Orange County NC Website
DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget Worksheet <br /> AGENCY NAME: Senior Care of Orange County; Inc. <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations $ 150 $ 550 $ 250 -55% <br /> Program Generated Revenue (fees) $ 297,933 $ 318,951 $ 335,000 5% <br /> Local Government Grants: . <br /> Orange County $ 25,000 $ 25,000 $ 25,000 0% <br /> Town of Chapel Hill $ 750 $ 1,500 $ 1,500 0% <br /> Town of Carrboro $ 1,000 $ 1,000 $ 1,000 0% <br /> Other Local: IIIIIIII 0 <br /> Other Local: Mill.111 .111.111111111 0 <br /> Other Local: 111111M11111.111 0 <br /> If more than 3 sources,please <br /> provide a separate list. <br /> Non-Local Government Grants <br /> Triangle United Way $ 928 1311111.1M 0 <br /> State Government IIIIMIllill. 0 <br /> Federal Government 11111M110. 0 <br /> Other Grants: 11111111111111=111.11 0 <br /> Other Grants: .1 .111=11111 0 <br /> Miscellaneous/Other Revenue 111=M11 0 <br /> !lease list 3 largest rViscellanous sources: <br /> $ _ <br /> $ _ <br /> $ _ <br /> Total Program Revenue $ 325,761 $ 347,001 $ 362,750 M!! <br /> PROGRAM EXPENSES <br /> Compensation $ 295,014 $ 312,000 $ 310,000 -1% <br /> Rent&Utilities $ 1,561 $ 1,561 $ 1,561 0% <br /> Supplies&Equipment $ 13,423 $ 11,000 $ 12,500 14% <br /> Travel &Training $ 1,964 $ 1,430 $ 1,500 5% <br /> Other Expenses: $ 36,885 $ 38,000 $ 37,000 -3% <br /> Flease list 3 largest"Other Expenses": <br /> Insurance $ 20,943.00 <br /> Snacks $ 6,324.00 <br /> Copier Lease $ 3,465.00 <br /> Total Program Expenses $ 348,847 MIMI 0% <br /> SURPLUS/(DEFICIT)FOR PERIOD: I $ (23,086) $ (16,990)1 $ 189 1 1011 <br /> Main Application 1/25/2016 12:26:51 PM Page 18 of 21 <br />