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DocuSign Envelope ID:3457204A-7765-4E36-8B42-227F6F673AF6 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 4. Attachments a. ® Audit: Organizations receiving $300,000 or more in Federal <br /> financial assistance, and/or organizations with more than $500,000 <br /> of receipts and expenditures in a fiscal year, must secure an audit. <br /> b. ® IRS Federal Form 990 <br /> c. ® NC Solicitation License (***see note) <br /> d. ® IRS Federal Tax-Exemption Letter <br /> e. ® Certificate of Insurance (***see note) <br /> f. ® List of Board of Directors <br /> g. ® Solid Waste Program Fee (SWPF)Verification (***see note) <br /> Application Submittal Checklist 1/31/2017 12:37:26 PM Page 6 of 45 <br />