|
DocuSign Envelope ID: 717C8AE2- 4D6E- 4E46- A9A7- F4213973D039
<br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
<br />Agency Budget
<br />Operating Budget for Entire Agency
<br />AGENCY NAME:
<br />AGENCY REVENUE
<br />Private Donations
<br />Club Nova Community, Inc
<br />Agency Generated Revenue (fees)
<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 /HOM'E /etc.)
<br />Private Foundation Grants
<br />Other Revenue
<br />' "This budget excludes Capital Campaign revenue
<br />Total Agency Revenue
<br />AGENCY EXPENSES
<br />Compensation
<br />Rent & Utilities
<br />Supplies & Equipment
<br />Travel & Training
<br />Other Expenses: Include the following: Payroll taxes,
<br />Benefits, Consultinglprofessional Services, Legal Counsel, IT,
<br />accreditation and certification, dues and membership
<br />'This budget excludes Capital Campaign revenue
<br />Total Agency Expenses
<br />SURPLUS/(DEFICIT) FOR PERIOD:
<br />FY 2018 -19 Agency Budget
<br />$ 34,9511 $ 5,665 1 $ 10,000 1 77%
<br />Actual
<br />2016 -17
<br />Estimated
<br />2017 -18
<br />Projected
<br />2018 -19
<br />Percent
<br />Change
<br />$
<br />114,456
<br />$
<br />115,000
<br />$
<br />115,000
<br />0%
<br />$
<br />463,598
<br />$
<br />483,000
<br />$
<br />483,000
<br />0%
<br />$
<br />13,500
<br />$
<br />19,000
<br />$
<br />20,000
<br />5%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />16,000
<br />$
<br />19,000
<br />$
<br />20,000
<br />5%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />95,000
<br />$
<br />107,500
<br />$
<br />120,000
<br />12%
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />44,990.00
<br />$
<br />11,247.00
<br />$
<br />10,000.00
<br />$ (0.11)
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />-
<br />$
<br />-
<br />$
<br />-
<br />0
<br />$
<br />25,000.00
<br />$
<br />20,000.00
<br />$
<br />20,000.00
<br />$ -
<br />$
<br />127,647
<br />$
<br />130,000
<br />$
<br />130,000
<br />$ -
<br />$
<br />$
<br />900,191
<br />485,080
<br />$
<br />$
<br />904,747
<br />500,123
<br />$
<br />$
<br />918,000
<br />506,000
<br />1%
<br />1%
<br />$
<br />35,957
<br />$
<br />37,000
<br />$
<br />38,000
<br />3%
<br />$
<br />67,745
<br />$
<br />70,000
<br />$
<br />72,000
<br />3%
<br />$
<br />60,333
<br />$
<br />60,000
<br />$
<br />62,500
<br />4%
<br />$
<br />216,125 1
<br />$
<br />231,959 1
<br />$
<br />229,500
<br />-1
<br />$
<br />865,240
<br />$
<br />899,082
<br />$
<br />908,000 1
<br />1%
<br />$ 34,9511 $ 5,665 1 $ 10,000 1 77%
<br />
|