B-CAP
APPLICATION FORM FOR OPERATION IN BUSINESS INCUBATOR
Name of the company
Unified Reg.No.
Legal address
Actual address
VAT Payer Reg.No.
Bank
SWIFT code
Account No.
Phone
Fax
E-mail
Registration date of the company
Basic type of activities according to the
NACE classificatory (2nd red.)
SUMMARY OF THE BUSINESS PLAN (max. 3 pages)
1. DESCRIPTION OF THE COMPANY
1.1. A brief profile of the company – operational goals, current management team and personnel,
their skills and competences:
1.1.1. shareholders and percentage of their capital shares;
1.1.2. current management team and personnel;
1.1.3. operational goals and previous achievements of the company.
2. DESCRIPTION OF THE PRODUCT AND SERVICE
2.1. Description of the existing and planned products and services, their unique qualities, state of
development, a characterization of intellectual property rights.
3. MARKET AND COMPETITION
3.1. Description of the market — market availability, sales potential of the product, description of
the current competition.
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4. MARKETING STRATEGY
4.1. The current marketing strategy — marketing tools, pricing policy, channels and methods for
distribution of products and services.
5. FINANCIAL FORECAST
5.1.
A brief financial history (if applicable), financial forecast and justification of the
expected turnover and yield.
6. RISKS
6.1. The main operational risks of the company and their elimination methods.
7. OTHER RELEVANT INFORMATION
7.1. Persons that are planned to be employed; other relevant information related to the chosen
business activities.
8. LENGTH OF STAY IN BUSINESS INCUBATOR
8.1. The expected length of stay in Business Incubator. The maximum permitted length of stay is till 31st of
October from the day of entrance.
Please, consider a possibility to provide the following supportive services to the company
[mark with X, as necessary]:
Inzenieru Street 101, Ventspils, LV – 3601, Latvia
Ventspils High Technology Park 1, Ventspils, LV-3601, Latvija
Liela Street 1, Talsi, LV – 3200, Latvia
Rent of premises, public utilities. Necessary area of the premises, m2_______________.
Secretary services.
Rent of equipment (work bench, chair, shelf, computer equipment, Internet connection)
Work bench: _____; chair: ____, shelf: _____, computer: ______, Internet connection: ______.
Check, as necessary, and explain:
The company employs or plans to employ people with disabilities.
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Explanation:
The company employs or plans to employ people under 25 years of age, and this would be (or is)
their first workplace.
Explanation:
The company employs or plans to employ the migratory workforce of the European Community,
who need language training.
Explanation:
The company plans to create new workplaces or ensure maintenance of the existing ones.
Explanation:
The company is engaged in one of the horizontal priority branches: information technologies (IT),
environment technologies.
Explanation:
Hereby I certify that I have familiarized myself with the „Registration Methodology of
the Aid (de minimis) from Business Incubator” and
„Entrance and Leaving Procedure for the SMEs”.
ATTACHED:
Enterprise Form of Conformance;
Register Form on the Received Aid de minimis – for the aid de minimis received during
the last 3 years;
A copy of the Company Registration Certificate (if applicable);
A copy of the Company Tax-Payer Registration Certificate (if applicable);
CV of current management team;
Financial forecast for 3 years;
Register of Entrepreneurs issued certificate confirming information about Company's
shareholders and officials;
REPRESENTATIVE OF THE COMPANY:
[name, surname, title]
SIGNATURE:
DATE OF COMPLETING THE FORM:
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Appendix of application form
Enterprise Form of Conformance
No.
Criteria
Conformity
“Yes”/”No”
1.
The company has been registered in the Commercial Register of the Register Yes
of Enterprises of the Republic of Latvia for less than 2 years (before signing the
agreement with the operator of the business incubator).
2.
The company is not engaged in any of the following spheres that are not
supported by the business incubator:
1. manufacturing of agricultural produce;
2. fisheries and aquaculture;
3. coal mining industry;
4. nautical architecture;
5. financial mediation;
6. commerce;
7. commercial services;
8. transport;
9. manufacturing of alcoholic beverages;
10. tobacco products;
11. gambling.
The company has not been recognized insolvent, it is not involved in process
of rescue or legal protection, its commercial activities have not been
terminated, or the Commercial Register does not contain any data that affirm
that the company is in process of wind-up.
Yes
4.
The company has, in full and in due term, paid off taxes and other obligatory
payments established by the state or local government.
Yes
5.
Any physical person has not committed such crimes in interests of the Yes
company, which affect the financial interests of the Republic of Latvia or
European Union, and to the applicant of the project does not apply any
coercion measures, as stated in the Criminal Law.
6.
The company has not received and is not planning to receive a financing for the
same eligible costs as part of other activities from any local, regional, state or
European Union funds.
Yes
7.
The company has observed and has not breached the conditions for receiving
the funding.
Yes
8.
The company is not receiving support in any other business incubator in Yes
Latvia.
3.
Yes
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9.
10.
11.
12.
The company corresponds to the status of small and medium sized enterprise,
according to the definition of small and medium sized entity engaged in an
economic activity, as stated in the Commission Regulation (EC) No 651/2014
of 17th of June 2014, Annex I.
If company’s associated enterprise already receives support in this or any
other business incubator, it shall observe the requirements for receiving the so
called de minimis aid, as stated in Cabinet Regulations No. 835 7 October 2008
„Regulations on Supplement 2.32.1 Activity „Business Incubators” of the
Operational Programme „Entrepreneurship and Innovations””, as well as the
conditions of SME status, as stated in Clause 60.1.
The company does not intend to cover the costs incurred before concluding the
cooperation agreement on incubation.
The company operates or intends to operate in Ventspils, Talsi or such districts
as Ventspils, Talsi, Dundaga, Mērsrags and Roja.
Name, surname, title:
Signature:
Data:
Yes
Yes
Yes
Yes