Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
Goulburn Broken Catchment Management Authority
Beyond SoilCare Project Grants Application Form
Closing date: 5pm Monday 25th January 2016
CHECKLIST
Please note: To help you prepare the best application possible, all items below need to be considered and ticked
off. This will also assist us with assessment of your application.
Have you:

Read the Beyond SoilCare Project Grants Application Guidelines

Contacted the relevant GB CMA Program Manager(s) to discuss your project proposal?

Checked that your group Executive is aware and agrees to the final EOI submitted?

Included your contact details, and the group’s ABN (Qn 3) on the EOI?

Demonstrated a contribution of at least 30%, in either an in-kind or monetary
contribution (Qn 10)?

Prepared the budget, excluding GST (Qn 10)?

Signed the EOI (or typewritten if emailed) and checked that you are authorised to
sign/submit the form (Qn 13)?

Checked that your Group has current and adequate public liability insurance to
cover the project activities you are proposing?
Understand your OH&S obligations, including that if you are proposing to employ staff,
are you aware of your obligations as an employer to provide adequate insurance,
WorkCover, and OH&S for each of those staff, plus employment conditions as
recommended in principle under the Landcare Support Persons in Victoria Employment
Framework & Toolkit, (2004), where appropriate?
(If No, go to www.landcarevic.net.au/resources for more information)
Yes:___
No: ___
N/A:___
Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
EOI No.
Office use only
1. Project Title: (up to 12 words)
2. Name of Organisation
3. Organisation/Group contact details
Contact Name:
Address:
Phone:
Fax:
Incorporation:
Registered for GST:
Email:
ABN:
4. Geographic location of Project
 Within the Goulburn Broken Catchment
Please specify the closest town, region or locality to
the proposed project:
__________________________________________
 Multi-regional
Please specify the other region(s) to be included in the
proposed project:
____________________________________________
5. Project Description: Provide a description of your project including any background information, what is
the project addressing, why you chose the action(s) and location(s), what will be done, how it will be done
and by whom (up to 400 words)
6. What project outcomes and change will result from the project over the short and long term? (include
information on how your project would contribute to building resilience (eg ability to withstand shocks such
as drought), landscape health (eg improved soil condition) in the face of climate change, and who will benefit
from these outcomes)
a) Describe the short term outcomes: 0 to 5 years (eg more farmers aware of and engaged in practice)
Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
b) Describe the longer term outcomes: 5 to 20 years (eg reduced risk of salinity, increased cover of soil)
7. What are the key risks to the project being successful and how will these be mitigated? (eg no interest from
landowners, adverse seasonal conditions).
8. Provisional Budget 2015-16 (do not include GST) (ensure that you refer to guidelines for maximum budget
guidelines, and that you describe and cost all items).
Item
Applicant Funds
(group funds)
Other
Contributor
(State
who…….……………)
$
$
$
$
$
$
$
$
Total Capital Costs (GST exclusive)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Budget 2016-2017 (GST exclusive)
$
$
$
$
Employment / Project Management /
Facilitation
in-kind/volunteer labour
Total employment Costs (GST exclusive)
Eg 1. soil testing – add more lines as
required
Eg 2. speaker costs
Total Operating Costs (GST exclusive)
GB CMA
Funds
Sought
2016-17
Total
Budget
2016-17
Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
9. Outputs for Project 2016-17
Standard Output
Goulburn Broken CMA Output Description
Fence terrestrial remnant vegetation (ha)
Grazing regime (ha)
Fence wetland remnant (ha)
Natural Regeneration (ha)
Grazing Regime Change (ha)
Fence (km)
Water storage (no)
Irrigation infrastructure (ha)
Weed control (ha)
Pest animal control (ha)
Fence stream/river remnant (km)
Off-stream watering (no.)
Irrigation systems - reuse (no and ha)
Irrigation systems – improved or upgraded systems (ha)
Landform/lasergrading (ha)
Weed treated in high priority areas (ha)
Rabbits treated in high priority areas (ha)
Foxes treated in high priority areas (ha)
Revegetation - natives (ha)
Vegetation (ha)
Revegetation - Plantation / Farm Forestry (ha)
Pasture – plant (ha)
Whole Farm Plans - irrigation (no and ha)
Plan (no)
Whole Farm Plans - dryland (no and ha)
Strategies (no)
Assessment (no)
Studies, investigations or research (no.)
Partnership (no)
Community Groups Supported (no.)
Publication
Engagement event
Online/printed, Radio, Television (no.)
Conference, Field day, Presentation, Training, Workshop (no.
co-ordinated or established)
10. Group signature (Typewritten accepted as signature on emailed forms).
Name:
Position:
Signature:
Date:
2015-16 Target
Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
Completed Expression of Interest Forms must be submitted to the Goulburn Broken CMA:
Postal Delivery:
Darelle Siekman, Goulburn Broken CMA
PO Box 1752, SHEPPARTON, 3632
Email: darelles@gbcma.vic.gov.au
Applications close 5pm Monday 25th January 2016.
Please note that feedback on the Expression of Interest process is welcome. If you have any comments or
suggestions for improvement please forward them to Darelle Siekman at the address above.
Information in this form will be used by the Goulburn Broken CMA to respond to funding opportunities through
the Australian Government’s National Landcare Programme and the Victorian Goverment.
See the Goulburn Broken CMA Privacy Policy at www.gbcma.vic.gov.au.
Expression of Interest (EOI) Form
Natural Resource Management & Sustainable Agriculture Projects - 2016-17
Site Safety. Where do you fit in?
It doesn’t matter what job you do on your farm – everyone has a role in safety.
If a Victorian WorkCover Authority Inspector were to visit your farm, they will expect you to know
yours.
Landowner
Site Supervisor
Contractors
Tradespeople,
Labourers and
Apprentices
You have the primary
responsibility for safety
on your farm. It’s a duty
that can’t be contracted
out. Your job is to make
sure all employees or
contractors are doing
their jobs safely.




If you appoint a site
supervisor, ensure they
know construction
safety.
Ensure the site has a
safety plan and that it is
being followed.
Encourage supervisors
and contractors to
report safety issues, and
fi x them promptly.
Keep safety
communication
channels open.
As the landowner you can
supervise a site yourself
or delegate safety
responsibilities to a
supervisor. Your job is to
keep the site safe, even
when you are not there.







•
Know the site safety
plan and make sure
everyone sticks to it.
Ensure contractors are
inducted before they
start work.
Always know who is
working on your farm
and worksites and
conduct regular
inspections.
Be contactable and
make sure the right
people have your phone
number.
Ensure contractors are
doing their part with
site rules and Safe Work
Method Statements
(SWMS).
Find and fix hazards or,
if you can’t, promptly
raise the issue to the
next level.
Ensure the site is ready
for each contractor
before they arrive.
Talk regularly with
contractors and their
crews about safety on
site.
You are responsible for
the safety of your
employees and
contractors.
You might appoint a
leading hand or foreman
to manage your crew’s
safety on site.
• Know what your crew is
up to at all times.
• Ensure your crew is
inducted and obeys site
rules.
• Pay specific attention to
the training and
supervision of young or
inexperienced workers.
• Use a SWMS for high
risk construction work,
and make sure it suits
the site.
• Let the site supervisor
know when your crew is
on site.
• Find and fix hazards or,
if you can’t, report
them to the site
supervisor.
• Talk regularly with your
crew, site supervisor
and other contractors
about safety on site.
You must take care of
your own health and
safety, and the safety of
others.
You must co-operate with
your employer’s safety
requirements.
• Hold a Construction
Induction (CI) card and
the right licences for
your job.
• Be inducted to a site
before you start work.
• Follow site rules and
SWMS.
• Wear the right personal
protective equipment
(PPE).
• Clean up as you go.
• Find and fix hazards or,
if you can’t, report them
to your supervisor.
Get back to basics on site safety. For more information, go to www.vwa.vic.gov.au/safety-andprevention or call Victorian WorkCover Authority’s Advisory Service on 1800 136 089.