Orange County NC Website
Browse       Search
DocuSign Envelope ID:7B55B196-3912-4C1A-ADB4-A753058DFEFD XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> n) Program Budget <br /> 1. Submit your program budget. You may complete the provided template (separate As <br /> file) or you may submit your own budget file (as long as it contains the same information, <br /> in the same format, as requested in the provided template). <br /> Program 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 /> • Revenues <br /> o Private Donations <br /> a Program Generated Revenue <br /> a 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 /> • Orange County Human Services <br /> • Orange County Other (DO NOT Include HOME funding here) <br /> o Other Government Grants <br /> • Triangle United Way <br /> • State Government <br /> • Federal Government (CDBG/HOME/etc.) <br /> • Private Foundation Grants <br /> o Other Revenue <br /> • Expenditures <br /> • Compensation <br /> • Rent & Utilities <br /> • Supplies & Equipment <br /> • Travel & Training <br /> • Other Expenses <br /> 2. Program Budget Detail — Provide description of "other" budget items, not defined. <br /> 3. This program budget represents what percent of the agency budget? 1.5% <br /> 4. COST PER INDIVIDUAL <br /> This Cost per Individual must reflect the total program budget divided by the total number of <br /> program individuals in this application. <br /> Actual 2015-16 Estimated 2016-17 Projected 2017-18 <br /> Total Cost of Program $52,500.00 $51,500.00 $51,500.00 <br /> Total # of Individuals 96 106 127 <br /> Cost Per Individual $5.49 $4.68 $3.90 <br /> PROGRAM INFORMATION 1/26/2017 5:52:39 PM P a g e 24 of 26 <br />