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DocuSign Envelope ID: 1007B77C-A009-4AA3-964B-3B03B9585341 <br /> txnibit A-continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> Agency/Program Bridge II Sports: Boccia Ball <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations $ 2,250 $ 3,778 $ 2,878 -24% <br /> Agency Generated Revenue(fees) $ - $ 150 $ 300 100% <br /> Local Government Grants: <br /> Orange County $ 1,250 $ 1,250 $ 1,500 20% <br /> Town of Chapel Hill $ 750 $ 750 $ 1,500 100% <br /> Town of Carrboro $ 2,500 $ 1,750 $ 1,500 -14% <br /> Other Local: Town of Cary $ 2,000 $ 3,000 $ 3,000 0% <br /> Other Local: 0 <br /> Other Local: 0 <br /> If more than 3 sources,please <br /> provide a separate list. <br /> Non-Local Government Grants <br /> Triangle United Way 0 <br /> State Government 0 <br /> Federal Government 0 <br /> Other Grants: 0 <br /> Other Grants: 0 <br /> Miscellaneous/Other Revenue $ 2,000 $ 2,000 0% <br /> Please list 3 largest Miscellanous sources: <br /> Team Fundraising <br /> Total Agency Revenue $ 8 750 $ 12 678 $ 12 678 0% <br /> AGENCY EXPENSES <br /> Compensation $ 2,000 $ 2,400 $ 2,400 0% <br /> Rent&Utilities $ 150 $ 150 $ 150 0%I <br /> Supplies&Equipment $ 6,000 $ 9,399 $ 9,399 0% <br /> Travel&Training $ 600 $ 729 $ 729 0% <br /> Other Expenses: 0 <br /> Please list 3 largest"Other Expenses": <br /> Total Agency Expenses $ 8,750 $ 12,678 $ 12,678 0% <br /> SURPLUS/(DEFICIT) FOR PERIOD: I $ - I $ - I $ - I 01 <br /> Main Application 5/24/2016 9:03:13 AM .. 22 of 2 <br />