Download a Word Version [658kb]

17
COMMERCIALISING EMERGING TECHNOLOGIES (COMET) Assistance Plan Progress Report BEFORE YOU START: This report is used to provide the Commonwealth with regular updates on activities undertaken in relation to your COMET grant project. Reference documents available to assist you in completing this report include: COMET Grant Deed; COMET Guide to managing your grant; COMET Customer information guide; COMET You and your business adviser; and COMET You and your service provider. Note: The report can be filled out using Microsoft word by tabbing from text box to text box. Most text boxes can be expanded to accommodate your needs. Text boxes requiring numbers will only accept numbers. Table 3 under "Grant Funding Acquittals" is an exception. The table has been left unprotected to allow for the addition of lines to incorporate circumstances where you have a large number of invoices to enter. You have the option of printing the form, signing/dating (by hand) and sending through to your business adviser, or completing these processes using an electronic signature and e-mailing the form to the business adviser. The Assistance Plan Progress Report comprises four sections: Section 1: Grantee Details Section 2:Assistance Plan Progress; Commercialisation Outcomes; Grant Funding Acquittals; and Grantee Declaration Section 3:COMET Business Adviser Declarations and Recommendation – Business Adviser Use Only Section 4: Definitions SECTION 1 GRANTEE DETAILS Application Number: Company Name: Contact Person: COMET Assistance Plan Progress Report Page 1 of 17 Version 3.1 February 2009 COMET Section

description

 

Transcript of Download a Word Version [658kb]

Page 1: Download a Word Version [658kb]

COMMERCIALISING EMERGING TECHNOLOGIES (COMET)

Assistance Plan Progress ReportBEFORE YOU START:

This report is used to provide the Commonwealth with regular updates on activities undertaken in relation to your COMET grant project. Reference documents available to assist you in completing this report include:

COMET Grant Deed;

COMET Guide to managing your grant;

COMET Customer information guide;

COMET You and your business adviser; and

COMET You and your service provider.

Note: The report can be filled out using Microsoft word by tabbing from text box to text box. Most text boxes can be expanded to accommodate your needs. Text boxes requiring numbers will only accept numbers. Table 3 under "Grant Funding Acquittals" is an exception. The table has been left unprotected to allow for the addition of lines to incorporate circumstances where you have a large number of invoices to enter. You have the option of printing the form, signing/dating (by hand) and sending through to your business adviser, or completing these processes using an electronic signature and e-mailing the form to the business adviser.

The Assistance Plan Progress Report comprises four sections:

Section 1: Grantee Details

Section 2: Assistance Plan Progress; Commercialisation Outcomes; Grant Funding Acquittals; and Grantee Declaration

Section 3: COMET Business Adviser Declarations and Recommendation – Business Adviser Use Only

Section 4: Definitions

SECTION 1 GRANTEE DETAILS

Application Number:      

Company Name:      

Contact Person:      

Phone:      

Facsimile:       Reporting Period

E-mail:      From:      (dd/MM/yyyy)

Business Adviser:      To:      (dd/MM/yyyy)

COMET Assistance Plan Progress Report Page 1 of 11Version 3.1 February 2009COMET Section

Page 2: Download a Word Version [658kb]

SECTION 2

ASSISTANCE PLAN PROGRESS

Briefly report on the progress of your COMET Assistance Plan for this reporting period. The COMET Assistance Plan is located at Schedule 1 of the COMET Grant Deed (your contract).

(a) Outline what progress has been made since your last report in the implementation of your Assistance Plan.

     

(b) If applicable, outline issues causing delay with progress to your Assistance Plan.     

(c) Outline any matters which may affect your compliance with the COMET Grant Deed (for example: changes to company ownership/control/structure; changes to key personnel, changes to beneficial use of intellectual property).

     

COMET Assistance Plan Progress Report Page 2 of 11Version 3.1 February 2009COMET Section

Page 3: Download a Word Version [658kb]

COMMERCIALISATION OUTCOMES

PART A: CAPITAL RAISING OUTCOMES

Did you achieve any capital raising outcomes in this reporting period (or were not previously reported)? Definitions of the commercialisation outcomes are provided at Section 4 Part A.

Yes No (please one box)

If YES — complete Table 1 If NO — proceed to Part B.

Table 1: Capital Raising Outcomes - Complete columns (b) (where appropriate) (c) (d) (e) and (f). Note: Refer to email notification of this pending progress report, for cumulative outcomes (columns (c) and (d)).

(a)ID

number(refer

Attachment A)

(b)Commercialisation

outcome

(c)Enter number of cumulative

outcomes previously reported

(d)Cumulative $

value of outcomes previously reported

(e)Enter number of outcomes

not previously reported

(f)Enter $ value of outcomes

not previously reported

Ca

pita

l Ra

isin

g O

utco

me

s 1 Equity Injection

(Non-Public Equity)       $            $     

2 Initial Public Offering

(Public Equity)

      $            $     

3 Borrowing/Debt Financing      $            $     

4Other (please specify):

           $            $     

CHOOSE A CATEGORY (Please refer to Section 4 Part B for Definitions) if appropriate

Equ

ity In

ject

ion

(Cap

ital R

ais

ing

outc

ome

ID n

umbe

r 1-

se

e ab

ove

tabl

e)

Non-public Equity Injection

1. Angel Finance. Please specify whether: syndicate - Choose Syndicate type

OR individual - Choose individual type

2.Corporate Investment3.Innovation Investment Fund4.Pre-Seed Fund5.Pooled Development Fund6 Other Australian, State or Local Government Equity Program (please specify):      7.Other Venture Capital or Private Equity Fund8. Other (please specify):

     

Was the Equity Injection:a) Additional investment from existing shareholderb) Investment from a new shareholder

Initi

al P

ublic

O

fferin

g (C

apita

l R

aisi

ng

outc

ome

ID

num

ber

2 s

ee a

bov

e ta

ble)

Public Equity1.IPO2.Reverse Listing3.Other (please specify):      

Source of capital? Domestic International Both (please one box)

COMET Assistance Plan Progress Report Page 3 of 11Version 3.1 February 2009COMET Section

Page 4: Download a Word Version [658kb]

Bor

row

ing

/D

ebt

Fin

anci

ng

(Out

com

e ID

num

ber

3)

1.Financial Institution2.Non-Financial Institution3.Other (please specify):      

Oth

er

(Out

com

e ID

nu

mbe

r 4)

Other form of Capital (please specify):

     

PART B: NON CAPITAL RAISING OUTCOMESDid you achieve any non capital raising outcomes in this reporting period (or were not previously reported)? Definitions of the outcomes are provided at Section 4 PartA.

Yes No (please one box)

If YES — complete Table 2 If NO — proceed to Grant Funding Acquittals.

Table 2: Non Capital Raising Outcomes - Complete columns (b) (where appropriate) (c) and (d). Note: Refer to email notification of this pending progress report, for cumulative outcomes (column (c)).

(a)ID number

(refer Attachment A)

(b)Commercialisation outcome

(c)Enter number of

cumulative outcomes previously

reported

(d)Enter number of

outcomes not previously reported

Alli

ance

s 5 Strategic Alliances            

6 Joint Venture            

7Other (please specify):

                 

Lice

nce 8 Merchandising            

9Other (please specify):                  

Agr

eem

ent

10 Distribution            

11 Manufacturing            

12 Product Market Release           

13Other (please specify):                 

Pro

duct

ion

14 Manufacturing Commenced            

15 Product/Service Launched            

COMET Assistance Plan Progress Report Page 4 of 11Version 3.1 February 2009COMET Section

Page 5: Download a Word Version [658kb]

GRANT FUNDING ACQUITTALS

In Table 3 list invoices that have been paid and not previously claimed. Attach all invoices and proof of payment.

Note:

all activities must be approved by your business adviser before being undertaken; only activities undertaken by a service provider may be considered by the Commonwealth for reimbursement; and fees for services provided by related parties are not eligible expenditure.

For more information on related parties, refer to your COMET Grant Deed (see Section 7), the COMET Customer information guide and the Guide to managing your grant.

PROOF OF PAYMENT: INVOICES FROM YOUR SERVICE PROVIDER MUST INCLUDE THE FOLLOWING:

Copies of receipts (signed invoices are not acceptable) together with,

Copies of cheque account or bank account statements; or

For services provided by an overseas provider, the international transfer statement from your bank must be provided.

Date of the invoice; Date(s) the service was provided; Cost of the service; A clear description of services received; Your company name and address details; The supplier’s ABN; Any government charges; and GST where applicable.

Place cursor in first "Date of Invoice" field to begin text box tabbing:

TABLE 3: Invoices

Date of Invoice

(dd/MM/yyyy)

Name of Service Provider Invoice Number

Invoice's GST

Exclusive Amount

Assistance Plan Activities

(select multiply activity if appropriate for the invoice )

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity

                  $      Activity Activity Activity *

Additional lines will be added if you tab at the last 'Activity' text field marked * ; To get to 'TOTAL' text box, you will need to place cursor into this field and click once.

TOTAL $     

COMET Assistance Plan Progress Report Page 5 of 11Version 3.1 February 2009COMET Section

Page 6: Download a Word Version [658kb]

Total Expected Project ExpenditureProvide your best estimate of total expected project expenditure against each Assistance Plan Activity. The total should add to the total value of your COMET Grant Deed (see Item 1 of Schedule 1).

TABLE 4: Total Expected Project Expenditure Note: report 100% of expected expenditure by activity for the entire project.

Assistance Plan Activity (A)Total Expected project

expenditure (100%) – GST Exclusive

1. MANAGEMENT SKILLS

Management Team $     

Management Skills Course $     

Management Skills Development $     

2. STRATEGIC

Business Plan/Information Memorandum $     

Export Strategy $     

3. MARKET

Market Research $     

Market Validity $     

4. INTELLECTUAL PROPERTY $     

5. WORKING PROTOTYPE $     

6. PROVEN TECHNOLOGY $     

TOTAL $     

COMET Assistance Plan Progress Report Page 6 of 11Version 3.1 February 2009COMET Section

Page 7: Download a Word Version [658kb]

GRANTEE DECLARATION – GRANTEE TO SIGN

I       …………………………………………………………..state that:

I am a person duly authorised to act on behalf of the Grantee identified in Section 1 of this report;

The information I have provided is consistent with the approved COMET Assistance Plan under the COMET Grant Deed;

I am aware Eligible Expenditure means expenditure determined by the Commonwealth to be expended on the COMET Assistance Plan;

I am aware that Grant funds will only be used to pay for eligible expenditure under the COMET Grant Deed;

The business adviser has agreed to all services in accordance with the COMET Assistance Plan activities prior to entering into a contract with a service provider;

I have provided the business adviser with adequate records to assess that the services specified in the Assistance Plan have been undertaken and have met the standards specified in the agreement between the Grantee and the service provider.

I am aware that some or all of the Grant funds may be required to be repaid if there is a breach of the COMET Grant Deed;

All records relating to the COMET Assistance Plan are kept by the Grantee and are available for inspection by the Commonwealth and its auditor in accordance with the COMET Grant Deed; and

To the best of my knowledge the information set out in this form and its attachments is not false or misleading.

Grantee signature:      ___________________________________________

Date:       (dd/MM/yyyy)

NEXT STEP

Forward the completed Assistance Plan Progress Report and all supporting documentation to your business adviser.

Page 8: Download a Word Version [658kb]

SECTION 3 COMET BUSINESS ADVISER (BA) DECLARATIONS and RECOMMENDATION – BA USE ONLY

Are you aware of any circumstances and/or issues that may influence the acceptance of this report by the Commonwealth? For example:

matters of ownership/beneficial use of IP; a change in company key personnel whose technical or business skills are crucial to the success of

the COMET Assistance Plan; or particular conditions which are specific to the COMET Grant Deed and the COMET Assistance

Plan.

YES (check if required) NO (check if required)

If yes, please provide details below:

..............................................................................................................................................................................................

..............................................................................................................................................................................................

..............................................................................................................................................................................................

..............................................................................................................................................................................................

I ____________________________________________________ have been provided with evidence from the Grantee that the stated Activities reported for the reporting period have been undertaken, and have met the standards specified in the agreement between the Grantee and the service provider and are in accordance with the COMET Assistance Plan. To the best of my knowledge, the information contained in this report is true and correct and I support the changes proposed by the Grantee to the budget identified at Table 4.

all of the Activities are considered to be eligible. (check if required)

some of the Activities are considered to be eligible and some Activities are considered ineligible. (check if required)

Please provide details of activities considered ineligible.      ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

all the reported commercialisation outcomes are accurate by type and quantity. (check if required)

some of the reported commercialisation outcomes are not accurate by type or quantity. (check if required)

Please provide details of inaccurately reported commercialisation outcomes.      ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

BA's signature:      ___________________________________________

Date:       (dd/MM/yyyy)

Page 9: Download a Word Version [658kb]

Conflict of Interest Declaration (please sign where appropriate):

I have no actual or potential conflict of interest with the Grantee or its service providers.

BAs signature:      ___________________________________________

Date:       (dd/MM/yyyy)

I have a an actual or potential conflict of interest with the Grantee or its service providers.

BAs signature:      ___________________________________________

Date:       (dd/MM/yyyy)

When completed and signed by the Grantee and business adviser, please e-mail, mail or fax this COMET Assistance Plan Progress Report and associated documentation to:

COMETAusIndustryDepartment of Innovation, Industry, Science and ResearchGPO Box 9839CANBERRA ACT 2601

Facsimile: 02 6276 1947

E-mail: [email protected]

Page 10: Download a Word Version [658kb]

SECTION 4 DEFINITIONS

Part A: DEFINITIONS OF COMMERCIALISATION OUTCOMES

(Definitions of commercialisation outcomes are provided to customers to assist them in identifying each of the outcomes)

[Refer Section 2: Commercialisation Outcomes]

Capital Raising

1. Non Public Equity Injection: any funding that has been committed through a binding agreement to the COMET Grantee to commence operations, or finance a growth strategy, in return for a share of the company e.g. venture capital, business angel finance or other investors.

2. Public Equity: Equity capital invested in a public company.

3. Borrowing/Debt Financing: finance committed through a binding agreement to the COMET Grantee, and which needs to be repaid.

Alliances

5. Strategic Alliances: when an agreement between the COMET Grantee and another entity is entered into, stating that the involved parties will put in place specified actions to achieve a common goal.

6. Joint Venture: when a contractual agreement between the COMET Grantee and another party is entered into for the purpose of executing a particular business undertaking. All parties agree to share in the profits and losses of the enterprise. The venture is for one specific project only, rather than for a continuing business relationship as in a Strategic Alliance.

Licence

8. Merchandising: contract is signed by the COMET Grantee giving permission for another party to promote, buy and sell the product/service for which COMET funds were granted.

Agreement

10. Distribution: a contract is signed by the COMET Grantee authorising another party to supply to retailers/buyers the product/service for which COMET funds were granted.

11. Manufacturing: a contract is signed by the COMET Grantee authorising another party to manufacture the product/service for which COMET funds were granted.

12. Product/Market Release: a product is placed on the market by the COMET Grantee, or a contract is signed by the COMET Grantee, authorising another party to undertake the steps necessary to have the product/service for which the Grantee received funding available for sale.

Production

14. Manufacturing Commenced: COMET Grantee has commenced production of the product for which it received COMET funding, or a third party has commenced the manufacture of the product under licence to the COMET Grantee.

15. Product/Service Launched: COMET Grantee has introduced to the public the availability for purchase of the product/service for which it received COMET funding.

Page 11: Download a Word Version [658kb]

Part B: DEFINITIONS OF SOURCES OF CAPITAL:

(Definitions of sources of capital outcomes are provided to customers to assist them in identifying each of the outcomes)

Angel Finance: Finance can be provided by high net worth individuals or a network (syndicate) who invests their own money in entrepreneurial firms, and can be either formal or informal in nature: Syndicate: The grouping of angels into syndicates can be formal and have rules, a defined minimum

commitment, and provide expert advice to start-ups, OR can be informal alliances which make equity investments on an ad-hoc basis.

Individual: Formal angels provide expertise to the company in return for equity, and informal angels act as silent partners.

Borrowing/Debt Finance: Finance committed through a binding agreement, and which needs to be repaid. This is an amount owed to a person or organization (financial or non-financial institutions) for funds borrowed. Debt can be represented by a loan note, bond, mortgage or other form stating repayment terms and, if applicable, interest requirements.

Corporate Investment: Equity funding secured by COMET grantees from public or private companies. An initiative by a corporation to invest either in young firms outside the corporation or units formerly part of the corporation.

Financial Institution: Bank, Credit Union or Building Society.

IPO: "Initial Public Offering", "flotation", "float", "going public", "listing" are just some of the terms used when a company obtains a quotation on a stock market.

Non-public Equity: Any funding that has been committed through a binding agreement to the COMET Grantee to commence operations, or finance a growth strategy in return for a share of the company through private arrangements (as opposed to Public Equity).

Other form of Capital: Any other form of capital not covered under other outcomes.

Private Equity Fund: Organisations devoted to leveraged buyouts, consolidations, mezzanine and distressed debt investments, and a variety of hybrids such as venture leasing and venture factoring.

Public Equity: Equity capital invested in a public company.

Reverse Listing (or Reverse Take Over/Reverse acquisition): When a company buys out a larger company, but could also occasionally refer to a private company taking over a publicly listed company. This can be either by financial buy-out or replacing the management team. Typically, a public company that is taken over by a private company will remain listed, and the private company will use the acquisition as means of gaining a listing.

Various Government Equity Programs: Australian Government Programs such as the Innovation Investment Fund (IIF); Renewable Energy Equity Fund (REEF); Pre-Seed Fund (PSF); Pooled Development Fund (PDF); and others etc: State Government Programs (to be specified) and/or Local Government Programs (to be specified).

Venture Capital Fund: Independently managed, dedicated pools of capital that focus on early stage equity or equity-linked investments in privately held, high-growth companies. Many venture capital funds, however, occasionally make other types of private equity investments. Outside the United States, this phrase is often used as a synonym for private equity.