Orange County NC Website
DocuSign Envelope ID:990F6965-575D-4E0D-A54F-9DAD6D65198E t A - continued <br /> Provider'saAki lication <br /> 24 CFR 570.200(a), <br /> 4. Financial (for Program Budget Worksheet and Detail should reflect 570.201-570. 208, <br /> each expenses for the entire program and ALL sources of 507.503 <br /> program/ I funding. 24 CFR 570.506, <br /> project for 570.507, 570.601, <br /> which funding a. ® Program Budget Worksheet 570.602, 570.607(b), <br /> is requested) b. ® Program Budget Detail 570.611 <br /> 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, and <br /> OMB Circulars A-87 or A- <br /> 122; <br /> Treasury Circular 1075 <br /> 5. Supplemental A. ❑Part A: CDBG & HOME <br /> Sections (as B. ❑Part B: Construction/Rehab <br /> applicable) <br /> 6. Attachments a. ® Audit: Organizations receiving$300,000 or more OMB CircularA-133 <br /> in Federal financial assistance, and/or organizations <br /> with more than $500,000 of receipts and <br /> expenditures in a fiscal year, must secure an 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 24 CFR Parts 84 or 85 <br /> g. ® Articles of Incorporation/Bylaws 24 CFR 570.208, <br /> h. ® Authorization to Request Funds 570.500(c), 570.611 <br /> i. ® Authorized official designation <br /> j. ®Solid Waste Program Fee (SWPF) Verification <br /> Main Application 1/26/2016 5:06:15 PM Page 2 of 21 <br />