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DocuSign Envelope ID: E9553E7D-3748-4C37-A9D7-602D42934ACC t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> Agency/Prograrr Public Gallery of Carroro/General Operating Support <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations $ 2,775 $ 3,500 $ 4,000 14% <br /> Agency Generated Revenue (fees) $ 7,500 $ 8,850 $ 9,350 6% <br /> Local Government Grants: <br /> Orange County 0 <br /> Town of Chapel Hill 0 <br /> Town of Carrboro $ 500 0 <br /> Other Local: Carrboro Tourism $ 2,500 -100% <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 $ 2,250 $ 2,100 $ 3,000 43% <br /> Please list 3 largest Miscellanous sources: <br /> Fundraising Events $ 2,250.00 <br /> Total Agency Revenue $ 13 025 $ 16 950 $ 16 350 -4% <br /> AGENCY EXPENSES <br /> Compensation $ 876 $ 825 $ 750 -9% <br /> Rent&Utilities $ 9,099 $ 9,300 $ 9,600 3% <br /> Supplies&Equipment $ 600 $ 700 $ 700 0% <br /> Travel&Training $ - $ - $ - 0 <br /> Other Expenses: $ 5,369 $ 7,178 $ 5,500 -23% <br /> Please list 3 largest"Other Expenses": <br /> Insurance $ 2,000.00 <br /> music licensing fees&dues $ 2,275.00 <br /> advertising $ 558.00 <br /> Total Agency Expenses $ 15,944 $ 18,003 $ 16,550 -8% <br /> SURPLUS/(DEFICIT)FOR PERIOD: $ (2,919) $ (1,053) $ (200) 81% <br /> Main Application 5/25/2016 10:00:47 AM 0 I:°' , 15 of 2 <br />