Form A – Expression of Interest (EOI) Form – Biorenewables Capital Grant Scheme
(Please read the guidance document on how to complete this form)
1. Contact details
Business name1
Name:
Position:
Business
address1
Email:
Business postcode1
Telephone:
Website:
Mobile:
2. Business information
Business sector:
Date established/started trading (DD/MM/YYYY):
Companies house registration number:
VAT number:
3. SME eligibility
Annual turnover:
Value of balance sheet
Number of employees:
4. Equal opportunities information
Owner manager is described as:
OAsian or Asian British
OBlack or Black British
OChinese or other ethnic group
O Other (please specify)
OWhite
OMixed
O Not stated
O Male
O Female
O Not stated
O Is disabled
O Is not disabled
O Not stated
5. Where did you hear about the Biorenewables Capital Grant Scheme?
1
As registered with Companies House or HMRC (for sole traders)
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6. Project summary
a) Please tell us the title of the project
b) Please provide a brief history of the business and the market you are operating in.
c) Please summarise your project highlighting any feasibility work already undertaken and the current status of the
project.
d) Define the reason for undertaking the project, including key objectives for the project.
e) What do you consider to be the ‘innovative’ aspect of the project?
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f) What capital items are you seeking ERDF grant support for?
g) Define the timescales, including the period over which the project will be a) installed/established and b) be operational:
when from and for how long.
h) Summarise the total project cost and the maximum amount of funding requested (64% of eligible costs)
Detail how much will be contributed by the business and/or secured from a third party, as applicable.
Value (£)
ERDF funding
ERDF grant requested (64% of the total eligible costs of the project, to a maximum of £32,000)
Match funding
Own reserves
Loans
3rd party funding
TOTAL project costs:
The sum of the value of the ERDF grant and the total match funding must equal the total cost of the project
7. Project outputs –please identify any estimated outputs you expect as a result of implementing this project
Output
Quantity and description
No of jobs created:
No of jobs safeguarded:
New businesses created:
Increased sales:
Reduced costs:
Other (please provide details):
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8. State aid
You are being offered assistance under the European Commission’s State Aid Regulations. This allows a company to
receive up to €200,000 (at applicable exchange rate) of De Minimis state aid over a rolling three-year period. The
following requested information is a mandatory requirement to enable you to receive the support offered. To confirm that
you are able to receive this assistance you must declare the full amount of De Minimis aid you have already received
over the last 3 fiscal years. Potentially any assistance from a public body might be aid. Should you have any doubts on
this matter, please contact the organisation from which the assistance was received. These types of aid may have been
provided under De Minimis (as De Minimis aid) or under another State Aid regulation. If they are unable to say or there is
any uncertainty, assume that it was De Minimis aid unless its value exceeded €200,000 in which case it cannot have
been De Minimis.
Note: Any De Minimis state aid awarded to you under this project will have to be declared if you apply for other sources
of public funding in the future
I declare that the amount of De Minimis aid received by the company / organisation over the last three years is:
Organisation who provided
Date aid approved
Value (£)
Value (€)#
the aid*
* Add or delete rows as necessary

This should be the date the aid was approved, not the date the aid was received
# This should be the Official EU Accounting Exchange Rate from the date that the aid was approved not received:
http://ec.europa.eu/budget/contracts_grants/info_contracts/inforeuro/inforeuro_en.cfm
9. Data protection
The data contained in this Expression of Interest Form is a mandatory requirement to enable support to be provided by
this ERDF funded project. As well as being a record of the support provided, the data may be used to for reporting
purposes (e.g. to the European Commission) and also for subsequent evaluation of the project (e.g. to contact
beneficiaries to understand their views on how they have benefited from the project). The data may be used by the
project deliverer, the Department for Communities and Local Government (DCLG) or DCLG’s appointed agent (e.g. an
external consultant appointed to evaluate the project), for the purposes outlined above.
10. Declaration signatory of the beneficiary - confirming the details contained in this Expression of Interest Form are
true and accurate, and agreement that the data can be used as per the Data Protection statement.
Name:
Signature:
Position:
Date:
For Office Use Only. Please confirm the recipient is eligible for the proposed support, by signing this box.
Project manager name:
Project manager signature:
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