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DocuSign Envelope ID:7B55B196-3912-4C1A-ADB4-A753058DFEFD XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Program Budget <br /> Operating Budget for Program <br /> PROGRAM NAME: The Arc of the Triangle <br /> Actual Estimated Projected Percent <br /> PROGRAM REVENUE 2015-16 2016-17 2017-18 Change <br /> Private Donations $ 811 $ 1,500 $ 2,500 67% <br /> Program Generated Revenue $ 4,385 $ 4,500 $ 4,500 0% <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ 3,615 $ 5,000 $ 7,500 50% <br /> Other-Town of Carrboro $ - $ _ 0 <br /> Human Services-Town of Chapel Hill $ 5,000 $ - $ 12,500 0 <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ - $ - $ - 0 <br /> Other-Orange County $ 6,250 $ 6,000 $ 7,500 25% <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ _ $ _ $ _ 0 <br /> State Government $ 36 000.00 $ - 0 <br /> Federal Government(CDBG/HOMEletc.) $ - $ _ $ _ 0 <br /> Private Foundation Grants $ 26,414.00 $ 35,500.00 $ 16,000.00 $ 0.55 <br /> Other Revenue $ _ $ _ $ - 0 <br /> Total Program Revenue $ 81,475 $ 52,500 $ 50,600 -40 <br /> PROGRAM EXPENSES <br /> Compensation $ 48,133 $ 48,133 $ 48,133 0% <br /> Rent&Utilities $ 1,652 $ 1,652 $ 1,652 0% <br /> Supplies& Equipment $ 2,403 $ 1,500 $ 1,500 0% <br /> Travel&Training $ 350 $ 200 $ 200 0% <br /> Other Expenses: $ _ $ _ $ - 0 <br /> Total Program Expenses $ 52,538 $ 51,485 Is 51,485 0% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ 28,937 $ 1,015 $ (985)1 197% <br />