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DocuSign Envelope ID:72266CE5-DF5A-471E-B671-CC65C8960691 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME: EmPOWERment,Inc.-Rentals <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ - $ - $ - 0 <br /> Program Generated Revenue $ 305,469 $ 320,213 $ 329,820 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 $ 13,500 $ 20,000 $ 20,600 3% <br /> Other-Town of Chapel $ $ - $ - 0 <br /> Human Services-Orange County $ 20,000 $ 25,000 $ 25,750 3% <br /> Other-Orange County $ - $ - $ - 0 <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way 0 <br /> : <br /> State Government 0 <br /> Federal Government(CDBG/HOME/etc.) $ - $ 0 <br /> Private Foundation Grants $ - $ - 0 <br /> Other Revenue E11111111111111111 $ - $ 0 <br /> Total Program Revenue $ 386,470 1111111111 <br /> PROGRAM EXPENSES <br /> Compensation $ 61,294 $ 62,282 $ 64,150 3% <br /> Rent&Utilities $ 19,472 $ 28,068 $ 28,910 3% <br /> Supplies&Equipment $ 41,523 $ 43,738 $ 45,050 3% <br /> Travel&Training $ - $ - $ - 0 <br /> Other Expenses: $ 70,486 $ 62266 $ 64,134 3% <br /> Total Program Expenses MEI $ 196,364 $ 202,245 111111I! <br /> SURPLUS/(DEFICIT)FOR PERIOD: $ 156,694 I$ 178,859 I$ 184,225 I 3% <br />