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DocuSign Envelope ID: COBB49A6 -D1 E9- 42DE- 8E8D- 7583E683E1E2 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Other budget items include anticipated expenses to pilot our new Aspiring Employers <br />program, accounting fees (for Halliday CPA), "tabling" fees (at community events), <br />and employer networking meeting expenses. <br />3. This program budget represents what percent of the agency budget? 80 %* <br />*OCLW projects 35K as the certification program budget; however, when we expand <br />our Aspiring Employer pilot program with hoped -for private foundation grant funding <br />and private donations, our total agency budget is 43K. <br />4. COST PER INDIVIDUAL <br />The "individual" is each certified employer, <br />This Cost per Individual must reflect the total program budget divided by the total number of program <br />individuals in this application. <br />PROGRAM INFORMATION 1/21/2018 12:07:58 PM <br />Page: 17 of 17 <br />Actual 2016 -17 <br />Estimated 2017 -18 Projected 2018 -19 <br />Total Cost of Program <br />$2.2,446 <br />$21,186 _ ! $35,000 <br />Total # of Individuals <br />123 ^` -- <br />171 j 211 <br />Cost Per Individual <br />$182 <br />$124 $166 <br />PROGRAM INFORMATION 1/21/2018 12:07:58 PM <br />Page: 17 of 17 <br />