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DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />h) <br />iv. <br />If yes, is this agency an Orange County Living Wage Certified Employer? No <br />If no, please explain. <br />We hold a living Wage Certification from Durham County because our office is <br />physically located in Durham County. <br />Agency Budget <br />Is your agency cuo <br />local (Town of Cabo <br />funding? (Yes /No) No <br />Submit your agency's <br />Budget attached <br />ing and /or requesting other (non -Human Services) <br />of Ch Lel Hill, Orange County) government <br />Does your agency budget show a Surplus or <br />Balanced <br />Is there a significant change? Yes /No No <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />What is your agency's fiscal year? January 1, 2017- December 31, 2017 <br />Agency Information 2/16/2018 1:09:05 PM Page 11 of 20 <br />