Categorize Benefits of Project Management by rgh15271

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									                         Washington Families Fund Grant Agreement
                  Exhibit D-1: Quarterly Financial and Services Activities Report

                                                                   Agency Name:             Insert Agency Name

                                       Washington Families Fund Project Name:           Insert WFF Project Name

                                                                 Quarter ending:     Insert Date ( 12/31, 3/31, 6/30 or 9/30)

                                           Name of person fillout out this report:               Insert Name
1. Significant program events/Client highlights:




2. Trainings/Name of training & Who Participated):




3. Changes to program design:




4. Describe challenges and concerns encountered, including any related to training and TA:




5. Describe how the activities this quarter enhanced Housing and Employment System Coordination:




                                                                                                             Page 1
                                           Washington Families Fund Grant Agreement
                                    Exhibit D-1: Quarterly Financial and Services Activities Report



                                                Agency Name:         Insert Agency Name

                    Washington Families Fund Project Name: Insert WFF Project Name
                                               Quarter ending:   Insert Date ( 12/31, 3/31, 6/30 or 9/30)




Employment and Case Management

Total number of new clients assessed

Total number of unduplicated clients served

Number of clients exiting Navigator services

Number of referrals to WIA

Number of clients enrolled in WIA (of those referred)

Number of referrals to HIP

Number of clients enrolled in HIP (of those referred)

Number of clients referred to other employment services

Total number of unduplicated clients served by the
Navigator since the start of the program
Total number of case management hours provided during
the period



                        Please Report Head of household Unique Identifiers

Families who entered this period:                                Services accessed:                         Who Exited:




                                                                                                                     Page 2
                                                                                            Washington Families Fund Grant Agreement
                                                                                 Exhibit D-1: Quarterly Financial and Services Activities Report



                                            Agency Name:                  Insert Agency Name

               Washington Families Fund Project Name:                  Insert WFF Project Name

                                          Quarter ending:   Insert Date ( 12/31, 3/31, 6/30 or 9/30)


                                            1. Personnel                                    Washington Families Fund                                                   Matching Funds                             Total WFF
                                                                                                                                                                                                                    and
                                                                                                       Quarter                        Grant                              Quarter                         Match
                     POSITION TITLE                            FTE            SALARY                                 Total to Date                 FTE    SALARY                        Total to Date             Matching
                                                                                                       Actual                        Balance                             Actual                         Balance
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
                                                                                                                                                                                                                         0
Subtotal Salaries                                                                           0                    0              0              0                   0               0               0          0          0
Fringe Benefits @ ____%                                                                                                                        -
TOTAL PERSONNEL - FTEs, SALARIES & FRINGE                          -                        0                    0              0              0    -              0               0               0          0          0
Other Direct Expenses:                                                    Amount                                                                         Amount
2. Local Travel/Mileage                                                                                                                                                                                                  0
3. Equipment                                                                                                                                                                                                             0
4. Supplies                                                                                                                                                                                                              0
5. Telecommunications                                                                                                                                                                                                    0
6. Printing/Duplication                                                                                                                                                                                                  0
7. Mail/Postage                                                                                                                                                                                                          0
8. Subcontracted Services - Agency A                                                                                                                                                                                     0
9. Subcontracted Services - Agency B                                                                                                                                                                                     0
10. Subcontracted Services - Agency C                                                                                                                                                                                    0
11. Subcontracted Services - Agency D                                                                                                                                                                                    0
12. Cash Assistance to Families                                                                                                                                                                                          0
13. Other: Day Care                                                                                                                                                                                                      0
14. Other: Transportation                                                                                                                                                                                                0
15. Other: Food                                                                                                                                                                                                          0
Other: Emergency Assistance                                                                                                                                                                                              0
16. Subtotal Direct Expenses (sum lines 1-15)                                               0                    0              0              0                   0               0               0          0          0
17. Project Administration (up to 10% of line 16)
18. Total Support Services Expenses                                                         0                    0              0              0                   0               0               0          0          0
Support Services Revenue:                                                 Amount                                                                         Amount
19. Rent/Housing Operations Income Applied
20. Local Match and Other Sources
21. Washington Families Fund Request - Year 1
22. Total Support Services Revenue                                                          0                    0              0              0                   0               0               0          0          0
23. Net Gain/Loss (this amount should be zero)                                              0                    0              0              0                   0               0               0          0          0

Ratio of Matching Funds to WFF Funds in this Period          #DIV/0! Note: should be 2.00 (1.0 for HL) or greater for the year
Ratio of Matching Funds to WFF Funds YTD                     #DIV/0!


                                                                                                                                                                                                                      Page 3
                                                         Agency Name:               Insert Agency Name

                        Washington Families Fund Project Name:                  Insert WFF Project Name

                                                       Quarter ending:     Insert Date ( 12/31, 3/31, 6/30 or 9/30)



                                                                                                    April 1, 2010 -
Washington Families Fund
                                                                                                    March 31, 2011
Total Washington Families Funds expended                                                            $              -

                                                                                                    April 1, 2010 -
Matching Funds
                                                                                                    March 31, 2011
Housing Operations funding applied to services                                                      $              -
Cash Contributions from a WFF Project Partner
Other Sources of Funds:
 Federal funds
 State funds
 County funds
 City funds
 Corporate grants
 Foundation grants
 Private fundraising
 Other Agency funds - Describe:
Other - Describe
Other - Describe
Other - Describe
Other - Describe
Total Matching Fund Contributions                                                                   $                 -
Ratio of Matching Funds to WFF Funds in this Period                                                      #DIV/0!

Please note: You do not need to separate out individual contracts within each source type. So, for example, you
can add all the state sources together and report one amount for all state funds. If you have any questions about
how to categorize funds, please call Kelly at 206-805-6140. Thank you!

								
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