Orange County NC Website
Browse       Search
DocuSign Envelope ID: C2E9E60D-5370-4D81-B634-C12E6C6B9DB9 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> o Local Government Grants <br /> ▪ Carrboro Human Services <br /> • Carrboro Other <br /> • Chapel Hill Human Services <br /> • Chapel Hill Other (DO NOT include CDBG funding here) <br /> • Orange County Human Services <br /> • Orange County Other (DO NOT Include HOME funding here) <br /> o Other Government Grants <br /> • Triangle United Way <br /> • State Government <br /> • Federal Government (CDBG/HOME/etc.) <br /> • Private Foundation Grants <br /> o Other Revenue <br /> • Expenditures <br /> o Compensation <br /> o Rent & Utilities <br /> o Supplies & Equipment <br /> o Travel &Training <br /> o Other Expenses <br /> iii. Does your agency budget show a Surplus or Deficit? Neither <br /> Is there a significant change? Yes/No No <br /> Please provide a brief explanation for Surplus or.Deficit, and significant changes. <br /> iv. What is your agency's fiscal year? July 1, 2017 — June 31, 2018 for grant <br /> service purposes, although it is Jan 1 to Dec 31 for tax reporting pruposes. <br /> (Example: July 1, 2016 through June 30, 2017) <br /> Agency Information 1/31/2017 11:45:20 AM Page 8 of 20 <br />