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DocuSign Envelope ID: 134C4810- 3CA5- 4008- 9E74- 2A07D3AECED8 <br />EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Program Budget <br />Operating Budget for Program <br />PROGRAM NAME Club Nova Community, Inc. - O.C. Funding for Transportation <br />PROGRAM REVENUE <br />Private Donations <br />Program Generated Revenue <br />Local Governmont 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 />$ 29,053 <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />Other Revenue <br />Total Program Revenue <br />5 201.6 -17 2017 =98 Change <br />$ - $ - 0 <br />$ - $ - 0 <br />$ - $ - 0 <br />$ - $ - 0 <br />$ - $ - 0 <br />$ - $ - 0 <br />50,000 $ 50,000 $ 65,000 30% <br />$ - $ - 0 <br />$ - $ - 0 <br />$ 50,000 1 $ 50,000.1 $ 65,000 I 30 <br />PROGRAM EXPENSES <br />Compensation: Drivers, living wage increase, <br />transportation coordinator <br />Rent & Utilities <br />Supplies & Equipment: <br />Vehicle expenses /maintanance <br />Travel & Training <br />Other Expenses: <br />Total Program Expenses <br />$ 29,053 <br />$ 42,000 <br />$ 58,038 <br />38% <br />$ - <br />$ - <br />$ - <br />0 <br />$ 30,163 <br />$ 32,000 <br />$ 35,000 <br />9% <br />$ - <br />$ - <br />$ - <br />0 <br />$ - <br />$ - <br />$ - <br />0 <br />$ 59,216 <br />$ 74,000 <br />$ 93,038 <br />26% <br />SURPLUSI(DEFICIT) FOR PERIOD: 1 $ (9,216) $ (24,000) $ (28,038) -17% <br />We hired another staff for transortation coordinator and want to be Orance County Living Wage Certified which entales an increase for drivers <br />