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PROVIDER /AAA CHECKLIST <br />County (Fame FY17 <br />Attachment number 1 \n <br />F -6 Page 144 <br />NOTES: <br />Cabarrus County Department of Human Services <br />DATE: <br />DATE <br />Aging Funding Plan Draft Forms <br />Submitted <br />DAAS -730 <br />515/2016 <br />DAAS -731 <br />5/5/2016 <br />DAAS -732 <br />5/5/2016 <br />DAAS -732A <br />5/5/2016 <br />DAAS -732A1 <br />5/5/2016 <br />DAAS -733 <br />5/5/2016 <br />DAAS -734 <br />5/5/2016 <br />C/P Rights <br />51512016 <br />Budget Analysis <br />Match_ es <br />DAAS -732 <br />DAAS -732 <br />Grant Funds for FY`2017 = <br />427908 <br />427908 <br />DAAS 732a Revenues - Line I.J = <br />826615 <br />DAAS 732a Expenses - Line II.J <br />826615 <br />Revenues Line III. A. I = <br />826615 <br />Expenses (Line III.B.1 <br />826615 <br />Revenues Match Line I.J = <br />826615 <br />Revenues Line Itt.13.1 <br />826615 <br />Expenses Match Line II.J = <br />826615 <br />Expenses Line III.A.1 <br />826615 <br />DAAS -732a1 Total = <br />224587 <br />DAAS732a Line ILA <br />224587 <br />USDA correct for total service units @ 0.75 <br />28982 <br />28629 <br />28629 <br />ADH service cost matches allowable rate <br />Matches <br />DAAST32A <br />DAAS732 <br />DAAS732A <br />DAA <br />Block Grant Funding <br />Line LA <br />Col. A Total <br />427908 <br />427908 <br />Required Local Match -Cash & In -Kind <br />Line 1.13 <br />Col, B Total <br />47546 <br />47546 <br />Net Service Cost <br />Line I.0 <br />Col. C Total <br />475454 <br />475454 <br />USDA Subsidy <br />Line I.D <br />Col. D Total <br />28629 <br />28629 <br />Total Funding <br />Line I.0 +I.D <br />Col. E Total <br />504083 <br />504083 <br />Pro HCCBG Reimbursed Units <br />Line 11 LC - Total <br />Cal. FTotal <br />#DIV /01 <br />11111111111111 <br />Total Reimbursement Rate <br />Line 111.13.5 (by Service <br />Cal. G (by Service <br />Projected Total Service Units <br />Line 1115 Total <br />Col. I Total <br />#DIV /0! <br />#DIV /0! <br />Attachment number 1 \n <br />F -6 Page 144 <br />