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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 /> Total 77xx•Travel Expenses $55 $50 $0 <br /> 8113 •Van Related costs $66 $0 $0 <br /> 8xxx• Other Operating Expenses <br /> 8110• Meeting/Event Rental $1,716 $1,000 $1,100 <br /> 8120• Reception Expenses $668 $2,355 $2,500 <br /> 8150• Honorarium $600 $300 $500 <br /> 8160• Materials/Supplies(not office) $3,582 $2,875 $4,000 <br /> 8310•Advertising $7,035 $6,175 $7,000 <br /> 8333 • Insurance $340 $840 $1,000 <br /> 8420• Dues and Subscriptions $186 $180 $200 <br /> 8430• Licenses and Permits $787 $790 $900 <br /> 8525 •Volunteer Recognition $193 $260 $300 <br /> 8600• Gifts for volunteers/performers $81 $75 $200 <br /> 8720• Equipment Rental $680 $1,700 $900 <br /> 8730• Repairs& Main.-Equipt. $227 $200 $500 <br /> 8760•Assests Under$500 $0 $0 $0 <br /> Total 8xxx• Other Operating Expenses $16,095 $16,750 $19,100 <br /> 93xx• Other <br /> Expenses <br /> 9323 • Bank Charges $759 $680 $700 <br /> 9333 • PayPal transaction fee $498 $470 $500 <br /> Total 93xx• Other Expenses $1,257 $1,150 $1,200 <br /> 99xx• Other $0 $0 $0 <br /> Total Expense $77,444 $118,265 $117,416 <br /> Net Ordinary Income $21,145 -$21,675 -$10,916 <br /> Other Income/Expense <br /> Other <br /> Expense <br /> 9982 • Interfund <br /> Expense $0 $0 $0 <br /> 9999 • Suspense $0 $0 $0 <br /> Total Other Expense $0 $0 $0 <br /> Net Other Income (carry over from savings) $0 $21,675 $10,916 <br /> $21,145 $0 $0 <br /> Main Application 1/22/2016 8:56:04 AM Page 2 • f 2 <br />