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DocuSign Envelope ID: 535BB656- 53CF- 457A- 98B2- D73B9641501D XHIBIT A <br />PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Agency Budget <br />Operating Budget for Entire Agency <br />AGENCY NAME: Senior Care of Orange County; Inc. <br />AGENCY REVENUE <br />Private Donations <br />Agency Generated Revenue (fees) <br />Local Government Grants: <br />Human Services - Town of Carrboro <br />Other - Town of Carrboro <br />Human Services - Town of Chapel Hill <br />Other - Town of Chapel Hill <br />Human Services - Orange County <br />Other - Orange County <br />Other - Town of Hillsborough <br />Other Government Grants <br />Triangle United Way <br />State Government <br />Federal Government (CDBG /HOME /etc.) <br />Private Foundation Grants <br />Other Revenue <br />Total Agency Revenue <br />AGENCY EXPENSES <br />Compensation <br />Rent & Utilities <br />Supplies & Equipment <br />Travel & Training <br />Other Expenses: Insurances <br />SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (27,027) $ (14,960)1 $ 5,540 137% <br />FY 2015 -16 Comparative Agency Budget <br />Revised 9/29/2014 <br />Actual <br />2015 -16 <br />Estimated <br />2016 -17 <br />Projected <br />2017 -18 <br />Percent <br />Change <br />$ <br />740 <br />$ <br />500 <br />$ <br />500 <br />0% <br />$ <br />257,433 <br />$ <br />265,000 <br />$ <br />275,000 <br />4% <br />$ <br />1,000 <br />$ <br />1,250 <br />$ <br />1,500 <br />20% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />1,500 <br />$ <br />2,000 <br />$ <br />2,500 <br />25% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />25,000 <br />$ <br />28,750 <br />$ <br />37,500 <br />30% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />61,843 <br />$ <br />62,000 <br />$ <br />62,000 <br />$ - <br />$ <br />- <br />$ <br />- <br />$ <br />20,000 <br />0 <br />$ <br />t <br />3 <br />$ <br />- <br />0 <br />$ <br />$ <br />347,519 <br />326,925 <br />$ <br />$ <br />359,500'> <br />327,000 <br />$ <br />$ <br />399,000 <br />345,000 <br />11% <br />6% <br />$ <br />780 <br />$ <br />1,560 <br />$ <br />1,560 <br />0% <br />$ <br />24,797 <br />$ <br />26,500 <br />$ <br />27,000 <br />2% <br />$ <br />1,781 <br />$ <br />1,900 <br />$ <br />1,900 <br />0% <br />$ <br />20,263 <br />$ <br />17,500 <br />1 $ <br />18,000 <br />3% <br />MOM <br />374,546 <br />1 $ <br />374,460 <br />$ <br />393,460 <br />5% <br />SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (27,027) $ (14,960)1 $ 5,540 137% <br />FY 2015 -16 Comparative Agency Budget <br />Revised 9/29/2014 <br />