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State of North Carolina <br />Division of Social Services <br />Contract Application <br />E. Contract Identification: <br />I. Provider <br />Page 2 of 8 <br />a. Name of Contract Administrator Gloria Williams <br />Tel. #:(919) 9Z9-U494 <br />b. Name of Program Contact Person: <br />Tel. #: 9 19Y M-V4tP4 <br />Faye Hall <br />C. Program Name, Location and Mailin& Address: <br />Joint Orange Chatham Community Action Agency <br />105 West Chatham St., P. 0. Box 27 <br />Pittsboro, NC 28312 <br />d. Additional Service Delivery Sites: <br />410 Caldwell St., Chapel Hill, NC 27514 <br />Margaret Lane, Hillsborough, NC 27278 <br />e. Status: ( ) Public (x) Private, non- profit <br />( ) Private, for profit ( ) Individual <br />f. Provider Contract ID #: 56-0861200 <br />2. County De artment of Social Services <br />a. Name of .Contract Administrator: Martha Pryor -Cook <br />Tel. #: (9 19) ERE-. 2 <br />b. Name of Services Program Contact Person: we n d o 1 n D. Price <br />Tel. #: 737-8181 Ext . 2847 <br />C. Address of County Department of Social Services: <br />300 West Tr on Street <br />27278 <br />DSS -1292 (4/87) <br />Family Services <br />