| [NOFO Title] | |||||||||
| [NOFO Number] Performance Measures Template | |||||||||
| OMB Approval Number: 0920-1132 | |||||||||
| Expiration Date: XX/XX/XXXX | |||||||||
| Recipient Name: | |||||||||
| Performance Year: | |||||||||
| Submission Date: | |||||||||
| Performance Measure | ||||||||
| NOFO Measure Label | ||||||||
| Measure Number or Label | ||||||||
| Measure Description | ||||||||
| Strategy | ||||||||
| Unit of Analysis | ||||||||
| Numerator Definition | ||||||||
| Denominator Definition | ||||||||
| Measure Type | ||||||||
| Narrative | ||||||||
| Setting | ||||||||
| Data Source | ||||||||
| If other, specify: | ||||||||
| Other Attachments | ||||||||
| Measurements | ||||||||
| Year or Time Period | Target Numerator | Target Denominator | Target Percentage | Actual Numerator | Actual Denominator | Actual Percentage | Date Data Collected | Measurement Notes |
| Baseline | ||||||||
| Year 1 | ||||||||
| Year 2 | ||||||||
| Year 3 | ||||||||
| Year 4 | ||||||||
| Year 5 | ||||||||
| – Additional rows can be added to this table to capture additional years or time periods as may be required by the NOFO. | ||||||||
| – This page can be duplicated to capture work on additional performance measures as required by the NOFO. | ||||||||
| – The agency may provide guidance on format and purpose of each field, and whether it is required. For example, an agency may prescribe specific activities, may prescribe how to map activities to specific strategies or program/priority areas, or may leave the determination to the recipient. | ||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |