Download - Office of Environment and Heritage€¦ · Web viewBush Connect Program - 2015. Application Form. Closing date 5:00 pm 19 June 2015. About the program. Bush Connect. will fund and

2015 Bush Connect Application Form

Bush Connect Program - 2015

Application Form

Closing date 5:00 pm 19 June 2015

About the program

Bush Connect will fund and support community driven, consortium-based projects with an emphasis on on-ground activities to improve the condition of the natural environment within the New South Wales (NSW) portion of the Great Eastern Ranges (GER) corridor. Projects will be large-scale (tenure blind) and long-term (10 years).

For further information, please refer to the Bush Connect Program Guidelines.

Using this document

This document is the application template for the program and contains guidance on how to complete it. A variety of text styles have been employed throughout this document, and can be interpreted as follows:

· Grey boxes ( ) represent sections which require your input. These boxes will expand as you type, however, the amount you can enter is restricted to the size of text boxes provided - please ensure you make good use of the available space.

· Guidance on type of information required for each question/section has been provided.

Questions

If you require assistance with completing the application form, please contact theEnvironmental Trust on (02) 8837 6093 or [email protected]

Lead Applicant:

Project Title:

Funding Requested:

$

Section 1 – Registration and administration

1.1Project title

Provide a title for your project in 68 characters or less. If your application is successful, this project name will be used on all grant documentation and for promotional purposes.

1.2Project description

Please describe your project in 100 words or less. Note: this summary will be used for all promotional material relating to the grant, i.e. media, web site etc.)

1.3Project location

Provide location information for your project. Decimal degrees can be determined by accessing Google maps, navigating to your project site and right-clicking on ‘What’s here?’

Main local government area

Local Land Services area

State electorate

Latitude (decimal degrees)

Longitude (decimal degrees)

Provide location map(s) and plan(s) of your project site(s) as attachments with your application.

1.4Lead organisation details

Name of organisation

ABN

Registered for GST

Yes |_| or No |_|

Postal address

Suburb

State

Postcode

1.5What is the legal status of your organisation? (Select only ONE box for the lead organisation)

|_|

Community group

|_|

Not-for-profit organisation

|_|

Incorporated association

|_|

Other (please specify below):

1.6Project manager (Primary contact for the project)

The project manager is responsible for overall project organisation, management, planning, implementation, evaluation and reporting. A position description for the role of Project Manager that details the accountabilities and responsibilities should be included in the Appendices.

Title

First name

Surname

Position

Daytime phone

(0 )

Mobile

Email

1.7Senior authority (secondary contact for the project)

Include contact details for the person responsible for appointing/supervising the project manager (e.g. chairperson, general manager, senior supervisor, etc.)

Title

First name

Surname

Position

Daytime phone

(0 )

Mobile

Email

1.8How does your organisation function?

How does your organisation make decisions?

(e.g. Board, Committee, Quorum of members, etc.)

Office Bearers:

President/Chair/CEO

Treasurer/CFO

Are your officer bearers:

|_| Elected

|_| Appointed

Number of years operating:

Registration no.

Number of employees

Full-time

Part-time

How many members are there in your organisation?

Can members of the public join your organisation?

|_| Yes

|_| No

1.9Previous experience and relevance to local area

Briefly outline the previous experience held by your group and the project partners’ in undertaking projects of a similar nature. Explain how your organisation has links with the local area in which the project will take place.

1.10Has your organisation previously received Environmental Trust funding?

Yes |_| or No |_|

Program

(e.g. Restoration and Rehabilitation)

Reference number

Project name

Amount

Status

$

$

$

$

$

1.11Has your organisation previously received funding for this project site from a body other than the Environmental Trust?

Yes |_| or No |_|

Funding source

Year

Project name

Amount

Status

$

$

$

$

$

1.12Insurance

It is a condition of your grant that you have adequate insurance cover including public liability insurance of $10 million, workers compensation and volunteer insurance.

Company

Policy No.

Coverage

Currency (expiry date)

1.13Administrator details. If applicable see program guidelines for more information

Name of organisation

Administrator’s ABN?

Registered for GST

Yes |_| or No |_|

Postal address

Suburb

State

Postcode

Contact:

First name

Surname

Position

Daytime phone

(0 )

Mobile

Email

2015 Bush Connect – Application FormPage 1 of 19

Bush Connect projects are expected to be implemented through the collaborative efforts of a group of organisations (a Consortium).

Section 2 – Partnerships and stakeholders

2.1Partner organisations

Provide information on the partners, their role and type of agreement reached for their involvement. Examples have been provided, please delete and use these rows for providing your own responses.

Partner organisation name

Contact details

Role in project

Governance agreement

E.g. East-West Local Land Services

John Citizen – Team Leader Land Services. [email protected] (02) 4399 1234

Coordinator of four private landholder project sites. Will oversee bush regeneration and fencing contractors working on those sites and liaise with landholders. Responsible for vegetation monitoring for those sites.

Memorandum of understanding detailing expected contributions and input of E-W LLS signed on 21 May 2015.

E.g. National Parks and Wildlife Service (Rocky Creek NP)

Joan Smith - Ranger (Rocky Creek National Park). [email protected] (02) 4399 1235

Oversee linkages of new habitat corridors with existing National Park Reserve. Arrange promotion of the project to park visitors. Maintenance of regeneration works within National Park.

Letter of support outlining in-kind contribution value and commitment terms.


2.2Consortium establishment

Provide a brief summary of the process conducted to identify and engage relevant project partners.

2.3Internal communication and decision making

Describe the expected channels and frequency of communication between the project partners throughout the project. Describe the decision making processes and procedures that will be adopted by the consortium for this project.

2.4Core business

Explain why this project is not the core business of the lead group or any of the partner organisations and how it value adds to core business. You should also demonstrate the project is not cost-shifting or replacement funding.

2.5Financial governance

Detail the internal control systems you will put in place to ensure that project funding will be utilised and managed appropriately and not used for cost shifting of proponent or partner activities.

2.6Conflicts of interest

You are required to declare and manage any real, potential or perceived conflicts of interest that you may be aware of. Failure to declare a conflict of interest may amount to providing false information to the Trust and could cause your grant to be revoked.


2.7Funding allocations within consortium

Provide information on the partner organisations expected to receive Trust funding and/or provide financial or in-kind contributions to the project. This section allows for an overview of the distribution of Trust funds to project partners as well as cash and in-kind contributions they will provide (over the full 10 year life of the project). A detailed breakdown of costings will be captured in the Project Budget Form (Appendix 1). An example has been provided, please delete and use this row for providing your own response.

Partner organisation

Purpose of Funding

Trust funding allocated ($)

In-kind contribution ($)

Cash contribution ($)

Total ($)

E.g. East-West Local Land Services

Ecological restoration and fencing on project site to reduce threats. Monitoring of reduction in threats and response of species.

$50,000

$50,000

$30,000

$130,000

TOTAL

2.8Stakeholder identification and mapping

While this project will be delivered by the project consortium, other interested stakeholders may be involved. List the stakeholders to be involved in your project, and the type of engagement those involved will have. Mapping your stakeholders (both those you have an existing relationship with and those you seek to target) will help you identify early what communication tools you may need. Examples have been provided, please delete and use these rows for providing your own responses.

Organisation or group

Type of organisation

(Community group, individual, business, etc.)

Description of their interest, views or key skills

Type of engagement in the project

E.g. Rocky Creek Twitchers

Community group

The group has been active for several years and have strong local knowledge on bird species in the area. They are interested in improvements to local bird habitat, particularly for rare and endangered species

The group have agreed to assist with monitoring the project by conducting regular (bi-annual) bird surveys in set locations

E.g. Rocky Creek Hardware and Landscape supplies

Business

Important hub for the community

The store has agreed to put promotional materials in their shop window and is providing $500 toward fencing materials


Section 3 – Project information

3.1Project rationale

What is the environmental need or problem that your project is addressing?

3.2Project approach

What do you intend to do to address the problem, and why is this the best way of dealing with it?

3.3Alignment with program objectives

Describe how your project meets the objectives of the Bush Connect program:

3.3 (i)Improve the condition and connectivity of natural resources and ecosystems with the GER corridor.

Ensure you identify how the project will involve creation and/or enhancement of biodiversity corridors.

3.3 (ii)Increase the area of land (public and private) suitable for long-term protection for its environmental value through appropriate conservation mechanisms.

3.3 (iii)Increase the number of partnerships and alignment of efforts that protect the environmental values of the GER corridor.


Objective 1:

What would success look like?

Activity

(Significant steps or actions that are needed to produce the identified objective)

Project measures

(refer to Project Measures table for a range of measures that may be suitable for your project)

Total

projected

(this is what you aim to achieve by undertaking the activity)

How will you monitor your progress?

Year activity will be undertaken?

(may occur over multiple years] of the project)

Activitycompletion date(s)

(this should be the actual date you intend to complete each activity)

3.4Project plan

Lay out your project objectives (up to three), vision of success and activities for achieving this. A list of relevant Environmental Trust Project Measures can be found on the Trust website. Make sure you also include appropriate monitoring methods for determining the effectiveness of each activity. An example of a completed objective table is available on the Trust website.

Objective 2:


Activity


Project measures


Total

projected







Objective 3:


Activity


Project measures


Total

projected








3.5Site ownership and consent

Who owns and/or has legal responsibility for the project site? What permission do you have from the landowner to undertake your project on the site? (Complete as many as apply. If your application is successful, you will need to show proof of this approval and ensure that long-term maintenance requirements of the site have been identified and agreed to.)

Site

(map reference)

Landowner

Consent Status

Permission granted |_| In-principle approval |_| No approval|_|








3.6Existing site information

Studies, reports, assessments or plans e.g. local environment plans, catchment action plans, vegetation management plans, state of the environment reports?

Describe which particular component of thedocument/s your project relates to and how it will attempt to address the issue/meet a particular target.

3.7Threatened species, populations and communities

List any threatened species, populations and EECs relevant to your project site/s (as listed under the NSW Threatened Species Conservation Act 1995.) The Saving Our Species conservation projects database provides a map showing the location of all threatened species and populations in your LGA for your reference.

Common Name

Scientific Name

Saving our Species Management Stream

3.8Licenses

What scientific licenses or permits, if any, will be required to undertake your project? Advise if they are already in effect, or if an application will be necessary.

3.9Site maintenance

Describe how the site will be maintained beyond the 10 year project period. Who will be responsible for the maintenance activities?


Section 4 – Risk management

4.1Risk management documents

Implementation of your project will require ongoing adaptive management. This can be informed by effective risk identification and development of mitigation strategies at the project planning stage

Two documents exist to assist you with completing table 4.2:

1. Risk Management Framework (guidance on how to complete table 4.2)

2. Corridor Risk Assessment Framework (a guide to identifying and managing risks specific to habitat corridor creation).

|_| I have read both of the above documents

4.2Risk management. Examples have been provided, please delete and use these rows for providing your own responses.

Potential Risk

Step 1

Likelihood

Step 2

Impact

Step 3

Rating

Step 4

Mitigating actions

Step 5

E.g. Increased risk of bushfires being hosted and spreading via using the vegetation corridors created through the project

Moderate

Major

High

Ensure minimum buffer zones are retained between revegetation areas and buildings/assets. Consider appropriate fire regimes for future implementation in consultation with RFS and NPWS.

E.g. Fox harbour and passage enabled by the creation of the habitat linkages

Moderate

Moderate

Medium

Establish fox monitoring and baiting program to be conducted by East-West Local Land Services an in-kind contribution.

Section 5 – Finances

5.1Budget summary

The information within this table should reflect funding for the life of the project. Greater detail should be provided in the full budget template.

The total budget in years 1-6 should equate to approximately 80 per cent of the overall budget, with years 7-10 accounting for the remaining 20 per cent.

Funds

Year 1$

Year 2$

Year 3$

Year 4$

Year 5$

Year 6$

Year 7 $

Year 8$

Year 9$

Year 10$

Total

Environmental Trust Grant

N/A

N/A

N/A

N/A

Consortium financial contribution

Consortium in-kind contribution

TOTAL

80% of total budget over first six years from a combination of Trust and consortium contributions

Remaining 20% solely from consortium contributions

Bush Connect – Application Form and GuidelinesPage 17 of 19

Section 6 – Certification and feedback

6.1Referees

Please provide details of two referees we can talk to about your organisation and your project.

Referee 1

Referee 2

Name

Name

Title/position

Title/position

Organisation

Organisation

E-mail

E-mail

Phone no

(0 )

Phone no

(0 )

Mobile no

Mobile no

Fax no

(0 )

Fax no

(0 )

6.2Authorisation - applicant

Include the names of an office-bearer* in your organisation (e.g. Chairperson, Treasurer, Chief Executive Officer or Executive Officer) who are able to attest to the accuracy of the information within the application.

Name

Title/position

Organisation

E-mail

Phone no

(0 )

Date

Note:If the project is on land owned by the office-bearers, those office-bearers cannot authorise the application

6.3Authorisation – administrator. Only necessary if the grant is being administered by another organisation.

Please provide the name of senior manager within the administering organisation who can confirm that the organisation is prepared to act as administrator should the application be successful.

Name

Title/position

Organisation

Email

Phone No.

(0 )

Date

Application evaluation

Please provide some basic feedback on your experience with applying to the Bush Connect program. All feedback will be collated to provide overall picture and used to assist development of future Environmental Trust documentation.

6.4Time taken to develop your project (incl. negotiation with consortium members)

|_|

<5 hours

|_|

5-20 hours

|_|

20-40 hours

|_|

>40 hours

6.5Time taken to complete the application form

|_|

<2 hours

|_|

2-5 hours

|_|

5-10 hours

|_|

>10 hours

6.6Difficulty completing the application

|_| Very easy

|_| Easy

|_| Moderate

|_| Difficult

|_| Very difficult

6.7Where did you hear about this program?

Section 7 – Submission

Grant application checklist

|_|Answer all the questions in the application.

|_|Include a completed full budget template (financial information) with your application.

|_|Have your application authorised by the appropriately delegated person.

|_|Attach all required supporting information: certified organisational documents, CVs (maximum two page), briefs and job descriptions, letters confirming other funding. Additional information should be kept to a minimum. If your application refers to a large document, only include the relevant pages of that document i.e. title page, executive summary, relevant pages.

|_|Attach as many maps as necessary to clearly show the layout of your project site(s).

|_|Submit your application by the closing date – 5.00pm 19 June 2015

|_|We are unable to accept faxed applications or posted hardcopies.

|_|If your application and attachments are greater than 10MB, you may post a USB hard drive or CD containing these files along with a cover note to the below address.

Email to:

[email protected]

· Ensure you email your entire application, including all attachments, e.g. maps; CVs.

· Note:Emailed applications must not be larger than 10MB including all attachments.

· Please email the application form as a Word document and the budget spreadsheet as an Excel document - DO NOT PDF.

· Attachments can be emailed as Word, Excel or PDF documents.

Post to:

NSW Environmental Trust

PO Box 644

PARRAMATTA NSW 2124

· USB or CD only with cover letter

Any application that is late, incomplete or not eligible will not be considered.

Published by the NSW Environmental Trust, PO Box 644, Parramatta 2124 Phone: 02 8837 6093 Fax: 02 9895 6548

Email: [email protected] Website: www.environmentaltrust.nsw.gov.au OEH 2015/0216 April 2015

Bush Connect – Application Form and GuidelinesPage 19 of 19