It is important that you read the Grant application guidelines before completing the application form


Download 62.11 Kb.
NameIt is important that you read the Grant application guidelines before completing the application form
A typeDocumentation

logo_darkbg_mono c:\users\haskinsl\desktop\get ready logo.jpg

NDRP2013 -15 Round 2 Application Form 1L Local Government

ALL Local Government applicants must complete this form

It is important that you read the Grant application guidelines
before completing the application form.


Grant Scheme

All Hazards // Volunteer // please select one

Project Title

Short title by which the project will be known

Project Sponsor

Senior person responsible for ultimate decisions re: project direction and the resolution of stakeholder disagreement

Primary Beneficiaries

Organisations or Target groups

Funding Sought

What is the total amount of funding sought (GST Exclusive)?

Project Duration

x” months




SAFECOM Emergency Management Office welcomes all inquiries regarding any aspect of the NDRP and its related processes

More information is available from…

Website

www.safecom.sa.gov.au

Email

emergencymanagement@safecom.sa.gov.au

Contacts

NDRP Coordinator Angela Smith Phone: 8463 4147

Project Officer Linda Haskins Phone: 8463 4150




1. Contact Details

Organisation Name




ABN Number




Postal Address




Contact Person

The nominated contact person should be familiar with the project will be contacted if further information about the project is required

Position




Telephone




Email







2. Context

Outline the context/overview of the project, the business or policy context including any links to sector/agency strategic plans or state strategic plans.




3. Stakeholder Engagement

What other organisations/groups will participate in, provide technical advice or are supportive of this project?

Represented by: Name/Position/Organisation/Telephone/Email




4. Project Definition

4.1 Scope

Outline the scope of the project. What developmental stage is this project for example:

  • Scoping study

  • Pilot project

  • Trial Implementation

  • Rollout of agreed framework/system

  • Implementation of a sustainable model

Please include estimated Duration and Commencement date. Have any preliminary investigations, risk assessments, design work, development approval etc. already commenced or been completed?

4.2 Deliverable/s

List measurable deliverables the project will create e.g. training course material and number of graduates, reports with recommendations.

Outline any new or additional functionality or capability this project would establish.

4.3 Exclusions

What is outside the scope of the project?

4.4 Constraints

Document any constraints that you are aware of for the project.

4.5 Dependencies

Is the project dependent on anything/anyone to proceed or meet intended deliverables or timeframes?

4.6 Business Case

If a detailed business case has already been prepared then reference it here. If not please provide brief description of the anticipated cost/benefit of conducting this project.

4.7 Sustainability

Is it likely that future grant funding will be sought for subsequent stages of this project? Yes/No

What is the viability of this project if subsequent grant funding is not approved?

Please explain how ongoing funding and maintenance of project outputs and outcomes will be achieved or addressed in the project plan.

Have any organisations been identified or agreed to be responsible for the sustainable delivery of subsequent stages and/or the ongoing delivery of outputs/outcomes? What are the estimated ongoing costs?




5. Project Resources and Cost Estimates

This describes the anticipated type and quantity of resources required and their estimated value.

Financial expenditure will fund costs that will not be incurred if the application is unsuccessful. For example: time limited employment of a project officer, printing and publication costs, supply of services from external contractors.

In-kind contribution will recognise the estimated value of resources that will support the project but will not incur a specific financial cost or charge to the project. For example: supervision of project, or technical expertise provided by substantive staff, use of existing desk/phone and other accommodation facilities, stakeholder participation in project workshops, forums or one-on-one consultation and other costs that will be incurred irrespective of whether the application is successful.

Type of Resources

Quantity

Estimated financial expenditure

**GST EXCLUSIVE

Estimated in-kind contribution


Insert more lines as required




$

$







$

$

TOTAL




$00,000

**This should match the Financial Contribution in Section 6

$00,000

**This should match the In-kind Contribution in Section 6



6. Proposed Funding – Financial – Local Government Applications – GST Exclusive

Match funding components may be provided by a single agency or through a consortium of agencies that are willing to contribute to the project. It will be the applicant’s responsibility to establish and manage the various parties’ contributions. Confirmation of the availability of contributory funds is required.

Financial contribution will fund costs that will not be incurred if the application is unsuccessful. For example: time limited employment of a project officer, printing and publication costs, supply of services from external contractors.

In-kind contribution will recognise the estimated value of resources that will support the project but will not incur a specific financial cost or charge to the project. For example: supervision of project or technical expertise provided by substantive staff, use of existing desk/phone and other accommodation facilities, stakeholder participation in project workshops, forums or one-on-one consultation and other costs that will be incurred irrespective of whether the application is successful.

For the purposes of calculating match grant funding, the applicant can reduce their cash contribution by providing in kind contribution of up to 20% of the cash cost of the project.

Total Project Value will also be reported to demonstrate more accurately the full level of resource commitment to approved projects.

For the purpose of calculation all costs are GST exclusive.

Contact the NDRP Coordinator to complete this section.

Project Partner

Match funding

Financial Contribution

In-kind Contribution

Total

Commonwealth


Up to 33%










State Cabinet


Up to 33% combined










State Agency contribution










Local Government contribution


At least 34% combined










Non-Government contribution










Other funding sources,
please specify e.g. Corporate Sponsorship, other Grant programs










TOTAL Project Value




$00,000

**This should match the Financial Contribution in Section 5

$00,000

**This should match

the In-kind Contribution in Section 5

$00,000





7. Exceptional Circumstances Waiver

Please explain in this section why the normal match funding arrangements should be waived.

At their discretion, the relevant Assessment Panel/s may consider alternative match funding models, where adherence to the normal match funding arrangements would preclude participation due to financial hardship or to ensure an equitable cost share is achieved. A reduced applicant’s cash contribution may be considered for high priority initiatives or where the applicant is not the primary beneficiary of the project outputs or outcomes.




8. Project Deliverable(s) and Timelines

Project Deliverables are those tangible outputs that will be produced by the project (e.g. reports, brochures, fire break, levee bank or other treatments, plans, posters, training courses) listed in section 4.2

You will be required to demonstrate the achievement of specific deliverables in order to receive progress payments. Please complete the following table with deliverables relevant to your project.

Sample text is provided below for a 14 month project with financial expenditure of $130,000.

Deliverable

(refer to deliverables listed in section 4.2)

Estimated completion date for each deliverable

Estimated financial expenditure incurred for each deliverable

**GST EXCLUSIVE

Funding Agreement signed

April 2014

nil

Project Advisory Group established

Project Officer recruited/commenced

June 2014

$5,000

Stakeholder engagement commenced/conducted

September 2014

$30,000

Goods/Service specifications agreed

Construction works commenced

Training modules agreed / printed

November 2014

$25,000

Construction works completed

Training sessions conducted

March 2015

$50,000

Review and feedback

May 2015

$7,000

Project acquittal (min. 10%)

June 2015

$13,000




9. Quality Expectations

What measures will be made for the quality of the deliverables/outcomes? Are there set standards that the project needs to meet or other expectations?




10. Acceptance Criteria

Outline the acceptance criteria that the project will be assessed against.

How will you know that the project has achieved its intended deliverables/outcomes?




11. Project Risks

Are there any avoidable or unavoidable adverse impacts that may result from undertaking the project?

Are there any avoidable or unavoidable adverse impacts that may result if the project is NOT undertaken?

How will these potential adverse impacts be addressed or minimised as part of the project?




12. Attachments







13. Declaration

To be signed by the (eligible organisation) chief executive or equivalent

I certify that all details supplied in this application and in any attached documents are true and correct to the best of my knowledge, and that the application has been submitted with the full knowledge and agreement of the management of my organisation/group.

I have read the accompanying guidelines for applicants provided with this application form.

I agree that I will contact the NDRP Coordinator immediately if any information provided in this application changes or is incorrect.

I confirm that the Agency Contribution shown in Section 7 – Proposed Funding – Financial will be committed if a funding offer is made.

I consent to the release of information in this application (excluding personal details) for non-commercial public information purposes.

I understand that the information above will be used in accordance with relevant legislation and declare that this information is correct to the best of my knowledge.

Signature




Name




Position




Date





Please deliver hard copy applications to:

NDRP Coordinator

SAFECOM Emergency Management

Level 6, 60 Waymouth Street

DX 206

GPO Box 2706

ADELAIDE SA 5001
Please email soft copy applications and delivery advice to:

emergencymanagement@safecom.sa.gov.au

Please note: If you are submitting your application electronically, please .pdf the entire application and all attachments.

If the electronic application and/or supporting documents are larger than 5MB, please deliver the electronic version on a CD to the address above.



Project NDRP Application

Version

Page

Share in:

Related:

It is important that you read the Grant application guidelines before completing the application form iconIt is important you read these guidelines & notes before completing your application form

It is important that you read the Grant application guidelines before completing the application form iconImportant: Please read these directions before completing this Application,...

It is important that you read the Grant application guidelines before completing the application form iconPlease read this information before completing the enclosed Application Form

It is important that you read the Grant application guidelines before completing the application form iconPlease read the ‘applicant guidance’ booklet before fully completing the application form

It is important that you read the Grant application guidelines before completing the application form iconGuidance: Read this page before completing the Research Ethics Approval Application form

It is important that you read the Grant application guidelines before completing the application form iconPlease read the Guidance for Applicants before completing this form....

It is important that you read the Grant application guidelines before completing the application form iconPlease read the Guidelines for Applicants, which can be found at...

It is important that you read the Grant application guidelines before completing the application form iconPlease read the help text before completing your application

It is important that you read the Grant application guidelines before completing the application form iconPlease Read the Instructions Carefully Before Completing Application

It is important that you read the Grant application guidelines before completing the application form iconContact the foundation(s) they are interested in applying to prior...




forms and shapes


When copying material provide a link © 2017
contacts
filling-form.info
search