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DocuSign Envelope ID:2164F437-BF9D-46A1-B13B-7740B02003DA t A - continued <br /> Provider's Outside Agency Application <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/ funding. 24 CFR 570.506, 570.507, <br /> project for 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 570.502-570.504, <br /> c. ® Cost Per Unit 570.506, <br /> d. ® Agency Operating Budget Worksheet 570.507, 570.610; 24 CFR <br /> Parts 84 or 85, and OMB <br /> Circulars A-87 orA-122; <br /> Treasury Circular 1075 <br /> 5. Supplement A.❑ Part A: CDBG & HOME <br /> al Sections (as B.❑ Part B: Construction/Rehab <br /> applicable) <br /> 6. Attachment a.® Audit: Organizations receiving $300,000 or OMB Circular A-133 <br /> s <br /> more 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 24 CFR Parts 84 or 85 <br /> f. ® List of Board of Directors 24 CFR 570.208, <br /> g.® Articles of Incorporation/Bylaws 570.500(c), 570.611 <br /> h.® Authorization to Request Funds <br /> i. ® Authorized official designation <br /> j. ❑ Solid Waste Program Fee (SWPF) Verification <br />