Orange County NC Website
Browse       Search
~7 <br />Part III -Distribution of Estimated Revenue for Total Cost Reimbursement Method <br />A. Estimated Eligible and Matchable Costs Number Ratio <br />1. Estimated Eligible Clients 250 100% <br />2. Estimated ineligible Clients 0 0% <br />3. Total Clients 250 100% <br />B, Eligible Costs <br />(1) Matchable (2) Less (3) Net (4) (5) Costs Eligible <br />Costs Earned Matchable Estimated % for Financial <br />[Part 1, Line M, Income Costs of Eligible Participation <br />col.. (3) [B. (1) Less (2) ] [A. 1. (b)] [B. (3) x (4)J <br />$ $ $ $ $ <br />A. Program Costs Amount Source of Funds <br />1. Federal/State Funds $ 32,587 Work First <br />2. Local Matching Share $ County <br />3. Other Budgeted Funds $ <br />4. TOTAL REVENUE $ 32,587 <br />B. Fees (If Applicable) <br />1. Administrative Fee $ <br />2. Certification Fee $ <br />3. TOTAL FEES $ <br />Pazt V- Reimbursement Projections (For Title XX Providers Only) <br />Annual Projection .July- September <br />Projection October-June <br />Projection <br />A. $ B, $ C. $ <br />Signed: Date: <br />Provider/Authorized Official <br />Date: <br />County Director or Designee <br />