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DocuSign Envelope ID:78F84828-4CC5-4A5B-B256-33C571A84687 t A- continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> Agency/Progran Charles House:Daytime Eldercare 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) $ 381,700 $ 377,000 $ 535,000 42% <br /> Local Government Grants: <br /> Orange County $ 15,000 $ 15,000 $ 20,000 33% <br /> Town of Chapel Flill $ 9,000 $ 9,000 $ 11,000 22% <br /> Town of Carrboro $ 4,000 $ 3,500 $ 4,000 14% <br /> Other Local: 0 <br /> Other Local: 0 <br /> Other Local: 0 <br /> t 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 Triangle Comm Fndtn $ 15,000 $ 14,000 $ 15,000 7% <br /> Other Grants SECC $ 4,800 $ 5,000 $ 5,000 0% <br /> Miscellaneous/Other Revenue <br /> $$ <br /> $ - <br /> Total Agency Revenue $ 429 500 $ 423.500 $ 590 000 39% <br /> AGENCY EXPENSES <br /> Compensation/Personnel $ 325,000 $ 350,000 $ 410,000 17% <br /> Rent Utilities, Insurance, Property Expenses $ 28,250 $ 55,000 $ 89,000 62% <br /> Supplies,Equipment Program, Food Srv. $ 30,500 $ 33,000 $ 35,000 6% <br /> Administrative Expenses $ 11,900 $ 5,100 $ 7,500 47% <br /> Other Expenses: $ 14,775 $ 14,100 $ 23,000 63% <br /> Rease list 3 largest"Other Expenses": <br /> Depreciation/Amortization <br /> $ - <br /> $ - <br /> Total Agency Expenses $ 410 425 $ 457 200 $ 564 500 23% <br /> SURPLUS/(DEFICIT)FOR PERIOD: 1 $ 19,0761 $ (33,700)1 $ 25,500 1 176% <br /> Main Application 1/25/2016 11:54:37 AM Page 18 of 21 <br />