Property Level Flood Protection (Resilience) Grant Application Form IMPORTANT NOTES: THIS APPLICATION FORM IS FOR THE GRANT TO PROVIDE MEASURES WHICH WILL INCREASE THE FLOOD RESILIENCE OF RESIDENTIAL DWELLINGS AND BUSINESSES AFFECTED BY THE BOXING DAY 2015 FLOOD EVENT. PLEASE READ THE GUIDANCE NOTES BEFORE COMPLETING THE APPLICATION Please fill the form in CAPITAL LETTERS 1. CONTACT INFORMATION NAME : CONTACT PERSON : HOME/CORRESPONDENCE ADDRESS (including POSTCODE) : TELEPHONE NO. (Office hours) : TELEPHONE NO. (Out of hours) : FAX NO/EMAIL : 2. FLOODED PROPERTY DETAILS PROPERT TYPE (please tick): RESIDENTIAL ARE YOU THE PROPERTY OWNER? (yes/no) BUSINESS If no please provide details of the property owner PLEASE PROVIDE THE FULL ADDRESS OF THE FLOODED PROPERTY IF THIS IS DIFFERENT FROM THE HOME/CORRESPONDENCE ADDRESS ABOVE: PLEASE PROVIDE DETAILS OF ALL WHO HAVE OWNERSHIP INTERESTS IN THE PROPERTY TITLE FORENAME Urban Vision 2014 SURNAME Page 1 3. FLOOD DETAILS DATE PROPERTY FLOODED: CAUSE OF FLOODING (Please describe how the flooding occurred): (River or watercourse, Blocked Drain/Sewer, Extreme Rainfall, Other) DESCRIBE THE DAMAGE THAT WAS CAUSED IN YOUR PROPERTY ( i.e. What rooms were affected, how deep was the water, what items, surfaces or structures were damaged and how): PLEASE PROVIDE EVIDENCE OF FLOODING AT YOUR PROPERTY BY ATTACHING PHOTOGRAPHS TO THIS APPLICATION Urban Vision 2014 Page 2 4. THE NEXT STEPS You should submit your application form to: flooding.resilience@urbanvision.org.uk Your application will be checked against the qualifying criteria. You will then be contacted about the need to obtain a professional survey. Surveys should be undertaken by a relevant Building Engineer or similar with relevant experience of providing resilience measures. A copy of the completed works invoice must be forwarded to this office by 31st December 2016. Please note that at some future stage the Council may visit the premises to ensure the resilience and / or resistance measures have been installed in line with the requirements of the grant. If during the inspection it is found that the relevant measures and or equipment have not been installed or are no longer in situ then we may seek to recover the original grant and other action may be considered. However, you should avoid arranging the survey until your application has been approved, just in case the application/work is not eligible and the cost of the survey cannot be covered by a grant. The survey will help to identify the resilience and/or resistance measures appropriate for your property. A checklist of these is attached to the guidance notes, not all of which will be appropriate or required, and following the survey we will agree with you those that can be funded from the grant scheme. If you have had a survey carried out already to identify the most appropriate flood resilience measures, please provide a copy with this application. Please note that the maximum grant that can be applied for is £5,000 (including VAT). Any costs incurred above £5,000 will need to be met from your own funds. £500 (including VAT) of the maximum £5,000 can be used to instruct the Chartered Building Surveyor (Surveyor must be a Chartered Member of CIOB or RICS). Grants are only intended to fund measures which improve the property’s resilience or resistance to flooding, over and above repairs that would normally be covered by insurance. More information is available at National Flood Forum http://www.nationalfloodforum.org.uk/property-level-protection-community-tool/ FOR RETROSPECTIVE APPLICATIONS ONLY – If you are applying for works that have already been undertaken, please describe in detail what measures you have had installed, their cost and how you ensured value for money i.e. utilised insurance company contractor, or sought quotes from a range of providers. Evidence of quotes and invoices should please be included with your application. Urban Vision 2014 Page 3 5. Terms PLEASE READ THROUGH THE TERMS AND DECLARATION CAREFULLY BEFORE SIGNING AND SUBMITTING YOUR APPLICATION. THE FOLLOWING SETS OUT THE TERMS BY WHICH THE GRANT OFFER WILL BE MADE IF YOUR APPLICATION IS SUCCESSFUL. The Measures you choose to fit to your property will be selected entirely at your own risk. Should the property flood again in the future, the Council maintains no liability for the selection or installation of the Measures you have chosen. I / we agree to purchase and install the resilience / resistance measures (“the Measures”) that Salford City Council approves the funding for. I / we agree to store the Measures securely and protect them from damage. I / we agree to maintain the Measures in accordance with the manufacturer’s instructions. I / we agree to sign up to the Environment Agency’s Flood Warning Scheme. I / we agree to use the Measures in accordance with the manufacturer’s instructions. I / we agree to allow the Council access to the Property at all reasonable times for the purposes of inspection of the Measures. I / we agree that if the property is sold in the future, the Measures will remain with the property and pass to the new owner. The details of your name and address, details of Measures installed and the outcome of any inspection visits will be shared with the Department for Environment, Food and Rural Affairs (Defra). The Council will not (for any reason) share any of the information you have submitted with a third party. The Council or Defra may contact you in the future for the purposes of research, to identify if the property Level Flood Protection measures you selected have been of benefit to you or to inform you of any future flood response schemes. The Council shall not be liable to the Property Owner or persons with a lease with repairing obligations for any action, claim, demand, cost or expense incurred in respect of any loss or damage, including for any negligence, breach of contract, property damage or personal injury (including death) including any consequential or indirect loss, which arises out of or in connection with the installation or use of the Measures. The Council shall not be responsible for providing flood warnings or for ensuring that any party does so. The Council shall not be responsible for removing any fixtures associated with the Measures if or when the Property Owner no longer requires them. Ownership of the Measures shall vest in the Property Owner and the Council shall not be responsible for the repair or replacement of damaged or lost flood protection and resilience measures nor for the provision of any future measures. Urban Vision 2014 Page 4 6. DECLARATION I / we agree to the terms set out in this Application. I / we confirm we are the lawful owner(s) of / hold a lease with repairing rights for the property detailed in Section 1 of the application form Public funds must be protected and so the information you have provided on this form may be used to prevent and detect fraud. Should it be found that you have not used the grant funds to purchase and install the Measures identified in the attached Report, or that upon inspection the Measures are not found to be in place / available on site, or in an adequate state of maintenance, you risk prosecution and recovery of all grant payments. To the best of my / our knowledge the information in this form and all other information given in support of this application is correct. I confirm that I / we understand the purpose of this form and the reasons for the collection of my / our personal data (to the extent that this application form contains information which is personal data for the purposes of the Data Protection Act 1998) and that I agree to my / our personal data being used as stated. If any information changes I will inform Salford Council immediately. Name Signature Date 7. OFFICIAL USE ONLY I. .. have completed this form on behalf of the applicant and have read all the details over to him/her before asking him/her to sign the declaration. Signature: ... Urban Vision 2014 (please insert full name in lieu of signature) Page 5 Date: