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DocuSign Envelope ID: A89913EK- BAEC- 40F3 -91 E1- A9D77FC4C488 <br />EXHIBIT A: PROVIDER'S QUTSJDE AGENCY APPLICATION <br />Program Budge <br />Operating Budget for Program <br />PROGRAM NAME El Centro Hispano- Community Services (Carrboro Office) <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 />Oth T f Hillsborou h <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />Actual <br />2016 -17 ... <br />8,136 <br />12,031 <br />14,800 <br />36,970 <br />18,780 <br />- <br />80,775 <br />- <br />- <br />Estimated 2017: <br />18 <br />236,891.1 <br />Projected <br />2018 -19 .. <br />Percent <br />Change <br />$ 15,000 <br />$ 15,000 <br />0% <br />$ 25,000 <br />$ 18,000 <br />$ 25,000 <br />$ 20,000 <br />0% <br />11% <br />$ 36,970 <br />$ 36,970 <br />0% <br />$ 25,000 <br />$ 30,000 <br />20% <br />$ - <br />$ - <br />0 <br />1 $ 31,905 <br />$ 35,000 <br />10% <br />1 $ 54,168 <br />$ 54,168 <br />0% <br />I T, - <br />$ - <br />0 <br />er - own o g <br />Other Government Grants <br />Triangle United Way $ <br />State Government r$$ <br />Federal Government (CDBGIHOME/etc.) Private Foundation Grants <br />Other Revenue L$ <br />Total Program Expenses <br />SURPLUS!(DEFICIT) FOR PERIOD: <br />FY 2018 -19 Program Budget <br />$ 256, <br />$ 124,744 <br />'$ <br />236,891 <br />$ <br />236,891.1 <br />0% <br />$ 38,168 <br />$ <br />41,168 <br />$ <br />41,168 <br />0% <br />$ 5,505 <br />$ <br />5,500 <br />$ <br />5.,500 <br />0% <br />$ 8,761 <br />1 $ <br />13,025 <br />$ <br />15,000 <br />15% <br />$ 63,093 <br />$ <br />101,893 <br />$ <br />101,893 <br />0% <br />$ 240,2711 $ 398,477 1 $ 400,452 1 0% <br />$ 15,752 $ - $ 8,120 =0 <br />