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DocuSign Envelope ID:88377437-EE99-4E08-B6B1-CD4F113C0672 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Bride II Sports Agency & Program Budgets <br /> BITS Boccia Program Budget <br /> Program Itudget <br /> Operating Itudget!for!Program <br /> IPROGRAM NAME: =!crocia <br /> Pietua 11 Estimated 17,1„,.jeldeed percerti <br /> PROGRAM REVENUE !"..ii(1846, 25111,&17 201748 Change <br /> Rival*Donations $ 500 $ - $ .. 0 <br /> Program Generated!Revenue <br /> Local Government Grants: <br /> Human Services-Town of Can-1mm $ 1,750 $ 2,000 $ 2.250 13% <br /> Other-Town of Candor° $ - $ - $ 0 <br /> Human Semices-Town Of Chapel HI $ 2,500 $ 2$75 $ 312,5 <br /> Other-Town of Chapel HE $ - $ 1„125 $ -1015% <br /> Human Sernees-Orange County $ 2,500 $ 2„505 $ 2750 511: <br /> Other-Orange CUE* $ - $ - $ 0 <br /> Other-Town of IHillaborough $ - $ - $ 1 0 <br /> Other Government Grants <br /> Triangle United Way 5 0 <br /> State Government 5 -. $ - 0 <br /> Federal Government fC11(341HOOMEeitc.) 5 - $ - $ .. 0 <br /> Private Foundation Grants 5 - $ 2,500.00 $ (1..00) <br /> Other 1,..-_ ,Ariue, 5 0 <br /> Total' Program Revenue $ 7„250 $ 11,125, $ B,125 -27% <br /> PROGRAM EXPENSES <br /> Compensation 5 12,000 5 12,500) $ 13,230 5% <br /> Rent&Utilities 5 200 • 210 I 221 5% <br /> Supplies&Equipment 5 2,000 $ 2,100 $ 2,205 5% <br /> Travel&.Training S 1,000 $ 1,050 $ 1103 511: <br /> Other Expensesr S - 5 - $ 0 <br /> T,05:1 1] r0 giaim E "o.'7".'nee's $ 15,200 $ 15,960 $ 16,758 5% <br /> SUR PLUSADEHICIT) FOR PERIOD: $ (7„95011 $ 04,8351 $ ,(0',19,3311 -79% <br />