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DocuSign Envelope ID:4FF28E49-EE56-4A40-9331-F55AA8A05998 <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Agency Budget <br /> Operating Budget for Entire Agency <br /> AGENCY NAME: Institute of Art Therapy, Inc. <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2016-17 2017-18 2018-19 Change <br /> Private Donations $ 28,000 $ 35,000 $ 36,000 3% <br /> Agency Generated Revenue(fees) $ 158,000 $ 160,000 $ 175,000 9% <br /> Local Government Grants: <br /> Human Services-Town of Carrboro $ 4,000 $ 5,000 $ 10,000 100% <br /> Other-Town of Carrboro $ - $ - $ - 0 <br /> Human Services-Town of Chapel Hill $ 3,000 $ 3,000 $ 15,000 400% <br /> Other-Town of Chapel Hill $ - $ - $ - 0 <br /> Human Services-Orange County $ 1,000 $ - $ - 0 <br /> Other-Orange County $ - $ 3,300 $ 5,000 52% <br /> Other-Town of Hillsborough $ - $ - $ - 0 <br /> Other Government Grants <br /> Triangle United Way $ - $ - $ - 0 <br /> State Government $ - $ - $ - 0 <br /> Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 <br /> Private Foundation Grants 1 $ 13,000.00 $ 50,000.00 $ 30,000.00 $ 0.40 <br /> Other Revenue $ 1,000 $ - $ - 0 <br /> Total Agency Revenue $ 208,000 $ 256,300 $ 271,000 6% <br /> AGENCY EXPENSES <br /> Compensation $ 177,000 $ 200,000 $ 210,000 5% <br /> Rent&Utilities $ 10,500 $ 12,000 $ 13,000 8% <br /> Supplies& Equipment $ 5,500 $ 6,000 $ 7,000 17% <br /> Travel &Training $ 2,500 $ 1,500 $ 5,000 233% <br /> Other Expenses: $ 7,500 $ 8,000 $ 10,000 25% <br /> Total Agency Expenses $ 2031000 $ 227,500 $ 245,000 8% <br /> SURPLUS/(DEFICIT) FOR PERIOD: $ 5,000 1 $ 28,8001 $ 26,000 -10% <br /> FY 2018-19 Agency Budget <br />