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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?(Yes/No)No <br />If yes, please list below: <br />Include all programs that have funding requests/awards/totalsfrom 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 FY17-18 <br />Award <br />FY18-19 <br />Request <br />Source <br />Ex: Affordable Rental <br />Rehabilitation <br />0 $20,000 Carrboro -Affordable Housing <br />Ex: Agency Administration $15,000 $15,000 Carrboro –Other <br />Ex.Total $15,000 $35,000 Carrboro Total Funding <br />*Add rows or attach additional page, if needed. <br />ii.Submit your agency’s budget.You may complete the provided template(separate <br />xlsfile)or you may submit your own budget file (as long as it contains the same <br />information, and in a similar format, asrequested in the provided template). <br />Agency Budgets are required to define budget amounts for the previous program <br />year, current program year, and next program year for the following categories: <br />x Revenues <br />o Private Donations <br />o Program Generated Revenue <br />o 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 />EXHIBIT A: Provider's Outside Agency Application <br />DocuSign Envelope ID: 7399BACD-0CBF-4EF4-9068-B429A8CA12F8