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DocuSign Envelope ID:39EEFC69-D47C-4CE3-8A5C-0A87B55C2CD0 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Does this agency pay permanent employees a minimum living wage? (Yes /No) <br /> No <br /> If yes, is this agency an Orange County Living Wage Certified Employer? <br /> If no, please explain. <br /> Paying our employees a "living wage" is a goal for the KidSCope program that we are <br /> very close to achieving. KidSCope is, however, a program of Chapel Hill Training <br /> Outreach Project, Inc., a non-profit with many employees. Although the goal of paying <br /> a minimum living wage is an admirable one, KidSCope is not involved in salary <br /> decisions for the entire organization. <br /> h) Agency Budget <br /> Is your agency currently receiving and/or requesting other (non-Human <br /> Services) local (Town of Carrboro, Town of Chapel Hill, Orange County) <br /> government funding? (Yes/No) No <br /> If yes, please list below: <br /> Include all programs that have funding requests/awards/totals from Carrboro, Chapel <br /> Hill, and Orange County governments (other than Human Services). DO NOT include <br /> federal funding sources, such as CDBG and HOME. <br /> Program FY16- FY17-18 Source <br /> 17 Request <br /> Award <br /> Ex: Affordable Rental 0 $20,000 Carrboro - Affordable Housing <br /> Rehabilitation <br /> Ex: Agency Administration $15,000 $15,000 Carrboro — Other <br /> Ex. Total $15,000 $35,000 Carrboro Total Funding <br /> *Add rows or attach additional page, if needed. <br /> Agency : : �� ,� II 1 <br /> enc Information 2/9/2017 5 � 7 P �:� 1 <br />