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DocuSign Envelope ID: DB2FC63F- 0403 - 4403- BF86- OF5CB206F3F3 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Program Budget <br />Operating Budget for Program <br />PROGRAM NAME Orange County Rural Alliance �OCRA) Meals on Wheels Program <br />PROGRAM REVENUE <br />Private Donations <br />Program Generated Revenue <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 (CDBG1HOMEletc.) <br />Private Foundation Grants <br />Other Revenue <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 />20/7 -3 r-?1, 20/q <br />Actual <br />2016 -2017 <br />Estimated <br />2017 -2018 <br />Project d <br />2018 -2019 <br />Percent <br />Change <br />$ <br />35,924 <br />$ <br />36,000 <br />$ <br />36,000 <br />0% <br />$ <br />- <br />$ <br />- <br />10 <br />5 <br />- <br />$ <br />- <br />$ <br />0 <br />$ <br />- <br />$i <br />- <br />0 <br />s <br />$ <br />- <br />$ <br />0 <br />S <br />$ <br />- <br />$ <br />0 <br />5 <br />- <br />$ <br />12,500 <br />$ <br />40.000 <br />220% <br />S <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />$ <br />25,000.00 <br />0 <br />Is <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />$ <br />35,924 <br />- <br />$ <br />$ <br />48,500 <br />10,400 <br />$ <br />$ <br />101,000 <br />20.8[70 <br />108 %v <br />100 ° /0 <br />$ <br />600 <br />$ <br />3,000 <br />$ <br />3,000 <br />0% <br />$ <br />3,062 <br />$ <br />3,000 <br />$ <br />3,000 <br />0% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />15,958 <br />$ <br />17,967 <br />$ <br />68,543 <br />281% <br />$ <br />19,620 <br />$ <br />34,367 <br />$ <br />95,343 <br />177 °la <br />$ 16,304 1 $ 14,133 1 $ 5,657 -60/9, <br />IVO7e. -$ cot 4,r_t 6Q$ed an pGi 'A A i j c a I Vier. Jdn r - &e4 31 <br />Program Budget <br />