Expression of Interest Questionnaire
Flood Protection Program Intake 2013
All sections of the Expression of Interest Form must be completed
One project per application
Telephone: 250 952-5064 or 250 952-5065
Please complete the form below, sign, scan and save as the “local authority name - project name” and forward
by email to the Flood Protection Program at EMBCFloodProtection@gov.bc.ca
Completed application forms must be received no later than midnight, May 22nd 2013 to be considered.
Supplementary documents are not required and will not be evaluated.
SECTION 1
APPLICANT INFORMATION
Local Authority (Government)
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Name as it appears on the constitution and/or Certificate of Incorporation
Mailing Address
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Unit, Street and/or PO Box
City
Postal Code
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Click here to enter text.
Physical Address of Authority
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If different from above
City
Postal Code
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Project Contact Person
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Position
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Phone
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E-mail
Facsimile Click here to enter text.
Mobile Click here to enter text.
Click here to enter text.
Name of person with authority to sign application on behalf of the Applicant, if different from above:
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SECTION 2
PROJECT FUNDING REQUEST
PLEASE REFER TO THE 2013 FUNDING APPLICATION GUIDELINES (http://www.th.gov.bc.ca/BCFCC/)
FOR THE FOLLOWING SECTIONS
Project Category (choose one only)
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Category 1: Permanent infrastructure project (eligible for federal-provincial-local authority cost sharing):
A one year long project to be completed in either the 2014/15 fiscal year (April 1, 2014 to March
31, 2015) or the 2015/16 fiscal year (April 1, 2015 to March 31, 2016)
A two year long project to be completed between April 1, 2014 and March 31, 2016.
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Category 2: Strategic mitigation projects less than $50k (cost shared by province and local authority):
A small project completed within a six month timeframe between April 1, 2014 and March 31,
2016 that would not otherwise be eligible for funding under the Building Canada Agreements.
Retain a copy of this application for your organization’s records.
April 2013
Expression of Interest for Funding – Flood Protection Fund (Intake 2013)
Page 1 of 4
Project Name: Click here to enter text.
for example: Community - Riverside Road East Ring Dike
Amount of Funding Requested: Total Eligible Project cost $ Click here to enter text.
Funding Requested (2/3 federal/provincial) $ Click here to enter text.
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Please identify what mechanism the Local Authority intends to use to secure the local authority
contribution (e.g. inclusion in existing capital plan, future capital plan, referendum required). Click here to
enter text.
Is this application being submitted on behalf of a third party (e.g. private sector, residents) that will be
contributing the full one-third Local Authority share? (Yes / No) Click here to enter text.
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SECTION 3
If so, name and details: Click here to enter text.
PROJECT INFORMATION
Each section must be completed to be considered.
General
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Does this application represent a partnership project (e.g. more than on municipality, industry cost share
etc.)? (Yes / No) Click here to enter text.
 If so, name and details: Click here to enter text.
Name of the community and neighbourhood the project will help protect (e.g. Lakeside neighbourhood,
northeast section of Dry Gulch City). Click here to enter text.
What is the Latitude and Longitude of the proposed works? Click here to enter text.
What waterway(s) is this project related to? (e.g. lake, river, stream, ocean etc). Click here to enter text.
 If a river on a coast: Is this river within the tidal influence? Click here to enter text.
Is there a current hazard risk assessment, resiliency plan in place for the community? If so please list:
Click here to enter text.
Confirm that the authority listed in Section 1 will assume ownership, operation and maintenance of the
proposed works as consistent with the program guidelines. (Yes / No) Click here to enter text.
Project Description and Purpose Statement
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Provide a brief, yet specific description of the proposed works including lengths, volumes, type of work to
be completed. (Max 300 words): Click here to enter text.
Describe the nature of the flood threat, contributing factors (e.g. freshet, saturation, erosion, debris, etc.)
and how the proposed works will mitigate future flood risk (Max 300 words). Click here to enter text.
Project Background – History of threat, copies of documentation (i.e. forms) not required
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When was the last flooding or related event in this area? Click here to enter text.
 If applicable, please identify type of event and magnitude (e.g. overland flooding, breach, debris
flow, size of area impacted, assets affected etc). Click here to enter text.
What is the frequency of flooding in this area or specific years in which there has been flooding?
Click here to enter text.
 At what return period interval does flooding occur in this area? (e.g. 1 in 5 year) Click here to
enter text.
Has the subject area been under a Declaration of Local Emergency in the last 10 years?
(Yes / No) Click here to enter text.
 If so, when (list all years if more than one)? Click here to enter text.
Retain a copy of this application for your organization’s records.
April 2013
Expression of Interest for Funding – Flood Protection Fund (Intake 2013)
Page 2 of 4
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 Were evacuations required? Click here to enter text.
 How many people or homes were evacuated? Click here to enter text.
Has flooding in this area required funding or assistance through the Emergency Program Act (EPA)?
(Yes / No) Click here to enter text.
 If so, when was the last occurrence? Click here to enter text.
 Estimated response cost? $ Click here to enter text.
Has Disaster Financial Assistance ever been declared in this area? (Yes / No) Click here to enter text.
 If so, when (multiple years if applicable)? Click here to enter text.
Risk and Benefits – Why the project is important
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Describe any unique characteristics of the community/ area that would support this application for flood
protection (e.g. topographical characteristics, cultural, economic or heritage sites). Click here to enter
text.
Describe the area to be protected (residential, industrial, commercial, agricultural or mixed). Click here to
enter text.
Size of area to be protected (km2). Click here to enter text.
Number and type of properties to be protected (e.g. 200 residential homes, three industrial sites).
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Are there any vulnerable populations protected (e.g. infirm or difficult to move, affordable housing etc).
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Estimated value of assets protected (e.g. BC Assessment values within area, critical infrastructure).
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What other community features would be protected? (e.g. rail lines, transport routes, utilities, schools,
hospitals, environmental hazards etc). Click here to enter text.
Is the area to be protected within a designated flood plain? Click here to enter text.
What is the zoning within the area to be protected? Click here to enter text.
What is the typical age of the development(s) within the area to be protected (age of subdivision and
general statement on assets)? Click here to enter text.
Does the project help protect adjacent communities? Click here to enter text.
Technical
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What previous works have been completed that support the proposed project? Click here to enter text.
What engineering studies have already been completed and/or options explored to mitigate the flood risk
in this area (names, dates)? Click here to enter text.
Are additional works required to solve the problem beyond what this application will cover?
(Yes / No) Click here to enter text.
 If so, what are they? Click here to enter text.
Does this proposal resolve issues associated with remnant or orphan flood protection works?
(Yes/No) Click here to enter text.
 If so, provide details: Click here to enter text.
Are there any additional environmental benefits gained from doing the project? (Yes/No) Click here to
enter text.
 If so, provide details: Click here to enter text.
Has there been any engagement with, direction, or comments on the proposed works provided by the
Inspector of Dikes? (Yes/No) Click here to enter text.
 If so, provide details of involvement: Click here to enter text.
Retain a copy of this application for your organization’s records.
April 2013
Expression of Interest for Funding – Flood Protection Fund (Intake 2013)
Page 3 of 4
Land tenure for the project
Note: Land acquisition costs are not eligible for reimbursement.
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Is land (Rights of Way or other) acquisition required for this project? (Yes/No) Click here to enter text.
 If so, have preliminary agreements with land owners been secured? Click here to enter text.
Other Important information
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Provide any other important information that will assist in reviewing the project application
(max. 150 words). Click here to enter text.
Project Timeline and Cost
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Cost - One Year Projects:
 Total eligible project cost: $ Click here to enter text.
 Specify which fiscal year the project will be undertaken; either the 2014/15 fiscal year
(April 1, 2014 to March 31, 2015) or the 2015/16 fiscal year (April 1, 2015 to March 31, 2016)
Click here to enter text.
Cost - Two Year Projects:
 2014/15 Fiscal Year (Apr 1, 2014 to Mar 31, 2015) eligible project cost: $ Click here to enter text.
 2015/16 Fiscal Year (Apr 1, 2015 to Mar 31, 2016) eligible project cost: $ Click here to enter text.
 Total eligible project cost: $ Click here to enter text.
SECTION 4
CERTIFICATION
My acceptance of this statement indicates that I confirm and acknowledge:
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I am a bona fide employee of the Local Authority making this application, and my position, title or role
within it is as indicated herein.
I am authorized to complete and submit this application by and on behalf of the Local Authority.
I certify that the information contained in this application is correct and complete at the date of
submission.
The applicant (Local Authority) understands and confirms that any information submitted herein may be
disclosed by Emergency Management BC, in compliance with the Freedom of Information and Protection
of Privacy Act.
Person Signing on Behalf of the Applicant (sign and scan document for email)
Signature
Date
Print Name
Title
Retain a copy of this application for your organization’s records.
April 2013
Expression of Interest for Funding – Flood Protection Fund (Intake 2013)
Page 4 of 4