Dandenong Ranges Environmental and Bushfire Reduction Community Grants Round 2 Expression of Interest for Large Projects Projects seeking over $50,000 are required to complete this Expression of Interest (EoI) form. The EoI describes the project concept (goals, approach, types of actions involved) and other general information. The EoIs will be assessed and those that clearly meet the objectives of the program may be invited to prepare detailed project proposals. EOIs MUST BE SUBMITTED BY 9AM 8th FEB 2016 Contact details Organisation Name Authorised officer Contact Person Contact Phone Number Contact Email Contact Mobile Number Postal Address ABN Number Suburb Post Code Group Incorporation Number / FTLA No. Is your organisation incorporated and working in the Dandenong Ranges? Is your organisation registered for GST? Yes / No Yes / No Is your organisation Insured? Yes / No What is the Land Tenure where your project will be working? Public Land / Private Land / Both In order to receive a Grant, your organisation will need to be covered by public liability insurance of $10M and personal accident insurance (or to be auspiced by an organisation that carries such insurance), or be a current member of the FTLA. If your application is successful, you will need to provide a photocopy of your certificate of currency. A certificate of currency is a summary of the insurance cover showing relevant details. Project details Please describe your project (what activities, when, who will participate, where will the work occur, how will the funding be used). Please include the specific location where the activity will occur (e.g. include a map, address, nearest crossroad). Please address the following in your description: What are you aiming to achieve with your project? How does your project contribute to the goals of the program? That is, how will your project contribute to biodiversity improvement? How will your project either reduce bushfire risk or at least avoid increasing it? Project Title: _____________________________________________________________ Organisation’s Experience Delivering Large Environmental Projects: ______________ _________________________________________________________________________ _________________________________________________________________________ Partners Involved: _________________________________________________________ Project Description. Program Priorities The goals of this program are to improve native vegetation and habitat for native species (via actions like managing weeds and pest animals) while reducing (or at least not increasing) bushfire risk. Describe how your project contributes to these priorities: Improve native vegetation and habitat for native species (including managing invasive weeds or pest animals) Reduce bushfire risk (through fuel management) 2 2 Project delivery For each of the main activities in your project, please describe how it will be delivered. Delivery approaches include volunteer labour, grants, contractors, workshops, property plans etc. Project risks Describe the key risks to the project. These are the risks that are very likely to arise and they will have a significant impact on delivery of the project (high likelihood and high consequence. Describe how these key risks will be managed. Attach a detailed risk assessment (appendix 1) of all foreseeable risks associated with the project. . 3 3 Outputs Please list the specific outputs your project will produce. Outputs are the tangible products and measures of activities. Select from: Native vegetation – area established, maintained or modified (includes direct seeding, mulching, plant guarding, slashing, thinning, tube stock planting) Weed control – area treated (includes biological control, burning, manual removal, drill and fill, mechanical removal, spray) Pest animal control – area treated (includes baiting, fumigation, shooting, trapping, habitat destroyed) Fencing – area where fence installed, maintained, removed, modified or replaced (includes fencing for containment or exclusion). Please nominate target – domestic stock, pest animals, native species, vehicles, people Area where fire regime has been altered Land manager agreements – number and area covered by the agreement, type of agreement (including binding non-perpetual, or binding perpetual) Field day, presentation, training or workshop – number of events, participants Management plan – area covered by plan and focus for the plan (e.g. conservation, fire, management practices, flora, fauna, culture, heritage) Output [add further lines as needed] E.g. Native vegetation modified via planting of understorey grasses Weed control by manual removal and spraying Approximate quantity 80 ha 110 ha 4 4 Funding request Please provide a broad budget for the project. Funding rates /costing guidelines: Volunteer in-kind labour is to be costed at $30/hour (max). Generally contractor rates should be under $60/hour. Rates above this must be explained and justified. A maximum of 10% of project budgets can be allocated to project management and administration. Any requirements above this will require strong justification and will be considered on a case by case basis. Type of work [add further lines as needed] Approximate budget E.g. Revegetation and vegetation enhancement Vegetation management for fuel reduction Planned burn $20,000 $48,000 $35,000 TOTAL FUNDING REQUESTED: $___________________ TOTAL CO-INVESTMENT (CASH OR IN-KIND) ANTICIPATED: $___________________ 5 5 Acknowledgement On behalf of the organisation we understand that this is an expression of interest only and that final project approval will be subject to funding availability and project suitability. Assistance is not available for work completed prior to project approval and the signing of an agreement. If submitting this form electronically, please type your name in CAPITALS in the signature box and it will deemed that you agree to the terms above. Group President / Delegated Manager Signature: Name: Date: Position: Group Secretary or Treasurer / Delegated Officer Signature: Name: Date: Successful organisations will be required to enter into a signed agreement with the PPWCMA that will provide a summary of agreed works, timeframes and reporting requirements. This agreement will be a legal document. Privacy Personal information supplied by you and/or contained herein is collected, stored and maintained for the purpose of facilitating and administrating this grant process. This information maybe disclosed to relevant government organisations or other agencies for the sole purpose of administering the grant for which the information was collected. The information collected is not traded, sold, licensed nor used for commercial marketing purposes. You have the right to access to this information. Sites are to be made available for auditing, monitoring or demonstration purposes at the request of PPWCMA staff. Submission Checklist Have you: [ [ [ [ [ [ [ ] Completed all sections of the application form? ] Attached a completed risk assessment? ] Obtained all the necessary signatures? ] Included written permission from the land manager if you are working on Public Land? ] Attached copies of all relevant documentation? ] Double checked your budget figures? ] Included a map of your project location? Please send your completed application to: Dandenong Ranges Community Grants C/O PPWCMA Lvl 1, Landmark Corporate Centre 454 – 472 Nepean Hwy Frankston Victoria 3199 Or email the completed form and documents to: Community.grants@ppwcma.vic.gov.au REMEMBER: EOI CLOSE 9AM 8TH FEB 2016 6 6 Appendix 1. Risk Assessment Template Risk Assessment What are the major foreseeable risks facing your project, and what measures do you have in place to reduce their impact? Refer to the risk assessment table below and page 11 of the guidelines to determine the rating. Risk Description Likelihood* Consequence* Rating Current Controls/Contingency Describe the risk, its RARE, UNLIKELY, INSIGNIFICANT, LOW, Describe what you will do to mitigate the sources and impacts POSSIBLE, LIKELY, MINOR, MODERATE, MEDIUM, risk, source or impact to an acceptable ALMOST CERTAIN MAJOR, CRITICAL HIGH, level SEVERE LIKELIHOOD CONSEQUENCE Insignificant Minor Moderate Major Critical Almost Certain Low Medium High Severe Severe Likely Low Medium Medium High Severe Possible Low Low Medium High Severe Unlikely Low Low Low Medium High Rare Low Low Low Medium High 7 7