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DocuSign Envelope ID:71415AD7-D o�4C��9A9-F93F7208DC62 XHIBIT A
<br /> PROVIDER'S OUTSIDE AGENCY APPLICATION
<br /> Orange Congregations In Mission
<br /> Samaritan Relief Ministry
<br /> REVENUE
<br /> Account Title 2016 Actual 2017 Approved Budget 2018
<br /> Contributions $ 10,325.63 $ 25,000.00 $ 25,000.00
<br /> United Way $ 33,745.50 $ 14,500.00 $ 14,500.00
<br /> Fuel-Duke Energy Foundation $ 8,652.27 $ 9,000.00 $ 9'000.00
<br /> Water Assist.Grant Hillsborough $ 7,788.95 $ 5,600.00 $ 5,600.00
<br /> Food Contribution-Cash $ 21,643.40 $ 19^000.00 $ 19,000.00
<br /> Food Contribution-Non Cash $348,534.08 $33[l000.0U $330,000.00
<br /> Local Grants (Orange County) $ 33,416.00 $ 33,415.00 $ 58,415.00
<br /> Other Grants $ ],800.0] $ 6,500.00 $ 6,500.00
<br /> Fundraising $ 9,072.68 $ 3,000.00 $ 3,000.00
<br /> Walk for Hunger $ 5,976.50 $ 6'000.00 $ 6,000.00
<br /> FEMA $ 13,246.00 $ 15,000.00 $ 15,000.00
<br /> $495,201'00 $467,015.00 $492,OlS.00
<br /> Orange Congregations In Mission
<br /> Samaritan Releif Ministry
<br /> EXPENSES
<br /> Account Title 2016 Actual 2017 Approved Budget 2018
<br /> Salaries $ 55,131.69 $ 52,300'00 $ 52,300.00
<br /> Retirement Plan Contribution $ 1,373.67 $ 875.00 $ 875.00
<br /> Payroll Taxes $ 4,371.92 $ 4,254.88 $ 4,254.00
<br /> Group Insurance $ 7,897.66 $ 8,000.00 $ 8,000.00
<br /> Accounting Fees $ 7,452.25 $ 12,000.00 $ 13,000.00
<br /> Utilities $ 2,578.21 $ 3,000.00 $ 3,000.00
<br /> Client Utilities $ 26,758.I9 $ 35,000.00 $ 40,000.00
<br /> General Insurance $ 2,295.90 $ I,400.00 $ 2,400.00 .
<br /> Repairs& Maintenance $ 4,794.57 $ 3,000.00 $ 3'000.00
<br /> Dumpster Fee $ 499.77 $ 550.00 $ 550'00
<br /> Advertising/Public Relations $ 363.47 $ 300.00 $ 300.00
<br /> Telephone $ 1,827.69 $ 1,500.00 $ 1'500.00
<br /> Office Supplies $ 791.29 $ 1,000.00 $ 1,000.08
<br /> Bank Charges $ 136.73 $ 200.00 $ 200.00
<br /> Postage $ 578.16 $ 500.00 $ 500.00
<br /> Publications $ 127.6I $ 300.00 $ 300.00
<br /> Dues&Training $ 197.50 $ 400.00 $ 400.00
<br /> Travel $ 49.32 $ 50.00 $ 50.00
<br /> Printing $ 409.47 $ 250.00 $ 250.00
<br /> Computer/Copier $ 1'288.56 $ 2'300.00 $ 2,200.00
<br /> Depreciation $ 474.37 $ 300.00 $ 300.00
<br /> Awards& Regognition $ 137.87 $ 200.00 $ 200.00
<br /> Taxes& Licenses $ 103-06 $ 70.00 $ 70.00
<br /> Non-Cash Food Donations $348'534.08 $330,000.00 $33[\00O.OU
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