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<br />Schedules B, C, D <br /> <br />County <br /> <br />C;:l~~ <br /> <br />Agency/Facility Name C;:I~~ Cnllnty Ann~Y <br /> <br />Equipment Schedule B <br /> <br />A <br /> <br />x <br /> <br />8 <br /> <br />= <br /> <br />c <br /> <br />Item Purchased Estimated Percentage Total <br /> Cost FNP use In-Kind Value <br />Color Copier $13,000.00 10% $1,300.00 <br /> <br />Total: Equipment $ $1.300.00 <br />(Transfer to Contributor Support Form Value of Equipment) <br /> <br />Supplies and Materials Schedule C <br /> <br />Materials <br />Office Su lies <br />Food Su lies <br />Demonstration Su lies <br /> <br />Value <br />$350.00 <br /> <br />Total: Supplies/materials $ 350.00 <br />(Transfer to Contributor Support Form Value of Supplies/Materials) <br /> <br />Other Resources Schedule D <br /> <br />Other resources include such things as long distance phone charges, printing, fax <br />charges, educational materials, mileage, etc. <br /> <br />Total: Other Resources $ <br />(Transfer to Contributor Support Form Value of Other In-Kind Resources) <br /> <br />Signature: i97.tzci eo';1,~ <br />~/ Department Head irector <br /> <br />Revised 3/08 <br />