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2017-473-E DSS - The Exchange Club Center for the Prevention of Child Abuse in NC - Outside Agency Performance Agreement
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2017-473-E DSS - The Exchange Club Center for the Prevention of Child Abuse in NC - Outside Agency Performance Agreement
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Last modified
7/2/2018 10:58:20 AM
Creation date
9/19/2017 11:25:54 AM
Metadata
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Template:
Contract
Date
7/1/2017
Contract Starting Date
7/1/2017
Contract Ending Date
6/30/2018
Contract Document Type
Agreement - Performance
Agenda Item
6/20/17
Amount
$9,638.00
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R 2017-473-E DSS - The Exchange Club Center for the Prevention of Child Abuse in NC - Outside Agency Performance Agreement
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2017
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DocuSign Envelope ID:87560079-2786-4376-A189-DC48D9482BE7 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Additional Program Information <br /> I) Target Population 9 p <br /> ' Complete the following tables, with numbers (not percentages)of individuals served and to be <br /> served, to the best of your ability, *(numbers reflecting estimates for this funding request not total from <br /> other funding supports. broken down by#of families in geographic section) <br /> Program Target Population Demographics <br /> Actual Estimated Projected <br /> 2015-16 2016-17 2017-18 <br /> Gender . .. ' .'. "_..,� 8 Families [[ 10 11 <br /> I Male 14 22 18 j <br /> Female 11 18 22 <br /> Total 25 40 40 <br /> African-American 4 12 <br /> 10 <br /> American Indian or Alaska Native 0 0 0 <br /> Asian 0 0 0 <br /> Caucasian 12 24 26 <br /> Native Hawaiian or other Pacific Islander 0 0 0 <br /> Other: specify . Multiple Ethnicities 9 4 4 <br /> Total 25 40 40 <br /> Of the above, how many Hispanic/Latino 9 4 12 <br /> Of the above, how many non-Hispanic/Latino 16 36 28 <br /> Total 25 40 40 <br /> . Age <br /> 0-5 years 7 11 12 <br /> 6-18 years 8 11 11 <br /> 19-50 years 10 16 16 <br /> 51+years 0 2 1 <br /> Total 25 40 40 <br /> Geographic Location <br /> Alamance County _ 0 0 0 <br /> Chatham County 0 0 0 1 <br /> Durham County 0 0 0 <br /> Wake County . 0 0 0 1 <br /> Orange County Breakdown Families <br /> Chapel Hill Public Housing 1 1 2 <br /> Town of Chapel Hill(Non-Public Housing) 3 3 3 <br /> Town of Carrboro 0 o <br /> �' a rbaro 0 1 1 <br /> Town of Hillsborough 3 4 5 <br /> City of Mebane(Orange County) 0 0 0 <br /> Orange County(Outside Municipalities) 1 1 0 . <br /> Total 25 , 36 40 <br /> 1. <br /> PROGRAM INFORMATION 1/27/2017 1:48:20 PM Page 10 of 12 <br />
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