Orange County NC Website
Browse       Search
DocuSign Envelope ID: C2E9E60D-5370-4D81-B634-C12E6C6B9DB9 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> h) Agency Budget <br /> i. Is your agency currently receiving and/or requesting other(non-Human Services) <br /> local (Town of Carrboro, Town of Chapel Hill, Orange County) government <br /> funding? (Yes/No) Yes <br /> If yes, please list below: <br /> Include all programs that have funding requests/awards/totals from Carrboro, Chapel Hill, <br /> and Orange County governments (other than Human Services). DO NOT include federal <br /> funding sources, such as CDBG and HOME. <br /> Program . FY16-17 FY17-18 Source <br /> Award Request <br /> E ;Affordable Rental l $20,0{0' Carrboro Affordable Housing <br /> l ehabilitation <br /> Agency Administration $15,000 $15,000 Carrboro 'Other' <br /> l� Total $ 5,000 $35,000 Carrboro Total Finding <br /> Local match for Orange $3600 $3600 Orange County (We do not have <br /> County JCPC funding (We do to request these funds. If we are <br /> not have to request these funded by JCPC, Orange County <br /> funds. If we are funded by automatically provides the <br /> JCPC, Orange County match.) <br /> automatically provides the <br /> match.) <br /> *Add rows or attach additional page, if needed. <br /> ii. Submit your agency's budget. You may complete the provided template (separate <br /> xis file) or you may submit your own budget file (as long as it contains the same <br /> information, and in a similar format, as requested in the provided template). <br /> Agency Budgets are required to define budget amounts for the previous program <br /> year, current program year, and next program year for the following categories: <br /> • Revenues <br /> o Private Donations <br /> o Program Generated Revenue <br /> Agency Information 1/31/2017 11:45:20 AM Page 7 of 2 0 <br />