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DocuSign Envelope ID: E7784BE7- 82AF- 4AF1- AA11- 944D2300E76D
<br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
<br />Agency Budget
<br />Operating Budget for Entire Agency
<br />AGENCY NAME: Chapel Hill Training- Outreach Project, Inc. (KidSCope)
<br />AGENCY REVENUE
<br />Private Donations
<br />Agency Generated Revenue (fees)
<br />Local Government Grants:
<br />Orange County
<br />Town of Chapel Hill
<br />Town of Carrboro
<br />Chatham County
<br />Other Local: Strowd Roses
<br />Other Local: Duke Corp
<br />Other Local: Misc
<br />provide a separate list.
<br />Other Government Grants
<br />Triangle United Way
<br />State Government
<br />Federal Government
<br />Other Grants: NC Pre -K
<br />Other Grants: CACFP
<br />Miscellaneous/Other Revenue
<br />Please list 3 largest Miscellaneous sources 17 -18:
<br />Total Agency Revenue
<br />AGENCY EXPENSES
<br />Compensation
<br />Rent & Utilities
<br />Supplies & Equipment
<br />Travel & Training
<br />Other Expenses:
<br />Please list 3 largest "Other Expenses" 17 -18:
<br />Indirect Cost to CHTOP, Inc $114,092.00
<br />Contracted Services $ 79,180.00
<br />Rent & Utilities $ 89,904.00
<br />Total Agency Expenses
<br />SURPLUS /(DEFICIT) FOR PERIOD: 1 ($113,994) ($45,674) ($45,674) 0%
<br />h) Agency Budget
<br />Agency Information 1/22/2018 3:23:54 PM Ij --3 g e 1 3 o f
<br />Actual
<br />2016 -17
<br />Estimated
<br />2017 -18
<br />Projected
<br />2018 -19
<br />Percent
<br />Change
<br />$
<br />8,777
<br />$
<br />11,500
<br />$
<br />11,500
<br />0%
<br />$
<br />1,019,027
<br />$
<br />785,654
<br />$
<br />785,654
<br />0%
<br />$
<br />75,000
<br />$
<br />75,000
<br />$
<br />75,000
<br />0%
<br />$
<br />4,500
<br />$
<br />4,500
<br />$
<br />4,500
<br />0%
<br />$
<br />2,200
<br />$
<br />2,200
<br />$
<br />2,200
<br />0%
<br />$
<br />1,750
<br />$
<br />5,000
<br />$
<br />5,000
<br />0%
<br />$
<br />4,081
<br />0
<br />$
<br />$
<br />479
<br />57,768
<br />$
<br />58,068
<br />$
<br />58,068
<br />0
<br />0%
<br />0
<br />$
<br />374,744
<br />$
<br />388,624
<br />$
<br />388,624
<br />0%
<br />$
<br />175,675
<br />$
<br />118,000
<br />$
<br />118,000
<br />0%
<br />$
<br />73,701
<br />$
<br />52,600
<br />$
<br />52,600
<br />0%
<br />$
<br />$
<br />329,694
<br />396
<br />M2127
<br />,,288
<br />$
<br />$
<br />$
<br />335,163
<br />1 836 309
<br />1,398,890
<br />$
<br />$
<br />$
<br />335,163
<br />1 836 309
<br />1,398,890
<br />00
<br />0%
<br />0%
<br />$
<br />103,080
<br />$
<br />110,025
<br />$
<br />110,025
<br />0%
<br />$
<br />77,083
<br />$
<br />64,325
<br />$
<br />64,325
<br />0%
<br />$
<br />28,514
<br />$
<br />32,106
<br />$
<br />32,106
<br />0%
<br />$
<br />387,426
<br />$
<br />276,637
<br />$
<br />276,637
<br />0%
<br />2,241,391
<br />1,881,983
<br />1,881,983
<br />0%
<br />SURPLUS /(DEFICIT) FOR PERIOD: 1 ($113,994) ($45,674) ($45,674) 0%
<br />h) Agency Budget
<br />Agency Information 1/22/2018 3:23:54 PM Ij --3 g e 1 3 o f
<br />
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