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DocuSign Envelope ID:64D61581-25C0-4408-84C2-991109E2DF4C XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Section III. Program Information <br /> Program Budget Worksheet <br /> AGENCY NAME: Inter-Faith Council for Social Service - Residential Services <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ 52,331 $ 12,574 $ 12,574 0% <br /> Program Generated Revenue(fees) $ 659 $ 523 $ 523 0% <br /> Local Government Grants: <br /> Orange County $ 880 $ 1,000 $ 1,000 0% <br /> Town of Chapel Hill $ 380 $ 500 $ 500 0% <br /> Town of Carrboro $ 200 $ 239 $ 239 0% <br /> Other Local: --- 0 <br /> Other Local: --- 0 <br /> Other Local: --- 0 <br /> If more than 3 sources,please <br /> provide a separate list. <br /> Non-Local Government Grants <br /> Triangle United Way $ 1,704 $ 1,865 $ 1,865 0% <br /> State Government $ - $ - $ - 0 <br /> Federal Government $ - $ - $ - 0 <br /> Other Grants Foundations $ 3,912 $ 4,179 $ 4,179 0% <br /> Other Grants Access To Recovery $ - $ - $ - 0 <br /> Miscellaneous/Other Revenue $ 3,083 $ 7,157 $ 7,157 0% <br /> Please list 3 largest Miscellanous sources: <br /> Endowment Inc <br /> Events <br /> CDBG <br /> Total Program Revenue $ 63 149 $ 28 037 $ 28 037 0% <br /> PROGRAM EXPENSES <br /> Compensation $ 18,466 $ 20,133 $ 20,737 3% <br /> Rent&Utilities $ 757 $ 883 $ 909 3% <br /> Supplies& Equipment $ 723 $ 396 $ 396 0% <br /> Travel &Training $ 12 $ 8 $ 8 0% <br /> Other Expenses: $ 33,356 $ 7,328 $ 5,987 -18% <br /> Please list 3 largest"Other Expenses": <br /> Crisis Intervention Program <br /> Professional Fees <br /> Food <br /> Total Program Expenses $ 53 314 $ 28 748 $ 28 037 -2% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ 9,835 I $ (711)1 $ (0)1 100% <br /> FY 2015-16 Program Budget <br /> Revised 9/29/2014 <br />