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DocuSign Envelope ID: 1BB65AEA-3E6A-45BE-8A7F-19FFOF9A712A <br /> EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <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 /> a Other Government Grants <br /> • Triangle United Way <br /> ■ State Government <br /> ■ Federal Government (CDBGIHOMEIetc.) <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 /> iiii. Does your agency budget show a Surplus or Deficit? Yes <br /> Is there a significant change? Yes/No No <br /> Please provide a brief explanation for Surplus or Deficit, and significant changes. <br /> A small deficit in the 2018 operating budget represents a slight increase in staffing to <br /> manage the successful development and implementation of all STEM activities across <br /> museum programs. This deficit will be addressed through cash-forward surplus in 2017. <br /> iv. What is your agency's fiscal year? January 1 2018 - December 31 <br /> 2018 <br /> (Example: July 1, 2016 through June 30, 2017) <br />