2020-872-E Social Svc - PORCH Chapel Hill-Carrboro outside agency agreement

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—DocuSign Envelope ID:8173BBCF-1050-4110-B8C4-4622BA864EOB COVE1t GAGE Applicant Contact Information Applicant Organization's Legal Name: PORCH Chapel Hill-Carrboro Applicant Organization's Physical Address: 218 Lake Manor Road, Chapel Hill, NC 27516 Applicant Organization's Mailing Address: 218 Lake Manor Road, Chapel Hill, NC 27516 Applicant organization's Web Address: https://chapelhill.porchcommunities.org Executive Director: Debbie Horwitz Telephone Number: (919) 971-1749 E-Mail:debbie @porchcommunities.org Tax ID Number:27-2759081 Funding Request Please list all Fiscal,Year 2021 Human Services(HS)funding requested for all programs and the proposed use of funds(please list program name only) Program Carrboro - Chapel Hill Orange Total HS - HS County-HS Food For Families Program $5,600 $13,225 $15,720 $34,545 Operations Operations Operations Totals $5,600 $13,225 $15,720 $34,545 Briefly explain your'proposed use of funds: Funds will be used to support the purchase and transport of fresh food for 50 food- insecure families in Chapel Hill-Carrboro (20 supported by OC, 20 by CH and 10 by C) and to 10 families in Hillsborough (supported by OC) enrolled in PORCH's Food for Families program. We are also requesting funding to cover shares of traditional Asian produce from TTCF for 25 FFF families from Burma (CH). To the best of my knowledge and belief all Information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. r Signature: Ex utive Dir y Date Signature: L ect !I `�'` ''i`� t i' Board Chairperson Dat Cover Page Via:�, 6 r 2 1 .........._.............................. ..-.......-............................. . .............................. . .................. ........... ............. . ......... _ ............................ ............ ___..