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DocuSign Envelope ID:FF14B287-E90C-42B9-8A0F-A14FA00E82AF <br />Champion(s)travel/expenses to Development Day,Seattle (Coordinator participation in this <br />meeting optional but recommended) <br />Computer Support/Tech Services <br />Rent/Insurance/Janitorial/Maintenance <br />Utilities <br />Operating Expenses Subtotal <br />Indirect Costs <br />TOTAL EXPENSES <br />FUNDING SOURCES Year One Year Two <br />Other Funding (United Way,Grants,Community Development Block Grant,etc.) <br />Agency Funds and/or In-Kind <br />Current Health Care Authority Contract <br />TOTAL FUNDING <br />Page 20 of 20 <br />HCA Contract No.:K2747-04