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DocuSign Envelope ID:6BDD2794-5ECO-4DFF-B4F6-F496A1C3AB13 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations $ 1,081 $ 350 $ 500 43% <br /> Agency Generated Revenue(fees) $ 2,445 0 <br /> Local Government Grants: <br /> Orange County $ 20,000 $ 11,400 $ 12,540 10% <br /> Town of Chapel Hill $ 13,000 $ 5,700 $ 7,500 32% <br /> Town of Carrboro $ 14,000 $ 3,610 $ 5,000 39% <br /> Other Local: Town of Carr-Outreach $ 27,728 $ 36,970 $ 40,667 10% <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:Foundations $ 95,954 $ 28,126 $ 104,284 271% <br /> Other Grants: 0 <br /> Miscellaneous/Other Revenue $ 20,611 $ 15,000 0 <br /> Rease list 3 largest Miscellanous sources: <br /> Program Revenue $ 15,000.00 <br /> $ - <br /> $ - <br /> Total Agency Revenue $ 194 819 $ 86 156 $ 185 491 115% <br /> AGENCY EXPENSES <br /> Compensation $ 73,836 $ 75,938 $ 145,673 92% <br /> Rent&Utilities $ 44,413 $ 17,792 $ 17,792 0% <br /> Supplies&Equipment $ 2,878 $ 3,100 $ 3,600 16% <br /> Travel&Training $ 6,132 $ 1,900 $ 2,345 23% <br /> Other Expenses: $ 59,971 $ 17,615 $ 16,081 -9% <br /> Rease list 3 largest"Other Expenses": <br /> IT Servcies $ 2,366.00 <br /> Project Expenses $ 13,125.00 <br /> other fees dues $ 590.00 <br /> Total Agency Expenses $ 187,230 $ 116,345 $ 185,491 59% <br /> SURPLUS/(DEFICIT)FOR PERIOD: L$ 7,588 1 $ 130,1894 $ - J 100%l <br /> Main Application 5/24/2016 4:41:37 PM .. 2 o of 5 <br />