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DocuSign Envelope ID: B55679E1-82FB-4A06-BBCF-6BC218E4CADA t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 24 CFR 570.200(a), <br /> 4. Financial Program Budget Worksheet and Detail should reflect 570.201-570. 208, <br /> (for each expenses for the entire program and ALL sources of 507.503 <br /> program/ funding. 24 CFR 570.506, <br /> project for 570.507, 570.601, <br /> which a. Program Budget Worksheet 570.602, 570.607(b), <br /> funding is b. Program Budget Detail 570.611 <br /> requested) 24 CFR <br /> c. Cost Per Unit 570.502-570.504, <br /> d. Agency Operating Budget Worksheet 570.506, <br /> 570.507, 570.610; 24 <br /> CFR Parts 84 or 85, <br /> and OMB Circulars A- <br /> 87 or A-122; <br /> Treasury Circular 1075 <br /> 5. Supplement A. Part A: CDBG & HOME <br /> al Sections B. Part B: Construction/Rehab <br /> (as <br /> applicable) <br /> 6. Attachments a. Audit: Organizations receiving $300,000 or more OMB Circular A-133 <br /> in Federal financial assistance, and/or <br /> organizations with more than $500,000 of receipts <br /> and expenditures in a fiscal year, must secure an <br /> audit. <br /> b. IRS Federal Form 990 <br /> c. NC Solicitation License <br /> d. IRS Federal Tax-Exemption Letter <br /> e. Certificate of Insurance <br /> f. List of Board of Directors <br /> g. Articles of Incorporation/Bylaws 24 CFR Parts 84 or 85 <br /> h. Authorization to Request Funds 24 CFR 570.208, <br /> i. Authorized official designation 570.500(c), 570.611 <br /> j. Solid Waste Program Fee (SWPF) Verification <br /> 0:°'age 2 of 23 <br />