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DocuSign Envelope ID:72266CE5-DF5A-471E-B671-CC65C8960691 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Work Statement <br /> m) Complete the Work Statement Chart to describe the work to be performed. <br /> This chart is used to document program activities, program goals, performance measures, <br /> and actual results. (Add more rows as needed) If this is a new program, you will only <br /> document the projected information. Every program is required to have AT LEAST 1 <br /> Program Activity, which should be SMART( pecific, Measurable, Achievable, Relevant, and <br /> Time-bound. Click on SMART Goals to learn more. <br /> • Program Activities should outline major activities the agency implements to accomplish its <br /> program goals. (i.e. Deliver meals to elderly/disabled residents.) <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br /> statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br /> Monday-Friday.) <br /> • Performance Measures describe how you will evaluate the degree in which you achieved <br /> the stated goals. (i.e. Will track the number of meals delivered each day.) <br /> • Actual Program Results use program results to indicate the actual measureable <br /> achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br /> 105 meals per day.) <br /> Work Statement Chart for Program Rental Property Management <br /> 1. Program Activity Name Increase number of rental units (currently have 40 units) <br /> Program Goal Increase by one unit <br /> Performance Measures Document new rental units on spreadsheet <br /> Previous Year Program Results 2 <br /> Current Year Estimated Results 2 <br /> Next Year Projected Results <br /> 2. Program Activity Name Housing for homeless, disabled, and veteran population <br /> Program Goal <br /> Performance Measures Collaborations with other agencies to reach this <br /> population <br /> Previous Year Program Results 2 <br /> Current Year Estimated Results <br /> Next Year Projected Results <br /> 3. Program Activity Name Unit turnover <br /> Program Goal Maintain 5% vacanc or less <br /> Performance Measures Chart monthly vacancies <br /> Previous Year Program Results 98.5% <br /> Current Year Estimated Results 95% or less <br /> Next Year Projected Results 95% or less <br /> 4. Program Activity Name Complete annual housing inspections <br /> Program Goal Complete 90% of inspections <br /> Performance Measures Document on HQS <br /> Previous Year Program Results 100% <br /> Current Year Estimated Results 95% <br /> Next Year Projected Results 95% <br /> PROGRAM INFORMATION 1/25/2017 4:42:59 PM Pa . ,..-3 1 9 t„, i 22 <br />