Orange County NC Website
Browse       Search
DocuSign Envelope ID:AB039DC1-8309-4D41-B525-6E84F973FAA6 <br /> EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION CONTINUED <br /> MAIN 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, <br /> project for 570.507, 570.601, <br /> which funding a. I Program Budget Worksheet 570.602, 570.607(b), <br /> is requested) b. I Program Budget Detail 570.611 <br /> 24 CFR <br /> c. Cost Per Unit <br /> 570.502-570.504, <br /> d. I Agency Operating Budget Worksheet 570.505, <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. 0 Part B: Construction/Rehab <br /> applicable) <br /> 6. Attachments a. ■ Audit: Organizations receiving$300,000 or more OMB Circular A-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. i1 NC Solicitation License <br /> d. IRS Federal Tax-Exemption Letter <br /> 0. 1 Certificate of Insurance <br /> f. I List of Board of Directors 24 CFR Parts 84 or 85 <br /> g. ii Articles of incorporation/Bylaws <br /> 24 CFR 570.208, <br /> h. Authorization to Request Funds 570.500(c), 570.611 <br /> Authorized official designation <br /> j. Solid Waste Program Fee(SWPF) Verification <br /> Main Apprication 1/24/2016 4:55:46 PM Page 2 of 21 <br />