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.. ADI)E lid . Home and Comm nay Ogre Black Cr-out fat OJT Ad u lt5. . <br /> .fl.. l' .1l•;1 V T 1 ROV1I)W DOA-732(Hey-ICI - <br /> r Coun ty D55 County Fell pig Plan Criu n ly Orange <br /> .99 Tryca.Street July 1,20112 through June 11).20 3 <br /> Dr u+,..1.0., NC 27278 Provider Serve ices $urnrri pry <br /> " I <br /> I _ <br /> C D E. i 1(._; I] I I <br /> +er. 1.el.rve Projtcled Projected. Projected Frojec Leis <br /> I]iei aruir Nark Gtant Tundi , Required Nat* USDA Teta HICCIX: im}unc HOCK; Tut2 I <br /> es Dual EMI Ai':e hi-1 lcr 1'u-till Loral Match u Cost Suteid Fund. c. Unit; late Cli E IJ rt:ts <br /> •uc Aid. • \\ \h 1' \ 32132 37759 37759 3 10 •IIs 3215.'2 <br /> • 0 0 C) <br /> . Mil . <br /> IN&M 0 U 0 <br /> INIM \\WO,‘\\\' 11J 0 _ . 1C1 , <br /> NM • \ . 0 il - 0 - i <br /> MINNIE • \\\\VI 0 0 13 ME <br /> \•\.' • !\ \ 0 '' 0 li <br /> • MN . ' • 'I. 111.1;\A\ 0 .1) 13 . <br /> �.\\\%.\\)A\ 0 0 <br /> . II. \\\\\\\\L„\ 01 1 (1 • <br /> \''...\\\\ II 13 111 <br /> Total IMEN ii IM 0 0 EMU <br /> it pay Car &Aclult Tay I lealth.Care NeServicv Gust ' <br /> ALJC ATiI-n • <br /> C;Lre Certification of required minimu rr.local match d u i-i d ability. i/'•._ i /2//S2 r i r!, 002 . <br /> aorta l uireJ local match will be E.X pcndcd turtu[i aeus[y Author ki Sicri FA 11 rer Title Da(i <br /> i liStr tiwe With B X Crank Funding ' _' Sen..ice Provider ,1/4 j <br /> ier.Cost Tot;L . - ' <br /> 4,3 e., r Co.) %i illat Date. . <br /> County Flaw�x�Officer ��� Si� itiatu re*�•l�iirm <br /> 01 <br />