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DocuSign Envelope ID:A6B9A80E-25C6-439A-A77D-6C8B04CDDFE2 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Agency Budget <br /> Operating Budget for Entire Agency <br /> AGENCY NAME: <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ 56,562 $ 57,625 $ 58,777 2% <br /> Agency Generated Revenue (fees) $ 444,812 $ 502,804 $ 532,190 6% <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ 2,200 $ 2,500 $ 3,500 40% <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ - $ - $ - 0 <br /> Other-Town of Chapel Hill $ 1,000 $ 1,000 $ 1,000 0% <br /> Human Services- Orange County $ 2,000 $ 3,500 $ 10,000 186% <br /> Other- Orange County $ - $ - $ - 0 <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Durham County $ 8,190 $ 8,190 $ - -100% <br /> Other Government Grants <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government (CDBG/HOME/etc.) $ - $ - $ - 0 <br /> Private Foundation Grants $ 10,000.00 $ 10,000.00 $ 10,000.00 $ - <br /> Other Revenue $ 41,276 $ 43,000 $ 40,000 $ 0.07 <br /> Total Agency Revenue $ 566,040 $ 628,619 $ 655,467 4% <br /> AGENCY EXPENSES <br /> Compensation $ 397,031 $ 458,453 $ 477,003 4% <br /> Rent& Utilities $ 47,251 $ 52,655 $ 57,498 9% <br /> Supplies & Equipment $ 55,233 $ 76,115 $ 77,674 2% <br /> Travel & Training $ 926 $ 1,500 $ 2,000 33% <br /> Other Expenses: $ 28,383 $ 39,896 $ 41,292 3% <br /> Total Agency Expenses $ 528,824 $ 628,619 $ 655,467 4% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ 37,216 I $ - I $ - I 0 <br /> FY 2015-16 Comparative Agency Budget <br /> Revised 9/29/2014 <br />