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DocuSign Envelope ID: DBF0775B-3A75-4D97-9EA7-5AC7933304BF t A - continued
<br /> Provider's Outside Agency Application
<br /> MAIN APPLICATION
<br /> 5200• Sale of
<br /> Goods $19,995 $19,200 $27,000
<br /> 5410• Program Service Fees $0 $0 $0
<br /> 5540• Event Ticket Sales $10,040 $17,740 $15,000
<br /> 5560•Vendors
<br /> Fees $7,827 $7,125 $8,500
<br /> 5600•Advertising& Equipment Rental $25 $0 $0
<br /> Total
<br /> Income $110,156 $108,315 $123,500
<br /> Cost of Goods Sold
<br /> 50000• Cost of Goods Sold $11,567 $11,725 $17,000
<br /> Total COGS $11,567 $11,725 $17,000
<br /> Gross Profit $98,589 $96,590 $106,500
<br /> Expense
<br /> 66900• Reconciliation Discrepancies $100 $0 $0
<br /> 700• Payroll
<br /> Expenses
<br /> 701 •Wages&Salaries $6,132 $28,000 $33,000
<br /> 702 • Payroll Tax Expense $502 $3,000 $3,486
<br /> Total 700• Payroll Expenses $6,634 $31,000 $36,486
<br /> 7100• Contracted Services
<br /> 7110• Performance Services
<br /> 7110-1 • Production $750 $5,750 $3,500
<br /> 7110• Performance Services-
<br /> Other $20,433 $31,800 $17,000
<br /> Total 7110• Performance Services $21,183 $37,550 $20,500
<br /> 7120• Instructors Fees $1,274 $0 $1,500
<br /> 7130• Security Services $900 $1,600 $2,000
<br /> 7160•Accounting Service Fees $273 $300 $500
<br /> 7198 • Other Contracted Services $3,705 $3,650 $4,000
<br /> 7100• Contracted Services-Other $1,180 $60 $500
<br /> Total 7100• Contracted Services $28,515 $43,160 $29,000
<br /> 73xx• Office
<br /> Expenses
<br /> 7310• Supplies $2,273 $1,785 $2,000
<br /> 7311 • Software Expense $220 $300 $1,000
<br /> 7340• Internet Access& E-mail $2,055 $1,900 $4,000
<br /> 7350•Website Maintenance& Hosting $2,400 $2,400 $4,400
<br /> 7360• Postage and Shipping $1,250 $1,300 $1,300
<br /> 7380• Printing&Copying $1,470 $3,180 $2,830
<br /> Total 73xx• Office Expenses $9,668 $10,865 $15,530
<br /> 75xx• Occupancy Expenses
<br /> 7510• Rent& Utilities $15,054 $15,290 $16,100
<br /> Total 75xx• Occupancy Expenses $15,054 $15,290 $16,100
<br /> 77xx•Travel
<br /> Expenses
<br /> 7710• Mileage Reimbursements $55 $50 $0
<br /> Main Application 1/22/2016 8:56:04 AM Pogo 22 • f 2
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