Orange County NC Website
Browse       Search
A5. Preferred Phone <br />Number <br />+19199036308 <br />A6. E-Mail board@wcha.coop <br />A7. Tax ID Number 56-2276970 <br />A8. W here did you hear <br />about this grant <br />opportunity? <br />Other <br />A8a. Please describe <br />how you heard about this <br />grant opportunity. <br />via our work with Urban Sustainability Solutions (UrbanSS.org). <br />A9. Have you applied to <br />this grant opportunity <br />before? <br />No <br />Disclosure of Potential <br />Conflicts of Interest and <br />Non-Discrimination <br />Clause <br />Are any of the Board Members or employees of the organization which will be carrying out this <br />project or their named project collaborators/partners or members of their immediate families, or <br />their business associates: <br />A10. Select any of the <br />following that apply: <br />c. Current beneficiaries of the program for which funds are being requested <br />A10c. Please provide a <br />full explanation for why <br />you selected "Current <br />beneficiaries of the <br />program for which funds <br />are being requested" <br />(100 word limit) <br />Members of the board are residents of the W eaver Community and, as such, will benefit from the <br />windows replaced in their own units, as well as all others. <br />A11. NON- <br />DISCRIMINATION <br />Provider agrees as part of consideration of the granting of funds by funding agencies to the <br />parties hereto for themselves, their agents, officials, employees and servants agree not to <br />discriminate in any manner on the basis of race, color, gender, national origin, age, handicap, <br />religion, sexual orientation, gender identity/expression, familial status or veterans status with <br />reference to any activities carried out by the grantee, no matter how remote. The parties hereto <br />further agree in all respects to conform to the provision and intent of Orange County Civil Rights <br />Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is <br />enforced by action for specific performance, injunctive rel ef, or other remedy as by law provided; <br />this provision shall be binding on the grantees, the successors and assigns of the parties hereto <br />with reference to the above subject manner. <br />To the best of my <br />knowledge and belief all <br />of the above information <br />is true and current. I <br />acknowledge and <br />understand that the <br />existence of a potential <br />conflict of interest does <br />not necessarily make the <br />program ineligible for <br />funding, but the <br />existence of an <br />undisclosed conflict may <br />result in the termination <br />of any grant awarded. <br />checked <br />A12. Primary Contact <br />Name <br />Emily <br />Mulzoff <br />A13. Primary Contact <br />Title <br />W CHA Board President <br />Docusign Envelope ID: 9BD8B7A7-7606-416D-8B35-9C4C6D7EF1DB