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DocuSign Envelope ID: D13694BA-66F1-4441-9114-5334F2B6AC3D XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME <br /> Actual Estimated Projected ' Percent <br /> PROGRAM REVENUE 2015-16 2016-17 , 2017-18 Change <br /> Private Donations $ - $ - $ - 0 <br /> Program Generated Revenue $ - $ - $ - 0 <br /> Local Government Grants: EMIIIIIMIll <br /> Human Services-Town of Carrboro $ 1,000 $ 1,000 $ 1,000 0% <br /> Other-Town of Carrboro - 0 <br /> Human Services-Town of Chapel Hill $ 2,500 . $ 2,500 $ 2,500 : 0% <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County ,$ 20,000 $ 20,000 $ 20,000 0% <br /> Other-Orange County $ - $ - $ - , 0 <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government(CDBG/HOMEJetc.) $ - $ $ - 0 <br /> Private Foundation Grants $ 5,000.00 $ 12,500.00 $ 12,500.00 $ - <br /> Other Revenue $ - $ - $ - 0 <br /> IIIIIMINI <br /> Total Program Revenue $ 28,500 $ 36,000 $ 36,000 0% <br /> PROGRAM EXPENSES <br /> Compensation $ 21,573 $ 21,543 $ 22,495 4% <br /> Rent&Utilities $ 1,150 $ 1,150 $ 1,150 0% <br /> Supplies& Equipment $ - $ 2,934 $ 2,240 -24% <br /> Travel&Training $ - $ 3,049 $ 3,029 -1% <br /> Other Expenses: $ 9,210 $ 9,210 $ 10,160 10% <br /> MIIIM <br /> Total Program Expenses $ 31,933 $ 37,886 $ 39,074 3% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ (3,433)1 $ (1,886)1 $ (3,074)1 -63% <br />