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DocuSign Envelope ID: 74839431 - 9216- 429F- BFA4- 2AC6473BD9D3 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Program Budget <br />Operating Budget for Program <br />PROGRAM NAME Anger Management <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 (CDBGIHOMEIetc.) <br />Private Foundation Grants <br />Other Revenue fund bal. <br />Total Program Revenue <br />PROGRAM EXPENSES <br />Compensation <br />Rent & Utilities <br />Supplies & Equipment <br />Travel & Training <br />Other Expenses: (Contract facilitators) <br />Total Program. Expenses <br />$ <br />$ <br />Actual <br />2016 -17 <br />- <br />376 <br />$ <br />$ <br />Estimated <br />2017 -18 <br />2,604 <br />S <br />Projected <br />2018 -19 <br />6,000 <br />Percent <br />Change <br />0 <br />131% <br />$ <br />$ <br />1,250 <br />- <br />$ <br />$ <br />1,750 <br />- <br />$ <br />$ <br />2,500 <br />_ <br />43% <br />0 <br />5 <br />3,750 <br />$ <br />3,075 <br />$ <br />3,000 <br />-2% <br />$ <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />1;_I <br />A. <br />2,350 <br />$ <br />2,500 <br />F °fo <br />$ <br />- <br />$ <br />- <br />0 <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />a <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />2,646 <br />Is <br />_ <br />0 <br />1$ <br />$ <br />9,022 <br />5,400 <br />$ <br />$ <br />9,775 <br />4,950 <br />$ <br />$ <br />14,000 <br />6,385 <br />43% <br />29% <br />$ <br />1,400 <br />$ <br />2,575 <br />$ <br />2,575 <br />0% <br />$ <br />120 <br />$ <br />120 <br />$ <br />120 <br />0% <br />$ <br />102 <br />$ <br />120 <br />$ <br />120 <br />0 % <br />$ <br />2,000 <br />$ <br />2,000 <br />$ <br />4,800 <br />140 %0 <br />$ <br />9,022 <br />$ <br />5,775 <br />$ <br />14,000 <br />43% <br />SURPLUS/ {DEFICIT} FOR PERIOD: 1 $ - 1 $ s $ _ 0 <br />