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Overall Program Budget <br />Agency Piedmont Health Services, Inc. <br />Proposed Program Title Community MOUD for Orange County <br />Project Period Total <br />Revenues:Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total <br />Orange County Opioid Settlement Funding $ 50,400.00 $ 57.00 $ 50,400.00 $ - $ - 50,400.00$ <br />Revenues: $ - $ - $ - -$ <br /> $ - $ - $ - -$ <br /> $ - $ - $ - -$ <br /> $ - $ - $ - -$ <br /> $ - $ - $ - -$ <br />Total Revenues: $ 50,400.00 $ 57.00 $ 50,400.00 $ - $ - $ - $ - $ - $ - 50,400.00$ <br />Project Period Total <br />Expenses:Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total Opioid Settlement <br />Funds <br />Other Funding <br />Sources <br />Total <br />Personnel and Benefits: 20,400.00 57.00 20,457.00 - - 20,457.00 <br />Operations Expenses: 30,000.00 30,000.00 - - 30,000.00 <br />Subcontractor Services: <br />Subcontractor 1 name - - - - - - - <br />Subcontractor 2 name - - - - - - - <br />Subcontractor 3 name - - - - - - - <br />Capital - - - - <br />Administrative/Indirect cost (no more than 10%) - - - - <br />Total Expenses: 50,400.00 57.00 50,457.00 - - - - - - 50,457.00 <br />Total Program Expense Budget <br />2025 2026 2027 <br />Complete this form for all revenue sources, as well as expense sources other than Opioid Settlement funds. Figures for expenses using Opioid <br />Settlement funds will automatically populate from detail tabs of spreadsheet, except for the administrative/indirect cost line item, which should be filled <br />out in this tab. Add rows as needed. Enter information in yellow shaded cells only. <br />Total Program Revenue Budget <br />2025 2026 2027 <br />Docusign Envelope ID: C8A5641B-110D-44D8-B267-1820E0BBAE3E