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DocuSign Envelope ID: 2F546B53- F2D1- 407D- A1C7- 26EB823DOFFD <br />h) Agency Budget <br />i. Is your agency currently receiving and/or requesting other (non -Human Services) <br />local (Town of Carrboro, Town of Chapel Hill, Orange County) government <br />funding? (YeslNoj No <br />If yes, please list below: <br />Include all programs that have funding requestslawardsltotals from Carrboro Chapel hill <br />and Orange County governments (other than Human Services). DO NOT include federal <br />funding sources, such as CDBG and HOME. <br />Program <br />FY17 -18 <br />Award <br />FY18 -19 <br />quest <br />Source <br />Ex:- Afordable Rental <br />�R erabilitation: <br />- 1pr, <br />$20,]Dfl <br />9` <br />Carrboro;.. Afordab~ Housing i <br />Ex; Agengy Admir�istrabon <br />;Q0[}' <br />$1,5 QQCI <br />Garrboro - Other, <br />ExvTotal' <br />' $15; Lift <br />$35 -000 <br />- :Carrboro Total Funding , <br />i <br />i <br />i <br />I <br />I <br />! <br />-Aaa rows or anacn aacitlonai page, a needed. <br />iii. Submit your agency's budget. You may complete the provided template (separate <br />x[s file) or you may submit your own Budget file (as long as it contains the same <br />information, and in a similar format, as requested in the provided template). , <br />Agency Budgets are required to define budget amounts for the previous program <br />year, current program year, and neat program year for the following categories: <br />• Revenues <br />c Private Donations <br />a Program Generated Revenue <br />v Local Government Grants <br />■ Carrboro human Services <br />• Carrboro Other <br />■ Chapel Hill Human Services <br />■ Chapel Hill Other (DO NOT include CDBG funding here) <br />Agency Information 1/22/2018 12:44:365 PM Page 'I I of 27 <br />