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DocuSign Envelope ID: E30588DE -A1 BC- 443D- A5C4- 3BE790331500 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Bridge II Sports <br />Program Budget <br />PROGRAM NAME: Adapted Sports Programing <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 Hilisborough <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 />Actual <br />2016 -17 <br />Estimated <br />2017 -18 <br />Projected <br />2018 -19 <br />Percent <br />Change <br />$ <br />524 <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />1,182 <br />$ <br />3,808 <br />$ <br />2,000 <br />-47% <br />0 $ <br />2,000 <br />$ <br />1,000 <br />$ <br />3,300 <br />230% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />4,000 <br />$ <br />4,000 <br />$ <br />6,600 <br />65% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />2,625 <br />$ <br />2,719 <br />$ <br />3,630 <br />34% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />Is <br />- <br />$ <br />1 $ <br />- <br />1 fl <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />$ <br />- <br />$ <br />0 <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />- <br />$ <br />19,500 <br />$ <br />20,000 <br />3% <br />$ <br />16,975 <br />$ <br />15,344 <br />$ <br />27,470 <br />79% <br />$ <br />27,306 <br />$ <br />46,371 <br />$ <br />63,000 <br />36% <br />$ <br />54,551 <br />$ <br />72,169 <br />$ <br />71,950 <br />0% <br />$ <br />- <br />$ <br />- <br />$ <br />- <br />0 <br />$ <br />149 <br />$ <br />231 <br />$ <br />21,115 <br />9041% <br />$ <br />1,432 <br />$ <br />5,599 <br />$ <br />2,750 <br />-51% <br />$ <br />17,674 <br />$ <br />14,259 <br />$ <br />17,200 <br />21% <br />$ <br />73,806 <br />$ <br />92,258 1 <br />$ <br />113,015 <br />22% <br />SURPLUSI(DEFICIT) FOR PERIOD: 1 $ (46,500) $ (46,887)L$ (50,015) -9% <br />