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Innovation Fund
Supporting Documentation Package
February 10, 2006
Important: Applicants should discuss their proposal with a FedNor officer serving their area prior to filling in an application. To find your local FedNor officer, click here.
| LEGAL NAME OF
APPLICANT |
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| OPERATING NAME |
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| ADDRESS |
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| |
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CONTACT PERSON
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| TELEPHONE NUMBER |
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| FACSIMILE NUMBER/E-MAIL
ADDRESS |
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| TYPE OF BUSINESS |
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| FUNDING SOURCES: |
|
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| TOTAL COSTS |
$ |
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| PROJECT COSTS: |
|
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| |
$ |
| TOTAL COSTS |
$ |
|
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CERTIFICATION
The undersigned
certifies:
- that all
information provided to FedNor/Industry Canada in support of this
request for funding is exact, true and complete, and undertakes
to provide any further information that may be required for FedNor
to render a decision, in a timely manner;
- that information
required in the attached table is being provided for all federal
and provincial government grants and contributions regarding the
proposed project; and,
- that the
Applicant (organization or firm) is current on all obligations
to the federal government under agreements for other financial
assistance; that the execution of the proposed project will not
prevent the applicant from continuing to meet these obligations
and from maintaining the economic benefits anticipated by the
other agreements; and that these obligations will not preclude
the applicant from fulfilling its obligations under the proposed
project.
The undersigned
provides consent for FedNor/Industry Canada :
- to gather
from, and share with, other government sources of assistance the
necessary information to ensure there will be no duplication of
assistance and to confirm that all agreements are being adhered
to; and
- to make
sufficient credit and other enquiries that may be necessary in
the evaluation of this request for financial assistance.
The Applicant
is aware that, in accordance with government policy, FedNor contributions
are repayable.
Signature:
________________________________________________________
(Officer with signing authority)
Applicant:
________________________________________________________
(Name of organization or firm)
Date: __________________________________________________________
Attachment
(s)
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Please complete the
following table for each federal and provincial government grants and
contributions received by your firm or organization or a related firm
or organization (i.e. the one that it controls or is being controlled
by) that is related to the proposed project. This includes :
- assistance for
which a contractual obligation still remains outstanding, including
projects not completed, repayments, obligation to maintain set employment
levels, obligation to remain in current location, etc.; and,
- applications for
financial assistance which are still pending.
You may wish to attach
a copy of the relevant agreement(s).
N.B. If there are
no other government funding sources related to the proposed project, please
indicate ‘Not Applicable'on the table.
GOVERNMENT FINANCIAL
ASSISTANCE (Related to the Proposed Project)
Federal,
Provincial or Municipal
Government Funding Source |
Contact Name:
____________________________
Ministry/Department/Agency:_________________
Telephone Number:
______________________
|
Status
If outstanding, specify whether project not complete; repayments;
obligation to maintain set employment levels; obligation to remain
in current location, etc.
If pending, please specify. |
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Project
Description
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Purpose
of Grant/Contribution
(e.g. eligible costs)
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Amount
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$ |
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Contract
Signature Date
Project
Completion Date
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Undertakings
and Conditions
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Existence
of any dispute with the supplying entity of this assistance
(Please specify)
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If you require
additional information, please contact the
FedNor
Officer in your area.
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INSTRUCTIONS TO THE APPLICANT
Detailed below are the contents of the Supporting Documentation Package which
must be submitted with your application for funding for Innovation Projects.
This normally provides sufficient information to permit an assessment and decision
on your application. The Officer assigned to your project may request additional
information or clarification of the data provided. All information provided
will be kept strictly confidential.
Please complete and sign the accompanying FedNor application form and return
it with the Supporting Documentation Package.
The following checklist has been provided for your convenience. Please ensure
that it is completed and also returned with your application:
| Enclosed |
Yes |
No |
| 1. History of Organization/Economic Benefits of Project |
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| 2. Management Resumé |
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| 3. Markets and Competition |
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| 4. Preliminary Financial Forecast |
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| 5. Statement of Work and Costing Schedule for Innovation Projects |
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| 6. Financial Statements |
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| 7. Articles of Incorporation/Partnership Registration |
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| 8. References |
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| 9. Environmental Assessment |
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When completed, the package should be returned to:
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FedNor
19 Lisgar Street
Room 307
Sudbury, Ontario
P3E 3L4
Telephone (705) 671-0711
Fax (705) 671-0717
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FedNor
70 Foster Dr.
6th Floor, Suite 600
Sault Ste. Marie, Ontario
P6A 6V4
Telephone (705) 941-2014
Fax (705) 941-2085
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FedNor
244 Lincoln Street
Thunder Bay, Ontario
P7B 5L2
Telephone (807) 766-1800
Fax (807) 346-8474 |
Attention: Innovation Fund
Toll Free 1-877-333-6673
1. HISTORY OF BUSINESS/ECONOMIC
BENEFITS OF PROJECT
1.1. Please indicate the legal status of the applicant: (Private Corporation, Public Corporation, Non-Share Capital Corporation, Other.)
1.2. Please list any subsidiaries or related organizations.
1.3. Who started the organization? When and where was the organization established?
1.4. What is the organization's mandate?
1.5. What changes have occurred in either ownership or orientation since the business was started?
1.6. Briefly outline the economic benefits which will accrue to Northern Ontario and Canada as a result of your project
2. MANAGEMENT RESUMÉ
Please indicate the names and positions of management personnel, identify the person responsible for managing the project, identify the person(s) responsible for completing progress reports and filing financial claims to FedNor.
Attach a list of Board of Directors with positions held. (I.e. Chair, Audit Committee, etc.)
3. MARKETS AND COMPETITION
3.1. Target Market
Describe your target market. What is the estimated size of the market and your anticipated market share? Who will access the services being planned?
3.2. Market Strategy
Outline the detailed market strategy you will use to get your desired market share for this new service, product or process. Include specific costs for this market strategy and identify these in your three year budget forecast as required in 4. Preliminary Financial Forecast. Also include a copy of your advertising literature if available.
3.3. Competition
Identify your competitors. Outline your competitive strengths and weaknesses.
What impact will your project have on your competitors?
4. PRELIMINARY PROFITABILITY ANALYSIS
Please provide a 3 year forecast based on Cash Flow. Use separate lines to indicate major revenues and expenses related to this project. Where applicable, provide your regular budget and a separate forecast of revenues/expenses arising from this project.
5. STATEMENT OF WORK AND COSTING
SCHEDULE FOR INNOVATION PROJECTS
The Statement of Work should set out in detail the work to be carried out, along with the associated costs. In order to facilitate project assessment, please provide the following information, as indicated below.
On a separate sheet of paper, use the following headings to provide the necessary information:
| A. Statement of Work |
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a)
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Purpose:
Describe the objectives of the innovation project.
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b)
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Background:
Provide any necessary background information to better understand the
project. This should include work done to date.
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c)
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Performance Targets:
List and describe the project specifications, performance levels, durability
requirements, cost limitations, minimum industry standards, tolerances,
etc., which must be met for the innovation project to be acceptable. These
should be stated, whenever possible, in measurable and quantitative
terms which can be used in assessing the ultimate success of the project.
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d)
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Major Tasks/Method of Approach:
Describe in point form the tasks/steps which will have to be undertaken
in order to complete the innvation project and reach the desired objectives.
Where appropriate, provide the following information for each task/step:
- the objective or purpose of the task;
- a technical description, in chronological order, of the work to be done
in the task;
- details of work to be done by your own staff;
- details of the work to be done by consultants and other sub- contractors;
- materials, special equipment required in the task;
- details of testing required;
- schedule, milestones, timing.
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e)
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Project Management:
Explain the management of the innovation project, control of expenses,
work review meetings, progress and final reports. |
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| B. Costing Schedule |
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a)
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Time Schedule Summary:
Using the tasks/steps which you developed in 3A above for your project,
provide a time schedule/chart similar to the following: |
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| TASKS/STEPS |
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| 1. Feasibility |
| 2. Design |
| 3. Fabrication |
| 4. Testing |
| 5. Pre-production |
| 6. Final Report |
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b)
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Cost Estimates:
Provide a cost estimate for each task/step, setting out the following
table: |
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TASK/
STEPS
NO.
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DIRECT
LABOUR
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FRINGE
BENEFITS
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DIRECT
MATERIAL
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SPECIAL
EQUIPMENT
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SUB-
CONTRACTS
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OTHER
COSTS
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TOTAL
COSTS
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| 1.
2.
3.
4.
5.
6.
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i)
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Direct Labour
This is the labour provided by your employees and should be for technical
employees such as engineers, draftspersons, technicians, operators,
etc., who are directly involved in the innovation project work. The
rate of pay actually received by the employee should be used in estimating
costs. Where management is involved in doing this work, the costs should
be no higher than the cost
of hiring a qualified employee. Please identify owner/manager costs.
Please present costs in a table as follows:
|
|
Example:
| Employee Classification |
Hours Required |
Rate of Pay |
Fringe Benefits |
Total |
| Engineer |
25 |
$35 |
20% |
$1050 |
| Lab Technician |
20 |
25 |
20% |
$600 |
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ii)
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Fringe Benefits
An allowance of 20% of total employee wages working on the project can
be charged. This replaces any other fringe benefit calculation for unemployment
insurance, CPP pension deductions, health benefits, etc.
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iii)
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Direct Material
List the materials and components required in completing the project,
along with their costs.
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iv)
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Subcontracts
Indicate the subcontractors (name of firm) that are required to complete
the innovation project, along with their cost breakdown of labour, materials,
travel. Non-arm's length contracts may be charged only at cost.
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v)
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Travel, Patents, Leasing, Special-Purpose
Equipment, etc.
Indicate other project-related costs, indicating the nature and cost of
each. |
6. FINANCIAL STATEMENTS (EXISTING BUSINESSES ONLY)
Please provide copies of your financial statements for the last two fiscal
years and the most recent interim financial statement. Interim financial statements
must be provided when the latest year-end statements are six months or older.
Year end statements must be produced by an established bookkeeper or accredited
accountant at arms length from the applicant, and must contain, as a minimum,
an opinion on the statements, a balance sheet, a statement of earnings and notes
to ther financial statements. Interim financial statements may be prepared by
the applicant.
7. ARTICLES OF INCORPORATION/PARTNERSHIP
REGISTRATION
All incorporated businesses must supply a copy of their Articles of Incorporation. Existing partnerships must provide a copy of their current registration certificate.
8. REFERENCES
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| Name: |
Address: |
Telephone: |
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Bank Manager
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Accountant
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Solicitor
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Insurance Agent
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Industrial Contact
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9. ENVIRONMENTAL ASSESSMENT
When it is determined that a proposed project falls under the provisions of
the Canadian Environmental Assessment Act, an environmental assessment will
need to be completed consistent with the Act, before a final decision can be
made regarding the provision of a FedNor contribution toward the project. For
further information, contact the FedNor Officer in your area. More detailed
information regarding the Act and its provisions, can also be obtained at the
Canadian Environmental Assessment Agency`s Website www.ceaa.gc.ca
PAYMENT OF FEDNOR CONTRIBUTIONS
- OPERATING COST PROJECTS
Detailed instructions and claim forms will be provided to applicants after
their projects are approved by FedNor. However, applicants may find the following
general information useful in their financial planning.
In order to receive payment, applicants must file a claim. The claim must include
a listing of all the costs incurred for the project. Copies of all invoices
over $1000 must accompany the claim.
Applicants may claim 90% of the approved FedNor contribution during the implementation
phase of the project. The final 10% of the approved FedNor contribution will
be released following completion of the project, submission of the required
final report, and audit of the project. All projects are audited by auditors
approved by FedNor to verify that the funds provided were used in accordance
with the terms and conditions of the contribution agreement, and that costs
claimed by the applicant were actually paid. Accordingly, applicants are required
to maintain proper books and records of the costs of the project, including
invoices and cancelled cheques, and to provide FedNor auditors with access to
these records when requested.
Claims for non-arms-length transactions are permitted, although they must be
claimed at direct out-of-pocket cost with no allowance for overhead or profit.
Use of internal labour is permitted at actual regular rate of pay with a flat
20% allowance for fringe benefits.
The federal goods and services tax (GST) is an eligible cost only where the
amount of the tax is not refundable in whole or in part by Canada Customs and
Revenue Agency.
If applicants arrange for bridge financing of their FedNor contribution with
a bank or other financial institution, FedNor will accept a direction to pay
the proceeds of a FedNor contribution jointly to an applicant and the financial
institution providing the bridge financing.
In accordance with government policy, FedNor contributions to business are
repayable. The terms of repayment will be determined on a case by case basis.
Repayment is of the principal only.
Confidentiality: No commercially confidential information which you
submit to us will be disclosed unless otherwise specified by you; required to
be released by law; or required by the Minister of Industry to be released to
an international or internal trade panel for the purposes of the conduct of
a dispute in which Canada is a party or a third party intervener. Information
on the federal government's Access to Information Act is available on
the following Web site: http://www.canada.justice.gc.ca/en/ps/atip/index.html
Any information that you wish to be considered as confidential should be annotated
accordingly.
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FedNor
