"Covering Letter Application Against Expression of Interest - DOC"
Low Emissions Energy Development Fund Application Form 1/12 Low Emissions Energy Development Fund: Application Form Application help and further information The Low Emissions Energy Development Fund Application Guidelines provide additional information to assist in preparing your application. You can find these at the Department of Environment and Conservation’s (DEC’s) website at www.dec.wa.gov.au or by contacting email@example.com. If you need assistance to prepare your application or require further information, please contact Charles Crouch, Acting Programs Manager at the Office of Climate Change on (08) 6467 5545 or send an email to firstname.lastname@example.org. Deadline for applications Applications should be lodged by 5 pm, Wednesday 19 December 2007. Please note that it is your responsibility to ensure the application is lodged by this deadline. Applications received after that time will not be considered unless there is conclusive evidence that the application was mishandled. Electronic lodgement of applications is preferred and should be emailed to email@example.com by the deadline. Alternatively, applications can be sent to arrive by the due date and time to: LEED Application Office of Climate Change Department of Environment and Conservation Level 4, 168 St Georges Terrace PERTH WA 6000. Hard copy applications should include electronic copies of documents submitted on a CD or other storage device. Eligibility check list [Please refer to section 4.1 of the Application Guidelines] To qualify for consideration for Low Emissions Energy Development (LEED) funding, applicants are required to meet the following eligibility criteria. Further information on these criteria can be found in the Application Guidelines. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 2/12 Please indicate whether you meet each criterion by ticking the appropriate box. Is your proposal consistent with WA Government policy as YES NO outlined in the Application Guidelines? Are the emissions reductions in your proposal linked to either YES NO the production of energy or reduction in its use? Are you seeking a total of $250,000 or more of LEED YES NO funding? Will LEED be the only source of WA State Government YES NO funding for your project? Are you based in or do you have an office in WA? YES NO Is funding being sought for a new project (i.e. one that has YES NO not already commenced at the time of making this application)? For every dollar of LEED funding identified can you deliver YES NO three dollars of funding from other sources? Is your organisation: YES NO a university; a registered business with an ABN; a government organisation; or an incorporated not for profit organisation? If your application is successful, will your project be YES NO completed within 10 years of being awarded funding? Will the new technology underpinning your project be YES NO commercially viable by 2020? Will most activity and expenditure in the proposed activity YES NO occur in WA? If you answer ‘yes’ to all questions, you are eligible to apply for funding under the LEED. Applicants unable to meet these criteria are ineligible for LEED funding. Applicant details [Please refer to section 4.2 of the Application Guidelines] Contact information Organisation name Contact name and position Telephone Facsimile Email Website address Business address Postal address ABN (if applicable) Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 3/12 Declaration [Please refer to section 4.3 of the Application Guidelines] I (name)…….……………………………………………………………………………………………. Position………………………………………………………………………………………………….. Organisation…………………………………………………………………………………………….. as an authorised officer of the organisation making this application acknowledge that: this application is an expression of interest and no contractual arrangement is intended to be entered into on behalf of the State of Western Australia for disbursement of money from the LEED Fund by provision of this form and/or receipt of an application; to receive funding from the LEED Fund, successful applicants will need to comply with the terms and conditions of a written agreement on behalf of the State after negotiations as to project milestones and a funding program have been agreed; DEC may refer this application to government agencies and members of its Independent Expert Advisory Group (which has non-Government members) to obtain comments for assessment purposes; the WA Government may make public that the organisation has applied for funding under the LEED Fund, whether or not this application is successful; if this application is successful, details of the project and the funding awarded may be made public by the WA Government; that if this application is successful, the applicant will not publicise the awarding of funding until successful applications have been announced by the Minister for Climate Change and the Minister for Energy; and the information contained in this application is true and correct. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 4/12 Project details [Please refer to section 4.4 of the Application Guidelines.] Please provide a brief (no more than 500 words) overview of the project and how LEED funding is intended to be used to support it. Your statement should include: the purpose of the project, the activities to be undertaken and the expected outcomes; your arguments that the project will either not proceed or be significantly delayed without support from the LEED; and the stage the project is currently at (such as financial investment decision, detailed design, basis of design or conceptual phase) along with the remaining steps to delivery. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 5/12 Statement against selection criteria Please provide a statement to indicate how your proposal meets each selection criteria outlined below. All sections must be completed for your application to be considered. Keep your statement under 500 words. Funding sought [Please refer to section 4.5.1 of the Application Guidelines] Your statement should include the following: The total amount of funding sought and proposed payment schedule. Leverage ratio: Applicants will be required to demonstrate a 1:3 leverage ratio, meaning that for every dollar of LEED funding, three dollars of funding sources from elsewhere will be required. Applicants should indicate the sources of this funding and how much is proposed to be in kind and the nature of any in kind funding. Whether other, non-WA Government funding programs are available and/or will be applied for to support the proposed project and the extent of this additional funding. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 6/12 Please also complete the following table outlining proposed milestones and payment schedules. Note that successful applicants will be required to negotiate detailed milestones as part of developing an agreement with the Office of Climate Change and that payments will only be made on achievement of the linked milestones. Consistent with the LEED Fund’s 1:3 leverage ratio, LEED funding will only be provided to meet up to 25 per cent of milestone expenditure. LEED funds must be fully dispersed within five years of being awarded. Milestone Milestone tasks Start Completion Expected Funding number* date date expenditure sought at to complete milestone 1 2 3 4 5 Total * This table is not intended to be prescriptive as to minimum or maximum number of milestones required. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 7/12 Organisational ability [Please refer to section 4.5.2 of the Application Guidelines] Applicants should demonstrate that their organisation has the expertise and resources to successfully implement the proposed project. This section should include: technical strength of the organisation; financial viability; previous experience; management capability; details of key personnel and their qualifications and experience; and demonstration of the ability to provide a detailed project plan including implementation, milestones and methodology in the event of selection. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 8/12 Emissions reduction [Please refer to section 4.5.3 of the Application Guidelines] This section should include: the quantity of emissions (expressed in tonnes of CO 2e) from the applicant’s operations in WA expected to be abated as a result of the funding and over what period (including the tonnes of CO2e expected to be abated per dollar of LEED funding); the quantity of emissions (expressed in tonnes of CO 2e) in WA from other parties expected to be abated as a result of the funding and over what period; and the estimated effective total cost of abatement per tonne for both categories. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 9/12 Technological innovation [Please refer to section 4.5.4 of the Application Guidelines] Information in this section should include the degree of innovation in the new technology proposed and whether it is being used elsewhere or in WA. Applicants should refer to the Application Guidelines for a discussion on the stages of technology to be targeted by the LEED. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 10/12 Economic and strategic advantages of the project to WA. [Please refer to section 4.5.5 of the Application Guidelines] Applicants should indicate the economic and strategic advantages of the project to WA. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 11/12 Risk management [Please refer to section 4.5.6 of the Application Guidelines] Applicants should indicate the risks to project delivery and abatement outcomes as well as any potential negative impacts associated with the project and how they are proposed to be managed. Office of Climate Change November 2007 Low Emissions Energy Development Fund Application Form 12/12 Additional information [Please refer to section 4.6 of the Application Guidelines] Applications will be assessed on the statements against selection criteria and it is not necessary to provide additional information. However, if you wish to provide additional information in support of your application it will be considered. If additional information is submitted, please indicate briefly in a covering note totalling no more than 500 words how the additional item(s) supports your application. Applicant checklist Have you: Completed and answered ‘yes’ to all eligibility criteria? Completed the applicant details section? Signed and date the authorisation? Completed the project details section? Provided information against all evaluation criteria? Considered whether additional information should be included and provided a covering letter to indicate the relevance of any additional information? Office of Climate Change November 2007