Regional Development Australia Fund – Round Two Expression of Interest Form Advice to Applicants 1.
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Potential applicants must carefully review the Regional Development Australia Fund (RDAF) Round Two Guidelines prior to completing this form. It expected that applicants will have assessed and confirmed that they can meet the eligibility criteria for Round Two of RDAF prior to completing this form. The Expression of Interest form includes a declaration confirming that the project meets the eligibility criteria set out in the RDAF Round Two Guidelines and that all mandatory documents can be provided. This declaration must be signed by the applicant for the EOI to be considered. Eligible organisations can submit one (1) Expression of Interest form for a single project. The first Expression of Interest form submitted by an applicant will be accepted. Subsequent forms will not be accepted or considered by Regional Development Australia (RDA) committees. Responses to questions should be short and succinct. Sections A, B and C seek factual data. Section D seeks information about the project and its impact on the region. Responses to each question in Section D is limited to 350 words. Text over this limit will not be considered by RDA committees in their decision‐making. Attachments will not be accepted and, if provided, will not be considered by RDA committees in their decision‐making. Expression of Interest forms will be considered by the RDA committee, with three viable priority projects selected by each committee. These projects will proceed to full application, once the proponent has been notified in writing by the Department. Expressions of Interest must be emailed to both the RDA committee and to the Department of Regional Australia ([email protected]) by 5pm local time on Thursday, 1 December 2012. Contact details for RDA committees are located on the Department’s website at www.regional.gov.au. Both the nominated contact officer and officer with responsibility for the project will be notified of the outcome of this Expression of Interest by the Department. Advice will be provided to officers on Wednesday, 11 January 2012. Please provide details of an alternate contact, should the nominated officers not be available at that time. RDAF Round Two Expression of Interest Form A. Details of Applicant Organisation Name Australian Business Number Applicant Type Local Government Body Not‐for‐profit organisation Annual income (Not‐for‐Profit) $ Physical Address Postal Address Authorising Officer Name: Phone number: Email address: Contact Officer for project Name: Phone number: Email address: B. Details of Project Project Name Type of Project Describe the nature of the infrastructure (ie new community building, airport upgrade, theatre, museum) Location of Project List the street address of the project Local Government Area Regional Development Australia Committee Is the RDAF funded activity part Yes/No. If yes, please describe the larger project and that of a larger project? component for which RDAF funding is requested. Has the larger project already commenced? Yes/No. If yes, please list the project commencement and completion dates. If no, list the planned project completion dates. Commencement and completion dates of activity to be funded by RDAF. Commencement: Completion: 2
RDAF Round Two Expression of Interest Form C. Details of Funding Value of grant requested $ Value of project $ Value of partnership funding $ Value of partnership funding that is: • Confirmed; • Requested, but not confirmed; • Not yet requested. Funding Names of Contributors $ $ $ D. Details of Project
What is your project? Your answer should provide a clear and succinct overview of the project to be funded, including its nature, scope and the service that will be delivered from the infrastructure. Response should be no more than 350 words.
What benefits will your project deliver for the community and economy? Describe the need being met by your project and the impacts of your project on the region, community and local economy. Describe the issue in your RDA committee’s Regional Plan that is being addressed, and how that issue is being addressed. Response should be no more than 350 words.
Does your project benefit the broader region? Describe the broader impact of your project, focusing on its impacts across Local Government Areas, within the whole of the RDA and bordering (or other) RDA committee areas (as appropriate). Response should be no more than 350 words.
What consultations have you undertaken with local communities? Is there broad community support for your project? Identify key stakeholders who are supportive of the project. Describe the consultations undertaken by your organisation and their outcomes. Identify stakeholders who are opposed to the project? Response should be no more than 350 words.
How will your project be delivered? Describe how your project will be delivered. Include the planning, construction and other approvals that are in place/will shortly be provided/have been applied for. Response should be no more than 350 words.
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RDAF Round Two Expression of Interest Form E. Confirmation of Eligibility I, [insert name], confirm that my organisation has reviewed the Guidelines for Round Two of RDAF, the following eligibility and selection criteria, and the content of the mandatory documents. I confirm that my organisation can meet all of the following eligibility criteria and supply all of the mandatory documents by 15 February 2012. •
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I represent a local government organisation or an eligible not‐for profit organisation. My project is ‘shovel ready’ and will commence within 6 months of signing the Funding Agreement? •
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My project is predominantly infrastructure in nature. My organisation is requesting between $500,000 and $15 million, and may provide partnership funding. The component of the project for which RDAF funding is requested will be completed by the end of the 2014‐15 financial year. My project will have a broad regional impact, which is supported by documents and data. My project has community support. My organisation can implement the project and it is sustainable and viable in the longer term. My organisation has the following mandatory documents to support our application. 9 Letters to confirm partnership funding from the funding provider; Letters of support and evidence of community consultation; Audited financial statements for the most recent three consecutive years; Evidence that projects which are similar in size or scope have been delivered on time and on budget by my organisation; A Business Case incorporating the scope and outputs of the project; An Asset and Operations Management Plan; A Project Management Plan; A Risk Management Plan; A Project Quality Plan; and a Procurement Management Plan. My organisation can present a strong, well supported case against the three selection criteria. 9 The extent to which the project will contribute to and sustain regional economic growth; 9 The extent to which the project will provide community benefit; 9 The extent to which the applicant leverages additional funding from a variety of sources. My organisation is willing to enter into a Funding Agreement with the Department. •
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I, [insert name], confirm that I am a person authorised to make this declaration on behalf of my organisation. I confirm that all of the information provided in this Expression of Interest form is true, correct and accurate. Name Signature Date Position 4