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DocuSign Envelope ID:9F461F1C-C86C-42DC-B78C-50FC18D204DF <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> ii. Submit your agency's budget. You may complete the provided template (separate <br /> As file) or you may submit your own budget file (as long as it contains the same <br /> information, and in a similar format, as requested 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 /> • 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 /> ■ 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 /> o Compensation <br /> o Rent & Utilities <br /> o Supplies & Equipment <br /> o Travel & Training <br /> o Other Expenses <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 /> 2016-17 was another challenging year for The Arc. The last several months the executive <br /> director spent cutting expenses in the areas of administrative salaries, mileage, and <br /> general office expenses to put them in line with our income. 2017-18 is proving that these <br /> changes are working. As of November 2017 our financial statement shows our Net <br /> Income as a positive figure. We are also seeing a growth in income from our individual <br /> services in Wake and Durham counties. <br /> iv. What is your agency's fiscal year? July 1, 2017 through June 30, 2018 <br /> (Example: July 1, 2016 through June 30, 2017) <br /> Agency Information 1/20/2018 3:58:40 PM Page 12 of 24 <br />