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P a g e 1 o f 15 <br /> <br /> <br />Orange County Community Climate Action Grant - Application 2023-24 <br />SUBMISSION CHECKLIST <br /> <br />Primary Applicant Organization: __HILLSBOROUGH UNITED CHURCH OF CHRIST __ <br /> <br />Project Name: SOLAR PANEL PROJECT <br />Section Subsection <br />Cover Page <br /> <br /> x Applicant and Collaborator/Partner Contact Information <br /> x Funding Request Summary <br /> x Signed Application Cover Page <br />Disclosure x Signed Disclosure of Conflicts of Interest and Clause <br />Applicant Organization and <br />Collaborator Information <br /> x Applicant organization’s Date of Incorporation (if applicable) <br /> x Applicant organization’s Purpose/Mission (if applicable) <br /> x Living Wage <br /> x Schedule of Positions (if applicable) <br /> <br /> Project Information <br /> <br /> x Project Name <br /> x Project Description and Climate Plan Alignment <br /> x Collaborator Information (if applicable) <br /> x Criteria-Specific Sections 1-7 <br /> <br />Attachments <br />(A description of these items is <br />available on page 13: “Description <br />of Required Attachments.” Please <br />contact us if it will not be <br />possible to provide any of these <br />required attachments at the time <br />of application: <br />aeckberg@orangecountync.gov <br /> <br /> <br /> <br /> ]x Applicant Organization’s Annual Budget and Proposed Project Budget <br />(Use template provided) <br /> x Applicable Financial Records to prove eligibility: IRS Federal Form 990 or <br />Applicant Organization’s Tax Returns from 2022 <br /> x 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 />2022 <br /> x List of members of organization’s Governing Board (if Board exists) <br /> x Certificate of Insurance <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 1DA01EE2-D61E-4F21-8905-BE343438D3ED