Application for Funding Support for Pilot Clustering Programme (Phase 2 – Facilitation Phase)
Legal Basis – the legal powers to cover this activity will be provided through De Minimis Aid under Section 7(a) of the 1998 Industrial Development Act
Please refer to Appendix 1 of the Clustering Programme Reference Document when completing Expenditure and Funding details associated with this application.
Completed Application Forms should be sent via email to:

We anticipate that Applications may be received from a variety of entities. If an already well established Network or trade/representative organisation is submitting an application on behalf of its members, please complete Section 1 & Section 2 below. If the applicants seeking support are not part of an already established Network or trade/representative organisation, please commence the application at Section 2.

1.  ESTABLISHED NETWORK/TRADE REPRESENTATIVE ORGANIASTION
Organisation Name: / Tel. no.:
Address: / Email Address:
Primary Contact / Web Address:
Overview of the Organisation/Network and its members: (Please outline the main activities and supports associated with the Organisation, including the main sources of operational funding)
2.  APPLICANT DETAILS
Please list the enterprises or other organisations that have agreed to participate in the Clustering Project. Please note that a minimum of 5 Agency client companies are required to apply. Agencies include Enterprise Ireland, IDA Ireland, Udarás na Gealtachta and/or County/City Enterprise Boards. For Grant Payment purposes a Lead Company, to whom the grant will be paid, must be nominated.
Company 1
Lead Company Name[1]:
(Registered) / CRO Registered Number:
Business Address: / Tel no.:
Principal business / Web Address:
Contact Name/Role: / Email Address:
Name of Agency you are client of (e.g. Enterprise Ireland, IDA Ireland etc.)
Name of your contact in that Agency:
Company 2
Company Name[2]:
(Registered) / CRO Registered Number:
Business Address: / Tel no.:
Principal business / Web Address:
Contact Name/Role: / Email Address:
Name of Agency you are client of (e.g. Enterprise Ireland, IDA Ireland etc.)
Name of your contact in that Agency:
Company 3
Company Name[3]:
(Registered) / CRO Registered Number:
Business Address: / Tel no.:
Principal business / Web Address:
Contact Name/Role: / Email Address:
Name of Agency you are client of (e.g. Enterprise Ireland, IDA Ireland etc.)
Name of your contact in that Agency:
Company 4
Company Name[4]:
(Registered) / CRO Registered Number:
Business Address: / Tel no.:
Principal business / Web Address:
Contact Name/Role: / Email Address:
Name of Agency you are client of (e.g. Enterprise Ireland, IDA Ireland etc.)
Name of your contact in that Agency:
Company 5
Company Name[5]:
(Registered) / CRO Registered Number:
Business Address: / Tel no.:
Principal business / Web Address:
Contact Name/Role: / Email Address:
Name of Agency you are client of (e.g. Enterprise Ireland, IDA Ireland etc.)
Name of your contact in that Agency:
Start Date of Project[6]
Expected Completion Date

Enterprise Ireland & IDA Ireland will not release any information received as part of this application except as may be required by law, including the Freedom of Information Act 1997 (as amended from time to time). In the event of a FoI request, the client will be given reasonable advance notice in order to contest such disclosure.

OUTLINE OF THE PROPOSED COLLABORATIVE PROJECT
When completing this section, please refer to the Reference Document, in particular eligible projects (Section 7) and evaluation criteria (Section 9) being utilised, to ensure sufficient information is provided to assess your application.
Please address the following:
1.  Please provide a clear overview[7], including key aims and objectives, of the clustering project being undertaken.
2.  Please indicate if the members of the Group have identified someone to act as a Facilitator to the Group or the background of the individual required. (Please give details). Have the members collectively agreed to the selection of this person?
Affiliate Enterprises: (Please use this area to highlight any affiliate members of the Group not previously listed – Refer to Reference Document, Section 7)
1. Organisation /Contact Name
2. Organisation/Contact Name
3. Organisation/Contact Name
EXPENDITURE & FUNDING DETAILS
(Refer to Appendix 1 of Reference Document for Maximum Limits and Rules)
DETAIL OF WORK AND EXPENDITURE / Study Costs / EI Office Use Only
Salaries and Overheads:
Name/Company / Function / Cost per week / No. of weeks

Salaries Sub-total

Overheads: (may not exceed 30% of the Salary)

Sub-total Salaries and Overheads

Foreign Travel and Subsistence:
Name/
Company / Country & Purpose of Trip / Travel Costs / Subsistence
Costs / Total Travel + Subsistence

Sub-total Foreign Travel and Subsistence

Prototyping Expenditure:

Sub-total Prototype Expenditure

Consultancy Fees:
Name / Function / Cost per day / No. of days
Sub-total Consultancy Expenditure
Trade Fair Details and Expenditure:
Name of Trade Fair:
Location:
Date of Trade Fair:
List Name of Person(s) Attending and Position within their Company *
Trade Fair Expenditures / Cost / EI Office Use
Entry Fees
Stand/Exhibition Space Rental Fees
Stand Set-up and Installation Costs:
§  This can include transportation costs for products/exhibit, installation costs at the event (excluding own employee labour). Rental cost of equipment/ICT for the stand e.g. Lighting, Projectors, Laptops, Display Monitors etc.
§  Note Purchase of equipment/ICT is not eligible
Trade Fair Overheads/Sundries:
§  Maximum expenditure of €500 is allowable towards the cost of trade show related promotional material, brochure design/printing costs, translation costs etc
Sub Total Trade Fair Expenditure
Total Facilitation (Phase 2) Expenditure

Please provide any further relevant documentation that will support your Application.

Declaration by Authorised Officer of the Applicant(s)

The following Declaration must be completed all enterprises who are client companies of enterprise development agencies i.e. Enterprise Ireland, IDA Ireland, Udarás na Gaeltachta and/or County/City Enterprise Boards. Please copy and append a Declaration for EACH company to this Application.

DECLARATION BY APPLICANT
An Authorised Officer of the Company or the Promoter should complete this Declaration.
I confirm that the Company/ Promoter: / Yes / No
1 / Is a Small Enterprise (SE) [8]
2 / Is a Medium Enterprise (ME) [9]
3 / Is a Large Company
4 / Is part of a Group structure
5 / Has submitted a current Annual Business Review (ABR)
If Yes, please state year e.g. 2011
6 / Is currently availing of the Audit Exemption
7 / Has submitted our most recent Audited Accounts to our Development Advisor/Agency Executive
.
If No, I confirm that I will now submit our most recent Audited Accounts to our Development Advisor (softcopy versions are preferred).
8 / Has submitted Management Accounts no more than three months old to our Development Advisor.
If No, I confirm that I will now submit our Management Accounts no more than three months old to our Development Advisor (softcopy versions are preferred).
9 / Has received DE MINIMIS AID[10] in the last three years.
Note: a false declaration by a company/group resulting in the threshold of €200,000 being exceeded could later result in the aid being recovered with interest.
If YES, how much De Minimus Aid has been granted to your company in the last three years (please list type, amount and date received).
Type / Amount / Date Received
I confirm that the company has NOT and WILL NOT seek aid from any other State Agency in respect of this expenditure.
Name of Company’s Authorised Officer/ Promoter
Date:

Completed Application Forms should be sent via email to:

[1] Please state the exact registered name of the Company

[2] Please state the exact registered name of the Company

[3] Please state the exact registered name of the Company

[4] Please state the exact registered name of the Company

[5] Please state the exact registered name of the Company

[6] Give the dates that the Facilitation Phase will begin and end. Any expenditure incurred prior to the start date may not be eligible for support

7 Initially describe the collaborative project to be investigated in one sentence - for example:

“….. the feasibility of manufacturing commercial waste handling equipment and systems”

[7]

[8] A Small Enterprise is defined as:

·  an enterprise that has fewer 50 employees and

·  has either an annual turnover and/or an annual Balance Sheet total not exceeding €10m

[9] A Medium Sized Enterprise is defined as:

·  an enterprise that has between 50 employees and 249 employees and

·  has either an annual turnover not exceeding €50m or an annual Balance Sheet total not exceeding €43m

In either case, if the enterprise is more than 25% owned by one or more enterprises or itself has a holding of more than 25% in any other enterprise, it will be necessary to consult the full definition in the Official Journal (see below).

Excluded from the holding company threshold in the above definition are public investment corporations, venture capital companies and institutional investors provided that they do not exercise control. However, an enterprise cannot be considered as meeting either definition if 25% or more of the capital or voting rights are directly or indirectly controlled, jointly or individually, by one or more public bodies.

Note - If a company is part of a group the employee, turnover, annual balance sheet and ownership limitsapply to the group.

For the full definition, see the “Official Journal of the European Commission (L 124/36) 20th May 2003 – Commission Recommendation of 6th May 2003 concerning the definition of micro, small and medium-sized enterprises”.

[10] De Minimis Aid:
The aid being sought is provided under the European Commission Regulation on De Minimis Aid. Small amounts of State aid, up to 200,000 Euros in any three-year period to any one enterprise, are regarded as too small to significantly affect trade or competition in the common market. Such amounts are regarded as falling outside the category of State aid that is banned by the EC Treaty and can be awarded without notification to or clearance by the European Commission. A Member State is required to have a mechanism to track such aid (called 'De Minimis aid') and to ensure that the combined amount of De Minimis aid payments from all sources to one enterprise in any three-year period respects the 200,000 Euro ceiling. Please provide details of all other De Minimis aid which has been granted to your company within the past three years. It should noted that a false declaration by a company resulting in the threshold of 200,000 Euro being exceeded could later give rise to the aid being recovered with interest.