SPURonWA Grant
Round 1 Application form
Information
Grant guidelines
www.spur.wa.gov.au
Round 1 opening date
17 October 2016
Round 1 closing date
5pm AWST Friday 11 November 2016
Application lodgement
Via email to [email protected]
Incomplete or late applications will not be accepted
Outcome notification
Mid-December 2016
Questions?
Contact the SPUR grants coordinator on 9273 7525
Instructions
Please ensure you have read and understood the grant guidelines provided on the SPUR website
before completing this application.
Complete Questions 1-6 below in full. Question 2 (including all sub-questions) is to be answered in no
more than 3 pages. Arial font 11 should be used for all text.
Applications may be submitted in Microsoft Word or PDF format. Only attach supporting
documentation where requested. Any other supporting documentation will not be considered as part
of the assessment process.
Glossary
The following terms in this form have the following meaning:
Business failure
Liquidation, voluntary administration or receivership.
Idea / Concept
Abstract thought, plan or intention.
Market Ready
Concept tested and proven with strong business case developed to
support commercialisation.
Proof of Concept (POC)
Early stage prototype to demonstrate an idea, invention, process or
business model is feasible.
Prototype
A model of something from which others are copied or developed.
Senior Office Bearers
Key members of your team or business including but not limited to
partners, presidents, board members, directors, project managers.
Unique value proposition
Features of your business or product which distinguishes you from the
competition.
spur.wa.gov.au
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1.
Applicant details
(a) I am a… (please select)
☐
Business (go to (b))
/
☐
Individual (go to (e))
(b) Business name
(c) ABN
(d) Organisation type
(e) Contact person
(f) Position
(g) Address
(h) Address (cont.)
(i)
Town/City
(j)
State
(k) Phone
(l)
Email
(m) Website
spur.wa.gov.au
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2.
Project description – this section is to be answered in no more than 3 pages
(a) Project title. No more than ten words.
(b) Explain your new product or service. Clearly articulate how it meets the criteria of having a
“strong location information component”. Website, pictures and diagrams may be attached.
(c) Project team. List your key team members, their role and expertise. An organisation / team
structure chart may be attached.
(d) Current stage of your project. Select the option below which best describes the current stage of
your project. In the free text, explain what barriers, if any, you are experiencing in bringing your
product / service to market.
☐ Idea / Concept
☐ Market Ready
☐ Proof of Concept (POC)
☐ Prototype
☐ Other (detail):
(e) Select the insurances you currently have.
☐ Product & Public Liability
☐ Workers Compensation
☐ Professional Indemnity
☐ Other (detail):
(f) Is there any Intellectual Property (IP) involved in your project? If yes, what is the status of
the IP (eg No protection, Provisional, Patent, Trade Secret)?
(g) List competitors and/or similar products and services, if any. How does your product/service
compare? Explain your product/services competitive advantage / unique value proposition.
(h) Outcomes and benefits – longer term. What will be the broader outcomes and benefits of your
product/service for industry, government, the economy, and Western Australia as a whole?
(i)
Sustainability. Please explain what other funding sources you have secured or plan to secure
(including your own investment). How will these funding sources complement the SPUR grant
funds to ensure the product/service will make it to market and be sustainable? Details of amounts
will need to be provided in the Project Budget (Question 6).
spur.wa.gov.au
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3.
Grant funding
(a) What activities are you requesting grant funds to help pay for? Please list and explain each
item.
(b) Outcomes – short term. What will be the direct / short-term outcomes of completing the above
activities?
4.
Project plan
Please complete the below project plan for your project for the grant funding period (up to 6
months). Include all planned activities (not just the activities to be supported by the grant funds).
Project task
spur.wa.gov.au
Start date
Completion
date
Output/s
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5.
(a)
Financial standing
For the purpose of assessing your financial viability and standing, please respond to each of the
following questions.
Have you, your business or any of its senior office bearers been involved
in a business failure?
☐ Yes
☐ No
Have you, your business or any of its senior office bearers ever been
declared bankrupt?
☐ Yes
☐ No
Have you, your business or any of its senior office bearers ever been
involved in a government investigation?
☐ Yes
☐ No
Has any previous contract with you or your business been terminated for
cause?
☐ Yes
☐ No
Has there been any past, current, pending or finalised litigation against
yourself, your business or any of its senior office bearers during the last
three years?
☐ Yes
☐ No
Has there been any collection by a debt collection agency on behalf of
creditors for you, your business or its senior office bearers?
☐ Yes
☐ No
Will the cost of undertaking the activities proposed in this application
adversely affect you, your businesses or senior office bearers’ ability to
meet other financial obligations?
☐ Yes
☐ No
(b)
If you answered YES to any of the questions above, please provide a brief explanation. Please
be aware that additional information may be requested by the evaluation panel.
spur.wa.gov.au
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6.
Budget
Please provide a budget for the entire project of taking your product or service to market (as
much as known). Business as usual costs and salaries/time are not eligible for SPUR grant funding,
but may be included in your budget as your “own investment”. Itemise each expense separately. Add
additional rows as required. Amounts are to be exclusive of GST. If applicable, GST will be added to
the final grant amount.
Item
Own
Investment
($ and/or time)
Other
Funding
Sources
SPUR Grant
Funds
Requested
TOTAL
Investment to date (please indicate your approximate investment to date)
Grant funding period (please itemise your expenses during the grant funding period – up to 6 mths)
Post grant funding period (please list major anticipated costs post the grant funding period until
going to market, if known)
TOTAL
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Privacy and Confidentiality Statement
SPUR collects the information sought in this application so that it can check the applicant’s suitability
for funding under the SPURonWA grant program and for the purpose of verifying the applicant’s
ability to meet its contractual obligations.
Whilst care will be taken to treat information confidentiality, SPUR operates within a public
accountability framework and applicants are informed that the agency is subject to the Freedom of
Information Act 1992 which provides a general right of access to records held by Western Australian
State and Local Government agencies.
Applicants should be aware that limited information will be released by SPUR for transparency
reasons and may include details such as the names of recipients (business or individuals), the
amount of financial support, the name of the project/activity and a brief description. Information
pertaining to the receipt of State Government financial support may also be tabled in the Western
Australian Parliament.
Further information on the operation of the Freedom of Information Act 1992 can be obtained from
Landgate’s website.
Applicant declaration
I declare that I am authorised to complete, sign and submit this application. I declare that I have read
and understood the guidelines of the SPURonWA grant program and that, if successful, I agree to the
terms and conditions within the Grant Funding Agreement.
I understand that I may be contacted by SPUR to provide further information or clarify information
supplied in this application to assist with the assessment process and that the decision, once
communicated, is final.
I declare that the information contained in this application together with any statement attached is, to
the best of my knowledge and belief, true, accurate and complete in all material particulars. I also
understand that the provision of false or misleading information or the making of a false or misleading
statement in this application is a serious offence.
Name
Position title
Signature
spur.wa.gov.au
Date
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