <br />Contract Period: Jan. 1;1987 -June 30, ,S• <br />fit► <br />Line <br />1 <br />Service Expense <br />'Lin* item Ex erase <br />Admin. <br />Respite <br />rnunt:y <br />rntinty <br />[runty rnAmty <br />_ <br />Cotmt Count '' Total <br />A. Expenses: <br />1. Personnel 1. <br />2. Rent and Utilities <br />j. Rent and Utilities - <br />In -Rind <br />•. tqulpment (< $300) <br />S. Travel <br />6. Con"unlcations <br />]. Maintenance 6 Repair <br />�. Insurance /Bonding <br />�. Print.6 Supplies <br />12. indirect <br />13. Capital Equipment <br />14. Total Line Item <br />IS. Admin. Allocation <br />16. Total Service Exp. <br />17. Estimated Units <br />10. Service Unit Costs <br />19. Estimated Clients <br />7,182 <br />1;nn <br />701A7 <br />B. Resource Requirements <br />20. Iota Service Expenses <br />21. Program Income <br />23. Non -Match Cash <br />24. Non -Hatch In -Kind <br />25. Net Service Cost <br />26. "Jet Cost per Unit i t <br />27. Minimum Match: Cash <br />28. Minimum Batch: fn-Kind <br />29. AAA Share (fed. t. State) <br />7 6Q2 <br />Rig <br />500 <br />4,081 <br />4 .7 7 <br />510 <br />3,571 <br />n. AAA <br />4.17 <br />31. Description of Capital Equiprwrit Itcros: <br />R3 <br />