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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 />W ISEPlace <br />Steps to Independence <br />2322894 <br />Street Outreach Shelti X <br />HMIS Coordinated Assessment/Centralized Intake <br />What is the total unduplicated number (both Santa Ana residents and Non -Santa Ana residents) that this program <br />plans to serve during 2015-2016? <br />72 <br />What is the total unduplicated number of Santa Ana residents that this program plans to serve during 2015-2016? <br />38 <br />Program and Funding Description <br />Description of Work - In the space below, describe the program to be funded during the 12 -month contract period. <br />What specific activities will be undertaken during the contract period. Please be concise in your response. Only the <br />viewable space will print. <br />Steps to Independence Program is a shelter program for unaccompanied homeless women. The program includes <br />case manager, financial empowerment, life skills classes, assess to heath care, transportation and assistance with <br />permanent housing. <br />Schedule of Performance/Goal Outcomes <br />Estimate the number of ONLY unduplicated Santa Ana participants to be served by the funded program during the 12 - <br />month contract period per quarter. (Enter number of new Santa Ana Participants served each quarter. If they were <br />served in quarter 1 do not count them again <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 />12 <br />42 <br />Participants <br />Participants <br />Participants <br />Participants <br />Total Santa Ana Participants to be served. <br />Schedule of Invoicing <br />Estimate the amount of grant funds to be requested during the 12 -month contract period on a quarterly basis. <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 />$ 5,800.00 <br />$ <br />6,100.00 <br />$ <br />5,800.00 <br />$ <br />5,800.00 <br />$ <br />23,500.00 <br />Total Grant <br />Exhibit A <br />Page 1 of 1 <br />