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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 Wheelchair Basketball Program Budget
<br /> !Program tiulidgell
<br /> Operating Budget for IProgram
<br /> PROGRAM N ''E 'Wheelchair IBasketbaill
<br /> Actual Estiir :-..:14 proio., Percent
<br /> PROGRAM REVENUE 2$9,15-16 213116-11 213111,40 Change
<br /> Pt-hate!Donations $ 5.00, $ - $ ., Et
<br /> !Program Generated!Revenue $ - $ - $ _. U
<br /> !Local Government Grants,:
<br /> Human Services-Tom of Carnbom $ 1,750 $ 2,066 $ 2,25C 13%
<br /> Jr-Town of Carrboro $ _, $ _, $ - U
<br /> Human Services-Town of Chape4IHRI $ 2,500, $ 2,875 $ 3,125 lg%
<br /> Other-Town of Chapel Hal $ - $ 1,125 $ .,
<br /> Human Services•-Orange County $ 2,5ft $ Z625 $ 2,750:
<br /> Other ,Orange Courty $ - $ - $ ., El
<br /> Other-Town of Hillsborough $ - $ - $ - U
<br /> ,Other Government Grants
<br /> Triangle United Way $ - $ - $ ., D
<br /> State,Government $ - $ - $ ., 13
<br /> Federal Government(ODISGAHOMEretc„,) $ _, $ -, $ - 0
<br /> Private,!Foundation Grants $ - $ 2,500.00 $ - 5 u1.DU)
<br /> Other Revenue $ - $ - $ ., 0
<br /> TRAM Provarn Revenue $ 7,250 $ 11025 $ 8,425 -27%
<br /> PROGRAM EXPENSES,
<br /> Compensation 5 12410: 5 13,053 5 13,750 5%
<br /> Rent&Utilities 5 3,W0 5 3,150 5 3,3ca 5%
<br /> Supplies&Equipment 3 2,875 5 2,5136 5 2,625
<br /> Trawl&Training! 5 1,241, 5 1,260 5 1,323 5%:
<br /> 0th er Expenses: 5 - 5 - $ ., U
<br /> Titait IRrogram Expenses $ 18,985 $ 19„,973 $ 2114106 5%
<br /> SURPLUSIIDEFICITI FOR PERIOD: $ (11,735)1 i (8034811 $ (1,2,(3811)1 -46%1
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