Eastern Ontario Development Program

Eastern Ontario Development Program

(EODP)

Application for Funding

Business Development or Community Innovation Projects

Between April 1, 2018 & October 31, 2018

LegalName ofOrganization:
OperatingName of Organization:
Canada RevenueBusiness No.:
Business MailingAddress:
Telephone Number:
FaxNumber:
ContactPerson:
EmailAddress:
Website:
PROJECT NAME:
Project Description: / 200 Characters Maximum (full description on page 4)
AMOUNT REQUESTED:

Business /OrganizationProfile

Typeof Business/ Organization:

Business -SoleProprietorship / MunicipalGovernment / Not-for- Profit – CED Agency
Business - Partnership / Not-For-Profit / Other (specifybelow)
Business -Incorporated / FirstNations

Industry/Target Market Sector:

High Technology / Energy / R&D / Agriculture
Water / Aerospace/Aviation / SalesService / Other:
NAICSsubsector (three-digit code):
For a complete list, visit Statistics Canada
Example: 332 Fabricated metal product manufacturing; 541 Professional, scientific and technical services

Census Subdivision:

Code / Census subdivision / Code / Census subdivision
3515003 / Asphodel-Norwood / 3515015 / Selwyn
3515005 / Otonabee-South Monaghan / 3515019 / Curve Lake First Nation
3515008 / Hiawatha First Nation / 3515023 / Douro-Dummer
3515013 / Cavan-Monaghan / 3515030 / Havelock-Belmont-Methuen
3515014 / City of Peterborough / 3515037 / North Kawartha
3515044 / Trent Lakes

Length of Time in Operation:

Year(s): / Months:

Business/ Organization’s Mandate:

Describethe business/organization’smainactivities,whatproductorserviceisprovided?

Business/Organization Background and Key Personnel

ProjectDescription

Type of Activity: Check All That Apply

IndustryClusterDevelopment / ProductivityAssessments
BusinessIncubator / Capital Equipment Upgrade & Training
SupplyChainAnalysis and Development / MarketDiversification
InnovationProductDevelopment / Business Transition
ResearchDevelopment / Succession Planning
Strategic PlanningandResearchStudies / Business Certifications
Other: / Training and Youth Retention

Project Summary:

Provide a brief description of the project:

Project Timeline

StartDate:
*End Date:

*for projects less than 1 year in duration, end date should be December 31st of the year you are applying for

Project Activities & Deliverables

ProjectActivity / Completion Date / Project Partners / Outcome / Deliverable

Funding History

Haveyoureceived fundingfrom Peterborough CFDCthroughan EODPinitiative before?
Ifyes, is the proposed projectincremental?
(For thepurposeof this application“incremental”is defined as a projectthat is new or an initiative that is being added to a project thatwaspreviously funded underEODP)
Please indicate thecumulativeamount to dateyourbusiness/corporationhas receivedfrom thePeterboroughCFDC / $
Maximum amount per business/organization / $100,000.00
EODP funding available ( subtract cumulative amount from maximum amount) / $

Project Funding & Expenses

Attach separate detailedprojectbudget. Identifyallsources ofprivate & public funding.

Sources ofFunding / Amount
Applicant CashContribution(minimum of 50% - proof required) / $
Anticipated CFDC Loan Financing / $
Anticipated Bank/Credit Union Financing / $
AnticipatedEODP Contribution / $
Other Partner Funding (Please List All Sources Below) / $
Other Government Funding (Please List All Sources Below) / $
TotalFinancing: / $

Contact information for all ProjectPartners (Private & Public) is required:

Organization Name
Address
CRA Business Number
Contact Name
Amount Of Funding
Organization Name
Address
CRA Business Number
Contact Name
Amount Of Funding
Organization Name
Address
CRA Business Number
Contact Name
Amount Of Funding
Description ofEligibleCosts(excludingtaxes) / Amount
Labour: salaries, wages and employer expenses / $
Expertise: consultant and other professional services / $
Capital: equipment / $
Other: / $
TotalEligible Costs: / $

*Project cash flow is required with a breakdown of all anticipated expenses.

Economic Impact

Annual Sales Revenue

$ At The Time Of Application / Projected % Increase As A Result Of EODP Funding
Canadian Sales / $ / %
USA Sales / $ / %
International Sales / $ / %
Total Annual Sales / $ / %

Briefly explain why you anticipate an increase in your annual revenues.

Employment / Current # Of Employees / Projected Number of Employees at end of Project
Full Time / Part Time / Full Time / Part Time
Management, Business & Finance, Professional Services
Natural and Applied Sciences
Technical
Manufacturing and Utilities
Retail
Agriculture
Other
Total # Of Employees

Briefly explain how you will increase employment and manage this growth.

Attachments

A completed application form
2-3 quotations for itemspurchasedorservices provided must be included for eachexpense
Projectsthat involve hiringaconsultant must provide Terms of Referencefortherecruitment and hiringofthe consultant (who must be at arm’s length from the Applicant)
List of partners and project funding contributions
Copies of Articles of Incorporation / Letters Patent and Business Registration
(NOTE: If you are a current loan client this is not necessary)
Financial Statements - last 2 fiscal years
(NOTE: Confirmation of applicant’s contribution is required)
Applicants will be notified of the funding decision following the Board Meeting. If the Application is approved, the Peterborough CFDC will prepare and Letter of Offer outlining terms and conditions of funding.

Authorization and Certification

As the lead contact and as an authorized signing officer of the Applicant, I certify to the Peterborough CFDC that:
The principals of the Applicant have been notified and consented to PCFDC collecting, using, retaining and disclosing the information contained in this application for the limited purpose of determining eligibility for funding as is required by law and by PCFDC. I understand that PCFDC will handle personal information in strict confidence in accordance with Federal privacy law. This information may be reviewed by FedDev Ontario for the purposes of assessing project eligibility.
The information contained in this application is true and complete in all respects. If the PCFDC discovers that this application contains a material misrepresentation, this application shall be deemed to be withdrawn immediately by the Applicant.
The Applicant agrees to provide any additional information that the PCFDC may reasonably require for purposes of assessing this application.
As part of its project assessment process, Peterborough CFDC requires that all projects conform with the environmental guidelines set out in the Canadian Environmental Assessment Act. For more details of CEAA requirements please visit
The Applicant acknowledges that any approved Project under the Eastern Ontario Development Program
will require signing of a Contribution Agreement and mandatory monthly reporting.
The Applicant acknowledges that any approved Project will be the subject of public announcements and acknowledgement on
Name of authorized signatory (please print): / Title:
Signature: / Date:

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EODP-Application-2018-Community-Futures-Peterborough