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DocuSign Envelope ID: COBB49A6 -D1 E9- 42DE- 8E8D- 7583E683E1E2 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />0 Compensation <br />0 Rent & Utilities <br />0 Supplies & Equipment <br />0 Travel & Training <br />0 Other Expenses <br />iii_ Does your agency budget show a Surplus or Deficit? Surplus <br />Is there a significant change? Yes/No rtes <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />We show a small surplus for estimated FY 2017 -2018 and projected FY 2018- <br />2019. Regarding FY 2616- 2017's larger surplus, our Communications Coordinator <br />chose to contribute time as a volunteer, so in 2017 we had funding for a position <br />that no longer required compensation. We determined that a newly created <br />position of Certification Coordinator would best serve our program and make most <br />effective use of County funds. We hired our Certification Coordinator (Rachel <br />Mehalek) in late October of 2017. We'll see the surplus decrease as Rachel's <br />hours accrue. <br />iv. What is your agency's fiscal year? January 1, 2018 through December 31, 2018.* <br />(Example: July 1, 2016 through June 30, 2017) <br />*Please note that certification and financial data presented in this application corresponds <br />to the County's fiscal year (July 1 through June 30). <br />Agency Information 1/21/2018 12:07.58 PM Page 7 of 17 <br />