Community Vitality Program
Final Project Report Form
1. Grant Information – Indicate the type of grant and amount received.
Grant Stream
 Small Capital Projects
 Community Pride Projects /
Grant Reference Number
CVP : _____ : ______/ Grant Amount
$ ______
Project Title:
2. Organization Information- Please complete the following information.
Organization Name:
Mailing Address: / Postal Code:
Contact Person: / Position:
Phone: / Fax: / Email:
  1. Community Vitality Program Objectives:
The Community Vitality Program provides project grants to community initiatives that encourage local youth, voluntary and community actions to build sustainable communities and improve quality of life, focusing on:
1.enhancing the quality, accessibility and use of community facilities;
2.building community pride, encouraging volunteerism and community involvement;
3.engaging Aboriginal and young people as leaders in community activities; and,
4.improving access and inclusion for those who experience barriers to community involvement.
The Community Vitality Program will invest in community projects and initiatives that can have a lasting impact on the economic, social and cultural aspects of community life in Saskatchewan.
  1. Financial Information: Use the form below to report actual revenue and expenses for the project. In the CIF Funding Received column, identify for each budget item the dollar amount of the CIF grant that was spent on that item. Include all project revenues, expenses and in-kind contributions. Where requested, additional details should be included as an attachment.

BUDGET ITEMS / ORIGINAL PROJECT BUDGET / FINAL PROJECT STATEMENT / CIF FUNDING RECEIVED / IN-KIND
CONTRIBUTIONS
Income
Cash donations / $ / $ / $ / $
Fundraising / $ / $ / $ / $
Registration /
Participant Fees / $ / $ / $ / $
Other funding sources (please list in #5 Other FundingSources (below). / $ / $ / $ / $
Total Income / $ / $ / $ / $
Expenditures
Project materials
(please list) / $ / $ / $ / $
Minor equipment
(please list) / $ / $ / $ / $
Project staff salaries / $ / $ / $ / $
Project staff benefits / $ / $ / $ / $
Equipment rental / $ / $ / $ / $
Facility rental / $ / $ / $ / $
Other direct project
related expenditures
(please list) / $ / $ / $ / $
Total project expenditures / $ / $ / $ / $
Surplus (Deficit) / $ / $ / $
  1. Other Funding Sources: Please list other funding sources and amounts received.

Name of Organization/Fund / Amount Requested / Amount Received
  1. Financial Reporting:

Organizations receiving grants must submit a photocopy of actual receipts or payroll records or an audited financial statement that has been prepared by a recognized audit firm, signed by two Board members. Audited financial statements must clearly outline the CIF grant received as well as specific expenses related to the project.

Documentation submitted should match the expenses reported in the CIF Funding Received column in #4 Financial Information.

Original documents and receipts must be kept by the grant recipient for seven years as per recognized accounting principles.

Unused CIF funds, or funds used for purposes other than what was approved, must be returned to the Community Initiatives Fund.

Failure to meet the above funding obligations to the satisfaction of the CIF Board is grounds to restrict access to future funding.

  1. Project Report: Using the headings below, please provide the following information as an attachment to the report form. Responses should be brief and concise, with a minimum of additional attachments included other than those required to complete the report.

Project Summary

  • Provide a summary of the project or event including key dates, locations and activities that occurred.
  • Identify any activities that occurred that were different than those originally planned and why the changes were made.

Project Participants

  • Provide a brief summary of those people that attended or participated in the project or event.
  • Include a description of how community members, youth, volunteers, artisans and partners were involved in the project and how their involvement contributed to the success of the project.
  • Provide estimated attendance figures in the following chart.

Total Participants / Children
and youth
(under 25) / First
Nations and
Métis
Attendance
Estimated # of Attendees
Artist Engagement
Estimated # of Saskatchewan-based artists, artisans & musicians,
Volunteers
Estimated # of volunteers
Estimated # of volunteer hours

Project Goals and Objectives

  • Based on the original goals and objectives, describe the level of success of the project in meeting those goals and objectives.
  • Describe any additional unanticipated accomplishments that occurred as a result of the project.
  • Describe how the project was successful in achieving one or more of the Community Vitality Program objectives (see #3 Community Vitality Program Objectives).
  • Where possible provide specific, measurable statements of the outcomes of the project.

For Small Capital Projects

  • Describe the success of the project in:
  • completing the planned improvements to the building, structure or outdoor space involved in the project;
  • contributing to the long-term use, accessibility and safety of the facility for the benefit of the community;
  • securing other contributions and funding sources to ensure the long-term success of the initiative.

For Community Pride Projects and Events

  • Where applicable describe the success of the project in:
  • promoting an understanding of the history and heritage of Saskatchewan;
  • promoting and recognizing volunteerism;
  • enhancing the leadership abilities of individuals, organizations, and communities;
  • contributing to increased pride and sense of belonging of community members;
  • leaving a cultural or historical legacy for future generations.
  1. Information Certification

I hereby certify that the information contained in this follow-up report is accurate and complete.

______

Signature of Organization representativePosition

______

Print NameDate

A completed Final Project Report and documentation required for verification of expenditures must be provided before the final payment representing 20% of the total grant will be released and the grant file closed. The Final Project Report is to be completed and submitted within 60 days of project completion to:

COMMUNITY INITIATIVES FUND

1870 Lorne Street

Regina, SK

S4P 2L7

Attn: Rhonda Newton

June 2010 1