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North Carolina Divis Ian of Aging <br />Service Cost Computation Worksheet c:732A.als <br />Provider Cabamrs Active Jiving & Parks <br />County: Cabanas <br />Budget Period: luly 1, 2016 through June 3% 2017 <br />Revision _yes, _na, tevision datc <br />usrniasur� .,,me,.,.., s. rsrmrw <br />Jn <br />Grand <br />I. Projected Revenues Total A. Fed /State Funding From the Divislon of A 87,301 <br />Required Minimum Match -Cash l 11 /I//lll 1lllI/INJ !I /I //Jill! <br />1) County General Fund 9,700 IJ / / / / / /// 9,700 <br />2) 0 /11I1lIfl <br />31 _ 0 IIlIdIIII <br />Total Reoulred Minimum Match -Cash I 9 -706 1/11 /!NI/ 1 9700 <br />1j <br />0 <br />/1 / /llI /lI <br />IJ! /IJlll! /NII <br />�I <br />0 <br />/!!VIII// <br />3) <br />0 <br />!llflNll/ <br />1111111111 <br />Total Required M[nimum March. In-Kin, <br />o <br />NII!1111! <br />6 <br />6. Total Required Mirlmum Match (oath + I <br />9,7001////////// <br />_ 9,700 <br />C. Subtotal, Fed /State / Match Rei <br />97,DOI <br />1 7 <br />97,001 <br />D. USDA Cash 5ubsidy /Commodity Valuatl <br />0 <br />1l /1Jl/ /JI <br />0 <br />E OAA Title V Worker Wages, Fringe Denel <br />0 <br />97.00i <br />I I! / / llll <br />oral Cash, <br />11 County Gen_ er_al fund <br />0 <br />1lllllllll <br />IJ! /IJlll! /NII <br />?) <br />0 <br />!llli llll <br />31 <br />0 <br />IIIIJ /Jill <br />1111111111 <br />4) <br />o <br />NII!1111! <br />6 <br />F. Subtotal, Local Cash, Non -Match <br />11 1 110/818 <br />ti <br />oche: Revenues, Non -Match 111117 /111J1 1111111111 IJIII/N /111 /Il <br />1) Donations <br />0 <br />/ / / / / / / /// <br />IJ! /IJlll! /NII <br />2) State In -Home <br />0 <br />IlIlNllll <br />3j <br />0 <br />IIIIJ /Jill <br />1111111111 <br />G, Subtotal, Other Revenues, Non -Match <br />D <br />///11!17// <br />6 <br />Local In -Kind Resources (Includes Volunteer <br />fl/ //J//1/J)1 <br />1/Nll /J/ <br />IJ! /IJlll! /NII <br />1A <br />a <br />IlIlNllll <br />�I <br />o <br />1111111111 <br />3) <br />6 <br />iil/l!I!l1 <br />H. Subtotal, Local In-kind Resources, Nom <br />0 <br />I/J ///JJ// <br />1 7 <br />I. Client Program Income <br />0 <br />I //// J// <br />0 <br />J. Total Projected Revenues [sum I C,O,E,F, <br />97.00i <br />I I! / / llll <br />97,001 <br />Percent of Grand Total <br />100% <br />100.00;0 <br />D <br />m <br />3 <br />0 <br />0 <br />7 <br />7 <br />C <br />CS <br />0 <br />JtfJ!lillllllJl <br />7 <br />F -6 Page 112 <br />