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DAAS-732A <br />Provider: <br />County: <br />Budget Period:July 2021 through June 2022 <br />Other In-Home <br />Service Service <br />Senior Center Operation <br />HDM to Congregate <br />Clients/Delivery/Carry Out <br />Grand Total 170 185 <br />689,649$ 101,494$ 144,142$ <br /> 1) 76,630$ 11,278$ 16,016$ <br /> 2) -$ <br />3) -$ <br />76,630$ 11,278$ 16,016$ <br /> 1) -$ <br /> 2) -$ <br />3) -$ <br /> Total Required Minimum Match - In-Kind -$ -$ -$ <br />76,630$ 11,277$ 16,016$ <br />766,279$ 112,771$ 160,158$ <br />-$ -$ -$ <br />-$ <br /> 1) -$ <br /> 2) -$ <br />3) -$ <br />4) -$ <br />-$ -$ -$ <br /> 1) -$ <br /> 2) -$ <br />3) -$ <br />-$ -$ -$ <br /> 1) -$ <br /> 2) -$ <br />3) -$ <br />-$ -$ -$ <br />-$ <br />766,279$ 112,771$ 160,158$ <br />Orange County <br />Orange <br />North Carolina Division of Aging and Adult Services` <br />Service Cost Computation Worksheet <br /> Required Minimum Match - In-Kind <br /> B. Total Required Minimum Match (cash + in-kind) <br />I. Projected Revenues <br /> A. Fed/State Funding From the Div. of Aging & Adult Svcs. <br /> Required Minimum Match - Cash <br /> Total Required Minimum Match - Cash <br /> G. Subtotal, Other Revenues, Non-Match <br /> Local In-Kind Resources (Includes Volunteer Resources) <br /> H. Subtotal, Local In-kind Resources, Non-Match <br /> I. Client Cost Sharing <br /> J. Total Projected Revenues (Sum I.C,D,E,F,G,H, & I) <br /> C. Subtotal, Fed/State/Required Match Revenues <br /> F. Subtotal, Local Cash, Non-Match <br /> Other Revenues, Non-Match <br /> D. NSIP Cash Subsidy/Commodity Valuation <br /> E. OAA Title V Worker Wages, Fringe Benefits and Costs <br /> Local Cash, Non-Match <br />DocuSign Envelope ID: 16A1D963-40F9-46F1-A38B-8B0D62C87C54