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DocuSign Envelope ID: E546BA93-2CAA-4121-B91A-3F2107563B4D <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME My Brother's Keeper(MBK) Orange County <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-2017 2017-2018 Change <br /> Private Donations $ - $ - $ - 0 <br /> Program Generated Revenue $ - $ - $ - 0 <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ - $ - $ - 0 <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ - $ - $ - 0 <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ - $ 4,000 $ 134,750 3269% <br /> Other-Orange County $ - $ - $ - 0 <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 <br /> Private Foundation Grants $ - $ - $ - 0 <br /> Other Revenue $ - $ - $ - 0 <br /> Total Program Revenue $ - $ 4,000 $ 134,750 3269% <br /> PROGRAM EXPENSES <br /> Compensation $ - $ - $ 52,000 0 <br /> Rent& Utilities $ - $ - $ - 0 <br /> Supplies & Equipment $ - $ - $ 4,000 0 <br /> Travel &Training $ - $ - $ 37,500 0 <br /> Other Expenses: $ - $ 4,000 $ 41,250 931% <br /> Total Program Expenses $ - $ 4,000 $ 134,750 3269% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ - I $ - I $ - I 0 <br />