Application Form for Regional and Community Projects – March 2007
SUGAR INDUSTRY REFORM PROGRAMME 2004
Regional and Community Projects
Application Form
Round Four
Applications close 5.00pm, Australian Eastern Standard Time, on 27 April 2007
Late or incomplete Application Forms and supporting documents will not be accepted
Before you begin
This Application Form must be read in conjunction with the Sugar Industry Reform Programme 2004 Regional and Community Projects Guidelines, dated September 2005
(“the Guidelines”).
Please ensure that you meet all eligibility criteria specified in the Guidelines and that you provide all required information to complete your Application Form.
If you have any questions about the Guidelines or this Application Form please contact your relevant Sugar Executive Officer in Attachment A of the Guidelines.
Refer to the Guidelines to find out where to send your Application Form and supporting documentation.
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Application Form for Regional and Community Projects – March 2007
Contents
Information for Applicants...... 3
PART A:Applicant Details...... 4
PART B:Project Information...... 6
PART C:Assessment Criteria...... 9
PART D:Budget and Contributions...... 13
- Budget...... 13
- In-Kind contributions...... 14
- Timetable and Project Milestones...... 15
- Have you any commercial prospects?...... 15
- Is your proposal about alternative sugarcane-derived products?...... 16
- Do you require Infrastructure, council, planning and environmental
approvals?...... 16 - Do you have a Conflict of Interest?...... 16
- Is the information in your proposal Commercial-in-Confidence?...... 17
- Is this an extension of an existing project?...... 17
- Have you applied for RCP[1] funding before?...... 17
- Have you received or sought other government assistance?...... 18
PART E:Declaration...... 19
PART F:Feedback questions...... 21
Information for Applicants
Completing the Application Form
IT IS VERY IMPORTANT THAT APPLICANTS READ THIS APPLICATION IN CONJUNCTION WITH THE GUIDELINES.
The Guidelines and Application Form may be obtained from a Sugar Executive Officer (refer to Attachment A of the Guidelines) or downloaded from the website
Before submitting this Application Form to the relevant Sugar Executive Officer or the Australian Government Department of Agriculture, Fisheries and Forestry (Department) as required, please ensure that it is complete; and that all requested and relevant information is attached. If there is not sufficient room to provide your response within the form, please attach additional documentation.
Only eligible Applications that meet the Eligibility Criteria specified in the Guidelines will be assessed. If your Application Form does not include the information requested, or the information provided is unclear, your Application will not meet the Eligibility Criteria under the Guidelines and will not be assessed further. Further details of the Eligibility Criteria and assessment process can be found in the Guidelines.
Applicants should note that:
- projects must be completed by 31 May 2008 and therefore projects should be structured to meet this requirement. Whilst there is no limit on the size of proposals the submission of small projects is encouraged so as to provide greater certainty as to this delivery deadline.
- the Department is under no obligation to request missing or additional information;
- subject to you signing the Declaration in Part E, information submitted in this Application Form may be disclosed to relevant Commonwealth, State and/or local government agencies, organisations and individuals (including those you identify in the Application Form) to confirm claims or statements that you make in your proposal; and
- there are a number of Commonwealth disclosure obligations that arise under Commonwealth legislation and policy. These include the Freedom of Information Act 1982, the Financial Management and Accountability Act 1997, the Senate Order relating to disclosure of information about certain agreements, and requirements for the disclosure of information to the Parliament and its committees.
Subject to the legal and policy requirements referred to above, to the extent it is able to, the Department will treat information submitted by applicants as in-confidence, should this be requested by the Applicant. Applicants should mark such information as ‘Commercial-in-Confidence’.
REMEMBER, YOU CAN ASK YOUR SUGAR EXECUTIVE OFFICER FOR ASSISTANCE IN COMPLETING YOU APPLICATION.
Part A: Applicant details
Note: If this is a joint Application (there is more than one Applicant) please provide the same details in Part A for each Applicant as an attachment to this document
Name of Applicant
(ie individual/group/
organisation)______
Street Address______
Postal Address______
Town/ State/ Postcode______
Contact person______Position______
Phone number______Mobile Number______
Facsimile number______Email address______
What is this Applicant’s Australian Business Number (ABN) and/or Australian Company Name (ACN)?
What is this Applicant’s trading name?
Is this Applicant GST registered?
Your details for the above three questions can be found on the Australian Business Register website at
What kind of entity is this Applicant?
Note: Specify whether the Applicant is a sole trader, company, partnership, trust, incorporated association. For other entities, please provide details. Where applicable, include the date of registration and/or incorporation and relevant jurisdiction.
Describe this Applicant’s major business activities
If this Applicant is a joint Applicant. What is the relationship of this Applicant with the joint Applicant(s)? (eg are they related companies? Or do they have a contractual relationship?)
What is this Applicant’s Federal electorate/s?
Regional Advisory Group and/or Region
Note: For Queensland Applicants your relevant Sugar Executive Officer can verify your applicable Regional Advisory Group
Far North
Herbert
Burdekin
Mackay
Bundaberg
South
New South Wales
Western Australia
How many years has this Applicant been involved in the sugar industry/region?
Part B: Project information
Project Title (Maximum 15 words)
Note: This name will be used in all correspondence and communication. The title should give a good description of what the project is about.
Project Summary (Maximum 50 words)
Note: Briefly describe theproject proposal (eg construction of sugar store, cane rail transport link etc).
Project Aims (Maximum 100 words)
Intended Project Outcomes (Maximum half A4 page)
Note: This question cross-references with Part C Merit Criterion Six (page 10) and Part D – Timetable and Milestones. Supporting information may be attached on a separate page.
Project Description and Activities (Maximum half A4 page)
Note: Background information may be attached on a separate page.
How much funding are you seeking from Regional and Community Projects(GST exclusive)?
Requests for funding over $500,000
Applicants requesting funding over $500,000 must include a detailed and well developed business case demonstrating the project’s viability, including a cost-benefit analysis of the project to the region, and the economic, social and environmental feasibility of undertaking such a project.
Note: Applicants must provide this information as an attachment to the Application Form
Requests for funding under $500,000
Applicants seeking funding under $500,000, should clearly state the reasons why the proposal should be funded (refer to the Guidelines for details), and may also submit a business case.
Note: Applicants must provide this information as an attachment to the Application Form
Duration of Project
Note: Project must be completed before 31 May 2008.
Project Location
Note: Only answer this question if the project is not located at the Applicant’s physical address specified in Part A. The project must be undertaken within an established sugar growing region.
Unit/Lot No./Property Name ______
Street Address______
Town/State/Postcode______
Project Contact
Note: Please ensure the project contact knows the project well as he/she may need to respond to some specific questions, if required. For a group application, please nominate a single contact person for the project who will be the first point of contact for the project.
Name of individual______
Job Title______
Organisation______
Street Address______
Postal Address______
Town/ State/ Postcode______
Phone number______Mobile Number______
Facsimile number______Email address______
Project Partners
Will other individuals, groups or organisations be involved in the proposed project or be contributing to the proposed project in addition to the Applicant or joint Applicants?
YesNo
If yes, please provide details in the table below.
Note: If there is more than one project partner, please provide the same details as below as an attachment to this document. If details about project partners change after submitting this form, please advise the Sugar Executive Officer in your region (or the Department if applicant is located in NSW or WA) in writing as soon as possible.
Project Partners’ Organisation Details
Legal Name of Project PartnerABN and/or ACN
Type of Organisation / Individual / Other – please state
______
______
Non-profit organisation
For-profit organisation
Research institution
Registered charity/charitable organisation
Value of Contribution / $ / (cash) / $ / (in-kind)
Describe any conditions on the contribution (if applicable)
Status of contribution / Application submitted / Contribution requested
In negotiation
Contribution committed and yet to be received
Contribution received
Details of contact person for Project Partner
Position / Title
First Name / Last Name
Phone Number / Email Address
What is the nature of the relationship of the Applicant(s) with the Project Partners? (eg are they related companies? Or do they have a contractual relationship?)
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Application Form for Regional and Community Projects – March 2007
Part C: Assessment Criteria
The Regional and Community Projects is a competitive grant programme. Please ensure you fully address each of the Assessment criteria. For further information regarding the assessment process, please refer to the Guidelines.
Criterion 1: How does this project contribute to reform and restructure of the Australian sugar industry? (Maximum A4 page)
Criterion 2: Why is your project needed in your region?(Maximum A4 page)
Note: You should demonstrate how your project will benefit the sugar industry and/or the community.
Criterion 3: How is the project proposal consistent with all of the objectives and at least one or more aims of Regional and Community Projects as specified in the Guidelines?(Maximum A4 page)
Note: You must address all programme objectives and at least one or moreaims.
Criterion 4: How is the project proposal consistent with the identified regional reform priorities as determined within the sugar industry’s Regional Plan for your region? (Maximum A4 page)
Note: Regional Plans may be obtained from your Sugar Executive Officer. See the Guidelines for further information.
Criterion 5: Demonstrate the level of support for the proposal from within your region, including cross-sectoral industry support, and support from the community and from government. (Maximum A4 page)
Note: This is different to support received from project partners. Support from the community includes community consultation and outcomes from that consultation. You must provide letters of support either from community, industry and/or state or local government (not including project participants).
Criterion 6: What are the project’s intended outcomes and how will the project’s intended outcomes (listed on page six) benefit the region’s sugar industry and/or dependent communities? (Maximum A4 page)
Note: Responses should address:
- benefits resulting across the supply chain and how these benefits will be shared within the community;
- expected timeframes for outcomes;
- how outcomes will be measured and by who;
- how the outcomes will be reported; and
- whether the project is likely to become self sustaining after completion.
Your intended project outcomes as listed in Part B on page six may also be linked with the Milestones listed in
Part D – Budget and Contributions – Timetable and Project Milestones.
Criterion 7: Applicant(s) should provide evidence that they possess the relevant resources to implement and complete the project successfully by 31 May 2008. (Maximum A4 page)
Note: Responses should address:
- the Applicant’s own relevant skills and experience, demonstrated project management capability, organisational resources such as staff, office and equipment; and
- the ability to meet the Australian Government’s reporting requirements.
“Relevant resources” includes the number of staff, office facilities, relevant experience of individuals involved and any other resources associated with the project have that will ensure its success. Project management capability could be demonstrated by previous experience obtained from running a similar project, or having previously managed another activity that has had government support. Please attach copies of any relevant documents to support your claim eg Curriculum Vitae.
Criterion 8: Do you have access to adequate financial resources to contribute to the project?
Note: This criterion will be assessed with reference to the budget provided in Part D. Applicants must provide a statement of where the funding indicated in the budget provided in Part D will be sourced for the project. Applicants must provide evidence to verify their own and their project partners’ ability to contribute funding to the project. All letters regarding funding commitments must be specific to the project and dated within 3 months of the date of this Application Form. Refer to following.
Documents Attached?All Applicants must provide:
A statement of where the funding indicated in the Budget
(provided in Part D) will be sourced for the project
This statement is supported by:
Where applicable, current letters of confirmation of in-kind support showing
type of support and value amounts. This may include letters from financial
institutions providing evidence of finance available and/or letters from
partners confirming available cash or in-kind support.
(refer to Part D – Proposed Budget)
In addition
- Applicants who are public companies must provide:
- Applicants who are private companies, incorporated associations, sole traders or partnerships must provide:
or
Most recently prepared audited financial statements
OR
- Applicants who are private companies or incorporated associations that meet the definition of small companies, or are sole traders or partnerships equivalent to this definition must provide:
and
Copies of Applicant bank statements
(covering previous 12 months to date of this Application Form)
Note: Unaudited financial statements will only be accepted from Applicants which fall within the definition of "small" companies and/or associations under the Corporations Act 2001 or Applicants who trade as sole traders or partnerships that satisfy at least two (2) of the following tests:
- gross operating revenue of less than $10 million for the financial year;
- gross assets of less than $5 million at the end of the financial year;
- fewer than 50 employees at the end of the financial year.
Criterion 9: What is the level of risk associated with this project? What is your ability to manage this risk? Describe your strategy to manage project risk. (Maximum A4 page)
Note: Risks to this project may include competitive business threats, potential resource issues that may arise now or in the future, the availability of funds to meet any required contribution to the project costs, possible impact of weather conditions (eg drought, flood etc).
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Application Form for Regional and Community Projects – March 2007
Part D: Budget and Contributions
BUDGET
Describe each activity involved in the project and the item costs (refer to the Guidelines for ineligible items). Applicants are required to submit copies of quotes for the purchase of items eg. equipment or project management costs and the amounts below must correspond with letters of support, if applicable (refer to Criterion Eight).
Note: Funding from Regional and Community Projects will be awarded on a competitive basis of up to 50% of the total eligible project costs through cash and in-kind contributions (refer to Guidelines). No ineligible costs or activities should be included in the Budget even if the Applicant is to fund these activities. Also refer to page 18 of application form. Regional and Community Projects Funding is GST Exclusive. Do not include unidentifiable costs such as “materials” or “miscellaneous”. Please provide detailed costs.
Activities to be funded / Item CostsProvide details of each item / Applicant Contribution / Other Contributions
Include all other contributions, including project partner contributions (refer to Part B). / Regional &
Community
Projects / Total Budget
$
Number and/or time @ $per unit / $
Cash
(A) / $
In Kind
(B) / Name of Contributor/
Partner / $
Cash
(C) / $
In Kind
(D) / RCP Funds
Sought
(GST Excl)
(E) / TOTAL of
A+B+C+D+E
TOTAL
% Contribution to project budget
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Application Form for Regional and Community Projects – March 2007
APPLICANT IN-KIND CONTRIBUTIONS
If applicable, please describe your in-kind contributions, particularly how you calculated the dollar value of each item.
(e.g. In kind machinery contribution @ $X/hour operating cost of machinery for 20 hours/week for 40 weeks/year = $800X per year)
PROJECT PARTNER IN-KIND CONTRIBUTIONS
If applicable, please describe project partner in-kind contributions, particularly how you calculated the dollar value of each item.
(e.g. In kind machinery contribution @ $X/hour operating cost of machinery for 20 hours/week for 40 weeks/year = $800X per year)
TIMETABLE AND PROJECT MILESTONES
List the key milestones for your project, including detaileddescriptions and the funding sought for each milestone. Please include all milestones for your project, even if you are not requesting funding for that element of the project from Regional and Community Projects.
Note: if your application is successful, agreed milestones and reporting obligations will form part of your agreement with the Australian Government to monitor the progress of your project. Payment of Commonwealth funds will be linked to successful completion of milestones and reporting obligations. Please ensure that you have adequate funds (Regional and Community Projects and/or your own) to complete each milestone.
Milestone
The milestones will be key activities completed and/or outcomes attained during the life of your project. Your outcomes in Criterion Six may also be milestones. Provide detailed descriptions. / Month and year projected to complete each milestone / Maximum RCP Instalment($)
(GST Excl.) / Applicant’s contribution
($)
(GST Excl.)
TOTAL $
IF RELEVANT, demonstrate commercial prospects for the proposed project eg.any market analysis which identifies potential market share and strategies to access the market and overcome market competition.