Expression of Interest Form
Instructions

Please complete all sections in Part A of this form and Part B (see the separate
MS Excel spread sheet template).

Complete a separate Expression of Interest for each individual infrastructure
project.

Submit the completed forms together (Part A and Part B) by 4pm, 21 September
2012 either by email to rif@boprc.govt.nz or post to Matt Cowley, PO Box 364,
Whakatāne 3158.
PART A – Project Description
Project title:
Click here to enter text.
Organisation:
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Brief project description:
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Location of project:
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Details of infrastructure project
1
What does the project involve? (Select as appropriate)
Construction of physical assets and built structures
Purchase of freehold property or land
Significant equipment associated with the above
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2
Does the project promote sustainable regional economic development OR
promote environmental protection and enhancement that supports
sustainable regional economic development?
Yes
2.1
No
If ‘Yes’, please explain how the project promotes sustainable regional
economic development, or promotes environmental protection and
enhancement that supports sustainable regional economic development
(whichever is applicable):
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3
What type of infrastructure is the project? (Select Types 1, 2, or 3 as appropriate)
Type 1 – any one or more of the following:
Roading, bridging and transport infrastructure
Passenger transport systems and infrastructure
Flood control and drainage
Wastewater and sewerage systems
Broadband infrastructure
Environmental protection and restoration
Regional park acquisitions
Other transportation infrastructure
Lakes protection and restoration
Harbour protection and restoration
Energy and associated infrastructure
Emergency management infrastructure
Emergency recovery assistance
Type 2
Infrastructure projects that align or overlap with BOPRC activities in the
Ten Year Plan 2012-2022.
Type 3
Infrastructure projects that contribute significantly to sustainable regional
economic development of the region and promote the social,
environmental and cultural wellbeing of the Bay of Plenty.
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3.1
If the project is Type 2 or Type 3, please explain how:
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Benefits of the Project
4
What geographic area will directly benefit from the infrastructure project?
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5
Approximately how many people will directly benefit from the infrastructure
project? (either estimate number or list communities/towns/cities that will
directly benefit)
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Financial Information
6
When is the project expected to start and be completed?
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7
What is the total value of the project expected to be?
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8
What is the expected total amount of funding to be requested from the
Regional Infrastructure Fund?
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9
Expected type of funding sought from the Regional Infrastructure Fund: (tick
as appropriate and provide brief breakdown on how the project will utilise the funding type(s)
in the box below if not previously explained in Question 8)
Grant
Loan
Equity
Note – Bay of Plenty Regional Council is the final decision-maker on any allocation of funding
from the Regional Infrastructure Fund. Receipt by the Council of an Expression of Interest or
formal application does not represent a commitment of any kind by the Council or guarantee a
funding allocation will be made to the potential project partner.
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Signatures
Please provide the signatures of the Chief Executive (or equivalent) and the head of the
governing body of the organisation as confirming authorisation for submitting this expression
of interest.
......................................................................
.......................................................................
Signature
Signature
Title: Click here to enter text.
Title: Click here to enter text.
Date Click here to enter a date.
Date: Click here to enter a date.
Primary contact
Please provide details of the person authorised to be the primary contact for correspondence
with BOPRC officers:
Name:
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Title:
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Email:
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Phone:
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Postal Address:
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For your interest: Information required in a formal application
The following information will be required in a formal application to the Regional
Infrastructure Fund:

Description of other options for achieving the outcomes of the project.

List of consents (resource, building and other) required for the projects.

Complete financial analysis of the project (including business case if relevant).

Risk analysis.

Assessment of the impacts of the project on environmental, economic, social and
cultural factors.
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