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P a g e 1 <br /> <br />Community Climate Action Grant Program <br />Application FY 2021-22 <br /> <br />SUBMISSION CHECKLIST <br />Primary Applicant Organization: ____Rebuilding Together of the Triangle_____ <br /> <br />Project Name: Program for low-income Orange County homeowners to replace inefficient <br />furnaces with energy efficient, electric heat pump HVAC systems <br />Section Subsection <br />Cover Page <br /> <br /> Applicant and Collaborator/Partner Contact Information <br /> Funding Request Summary <br /> Signed Application Cover Page <br />Disclosure Signed Disclosure of Conflicts of Interest and Clause <br />Applicant Organization <br />and Collaborator <br />Information <br /> 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 /> <br />Project Information <br /> <br /> Project Name <br /> Project Description and Climate Plan Alignment <br /> Collaborator Information (if applicable) <br /> Criteria-Specific Sections 1-7 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A