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DocuSign Envelope ID: D9639255-8147-4A2F-A760-941BDE078E48 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Program Budget <br /> Agency/Progran Spoken Revolutions Youth Cycling <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 2016-17 Change <br /> Private Donations $ 12,101 $ 15,000 $ 16,500 10% <br /> Agency Generated Revenue (fees) $ - $ - $ - 0 <br /> Local Government Grants: <br /> Orange County $ - $ 1,250 $ 1,000 -20% <br /> Town of Chapel Hill $ - $ 1,250 $ 1,250 0% <br /> Town of Carrboro $ - $ 1,250 $ 1,250 0% <br /> Other Local: $ - 0 <br /> Other Local: $ - 0 <br /> Other Local: $ - 0 <br /> It 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 $ 2,000 $ - $ - 0 <br /> Please list 3 largest Miscellanous sources: <br /> Bressler Foundation $ 2,000.00 <br /> Total Agency Revenue $ 14 101 $ 18 750 $ 20 000 7% <br /> AGENCY EXPENSES <br /> Compensation $ - $ - $ - 0 <br /> Rent&Utilities $ - $ 1,000 $ 1,100 10% <br /> Supplies&Equipment $ - $ 333 $ 333 0% <br /> Travel &Training $ - $ 250 $ 250 0% <br /> Other Expenses: $ 13,940 $ 15,000 8% <br /> Please list 3 largest"Other Expenses": $ 13 828 <br /> Doke'n Revolutions Summer To $ 10,265.00 <br /> Contract Services $ 1,875.00 <br /> Insurance and Other Expenses $ 1,688.00 <br /> Total Agency Expenses $ 13,828 $ 15,523 $ 16,683 7% <br /> SURPLUS/(DEFICIT)FOR PERIOD: $ 273 $ 3,227 $ 3,317 3°/ <br /> Main Application 5/25/2016 10:17:47 AM .. i 1 4 o of 2 <br />