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PROVIDER /AAA CHECKLIST <br />County Name FY17 <br />Attachment number 1 \n <br />F -6 Page 158 <br />NOTES <br />Cabarrus Planning & Development <br />DATE: <br />DATE <br />Aging Funaing Plan Draft Forms <br />Submitted <br />DAAS -730 <br />5/512016 <br />DAAS -731 <br />5/5/2016 <br />DAAS -732 <br />51512016 <br />DAAS -732A <br />5/512016 <br />DAAS -732A1 <br />5/5/2016 <br />DAAS -733 <br />515/2016 <br />DAAS -734 <br />5/5/2016 <br />CIP Rights <br />5/5/2016 <br />Budget Analysis <br />Matches <br />DALAS-732 <br />DAAS -732 <br />Grant Funds for FY'2017 = <br />46824 <br />46824 <br />DAAS 732a Revenues - Line I.J = <br />52027 <br />DAAS 732a Expenses Line II.J <br />52027 <br />Revenues Line III. A. I = <br />52027 <br />Expenses Line 191.6.1 <br />52027 <br />Revenues Match Line I.J = <br />52027 <br />Revenues Line III.B.1 <br />52027 <br />Expenses Match Line II.J = <br />52027 <br />Expenses Line II {.A.1 <br />52027 <br />DAAS -73231 (Total)= <br />12000 <br />DAAS732a Line ILA <br />12000 <br />USDA correct for total service units @ 0.75 <br />#REF <br />0 <br />0 <br />ADH service cost matches allowable rate <br />Matches <br />DAAS732A <br />DAAS732 <br />DAAS732A <br />DAAS732 <br />Block Grant Funding <br />Line LA <br />Col. A Total <br />46824 <br />46824 <br />Required Local Match -Cash & In -Kind <br />Line I.B <br />Col. B Total <br />5203 <br />5203 <br />Net Service Cost <br />Line LC <br />Col. C Total <br />52027 <br />52027 <br />USDA Subsidy <br />Line I.D <br />Col. D Total <br />0 <br />0 <br />Total Funding <br />Line I.0 +I.D <br />Col. E Total <br />52027 <br />52027 <br />Projected HCCBG Reimbursed Units <br />Line III.0 -Total <br />Col. F Total <br />#DIV1O! <br />\%\\\\N \ \ \\ <br />Total Reimbursement Rate <br />Line 111.13.5 (by Service <br />Col. G (by Service <br />Projected Total Service Units <br />Line IILFTotal <br />Col. I Total <br />#DIV10! <br />#DIV /0! <br />Attachment number 1 \n <br />F -6 Page 158 <br />