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2018-515-E Finance - OC Disability Awareness Council outside agency agreement
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2018-515-E Finance - OC Disability Awareness Council outside agency agreement
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Last modified
8/30/2018 11:12:56 AM
Creation date
8/30/2018 8:22:17 AM
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Contract
Date
7/1/2018
Contract Starting Date
7/1/2018
Contract Ending Date
6/30/2019
Contract Document Type
Agreement - Performance
Amount
$8,513.00
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R 2018-515 Finance - OC Disability Awareness Council outside agency agreement
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2018
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DocuSign Envelope ID: 28872B9E- 993A- 44CA- 8A5E- OBDA1F6178CB <br />Exhibit A: Provider's Outside Agency Application <br />Additional Program Information <br />a) Target Population <br />Complete the following tables, with numbers (not percentages) of individuals served and to be <br />served, to the best of your ability, <br />Program Target Population Demographics I <br />Gender <br />Male <br />Female <br />*City /StatefCounty <br />Disabled <br />Total <br />Ethnicity <br />African- American <br />American Indian or Alaska Native <br />Asian <br />Caucasian <br />Native Hawaiian or other Pacific Islander <br />Other_ specify <br />Total <br />Of the above, how many Hispanic /Latino <br />Of the above, how many non - Hispanic /Latino <br />Age <br />Geographic Location <br />Total <br />0 -5 years <br />5.18 years <br />19 -50 years <br />51 + years <br />Total <br />Actual Estimated Projected <br />2015 -15 1 2015 -17 2017 -18 <br />180 <br />180 <br />200 <br />335 <br />335 <br />350 <br />515 <br />515 <br />550 <br />300 <br />300 <br />325 <br />495 <br />495 <br />540 <br />500 <br />500 <br />560 <br />195 <br />195 <br />215 <br />500 <br />500 <br />530 <br />0 <br />0 <br />0 <br />5 <br />5 <br />20 <br />495 <br />495 <br />540 <br />500 <br />500 <br />560 <br />Alamance County <br />Chatham County <br />Durham County <br />Wake County <br />Orange County Breakdown 250 250 350 <br />Chapel Hill Public Housing <br />Town of Chapel Hill (Non- Public Housing) <br />Town of Carrboro <br />Town of Hillsborough <br />City of Mebane (Orange County) <br />Orange County (Outside Municipalities) <br />150 <br />150 <br />200 <br />50 <br />50 <br />55 <br />325 <br />325 <br />350 <br />125 <br />125 <br />130 <br />500 <br />500 <br />530 <br />Alamance County <br />Chatham County <br />Durham County <br />Wake County <br />Orange County Breakdown 250 250 350 <br />Chapel Hill Public Housing <br />Town of Chapel Hill (Non- Public Housing) <br />Town of Carrboro <br />Town of Hillsborough <br />City of Mebane (Orange County) <br />Orange County (Outside Municipalities) <br />150 <br />150 <br />200 <br />50 <br />50 <br />75 <br />50 <br />50 <br />75 <br />PROGRAM INFORMATION 1129/2018 3:34:15 PM Page 18 of 24 <br />
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