Orange County NC Website
DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Agency Budget <br /> Operating Budget for Entire Agency <br /> AGENCY NAME Public Gallery of Carrbero dba WCOM <br /> Actual Estimated roles aPercent <br /> AGENCY REVENUE 2016-16 2016-17 2017-19 Change <br /> PrivateDanabmis 151D4 S 9DOO 8000 0% <br /> Agency Generated Revenue Ifees) $ 9,1527 5 1 D,Doo $ 10,501) 5% <br /> Loeai Government Grants: <br /> Human Services-Town of Camboro $ 753 5 1,Dflo $ 1,00C D% <br /> Other-TovmofCareihoro $ 2,5123 S $ D <br /> Human SerAoes-Town€rr Chapel Hill ; - 5 $ D <br /> Other-Town of Chapel Hill $ - 5 $ D <br /> Human Services-Orange Cou my S 25 D 5 1,11410 $ 1.001) D% <br /> Oltrer-Orange County S 5 - $ D <br /> Other-Town cf Hilsborough S 5 $ D <br /> 011her Goverrrrient Grants <br /> Triangle United Way S S $ C. <br /> State GcrVemrnent S S $ d <br /> Federal Government(CDBUHOMEletc.) S S $ C. <br /> Private Foundation Gra its S 2,301DO S <br /> ttrer 1.750.00 $ .CDC.C1D 4% <br /> O Revenue 5 '.'24 5 - $ - C. <br /> Total Agency Revenue $ 22,355 S 19 J50 $ 20.500 4.' <br /> AGENCY EXPENSES <br /> Conmx-nsafim $ 915 S 250 S MC 3% <br /> Rent&utifffies $ 9.292 S 9,150 9 0,50C 4% <br /> Supplies&Equipment $ 4,207 S 4,0,34 5 4,50C 1% <br /> Travel&Training 5 - $ - S D <br /> CH]her Expenses: $ 6,879 S 4,155 S 4,50C 3% <br /> Total Agency Expenses 3 21,293 $ 18,225 $ 19,350 6% <br /> SURPLU&(DEFICIT) FOR PERIOD: 1,0621 $ 1..5251 $ 1,150 1 <br /> FY 21115-16 Canparative Agerxry Budget <br /> Devised gr29M14 <br /> iii. Does your agency budget show a Surplus or Deficit? Surplus <br /> Is there a significant change? Yes/No Yes <br /> Please provide a brief explanation for Surplus or Deficit, and significant changes. <br /> Agency Information 2/8/2017 9:06:10 AM Page 8 of 18 <br />