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DocuSign Envelope ID: D068E7B0- D869- 43F4- B35C- 428F10E3BDC1
<br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
<br />Agency Budget
<br />Operating Budget for Entire Agency
<br />AGENCY NAME:
<br />AGENCY REVENUE
<br />Private Donations
<br />DISPUTE SETTLEMENT CENTER
<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:
<br />Total Agency Expenses
<br />SURPLUS /(DEFICIT) FOR PERIOD:
<br />FY 2018 -19 Agency Budget
<br />$ (11,052) $ - 1 $ - 1 0
<br />Actual
<br />2016 -17
<br />Estimated
<br />2017 -18
<br />Projected
<br />2018 -19
<br />Percent
<br />Change
<br />$
<br />51,803
<br />$
<br />26,000
<br />$
<br />65,000
<br />150%
<br />$
<br />195,772
<br />$
<br />254,000
<br />$
<br />270,000
<br />6%
<br />$
<br />9,000
<br />$
<br />10,000
<br />$
<br />14,000
<br />40%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />12,000
<br />$
<br />14,000
<br />$
<br />18,000
<br />29%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />80,000
<br />$
<br />81,500
<br />$
<br />85,000
<br />4%
<br />$
<br />8,118
<br />$
<br />8,315
<br />j $
<br />9,146
<br />10%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />0
<br />$
<br />27,061.00
<br />$
<br />27,718.00
<br />$
<br />30,489.00
<br />$ 0.10
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />64,048.00
<br />$
<br />45,000.00
<br />$
<br />70,000.00
<br />$ 0.56
<br />$
<br />2,042
<br />$
<br />500
<br />$
<br />400
<br />$ (0.20)
<br />$
<br />$
<br />449,844
<br />418,007
<br />$
<br />$
<br />467,033
<br />413,793
<br />$
<br />$
<br />562,035
<br />502,702
<br />20%
<br />21%
<br />$
<br />7,285
<br />$
<br />8,000
<br />$
<br />9,000
<br />13%
<br />$
<br />5,107
<br />$
<br />5,500
<br />$
<br />14,500
<br />164%
<br />$
<br />8,895
<br />$
<br />9,800
<br />$
<br />12,000
<br />22%
<br />$
<br />21,602
<br />$
<br />29,940
<br />1 $
<br />23,833
<br />1 -20%
<br />$
<br />460,896
<br />$
<br />467,033
<br />1 $
<br />562,035
<br />1 20%
<br />$ (11,052) $ - 1 $ - 1 0
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