2025-132-E-County Mgr-Jubilee Healing Farm-Food Forest

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Page 1 of 22 Orange County Community Climate Action Grant - Application 2024-25 SUBMISSION CHECKLIST Primary Applicant Organization: Jubilee Healing Farm, Inc Project Name: Cob Classroom and Food Forest Note: Please read the Background and Information document before filling out this application. Section Subsection Cover Page ☐ Applicant and Collaborator/Partner Contact Information ☐ Funding Request Summary ☐ Signed Application Cover Page Disclosure ☐ Signed Disclosure of Conflicts of Interest and Clause Applicant Organization and Collaborator Information ☐ Applicant organization’s Date of Incorporation (if applicable) ☐ Applicant organization’s Purpose/Mission (if applicable) ☐ Living Wage ☐ Schedule of Positions (if applicable) Project Information ☐ Project Name ☐ Project Description and Climate Action Plan Alignment ☐ Collaborator Information (if applicable) ☐ Criteria-Specific Sections 1-7 Attachments - (A description of these items is available on page 13: “Description of Required Attachments.” Please contact us if it will not be possible to provide any of these required attachments at the time of application: sustainability@orangecountync .gov ☐ Applicant Organization’s Annual Budget and Proposed Project Budget (Use template provided) ☐ Applicable Financial Records to prove eligibility: IRS Federal Form 990 or Applicant Organization’s Tax Returns from 2023 ☐ Applicable Financial Records to prove eligibility of collaborator/partner (if they are receiving project funds): IRS Federal Form 990 or Tax Returns from 2023 ☐ List of members of organization’s Governing Board (if Board exists) ☐ Certificate of Insurance Docusign Envelope ID: 61C3903E-05FE-49FE-A6AF-E50B7D61917E