Canada – British Columbia Agri-Innovation Program APPLICATION FORM PART A APPLICANT INFORMATION PROJECT DESCRIPTION Canada-BC Agri-Food Innovation Program Checklist Please ensure that all of the following information has been completed and reviewed before you submit your application: Have you contacted an IAF Program Manager to discuss your project? A completed application form including all questions. Application has been signed by a person authorized to make any and all commitments to the project. A completed budget and performance plan including project milestones. A completed Communications Plan. Letters of Support (if applicable) have been attached to the Application. You have read and understand the terms and conditions as outlined in Part A. An electronic version of your completed Application may be sent to funding@iafbc.ca or to your Program Manager. Approved projects must be completed within 2 years of approval date. Projects approved after March 2016, must be completed no later than January 2018 Page 2 of 11 Canada – British Columbia Agri-Innovation Program Foundation Use Only Date Received: Date Revised: Application Number Project Title (10 words or less) Section 1A: Applicant Information Organization: Project Contact: Address: City: Telephone Number: Email address: Business or Association Number: NAICS Code (Must be supplied) Prov.: Fax Number: Website: PC: Section 1B: Designated Officer (Signing authority on behalf of the applicant) Name: Address: City: Telephone Number: Email address: Prov.: Fax Number: PC: Page 3 of 11 Section 2: PROJECT INFORMATION FUNDING PRIORITIES 1. Please indicate which one of the following priorities your project aligns with. RESEARCH & DEVELOPMENT PILOT & DEMONSTRATION COMMERCIALIZATION & ADOPTION FUNDING PRIORITIES 2. Please indicate which one of the following priorities your project aligns with. ADVANCEMENTS IN PLANT, ANIMAL AND FOOD SCIENCE ENERGY AND WASTE MANAGEMENT NEW PRODUCT DEVELOPMENT AND COMMERCIALIZATION IMPROVEMENTS IN SOIL, WATER AND AIR QUALITY CLIMATE CHANGE ADAPTATION Organization Type Sector Group Choose an item. Choose an item. Select the most appropriate organization type as it applies to the Applicant Select the most appropriate sector group as it applies to the application Page 4 of 11 Project Start Date*: Project End Date**: * Start date for funding through CBCAIP may not be prior to the Foundation’s approval date ** All projects must be fully completed (including final reporting) by Jan 31, 2018 Approved projects must be completed within 2 years of approval date. Projects approved after March 2016, must be completed no later than January 2018 1. Provide a brief executive summary of your project: 2. What are the projects objectives? What do you expect to achieve through this project? 3. How will the project results benefit the agriculture, agrifood and agribased product sectors in BC? 4. Project Background: 4.a How does this project respond to an opportunity, need, demand, gap or issue of the sector? Explain. 4.b Describe how the project advances the sectors knowledge or position in the subject area. Page 5 of 11 5. Project Activities: 5.a Describe your project activities in detail. Outline the steps you will take to accomplish the project. 5.b If applicable, please describe how your project builds on previous work/research or if it is new provide background. 5.c 5.d If your project has a research component, please append a detailed methodology. Please indicate if your project requires any type of regulatory assessment or permitting (For example, an environmental impact assessment). 6. Benefits and Impacts of your Project: PLEASE NOTE THAT YOUR FINAL REPORT MUST INCLUDE A PERFORMANCE MEASUREMENT OF THOSE ITEMS THAT YOU HAVE IDENTIFIED BELOW 6.a Identify the target audience and number of individuals that will be impacted and/or benefit from your project. Page 6 of 11 6.b Identify the tangible outputs or deliverables of your project (i.e. best practices, new products, technology, and/or information). 6.c Outline the activities you will undertake to evaluate the performance and success of your project. 6.d Identify any economic, social and/or environmental benefits your project is intended to provide and how you will measure them. 6.e Identify the shortterm results and how you will evaluate if you’ve successfully achieved them. 6.f Identify expected long-term results and describe how you will know if your project has been successful in achieving these results (i.e. beyond end of project). 6.g Provide an estimate of the financial impact that your project may have on the sector if adopted. Page 7 of 11 7. Communication Plan and Strategy: 7.a Describe how you plan to share the details of the project and the results. 7.b Identify the individuals or groups that you will target for communications or outreach. Indicate how they might be involved during the project. 7.c Identify the methods that you will use to disseminate and transfer the new knowledge to the target audience. 7.d Identify the type and number of communication materials that will be developed and produced and how they will be distributed. 7.e Indicate the number of presentations that will be made to the target audience and the anticipated reach. 7.f Indicate the number of scientific or popular articles that will be developed and how they will be distributed. Page 8 of 11 7.g Identify any other communication activities, including (but not limited to) internet/website publications, advertising, radio or television broadcasts. 8. Resources: 8.a Describe how your Organization intends to carry out the work (i.e. staff, contractors, consultants). Identify any other organizations or partners that will be involved with the project and their role. PART B: PROJECT BUDGET Please complete the Project Cost and Project Funding budget forms. These forms are located in the accompanying PDF or Excel file. These spreadsheets will help us to better understand your project and will also serve as a planning tool for you to ensure that you have thought about each step of your project. Page 9 of 11 TERMS AND CONDITIONS I/We confirm that I/we understand that the following conditions must be met for funding eligibility: The organization confirms that this application has been vetted by the Organization's Board of Directors and the Authorized Representative named below is that of the CEO / Chairperson / President or the Senior Financial Officer / Treasurer; The applicant must demonstrate to IAF that the applicant has adequate human resources, experience and financial resources required to carry out their responsibilities; The applicant must be in compliance with federal, provincial and/or municipal environmental requirements with respect to this project; The applicant agrees that this application form creates no obligation on the part of IAF to provide funding; The applicant agrees that information provided on this application form will be collected and used by IAF to determine eligibility of the applicant and the proposal for funding; The applicant agrees that information provided may be disclosed to third parties for purposes of assessing the project proposal for funding; The applicant agrees that any financial, commercial, scientific or technical information provided in this application will be treated in accordance with federal and provincial legislation which governs the management of information; The applicant confirms that there is no conflict of interest. If this application is approved: The applicant agrees that, if this application is approved, the individual/ organization will be required to enter into a contribution agreement that sets out terms and conditions for funding; The applicant agrees that costs incurred before the date of approval are not eligible for reimbursement; The applicant understands that failure to deliver the project as described in the application may result in non-payment and/or reimbursement of payments made; The applicant agrees to notify IAF in advance if changes to the project are required or delays in the project time line are anticipated (note: substantive changes to the project need to be approved in advance); The applicant agrees to carry out financial functions in accordance with Generally Accepted Accounting Principles; The applicant agrees to provide progress reports on a regular basis and a final performance report summarizing project reach, results achieved and resources expended; The applicant agrees to provide IAF with a copy of its annual report, upon request, and grants IAF or its designated representatives the right to conduct an audit on the project described in this application; The applicant agrees, as a condition of funding approval, to support overall communications objectives by providing third-party validation of the program. The applicant agrees to provide appropriate recognition for the financial assistance provided by IAF and its funders; The applicant will make available to IAF any communication vehicle developed under this project and agrees that IAF and its funders may use such vehicles for communications purposes; The applicant agrees that, if approved, information provided about the project or the results of this project may be posted on the IAF website and/or used in other communications activities by IAF or its funders; The applicant agrees that IAF, Canada and the Province of British Columbia will not be liable for any claims for damage and will indemnify IAF, Canada and the Province of British Columbia from any claims for damage by the applicant or third parties related to the activities carried out for the project by the applicant or on its behalf; The applicant agrees to ensure that IAF funding will not be used to pay government employees or to reimburse costs incurred by them collaborating on a project (i.e., to attend a meeting or conference, deliver a presentation, act as an expert, or collaborate in research). I/WE DECLARE that the information given in this application is to the best of my/our knowledge, complete, true and correct. I/WE CERTIFY that meeting the program eligibility criteria does not confer a right to financial assistance. The applicant agrees to comply with all applicable federal and provincial laws as they relate to this project. Agree to Terms and Conditions DO NOT Agree with Terms and Conditions Name of Signatory: Page 10 of 11 COPYRIGHT PERMISSION In addition to the implied consent at law allowing to reproduce and distribute any part of or the whole of the documentation provided in or with this Project Application Form for purposes consistent with the receipt, assessment and subsequent treatment of the Application, the Applicant also grants IAF, the Province of British Columbia or Agriculture and Agri-Food Canada permission to reproduce and distribute the whole or any part of the said documentation to third parties to determine eligibility for other Government of Canada or provincial programs from which the applicant might benefit, and to evaluate the scope, direction and effectiveness of agricultural programming and research in Canada. The Applicant’s voluntary grant of, or refusal to grant, this copyright permission in no way affects the Applicant’s eligibility under this funding program. Consent Refuse Name of Contact: Name of Signatory: Date: INTELLECTUAL PROPERTY Should your application be successfully considered you will be required to agree to the following before program funding can be released: The Ultimate Recipient is the owner of all intellectual property rights, including copyright, in all materials produced or acquired by the Ultimate Recipient as a result of this written Agreement (the “Ultimate Recipient Material”). (a) The Province exclusively owns all property and intellectual property rights, including copyright, in the Province Material unless the Province has indicated in writing that the Province Material is to be owned by the Ultimate Recipient, as the case may be. (b) The Ultimate Recipient must deliver the Province Material to the Province forthwith following the expiration or sooner termination of this Agreement. The Province or IAF may, at any time or times prior to the expiration or sooner termination of this Agreement, give written notice to the Ultimate Recipient requesting delivery by the Ultimate Recipient to the Province of any or all of the Province Material, in which event the Ultimate Recipient must forthwith comply with that request. Page 11 of 11