This project is part funded by Invest Northern Ireland and the European Regional
Development Fund under the Sustainable Competitiveness Programme for Northern Ireland.
APPLICATION FORM
Applicants Name:
Business Name:
Please complete all sections of this form and return a signed hard copy to the
address below:
John Harrison
Project Manager
InnoTech Centre
South West College
Burn Road
Cookstown
Co. Tyrone
BT80 8DN
Tel: 028 822 55223
By 12NOON ON 14TH MARCH 2014
LATE APPLICATIONS WILL NOT BE ACCCEPTED
Electronic copies will not be considered.
OVERVIEW OF RESOURCE EFFICIENCY PROGRAMME
The Resource Efficiency Programme aims to support micro/ SMEs within the Larne, Antrim, Ballymena,
Moyle and Newtownabbey District Council areas whose energy, waste, water/effluent and raw materials
costs are less than £30k (incl VAT) per annum.
The Programme will offering flexible, practical, client-led support to help companies realise cost savings
and achieve a competitive advantage through implementing improvements in their use of resources and
raw materials to increase profitability.
Participating businesses will receive:

A Resource Efficiency Audit, which will diagnose key areas where there is potential for achieving
efficiencies,

Up to 4 days’ one-to-one consultancy support to address these areas, and,

An Action Plan to outline the other issues your business should address and where you can access
support to take this forward.
NB: Please note the support provided is consultancy only; capital grants are not eligible.
Consultancy support will include (but is not limited to) the following areas:
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Reducing waste and carbon emissions
Identification of cleaner processing technologies
Minimising product losses
Improving energy efficiency
Accessing more sustainable water resources
Reviewing packaging requirements or use
Environment or energy management systems
Opportunities for renewable energy
Equipment Specification
BUSINESS ELIGIBILITY CRITERIA
To be eligible to apply, businesses and social enterprises should be:
 Located in the Larne, Antrim, Ballymena, Moyle and Newtownabbey District Council areas
 Trading for a minimum of 6 months
 Not in receipt of similar assistance from elsewhere
 Able to demonstrate resource and raw material costs totalling not more than £30,000 (inc VAT) per
year
PROGRAMME DELIVERY AGENTS
The programme delivery agents are South West College, InnoTech Centre in partnership with Fathom
Energy & Environment and B9 Solutions. For more information, or if you would like further guidance on
how to complete this Form please contact: John Harrison or Nicola Quinn on 028 822 55223.
Please provide complete answers to all of the following questions as marks are awarded for each Section
and Application Forms will be marked on merit for selection purposes. If further space is required please do
expand these boxes electronically or attach further information - please ensure that all attached
information is CLEARLY referenced.
SECTION ONE – BUSINESS DETAILS
A) Business Name
B) Contact name
Position in business
C) Business Address
D) Email address
E) Postcode (ESSENTIAL)
F) VAT registration
no
G) Telephone No.
Mobile no
H) Date Business
Established
I) Trading Status (Sole
Trader, Partnership,
Company Ltd etc)
J) What sector would
describe your business
(please tick)
K) No. of employees
(excluding owner) :
L) Is your company:
(please tick )
Agriculture  Catering & Hospitality  Computer Related Services  Construction 
Craft Products & Services 
Creative Arts  Domestic Services  Education 
Environmental  Finance & Business Services  Health & Beauty  Leisure 
Manufacturing  Technology  Professional Services  Retail – Goods 
Retail – Services  Transport/ Vehicle Services  Other (please
Specify)......................................
F/t
P/t
A non-Invest NI Client?
Yes / No
A non-active Invest NI Client?
Yes / No
An active Invest NI Client?
Yes / No
M) If applicable when did you
last avail of assistance
from Invest NI?
What type of assistance
did you receive from
Invest NI?
N) Please state any other
business support you are
currently receiving?
O) How did you hear about
this programme (please
tick)?
Launch     By Post  Word of Mouth  Contact from Council  Telephone Call
 By e-mail  Website  Social Media  Other  (Please
specify)...................................................
SECTION TWO – ABOUT YOUR BUSINESS
A) Please describe the products /
services your business
currently offers.
B) What types of
customers do you currently
sell to?
(e.g. public sector, private
sector, construction /
manufacturing etc)
C) What is your current annual
revenue?
£
D) What are your total costs (including VAT) per annum for:
-
Resources (e.g. electricity, gas, water, etc) + raw
materials?
These figures can be obtained from your annual accounts /
expenditure records.
If your business is registered for VAT, please ensure that
you have noted this on the previous page of this Form.
If an accurate figure is not available please state estimate
and note ‘E’ beside your figure.
What was
your annual
revenue the
year before?
£
SECTION THREE – YOUR ASPIRATIONS FOR THIS PROGRAMME
A)
The focus of the Programme is to enhance businesses’ resource efficiency to achieve
competitive advantage and increase profitability through reducing their costs.
Please tick up to a MAXIMUM OF 3 AREAS you wish to receive assistance with, AND explain how
this assistance would help your business reduce its resource/raw material costs?
Please tick
as
appropriate
Reducing overall
energy costs
Reducing waste /
carbon emissions
Accessing more
sustainable water
sources
Reviewing packaging
requirements for
using less packaging
or more sustainable
packaging
Optimising recycling
processes and
minimising waste
sent to landfill
Specification and
purchase of
suppliers of more
efficient equipment
Opportunities for
using renewable
energy or improving
efficiency
Introduction of
environmental or
energy management
systems
Other (please
describe)
How will this assistance benefit your business?
B) What added value will the Programme bring to your business? Please select the relevant areas
below and briefly explain how the assistance requested will help you achieve such?
Please tick
as
appropriate
Enhance Turnover
(Reduced overhead
through energy
savings; more
efficient use of
waste)
Enhance
productivity
(through improved
processes)
Job creation and
retention
Attract new
customers through
improved
sustainability
credentials
Ability to gain
support from other
programmes to
assist long term
sustainability
Please outline what impact this programme’s support will have
on your business in the relevant sections below.
DE MINIMIS AID
The aid being sought is provided under the European Commission Regulation on De Minimis Aid. Small
amounts of State aid, up to 200,000 Euros in any three-year period to any one enterprise, are regarded as
too small to significantly affect trade or competition in the common market. Such amounts are regarded as
falling outside the category of State aid that is banned by the EC Treaty and can be awarded without
notification to or clearance by the European Commission. A Member State is required to have a mechanism
to track such aid (called 'De Minimis aid') and to ensure that the combined amount of De Minimis aid
payments from all sources to one enterprise in any three-year period respects the 200,000 Euro ceiling.
Please provide details of all other De Minimis aid which has been granted to your company within the past
three years. It should noted that a false declaration by a company resulting in the threshold of
200,000 Euro being exceeded could later give rise to the aid being recovered with interest.
DECLARATION BY APPLICANT
An authorised representative of the business should complete this Declaration.
De Minimis Aid
Please provide details of any De Minimis Aid granted to your business within the last three years:
Note: A false declaration by a business/group resulting in the threshold of 200,000 Euro being
exceeded could later result in the aid being recovered with interest.
Please TICK the relevant box below:
EITHER:
OR:
I confirm that the company has been
granted only the following de minimis
aid within the past three years (supply
details)
No De Minimis aid has been granted to
the business within the past three years
£
I hereby give permission to disclose the information provided above (in strict
confidence) to the relevant funding agencies and delivery partners:
The InnoTech Centre, Fathom Energy & Environment, B9 Solutions, Larne,
Antrim, Ballymena, Moyle & Newtownabbey District Councils, DETI, Invest NI
and other agencies.
Submitted By:
(CAPITALS PLEASE)
Signed:
Position:
Date:
A SIGNED HARD COPY of this Application Form must be returned to:
John Harrison
Project Manager
InnoTech Centre, South West College
Burn Road
Cookstown
BT80 8DN
BY 12noon ON FRIDAY 14th MARCH 2014
Emailed / Faxed or late Applications WILL NOT be accepted