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Section III. Program Information
<br /> Program Budget Worksheet
<br /> AGENCY NAME: Piedmont Health Services, Inc •Carrboro Community Health Center
<br /> Actual Estimated Projected Percent
<br /> PROGRAM REVENUE FY2012 FY2013 FY2014 Change
<br /> Private Donations $ - $ 0
<br /> Program Generated Revenue(fees) $ 2,785,448 $ 3,078,048 $ 3,197,681 4%
<br /> Local Government Grants.
<br /> Orange County $ 10,000 $ 10,000 $ 10,000 0%
<br /> Town of Chapel Hi $ 4,000 $ 3,000 $ 3,000 0%
<br /> Town of Carrboro $ 2,000 $ 2,000 $ 2,000 0%
<br /> Other Local: orange Partnership/Smarf Start $ 44,000 $ 37,300 $ 37,355 00/0
<br /> Other Local: 0
<br /> Other Local; ce 0
<br /> I rrore than 3 sours,please
<br /> provide a separate fist.
<br /> Non-Local Government Grants
<br /> Triangle United Way $ $ - $ 0
<br /> State Government $ 6,969 $ 771 $ - -1000/0
<br /> Federal Godernment $ 380,772 $ 458,700 $ 400,710 -13%
<br /> Other Grants:Non-Govt Grants $ 248,136 $ 139,983 $ 188,650 35%
<br /> Other Grants: 0
<br /> MiseelleneousfOther Revenue $ 671,013 $ 73,460 $ 39,412 -46%
<br /> Please 5st 3largest Wcelanous sources:
<br /> Management Pees $
<br /> Patient Information $
<br /> 'fizer Share the Care Contribufioi $
<br /> Total Program Revenue $ 4,152,298 $ 3,803,262 $ 3,878,808 2%
<br /> PROGRAM EXPENSES
<br /> Compensation $ 2,932,208 $ 3,137,017 $ 2,833,199 -100/0
<br /> Rent&Utilities $ 96,761 $ 77,060 $ 147,374 91%
<br /> Supplies&Nuipment $ 317,531 $ 418,239 $ 366,049 -12%
<br /> Travel&Training $ 29,415 $ 25,562 $ 31,090 22%
<br /> Other Expenses: $ 939,470 $ 735,467 $ 438,134 -40%
<br /> Pease list 3 largest^Other fixpenses":
<br /> Patient Care
<br /> Contract Seruces
<br /> Repairs/Maintenanee $ -
<br /> Total Program Expenses $ 4,316,385 $ 4 393 345 1 $ 3 815,846 -131/
<br /> SURPLUS!(DEPICI-r)FOR PERIOD: $ (163,087) $ (690,083)1$ 62,962 111°t
<br /> Revised November 21,2013 Page JO of 15 Pages
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