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Name of Organization: <br />Name of Funded Program: <br />DUNS # <br />Contact Name and Address: <br />ESG 2015 -2016 <br />Scope of Work <br />Interval House <br />Domestic Violence Shelter Services <br />113510176 <br />uirector <br />Street Outreach Shelter X Homeless Prevention Rapid Re- Housing <br />HMIS Coordinated Assessment/Centralized Intake <br />What is the total unduplicated number (both Santa Ana residents and Non -Santa Ana residents) that this <br />program plans to serve during 2015 -2016? <br />155 <br />What is the total unduplicated number of Santa Ana residents that this program plans to serve during <br />62 <br />Program and Fundinq Description <br />Description of Work - In the space below, describe the program to be funded during the 12 -month contract <br />period. What specific activities will be undertaken during the contract period. Please be concise in your <br />response. Only the viewable space will print. <br />Interval House will continue to provide life saving shelter and support to a minimum of 62 homeless <br />victims of domestic violence and their children from the most underserved communities in Santa Ana. <br />Services will include: <br />EMERGENCY SHELTER: Interval House shelter programs offer a safe, caring, and homelike <br />environment for adults, adolescents, and children in life- threatening situations who are left homeless as a <br />result of domestic violence <br />ADDITONAL SPECIALIZED SUPPORT SERVICES: Comprehensive counseling; legal; health and <br />wellness; financial management; employment counseling; permanenet housing; and other services as <br />needed, provided by skilled counselors in over 70 languages. <br />Schedule of Performance /Goal Outcomes <br />Estimate the number of ONLY unduplicated Santa Ana participants to be served by the funded program <br />during the 12 -month contract period per quarter. (Enter number of new Santa Ana Participants served <br />each quarter. If they were served in quarter' <br />Quarter 1: July 1 - September 30 <br />Quarter 2: October 1 - December 31 <br />Quarter 3: January 1 - March 31 <br />Quarter 4: April 1 -June 30 <br />Pe <br />Pe <br />Ps <br />Tc <br />again in quarter 2) <br />rticipants <br />rtici pants <br />rtici pa nts <br />rtici pants <br />tal Santa Ana Participants to be served. <br />Schedule of Invoicinq <br />Estimate the amount of grant funds to be requested during the 12 -month contract period on a quarterly has <br />Quarter 1: <br />July 1 - September 30 <br />Quarter 2: <br />October 1 - December 31 <br />Quarter 3: <br />January 1 - March 31 <br />Quarter 4: <br />April 1 -June 30 <br />M24946.00 <br />Exhibit A <br />Page 1 of 1 <br />Total Grant <br />