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DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B
<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 />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 />Orange County- Career Explorers
<br />Durham Community Land Trust
<br />Federal Government (CDBGIHOMEIetc.)
<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 />EmPOWERment, Inc.
<br />$ 4,479 1 $ (11,830) $ (1,346) 890/,
<br />Actual
<br />2016 -17
<br />Estimated
<br />2017 -18
<br />Projected
<br />2018 -19
<br />Percent
<br />Change
<br />$
<br />64,307
<br />$
<br />65,594
<br />$
<br />66,906
<br />2%
<br />$
<br />38,317
<br />$
<br />39,084
<br />$
<br />39,866
<br />2%
<br />$
<br />10,000
<br />$
<br />15,000
<br />$
<br />20,000
<br />33 %
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />40,500
<br />$
<br />40,500
<br />$
<br />47,000
<br />16%
<br />$
<br />11,825
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />25,000
<br />$
<br />25,000
<br />$
<br />30,000
<br />20%
<br />$
<br />73,810
<br />$
<br />76,025
<br />$
<br />78,305
<br />3%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />12,500.00
<br />$
<br />12,875.00
<br />$
<br />13,261.00
<br />3%
<br />$
<br />4,000.00
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />448,054
<br />$
<br />461,496
<br />$
<br />475,341
<br />3%
<br />$
<br />$
<br />728,313
<br />315,612
<br />$
<br />$
<br />735,574
<br />318,769
<br />$
<br />$
<br />770,679
<br />321,957
<br />5%
<br />1%
<br />$
<br />148,824
<br />$
<br />156,266
<br />$
<br />164,080
<br />5%
<br />$
<br />35,617
<br />$
<br />37,398
<br />$
<br />39,268
<br />5%
<br />$
<br />7,685
<br />$
<br />8,070
<br />$
<br />8,474
<br />5%
<br />$
<br />216,096
<br />$
<br />226,901 1
<br />$
<br />238,246 1
<br />5%
<br />$
<br />723,834 1
<br />$
<br />747,404
<br />$
<br />772,025
<br />3%
<br />$ 4,479 1 $ (11,830) $ (1,346) 890/,
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