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Certified by: _______________________ Title: __________________________ Date: ____________ <br />(Provider’s Signature) <br />EXHIBIT “B” <br />Scope of Services –FY 2018-19 <br />Outside Agency Performance Agreement <br />Agency Name: <br />Program Name: <br />Funding Award: <br />Outline how the agency will spend Orange County’s funding award. <br />Program Services <br />Outline the critical services (activities)the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019. <br />Apartment Manager conducts periodic unit inspections, collects apartment rents, provides <br />assistance/guidance with Resident’s issues, prepares Annual Recertifications to establish the <br />Resident’s continued eligibility, assists with conflict resolutions and other day-to-day operational <br />activities. <br />Anticipated Outcomes <br />The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange <br />County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants <br />within that measure’s description or for an earlier performance measure. <br />Performance Measures Anticipated <br />Results <br />(14)Adults diagnosed with SPMI and at a heightened risk for homelessness will receive <br />assistance in maintaining independent living and avoid psychiatric hospitalizations. <br />Achieve <br />Goals <br />Expense Description Amount <br />Payroll <br />Employee Benefits -Calculated @ 20% of Payroll <br />Commercial Property Insurance/Liability/Data/Umbrella <br />Vehicle Insurance <br />Van Fuel <br />Van Repair/Maintenance <br />Telephone Internet <br />Program Supplies <br />Postage <br />Cellular Phone <br />Staff Training -Relias Learning <br />Replacement Furnishings -Resident Units <br />Resident Recreation <br />Trash Removal <br />Subtotal <br />Administrative Fee (10%) <br />Total Expenses & Administrative Fee Due <br />$22,680 <br />$4,536 <br />$2,136 <br />$1,104 <br />$576 <br />$1,200 <br />$2,676 <br />$1,500 <br />$60 <br />$408 <br />$600 <br />$1,800 <br />$1,680 <br />$180 <br />$41,136 <br />$4,114 <br />$45,250 <br />([HFXWLYH'LUHFWRU  <br />NewDestinations <br />Mental Health <br />$35,100(maxamounttobereimbursed) <br />$35,100wastheamountapprovedforNewDestinations. <br />TheCountywillonlyreimbursefeesupto$35,100 <br />XXXXXXX <br />XXXXXX <br />XXXXX <br />DocuSign Envelope ID: 45F8D9E2-21AC-4868-9A00-7CEFD1517F11 <br /><br />