Orange County NC Website
DocuSign Envelope ID: EA54395E-EA79-461 B-8A4A-AODF56E9A02D <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 1. Program Budget Detail — Provide description of"other" budget items, not defined. <br /> 2. This program budget represents what percent of the agency budget? 3% <br /> 3. COST PER INDIVIDUAL <br /> This Cost per Individual must reflect the total program budget divided by the total number of <br /> program individuals in this application. <br /> Actual 2015-16 Estimated 2016-17 Projected 2017-18 <br /> Total Cost of Program 14,000 14,000 20,000 <br /> Total #of Individuals 260 280 300 <br /> Cost Per Individual 53.8 50 66 <br /> PROGRAM INFORMATION 1/31/2017 3:19:07 PM <br />