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P a g e 3 <br /> <br />COVER PAGE <br />Applicant Organization’s Contact Information <br />Organization’s Legal Name: Rebuilding Together of the Triangle <br />Physical Address: 200 Trans Air Drive, Suite 200, Morrisville, NC 27560 <br />Mailing Address: 200 Trans Air Drive, Suite 200, Morrisville, NC 27560 <br />Web Address: www.rttriangle.org <br />Telephone Number: 919-341-5980 <br />E-Mail: info@rttriangle.org <br />Tax ID Number: 56-1955629 <br />Funding Request Summary <br />Please list all Fiscal Year 21-22 Community Climate Action Grant funding requested for the project <br />you are proposing and the proposed use of funds (please list project name only). Applicants will be <br />asked to provide more details on their proposed project budget in the Budget Worksheets <br />attachment. <br />Project Equipment Operations Personnel Total <br />Ex. Youth Climate Leadership Project $10,000 $15,000 $5,000 $30,000 <br />Heat Pump for Gas Furnace replacement <br />program <br />$113,000 $0 $0 $113,000 <br />Briefly explain your proposed use of funds (2-4 sentences): <br />To the best of my knowledge and belief all information and data in this application is true <br />and current. <br /> <br /> <br /> <br />Signature: __________________ July 28, 2021 <br /> Applicant’s Authorized Signatory Date <br />This program will replace home heating furnaces with electric heat pump heating systems for low-income <br />homeowners in Orange County. Priority will be given to homeowners who have experienced a system <br />failure and are without adequate heating. <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A