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PROVIDERIAAA CHECKLIST <br />County Name FY17 <br />Attachment number 1 \n <br />F -6 Page 117 <br />NOTES: <br />Cabarrus Active Living and Parks <br />DATE: <br />DATE <br />Aging Funding Plan Draft Forms <br />Submitted <br />DAAS -730 <br />51512016 <br />DAAS -731 <br />515/2016 <br />DAAS -732 <br />5/5/2016 <br />DAAS -732A <br />515/2016 <br />DAAS -732A1 <br />5/5/2016 <br />DAAS -733 <br />5/512016 <br />DAAS -734 <br />5/5/2016 <br />CIP Rights <br />5/512016 <br />Budget Analysis <br />Matches <br />DAAS -732 <br />DAAS -732 <br />Grant Funds for FY'2017 = <br />87301 <br />87301 <br />DAAS 732a Revenues - Line I.J = <br />97001 <br />DAAS 732a Expenses- Line II.J <br />97001 <br />Revenues Line III. A. I = <br />97001 <br />Expenses Line III.5.1 <br />97001 <br />Revenues Match {Line I.J = <br />97001 <br />Revenues Line III.B.1 <br />97001 <br />Expenses Match Line II.J = <br />97001 <br />Expenses Line III.A.1 <br />97001 <br />DAAS -732a1 Total = <br />30084 <br />DAAS732a Line ILA <br />39084 <br />USDA correct for total service units @ 0.75 <br />I#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 />67301 <br />87301 <br />Required Local Match-Cash & In -Kind <br />Line 1.13 <br />Col. B Total <br />9700 <br />9700 <br />Net Service Cost <br />Line LC <br />Col, C Total <br />97001 <br />97001 <br />USDA Subsidy <br />Line LD <br />Col, D Total <br />0 <br />0 <br />Total Funding <br />Line I,C +I.D <br />Col. E Total <br />97001 <br />97001 <br />Projected HCCBG Reimbursed Units <br />Line IILC -Total <br />Col. F Total <br />#DIV101 <br />\ \ \% \11 M\ <br />Total Reimbursement Rate <br />Line 111.8.5 (by Service <br />Col. G (by Service <br />Projected Total Service Units <br />Line III.F Total <br />Col. I Total <br />#DIVfO! <br />#DIVIO! <br />Attachment number 1 \n <br />F -6 Page 117 <br />