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EXHIBIT "A" <br />SEP 29 2016 <br />Submission Checklist <br />For office use only <br />Please mark "yes"or "no"to each criteria below: <br />im 5 Applicant filled out the proper application version for this <br />grant cycle. <br />Applicant answered each question. <br />A budget is attached which includes revenues,expenses <br />and anticipated profit or loss (plus previous 3 years <br />actuals for ongoing projects/events). <br />i The applicant has signed and dated the certification <br />U statement required in item 10 of the application. <br />I The application was submitted on time. <br />Proof of non-profit status is included (if applicable). <br />Please date stamp the application and initial. <br />County-wide Lodging Tax Application For Office Use Only P a ge 15