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Au-dE8
<br /> DocuSign Envelope ID:38357F45-0FD1-474F-992F-A2DODA42ik3E2 1 thtinued'—"—
<br /> Provider's Outside Agency Application
<br /> AGENCY NAME: Duke Home Care &Hospice
<br /> T'041,Aetta 14Est.Mate .; Projected, v Percent..„:1,0,,,,,i1,„66,,0,
<br /> .1 ,:f4, ;;, ,,:,,i8.,:..,;...,',..,24$1,A,::., ;;.,t$,,,,,•efik'6,0',,,,!;"],
<br /> PROGRAM REVENUE iO4'.12014415,""Iro."'"6" '66gr'),`"2015166606V 66606 "I P7:11 ij,,,'41"' V.,;,'",
<br /> Private Donations $ 344,833 $ 467,200 $ 467,200 0%
<br /> Program Generated Revenue(fees) .. $10,319,858 $11,008,000 $11,251,000 , 2%
<br /> l'I'''''',10;111111101,41illION.',ii•,iti'liagt01,P#,),1illir PATIVIRfailffillil Viiirlikt440,40'0060ti01,0:1
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<br /> Local Government Grants: 1441,f0gL1644,14,,,'gi'dg,tikm'i'fii Narodootagito4.lo do,lif,,,,,,,44.14,6,,,m,,,,o,N.
<br /> Orange County $ 1,000 $ 1,000 $ 1,000 0%
<br /> Town of Chapel Hill $ 3,000 $ 3,000 $ 3,000 0%
<br /> Town of Carrboro $ 3,800 $
<br /> 3,800 $ 3,800 0%
<br /> Other Local: 0
<br /> Other Local: 0
<br /> Other Local: 0
<br /> 0;, ,ii'le■t4i I r, -PV41 llit'tiq r 1,';;I'l,i.4'
<br /> If more than 3 sources,please
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<br /> 11.411: 11:('',',',Y f ',,.1::Ii''',IP''1,!'f' l't l' 5 ': 4:,4',d!::,:! :l,,„
<br /> provide a separate list. ), 'If 11 61 I ' ,,,;.6'6,' , 0,64 ...6,,1' 6!■1 .„1),...:F , A
<br /> ;.:1,fit■,,,I,',..!.f, 1, ; .„,,6'ti.,;.),Ft.,:..,,,',",:..,..!.',1,,,,.,!*, .i„.i ..11 ..‘,..6ini1.1.4,,
<br /> *iv i''''.:1.6111P 01 .'.''151 ';',',1h.f lti,1111.14 Aiw:i16..NR.4.,'''',..,1,1,!'wo,i,',...:o''.,;',:1,041.): .r.,. 0.,
<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 /> ' ISNININNORIS iliVaggliell 8111211110111 INIIIIIIIMININE
<br /> Miscellaneous/Other Revenue 0
<br /> ,,, ,i„,.,,,,,, ...,,,,.,,,,,,,,4,11,,,,1140,,,0 4".0Lp,P / Al , ■l',1 i ',e ''
<br /> Please list 3 largest Miscellanous sources: f nw
<br /> $ - i'l.i0ry„l,;;p:1a,,i.ia,,i 0 h.a (44 a1N r'::,
<br /> $ .. ;a!,1.,,lk :1:.,,,.Nk4.4..,,.,f1",,,",:,14.114,9'■0;.:16r„, 1
<br /> Total Program Revenue $10,672,491 $11,483,000 $11,726,000 2,,,,
<br /> PROGRAM EXPENSES ,J1,0t1..1",1 •I.0'4 P I01°1,.1;'1,,.iI„i f ril.iPI,,i 1'$.4 r,v1'0,'rVrittafi0torPHIRloilIs::‘,.pi1t4 i o,,i,,i,:f plll'.4,i,,A gA0.d.,
<br /> :,■1 , L !..,., ,..., ,.11,,
<br /> Compensation $ 5,344,986 $ 5,723,000 $ 5,927,000 4%
<br /> Rent& Utilities $ 233,663 $ 243,009 $ 252,730 4%
<br /> Supplies &Equipment $ 1,184,951 $ 1,208,000 $ 1,284,000 6%
<br /> Travel &Training $ 166,535 $ 173,196 $ 180,124 4%
<br /> Other Expenses: $ 4,090,343 $ 4,170,794 $ 4,237,146 2%
<br /> Please list 3 largest"Other Expenses: "P:140, Vii9P01;0,101,1.01A1A!°",1
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<br /> $
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<br /> $ '' I'llifAhjr,:jaNffi''',/41411' ',.';';'),'1:69'/,'',MA:41,,,",1.9"lon.al,..aa'1,aaasiaataapaaam iil'agiAIPIPParaala,Ca'aag
<br /> $ aallid'ai.'llierrq:',7aanaaa',.AaPaaaaali'a4alaaial''olaaa. ',aailaaaaaataAa.44,aoarala,qmiariaaaiNr,r0i,a.adaaa'aaa
<br /> - ;.r'l:'''','tl,''''4',Ik'I'','',16a',,'1!'',''','-'5,I,I,I,''''''','Jlf'a'k',11$1''''''''ii'',,';'1,',H111,aali.j':;i1,1-:','''',!fria.1,1!,ii, '''■,iail;:','','''1',n' 'll64-,a,!alltal,t111,,P;;;14,424'''''',,la
<br /> Total Program Expenses $11,020,478 $11,518,000 $11,881,000 3%
<br /> $ (347,987)1 $ (35,000)[ $ (155,000)1 -343%
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