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DocuSign Envelope ID:72266CE5-DF5A-471E-B671-CC65C8960691
<br /> EXHIBIT A
<br /> PROVIDER'S OUTSIDE AGENCY APPLICATION
<br /> Agency Budget
<br /> Operating Budget for Entire Agency
<br /> AGENCY NAME: EmPOWERment, Inc.
<br /> Actual Estimated Projected Percent
<br /> AGENCY REVENUE 2015.46 2016-17 2017-18 chan.e
<br /> Private Donations $ 12,584 $ 9,884 $ 10,181 3%
<br /> Agency Generated Revenue(fees) $ 19,543 $ 19,351 $ 19,932 3%
<br /> Local Government Grants:
<br /> Human Services-Town of Carrboro $ 9,500 $ 10,000 $ 10,300 3%
<br /> Other-Town of Carrboro $ - $ - $ _ 0
<br /> Human Services-Town of Chapel Hill $ 40,500 $ 47,000 $ 48,410 3%
<br /> _ $ _
<br /> Other-Town of Chapel Hill $ 16,225 $ 0
<br /> Human Services-Orange County $ 20,000 $ 25,000 $ 25,750 3%
<br /> Other-Orange County $ 49,076 $ 50,231 $ _
<br /> 51,738 °/
<br /> 38 300
<br /> Other-Town of Hillsborough $ - $ -
<br /> Other Government Grants
<br /> Triangle United Way $ - $ - $ - 0
<br /> State Government $ 12,509.00 $ - $ - 0
<br /> Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0
<br /> Private Foundation Grants $ 5,000.00 $ 31,000.00 $ 31,930.00 3%
<br /> Other Revenue 392,131 $ 418,434 $ 430,987 3%
<br /> Total Agency Revenue $ 577,068 $ 610,900 $ 629,227 3%
<br /> 1
<br /> AGENCY EXPENSES
<br /> Compensation $ 216,290 $ 211,654 $ 218,004 3%
<br /> Rent& Utilities $ 160,387 $ 197,406 $ 203,328 3%
<br /> Supplies & Equipment $ 38,106 $ 28,509 $ 29,364
<br /> , 3%
<br /> Travel &Training $ 3,613 $ 3,635 $ 3,744 3%
<br /> Other Expenses: $ 153,489 $ 163,062 $ 167,954 3%
<br /> Total Agency Expenses $ 571,885 $ 804,266 $ 622,394 3%
<br /> SURPLUS/(DEFICIT) FOR PERIOD: 1 $ 5,183 I $ 6,634 I $ 6,8331 3%1
<br /> FY 2015-16 Comparative Agency Budget
<br /> Revised 9/29/2014
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