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DAAS-732A
<br />Provider:
<br />County:
<br />Budget Period:July 2022 through June 2023
<br />Other Other Access In-Home In-Home In-Home 0 0 0 0 0 0 0 0
<br />Service Service Service Service Service Service Service Service Service Service Service Service Service Service
<br />Senior Center Operation Congregate Nutrition Information & Case Assistance
<br />In-Home Aide-Level II - Personal
<br />Care Adult Day Care Adult Day Health 0 0 0 0 0 0 0 0
<br />Grand Total 170 180 040 042 030 155 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
<br />756,786$ 102,580$ 214,168$ 263,713$ 116,141$ 20,184$ 40,000$ -$ -$ -$ -$ -$ -$ -$ -$
<br /> 1) -$
<br /> 2) -$
<br />3) -$
<br />-$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br /> 1) 84,088$ 11,398$ 23,796$ 29,301$ 12,905$ 2,243$ 4,445$
<br /> 2) -$
<br />3) -$
<br /> Total Required Minimum Match - In-Kind 84,088$ 11,398$ 23,796$ 29,301$ 12,905$ 2,243$ 4,445$ -$ -$ -$ -$ -$ -$ -$ -$
<br />84,088$ 11,398$ 23,796$ 29,301$ 12,905$ 2,243$ 4,444$ -$ -$ -$ -$ -$ -$ -$ -$
<br />840,874$ 113,978$ 237,964$ 293,014$ 129,046$ 22,427$ 44,444$ -$ -$ -$ -$ -$ -$ -$ -$
<br />18,400$ -$ 18,400$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<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 />859,274$ 113,978$ 256,364$ 293,014$ 129,046$ 22,427$ 44,444$ -$ -$ -$ -$ -$ -$ -$ -$
<br />Service Service Service Service Service Service Service Service Service Service Service Service Service Service
<br />Grand Admin.Senior Center Operation Congregate Nutrition Information & Case Assistance In-Home Aide-Level II - Personal Care Adult Day Care Adult Day Health 0 0 0 0 0 0 0 0
<br />Total Cost 170 180 040 042 030 155 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
<br />287,713$ -$ -$ 24,000$ 263,713$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br />102,580$ -$ 102,580$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br />390,293$ -$ 102,580$ 24,000$ 263,713$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br /> 1) FICA @ 7.65 29,857$ -$ 7,847$ 1,836$ 20,174$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br />-$
<br />-$
<br />-$
<br />-$
<br />-$
<br />29,857$ -$ 7,847$ 1,836$ 20,174$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br /> 1) -$
<br /> 2) -$
<br />3) -$
<br />-$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br />-$
<br />-$
<br />-$
<br />-$
<br />-$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$
<br /> 1) 129,046$ 129,046$
<br /> 2) 66,871$ 22,427$ 44,444$
<br />3) -$
<br /> 4) -$
<br /> 5) -$
<br /> 6) -$
<br /> 7) -$
<br />8) -$
<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 />Division of Aging and Adult Services
<br />Service Cost Computation Worksheet
<br />II. Line Item Expenses
<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 /> 6) Other
<br />B. Subtotal, Fringe Benefits
<br /> Staff Salary From Labor Distribution Schedule
<br /> 1) Full-time Staff (do not include Title V workers)
<br /> 2) Part-time staff (do not include Title V workers)
<br />A. Subtotal, Staff Salary
<br /> Fringe Benefits
<br />%
<br /> Travel
<br /> 2) Health Insurance
<br /> 3) Retirement
<br /> 4) Unemployment Insurance
<br /> 5) Worker's Compensation
<br /> 1) Per Diem
<br /> 2) Mileage Reimbursement
<br /> 3) Other Travel Cost
<br />E. Subtotal, Travel
<br /> General Operating Expenses
<br />Local In-Kind Resources Non-Match
<br />C. Subtotal, Local In-Kind Resources Non-Match
<br />D. OAA Title V Worker Wages, Fringe Benefits and Costs
<br />contractual
<br />support to clients
<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: 77B99AE1-C8D6-40A2-BBF0-532F9F8FCC22
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