Application Form - Investment Agriculture Foundation of British

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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
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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:
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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
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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.
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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.
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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.
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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.
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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.
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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:
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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.
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