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DocuSign Envelope ID: C47D73DC -CC50- 4723 - 8253- AE01785E7FAA <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Program Budget <br />Operating Budget for Program <br />PROGRAM NAME <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 (CDBG /HOME /etc.) <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: $ 42,945 $ 52,626 1 $ 49,967 1 -5% <br />FY 2018 -19 Program Budget <br />Actual <br />2016 -17 <br />Estimated <br />2017 -18 <br />Projected <br />2018 -19 <br />Percent <br />Change <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />392,036 <br />$ <br />407,717 <br />$ <br />424,026 <br />4% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />10,000 <br />$ <br />12,500 <br />$ <br />15,000 <br />20% <br />$ <br />30,666 <br />$ <br />25,166 <br />1 $ <br />25,166 <br />1 0% <br />6$ <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />=0l- <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ 153,226.00 <br />$ 166,653.00 <br />$ 162,128.00 <br />$ (0.03) <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />$ <br />585,928 <br />392,671 <br />$ <br />$ <br />612,036 <br />404,451 <br />$ <br />$ <br />626,320 <br />416,585 <br />2% <br />3% <br />$ <br />63,860 <br />$ <br />66,414 <br />$ <br />69,071 <br />4% <br />$ <br />36,696 <br />$ <br />37,794 <br />$ <br />38,931 <br />3% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />49,756 <br />$ <br />50,751 <br />$ <br />51,766 <br />2% <br />$ <br />542,983 <br />$ <br />559,410 <br />$ <br />576,353 <br />3% <br />SURPLUS /(DEFICIT) FOR PERIOD: $ 42,945 $ 52,626 1 $ 49,967 1 -5% <br />FY 2018 -19 Program Budget <br />