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DocuSign Envelope ID: 6818677A -D518- 4750- B391- F6169FB2A4C4 <br />Exhibit A: Provider's Outside Agency Application <br />Program Budget <br />Operating Budget for Program <br />PROGRAM NAME Caregiwing Collaborative <br />Actual Estimated Projected Percent <br />PROGRAM REVENUE 2016 -17 2017 -18 2018 -19 Chan e <br />Private Donations $ 102,100 $ 102,500 $ 102,500 0% <br />$ _ .S - $ - 0 <br />Program Generated Revenue <br />$ <br />85,000 <br />Local Government Grants: <br />85,000 <br />0% <br />Human Services - Town of Carrboro <br />S <br />4,000 <br />Other - Town of Carrboro <br />$ <br />- <br />Human Services - Town of Chapel Hill <br />S <br />4,000 <br />Other - Town of Chapel Hill <br />$ <br />- <br />Human Services - Orange County <br />$ <br />4,000 <br />Other - Orange County <br />$ <br />- <br />Other - Town of Hillsborough <br />$ <br />- <br />Other Government Grants <br />60,080 <br />5% <br />Triangle United Way <br />$ <br />80.00 <br />State Government <br />$ <br />- <br />Federal Government (CDBGIHOMEletc.) <br />$ <br />- <br />Private Foundation Grants <br />$ <br />11 500.00 <br />Other Revenue <br />$ <br />15.0{10 <br />Total Program Revenue <br />PROGRAM EXPENSES <br />Compensation <br />Rent & Utilities <br />Supplies & Equipment <br />Travel & Training <br />Other Expenses: <br />Total Program Expenses <br />SURPLUS/(DEFICIT) FOR PERIOD: <br />FY 2018 -19 Program Budget <br />gut <br />80.00 <br />15,000.00 <br />25 <br />. Irr <br />li <br />►r� rr <br />Fri <br />0 <br />20% <br />0 <br />50% <br />0 <br />$ 140,680 1 $ 158,084 1 $ 161,080 , 2 %. <br />$ 75,500 <br />$ <br />85,000 <br />$ <br />85,000 <br />0% <br />$ 10,000 <br />$ <br />10,000 <br />$ <br />10,000 <br />0% <br />$ 4Y50 <br />$ <br />5,500 <br />$ <br />5,500 <br />0% <br />$ 500 <br />$ <br />500 <br />$ <br />500 <br />0% <br />$ 49,930 <br />$ - <br />57,080 <br />$ <br />60,080 <br />5% <br />$ 140,680 1 $ 158,0801 $ 161,080 j 2% <br />