Proposal & CList Form-(is EDIT)

7/28/2019 Proposal & CList Form-(is EDIT)

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ALL INFORMATION PROVIDED IN THIS APPLICATION

WILL BE TREATED AS CONFIDENTIAL

Please read the Technofund Guidelines carefully before

you fill in this form.

All information required in the application form must be

given.

Please submit the project proposal together with the

business plan (1 hard copy and 20 CDs) but save theproject proposal in a separate file.

Incomplete application and/or application received after

the closing date of each cycle will be returned.

For office use only

Date Received

Reference No

Project Officer

PART 1: APPLICANT DETAILS

1.1 Particulars of Entity

Entity name:

FQ FEEDMILL SDN BHD

Company registration number (if applicable):817754-V

Date of Incorporation (if applicable):

We are currently a (Please mark (X) inappropriate box):

Start-Up Company

Spin-Off Company

PROJECT TITLE COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING

Please read the latest version (updated 31th July 2007)

of TechnoFund Guidelines for Applicant carefully beforeyou fill in this form.

Please submit 2 hard copies and 15 CDs (saved in

separate files) of project proposal, business plan andexecutive summary.

All information required in the application form must be

given. Incomplete or ineligible application will not beentertained.

Development and Procurement Division,Ministry of Science, Technology and Innovation (MOSTI)

Level 3, Block C5, Complex C,Federal Government Administrative Centre, 62662 Putrajaya

http://www.mosti.gov.my

Tel: 03 - 8885 8810 / 8163 (Helpdesk)Fax: 03 - 8888 9473e-mail: [email protected]
http://www.mosti.gov.my/mailto:[email protected]://www.mosti.gov.my/mailto:[email protected]


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Small Company X

Medium / Large Company

Public Listed Company

Government Linked Company

Institution of Higher Learning

Government Research Institute

Authorised capital :

RM 100,000.00

Paid up capital:

RM 100,000.00

Structure of Shareholding:

Malaysian:

Bumiputra

%

66.66

Non- Bumiputra 33.34

Foreign:

Total: 100.00

Core Business of Entity:

1. Manufacturing Animal Feed2. Sales & Marketing Finished product

3.

Address:

Lot 13G,Kawasan Perusahaan BukitAngkat,43300 Kajang,Selangor

Company Directors (if applicable):

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1.Hj Anuar bin Ibrahim

2.Dr.Iskandar Roshan bin Abdullah

3.Razis Shahrizan bin Zainal

Principal Researcher / Leader:

Hj Anuar bin Ibrahim

Designation :

Managing Director

Telephone no : Fax no :

03-87336073 03-87336095

E-mail:

[email protected]

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1.2Have you or your business previously applied or been connected with an application, forother Government R&D, commercialisation or related funding? Please mark (X) in theappropriate box.

Yes No x

If yes, please give details:

1.3

Have you or any other partner, member or director of your business ever been

disqualified from becoming a director?Please mark (X) in the appropriate box

Yes No x


1.4Have you or any other partner, member or director of your business ever been an owner,partner or director of a business which went into bankruptcy, liquidation or receivership?Please mark (X) in the appropriate box

Yes No x


1.5

How do you plan to fund your share of the project costs? Provide proposedsource of funding (for start-up, spin-off and small company) or evidence offunding (e.g. bank statement, bank facility / over draft, etc)

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PART 2: COLLABORATOR DETAILS

2.1Particulars of Collaborator(mandatory for IHL/GRI Applicant):

Company Name:

Universiti Malaysia Sabah

Company registration number:

Date of Incorporation:

24 Nov 1994

Our collaborator is:Please mark (X) in appropriate box

Start-Up Company

Spin-Off Company

Small Company

Medium / Large Company

Public Listed Company

Government Linked Company

Institution of Higher Learning x

Government Research Institute

Authorised Capital :

Paid-up Capital:

Structure of Shareholding:

Malaysian:

Bumiputra Non-Bumiputra

%

Foreign:

Total:

Core Business of Collaborator:

1.Education

2.

3.

Address:

Universiti Malaysia SabahLocked Bag 2073,88999 Kota KinabaluSabah Malaysia

Company Directors:

1.

2.

Contact Person:

Prof. Dr. Rosnah Ismail

Designation:

Deputy Vice Chancellor (Research &Innovation)

Telephone no :

088-320000 - 1407

Fax no :

088-448886

E-mail:

[email protected]

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PART 3: PROJECT DETAILS

You are applying for(Please mark (X) in the appropriate box)

Type ApplicationProposed Project Cost

(RM)

A: Pre-Commercialisation x3,195,080.00

B: IP Acquisition

Total

Note: Applicants can apply for a combination ofTypes A and B orType A only

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Technology Cluster(Please mark (X) in the appropriate box

Agriculture

Biotechnology X

Information and CommunicationTechnology

Industry

Sub cluster(please refer to the List of Sub Clusters at

http://ernd.mosti.gov.my/escience and indicate accordingly)

Sub cluster:

3.1 TYPE A: PRE-COMMERCIALISATION

3.1.1 Project Title

COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING

3.1.2 Project Summary

New fish feed formula that serve as a replacement fish-based feeds, using a mixture ofpoultry by-products and vegetable oils. The feed produced that was not only profitablefor aquaculture farmers but one which would also contribute to the environment.

3.1.3 Proposed Project Duration (months)

24 months

3.1.4 Location of the Proposed Project

Selangor
http://ernd.mosti.gov.my/http://ernd.mosti.gov.my/


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3.1.5 Technical Aspects (Refer Attachment)

a. Previous Work Done (Laboratory Proof of Concept)

b. Project Objectives

c. Methodology

d. Technology Benchmarking

e. Project Deliverables

f. Regulatory and Standards

g. Patentable Output

h. Project Risks

i. Project Benefits

j. Project milestones and activities (List the major milestones of the project(typically 5 to 8) in the table below. Outline the major activities of eachmilestone. A milestone typically consists of 8 to 12 activities. These activitiesshould collectively cover the scope of the milestone. The activity costs shouldbe equal to the total project cost.)

NO. MILESTONES ACTIVITIES DELIVERABLES COSTCOMPLETION

DATES

1.

2.

3.

4.

5.

6.

7.

8.

k. Project Gantt Chart (Please attach)

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l. Project Costing(Please itemise and provide breakdown for expenses of each componentand sub-component involved)

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NO EXPENSES ITEMSCOST(RM)

TOTAL(RM)

1.Pilot Plant & Equipment (ifapplicable)

2.Clinical Trial / Field Trial (ifapplicable)

3.Commercial Ready Prototype (ifapplicable)

4.IP Preparation and Registration(excluding maintenance)

5.Market Testing of CommercialReady Prototype

6.Regulatory and StandardsCompliance

7. Contract Expenditure

8.

Expenditure of Services (marketsurvey, consultancy andtesting)

Total Proposed Project Cost


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3.1.6 Project Team(Describe the technical and business capabilities, qualifications and experience ofproject team members. Please attach CV of each team member.)

Refer CV

3.2 TYPE B - IP ACQUISITION

3.2.1 Title

nil

3.2.2 Description(commercial potential, etc)

nil

3.2.3 IP Registration number and expiry date

nil

3.2.4 Original Owner(Please attach IP Acquisition Agreement with owner)

nil

3.2.5 Country of origin

nil

3.2.6 Cost of acquisition

3.2.7 Details of training provided

nil

NO EXPENSES ITEMS

COST

(RM)

TOTAL

(RM)

1.Acquisition of IP(laboratory scale

nil

2. Training (technology transfer) nil

Total Cost of Acquisition


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3.2.8 Novelty of IP to be acquired

nil

3.2.9 Proposed Acquisition Date

nil


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PART 4: DECLARATION

This form must be signed by someone with the legal authority to bind the applicant entity/institution(for example, an executive director of your entity)

I / We certify that:

a. I / We have read, understood and agreed to abide by the latest version of the TechnoFundGuidelines For Applicants;

b. The information provided in this application, including attachments, is true and correct to thebest of my knowledge; and

c. The Entity/Institution is free from any litigation pertaining to the proposed project in Malaysia

and overseas.

Name:

Designation:

Signature:

Date:

For enquiries, please e-mail: [email protected]

Applicants must use the latest version of the Project Proposal Form for submittingapplications and fill in the TechnoFund Application Checklistseparately. MOSTI

reserves the right to revoke application or withdraw approval based on falseinformation submitted by applicants.

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4.1 Declaration
mailto:[email protected]:[email protected]


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TECHNOFUND APPLICATION CHECKLIST

Reference No.

Entity Name FQ FEEDMILL SDN BHD

Project Title COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING

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No. Please mark ( ) in the appropriate box

( ) (For Official Use)Book 1 (2 hard copies)

1. Executive Summary (maximum 2 pages)

2. Project Proposal

3. Curriculum Vitae of project team

4. Form 9 (Company Act,1965)



7.

Recent EPF statement of all employees / work permitof foreign workers (Company Applicants and IHL/GRIMain Collaborator)

8.

MOU between IHL/GRI and Collaborator (to financethe portion of project cost not funded by TechnoFundand to commercialise project output) (IHL/GRIapplicants only)

9. IP Acquisition Agreement (for Type B only) 10. Itemised costing

Book 2 (2 hard copies)

11. Business Plan

12.Latest audited Financial Report (annual turnover,profit and loss statement, balance sheet, cash flow,etc) (Company applicants and IHL/GRI Collaborator)

CD (15 copies)

13.Project Proposal + Business Plan + ExecutiveSummary (in separate files)


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(For Official Use Only)

Status: Complete

Incomplete & Returned

Ineligible & Returned

Status: Complete



Remarks: Remarks:

Name of Desk Officer : Name of AD:

Signature: Signature:

Date: Date:

Ministry Chop:

Acknowledgement by Applicant:

Name :

Signature:

Date:

Updated: 31 th July 2007

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Proposal & CList Form-(is EDIT)

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