Orange County NC Website
Browse       Search
DocuSign Envelope ID: ED6C5D54-7108-4169-9541-C2FDA3EC8CA6 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> Agency/Program: <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations 0 <br /> Agency Generated Revenue(fees) 0 <br /> Local Government Grants: <br /> Orange County $ 4,000 $ 4,000 $ 10,000 150% <br /> Town of Chapel Hill $ 3,500 $ 3,500 $ 10,000 186% <br /> Town of Carrboro $ 2,500 $ 2,500 $ 10,000 300% <br /> Other Local: Hillsborough(discontinued) $ 400 $ - $ - 0 <br /> Other Local: ADA Project $ 650 $ 650 $ 650 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 0 <br /> Please list 3 largest Miscellanous sources: <br /> Total Agency Revenue $ 11,050 $ 10,650 $ 30,650 188% <br /> AGENCY EXPENSES <br /> Compensation $ 3,000 $ 3,000 $ 24,000 700% <br /> Rent&Utilities $ 2,000 $ 2,000 $ 2,000 0% <br /> Supplies&Equipment $ 3,000 $ 3,000 $ 2,000 -33% <br /> Travel&Training $ 1,500 $ 1,500 $ 1,000 -33% <br /> Other Expenses: $ 1,500 $ 1,500 $ 1,000 -33% <br /> Please list 3 largest"Other Expenses": <br /> Total Agency Expenses $ 11,000 $ 11,000 $ 30,000 173% <br /> (SURPLUS/(DEFICIT)FOR PERIOD: I $ 50 I $ (350) $ 650] 286J <br /> L <br /> Main Application 5/25/2016 9:25:11 AM Pa g I 7 of 2 <br />