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DocuSign Envelope ID: 5D25D6E0-716B-4244-AEA3-02E6A45FD852
<br /> EXHIBIT A
<br /> PROVIDER'S OUTSIDE AGENCY APPLICATION
<br /> Opportunity Class Leaders 0 0 0
<br /> Summer Interns 7,062 6,000 6,000
<br /> Additional Staffing Needs 1,056 1,712 1,712
<br /> Employee Benefits 4,032 11,903 12,379
<br /> Payroll Taxes 8,944 9,251 9,793
<br /> Subtotal: Personnel 98,304 131,755 137,058
<br /> Contracted Services
<br /> NC Campus Compact Americorps VISTA 3,000 0 0
<br /> NC IDA Collaborative Americorps VISTA 7,000 6,200 6,200
<br /> Subtotal: Contracted Services 10,000 6,200 6,200
<br /> Supplies and Materials
<br /> Printing and Copying 1,358 1,125 1,237
<br /> Food and Drinks 1,471 1,702 1,578
<br /> Office Supplies 587 863 888
<br /> Program Supplies 1,554 1,529 1,575
<br /> Subtotal: Supplies and Materials 4,970 5,218 5,278
<br /> Direct Member Support (Reimbursable)
<br /> Designated Direct Member Support 19,146 2,192 0
<br /> Subtotal: Direct Member Support 19,146 2,192 0
<br /> Operating Expenses
<br /> Rent, Utilities & Internet 25,728 25,728 25,728
<br /> Online Services 1,400 1,500 1,600
<br /> Staff&Volunteer Development 900 1,007 1,121
<br /> Travel and Transportation 250 250 250
<br /> Course Fees for Advocate Training 0 1,500 1,500
<br /> Payroll Services 462 378 389
<br /> Conferences & Memberships 489 1,100 1,100
<br /> Postage 402 418 460
<br /> Other: Bank Charges, Miscellaneous 388 300 300
<br /> Insurance, licenses and permits 671 425 438
<br /> Subtotal: Operating Expenses 30,691 32,606 32,886
<br /> Professional Fees
<br /> Other Professional Fees 156 0 1,000
<br /> Subtotal: Professional Fees 156 0 1,000
<br /> TOTAL EXPENSES 163,266 177,971 182,422
<br /> NET INCOME 0 0 0
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