Orange County NC Website
Browse       Search
t~ <br />Part III -Distribution of Estimated Revenue for Total Cost Reimbursement Method <br />(a) (b) <br />A. Estimated Eligible and Matchable Costs Number Ratio <br />1. Estimated Eligible Clients 16 <br />2, Estimated ineligible Clients <br />.3, Total Clients <br />B. Eligible Costs <br />16 <br />(1) Matchable (2) Less (3) Net (4) (5) Costs Eligible <br />Costs Earned Matchable Estimated % for Financial <br />[Part 1, Line M, hrcome Costs of Eligible Participation <br />col. (.3) [B. (1) Less (2)}] [A. 1. (b)] [B. (3) x (4)] <br />$ $ $ $ $ <br />A. Program Costs <br />1. Federal/State Funds <br />2. Local Matching Share <br />3. Other Budgeted Funds <br />4. TOTAL REVENUE <br />7, Fees (If Applicable) <br />I. Administrative Fee <br />2. Certification Fee <br />3, TOTAL FEES <br />Amount Source of Funds <br />$ 44.3?2.53 Work First Program <br />e <br />$ 44 322.53 <br /> <br />Part V-Reimbursement Projections (For Title XX Providers Only) <br />Annual Projection July- September <br />Projection October-.Tune <br />Projection <br />A. $ B. $ C. $ <br />Sib ed: Date: <br />Provider/Authorized Official <br />Date: <br />County Director or Designee <br />