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P a g e 1 o f 12 <br /> <br /> <br />SUBMISSION CHECKLIST <br /> <br />Primary Applicant Organization Town of Chapel Hill <br /> <br />Project Name(s) Tree Planting Program <br /> <br />Section Subsection <br /> Cover Page <br /> <br /> Applicant and Collaborator/Partner Contact Information <br /> Funding Requests <br /> Signed Application Cover Page <br /> Signed Disclosure of Conflicts of Interest and Clause <br /> <br /> <br /> <br /> <br /> <br />Applicant Information Applicant organization’s Date of Incorporation (if applicable) <br /> Applicant organization’s Purpose/Mission (if applicable) <br /> Living Wage <br /> Schedule of Positions (if applicable) <br /> <br /> Project Information <br /> <br /> Project Name <br /> Project Description <br /> Strategic Objective <br /> Target Population <br /> Performance Indicators <br /> Project Budget Summary <br /> <br /> Attachments <br />(A description of these items is <br />available on page 15: “Description <br />of Required Attachments.” Please <br />contact us if it will not be possible <br />to provide any of these required <br />attachments at the time of <br />application: <br />bbouma@orangecountync.gov) <br /> <br /> <br /> <br /> Applicant Organization’s Annual Budget and Proposed Project Budget (Use <br />template provided) <br /> Applicable Financial Records to prove eligibility: IRS Federal Form 990 or <br />Applicant Organization’s Tax Returns from 2019 <br /> Applicable Financial Records to prove eligibility of collaborator/partner (if <br />they are receiving project funds): IRS Federal Form 990 or Tax Returns from <br />2019 <br /> List of members of organization’s Governing Board (if Board exists) <br /> Solid Waste Program Fee (SWPF) Verification (for commercial property <br />owners and renters) <br /> Certificate of Insurance <br /> <br /> <br /> <br />DocuSign Envelope ID: 8858BEA8-FD65-4E72-A32A-868C9BDDE075