For Official Use Only Clean Technology Investment Programs Progress Report Note: This report template is Appendix 2 in the Guide to Managing your Grant This progress report is only required to measure the interim progress of milestones where an individual milestone period is greater than six months. Project Number Recipient Name Project Title Next Milestone Number Milestone Completion date as detailed in your Funding Agreement 1. Project Progress Do you expect to complete your next milestone by the due date and within your estimated budget as detailed in your Funding Agreement? Yes No If No, please comment on any expected variation to the completion date and budget, including reasons for the delays and efforts being made to address them. Please briefly describe (2 to 3 sentences) the project activities undertaken so far in the milestone period. Do you anticipate any changes to the project in terms of activities, outcomes, budget and timing? Yes No If Yes, please provide details including impact on project outcome, budget and timing. Clean Technology Investment Programs X480 Progress Report V4 131023 1 of 2 For Official Use Only 2. Certification I ......................................................being a person duly authorised by the Recipient hereby certify that: The information in this report is accurate, complete and not misleading. The eligible expenditure identified above has been spent only on the project and for the purposes stated in the Funding Agreement. I am aware of the Recipient’s obligations under their Clean Technology Investment Programs Funding Agreement, including, the need to keep AusIndustry informed of any circumstances that may impact on the objectives, completion and/or outcomes of the agreed project. I am aware that the Funding Agreement empowers the Commonwealth to terminate the Funding Agreement and to request repayment of funds paid to the Recipient where the Recipient is in breach of the Funding Agreement. Signed ............................................................................... Date 3. Submitting this report Please submit your completed report to your State or Territory Clean Technology Programs mailbox: State Mailbox NSW CTIPNSW@industry.gov.au VIC CTIPVIC@industry.gov.au QLD CTIPQLD@industry.gov.au SA CTIPSA/NT@industry.gov.au NT CTIPSA/NT@industry.gov.au WA CTIPWA@industry.gov.au TAS CTIPTAS@industry.gov.au ACT CTIPACT@industry.gov.au Clean Technology Investment Programs X480 Progress Report V4 131023 2 of 2