GENERIC PROJECT PROPOSAL TEMPLATE

1. GENERAL INFORMATION

NOHFC Project Number NOHFC Program

Project Name

Legal Name of Applicant

Corporation or Business Registration Number

Date of incorporation or registration of business name

Registered business name

Type of Legal Entity of Applicant Project Location (Community)

Lead Contact Alternate Contact

Mailing Address Mailing Address

Province Postal Code Province Postal Code Telephone Number ( ) - Telephone Number ( ) - Fax Number ( ) - Fax Number ( ) - E-mail Address E-mail Address

Nature of organization or business Last date of fiscal year

Amount requested from NOHFC Type of assistance requested (See Appendix A)

Proposed project start date Proposed project completion date

Liability Insurance Amount

2. PROJECT DESCRIPTION

Project Summary: Briefly describe the project (3 or 4 sentences), including a high-level description of what will be done.

Project Background: Outline the context for the project. Provide necessary background to understand why the project is being undertaken.

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Project Purpose: Explain the purpose of the project by describing what this project is aiming to achieve. What is its vision? What need or opportunity will it address?

3. PROJECT BENEFITS

In the table below, identify the following:

number of permanent jobs that are expected to be created as a result of the project. Also include a brief description of each position, annual rate of pay and the expected start dates

identify the number of jobs that are expected to be retained as a result of the project

Jobs Created/Retained

No. of Jobs Created No. of Jobs Retained

Dollars Leveraged

How have number of jobs created or retained been determined and substantiated? Please provide rationale and evidence of how job creation numbers have been determined (e.g. increase in projected operating costs)

Other Benefits

In the space below, identify specific results-based benefits that can be expected as a result of completing the project. Include the following:

anticipated economic benefits/spin-offs (e.g., investment levered) both during and following the term of the project

describe how the project promotes economic growth, innovation, and/or job creation in Northern Ontario (e.g., project leads to new business venture, results in marketable products or services, sector benefits, Northern Ontario benefits, sector development, improves quality of life, etc.)

describe how the project enhances the community's ability to attract/retain businesses and professionals describe how the project will improve the capacity and investment readiness of the community describe how the project will enable the community to realize economic development opportunities

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4. PROJECT BUDGETProject Costs Chart

Identify applicable cost categories such as: wages, consulting costs, materials, project management, equipment costs, etc. Indicate whether cost items are eligible or ineligible as per program criteria.

Project cost category Eligible Project Costs Ineligible Project Costs Total Cost

TOTAL

Project Funding

In the table below specify type of financing to be provided by other organizations. Note: In-kind contributions are not generally considered as an applicant’s contribution to the project. However, in some cases in-kind contributions including materials, equipment and volunteer labour may be counted in evaluating the share of partner contributions. In cases where in-kind contributions are considered eligible, they must be measurable and recorded. The following formulas may be used:

In Kind Use of Equipment Used: (Rate per hour) X (# of Hours used) = In-Kind Value

In-Kind Use of Labour: (# of employees) X (rate per hour) = In-Kind Value

Rates used should be in line with the skills trade rate established by Human Resources and Social Development Canada.

A 100% in-kind to 0% cash ratio is not acceptable. The level of in-kind contribution accepted by NOHFC will be based on: o client ability to contribute some cash towards the project the breakdown of the in-kind costs the

client is planning on providing towards the project.

Funding source Financing Type

Project Cost Category

Eligible Project Costs

Ineligible Project Costs

Total Funding Requested

TOTAL:

NOHFC % of total Eligible Project Costs

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Provide the name and location of the Applicant’s current banking institution (for non-municipal applicants). (Note: Lending institutions may be required to confirm the Applicant’s financial situation)

How have project costs been reviewed/verified for accuracy, completeness and reasonableness? Explain.

Have all identified funding partners committed to the project? If so, provide details (e.g., letter received); if not, provide an explanation.

Provide details on how the Applicant will obtain the identified contribution, and identify contingency plans for how any cost over-runs will be addressed. Explain.

Why is NOHFC funding necessary to make this project viable? Explain.

In addition to the funding sources identified above, has the Applicant approached/applied to any other funding programs? If yes, indicate organization and the status of those applications. If no, please explain.

Has private sector funding been considered? If not, explain whether there exist opportunities for private sector funding, corporate presence, etc.

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5. PROJECT PLANList project milestones or major activities (e.g. project design & engineering, site preparation, construction) on the next page. For each milestone, shade the boxes to reflect when that activity will be undertaken. If more space is required, please use additional sheets. Project Plan

Project Milestones

Year 1 (20XX – 20XX) Year 2 (20XX – 20XX) Year 3 (20XX – 20XX)

Apr 1- Jun 30

Jul 1- Sep 30

Oct 1- Dec 31

Jan 1- Mar 31

Apr 1- Jun 30 Jul 1- Sep 30 Oct 1- Dec

31 Jan 1- Mar 31

Apr 1- Jun 30

Jul 1- Sep 30

Oct 1- Dec 31

Jan 1- Mar 31

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6. NOHFC CLAIM SCHEDULEIn the table below, please indicate the dollar amount in the fiscal year where the Applicant expects to submit claims for reimbursement from NOHFC. Base cash flow requirements on the project plan above. Indicate the estimated expenditures for each year and include how much is expected to be claimed from NOHFC.

Year 1 (ending Mar 31/xx)

Year 2 (ending Mar 31/xx)

Year 3 (ending Mar 31/xx)

Total

Eligible Expenditures

NOHFC Claim

Note: The NOHFC’s standard process is to distribute payments upon receipt of a payment request and supporting documentation indicating that the items claimed have been paid. While it is possible to request an advance of funds if one is required, significant justification will need to be provided. Justification must include the specific timing and size of the advance payments based on realistic cash flow forecasts (with a breakdown by quarters.

7. EXPERIENCE WITH GOVERNMENT FUNDING PROGRAMS

Is the Applicant currently applying to, or receiving funding from, NOHFC for other projects? If yes, explain.

Identify any other completed projects for which the Applicant has received funding from NOHFC during the past five years

Has the Applicant received funding for similar types of projects from other government funding programs (provincial or federal)? Indicate program and project names.

8. PROJECT MANAGEMENT

Project Management Team: Identify the individuals who will be responsible for managing the project and provide their contact information and relevant experience with respect to this type of project.

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Reporting Structure: Identify the reporting structure or management structure for the project.

Project Management Experience: Identify any previous experience the Applicant has in managing projects of a similar nature. Indicate the projects and identify the outcome.

9. PROJECT SUSTAINABILITY

Marketing Answer the following questions as appropriate to this projectIdentify the proposed marketing strategy for this project (e.g. Who is the customer, what is the product/service, competition, target market, pricing, promotion, etc.) Provide a general description of how the community/region, clients or other potential users/participants will be engaged to ensure the success of the project, and its future sustainability.

Is the project (e.g. facility) the only one of its nature in the community?

Will the project directly compete with existing businesses or with similar projects in neighbouring communities? Explain.

Is the project (e.g. facility) used primarily by community residents or is it frequently used by residents of the region and beyond?

Describe how this project (e.g. facility) will benefit the community as a whole? Identify how many people/what percentage of the community will benefit from the project (e.g., utilize the facility)?

How diverse is the use of the facility? Is it used for a variety of events representing a cross section of the community? Identify how many functions are convened at the facility?

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Operating Costs

Once complete, is the project expected to generate new on-going revenues and/or incur future on-going operating costs? Yes No Explain.

Complete the following chart if the project will generate on-going revenues and/or incur on-going costs:Revenues Historic (Actual) Projected

Year 1Projected Year 2

Projected Year 3

Total:

Expenses Historic (Actual) Projected Year 1

Projected Year 2

Projected Year 3

Total:

Net Income Historic (Actual) Projected Year 1

Projected Year 2

Projected Year 3

Annual Cash Surplus:

Provide a detailed rationale for all projected revenues and what they are based on.

Provide assumptions and details for projected operating costs. If the project includes job creation, make sure to account for the new jobs in the projected operating costs.

If there are any annual operating deficits shown, please explain where the funding will come from to cover these shortages.

Should revenues be lower or expenditures higher than projected, resulting in an operating shortfall, provide an explanation as to how this would be covered, and what the impact would be on the organization.

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10. OTHER

Are there any potential risks that might threaten the successful completion of the project? Indicate how these risks will be mitigated.

Is there any other information relating to the project that the NOHFC should be aware of.

Please list all federal and provincial laws or regulations, all municipal by-laws, and any other orders, rules or by-laws that might affect the project (e.g. environmental approvals, zoning by-laws, etc.) What permits and/or approvals are necessary to initiate and complete the project? Indicate the status of each. (*Please see Appendix A for additional information)

As a condition of approval recipients will have to have in place adequate insurance coverage. Indicate the type and amount of insurance coverage currently in place by Applicant:

commercial general liability insurance on an occurrence basis for third party bodily injury, personal injury and property damage, including:

amount $____________________ a cross-liability clause; contractual liability coverage; tenants legal liability coverage (if applicable and with applicable sub-limits); non-owned automobile coverage with blanket contractual coverage for hired automobiles; employer’s liability coverage (or compliance with WSIA coverage) a 30-day written notice of cancellation, termination or material change, and other insurance coverage appropriate for the project

Where the project requires the purchase of supplies, equipment or services, indicate how best value for money will be ensured. Indicate where the Applicant has a procurement policy in place.

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11. SUPPORTING DOCUMENTATION (INCLUDE WHERE APPLICABLE)

Applicant’s proof of legal name and business name:o Certified copy of the articles of incorporation and amendments;o Copy of partnership agreement or partnership declaration; o Personal I.D. (e.g. driver’s license) (Note: for sole proprietors or partners in a partnership); and/oro Copy of business name registration

Copy of any related by-law(s) or resolution(s) supporting the project and indicating the Applicant’s funding commitment towards the project from (where applicable) municipal or band councils and not-for-profit boards of directors

Documentation confirming funding commitments of other project contributors or confirmation of acceptance of application to other funding sources

Copy of land ownership/lease documents, or land use permits

Where available attach copies of RFPs, consultant’s reports, building plans, contracts and tender documents, etc.

Copies of insurance certificate(s), and WSIB clearance certificate (* See Appendix B for additional information regarding Insurance)

Copies of quotations or estimates from suppliers, consultants, or contractors (including labour costs)

Copy of recent financial statements

Copies of rental or lease agreement

Is any key information missing from this proposal that will be submitted at a later date? Explain.

12. PROGRAM-SPECIFIC QUESTIONS

Complete the following section for Northern Energy Program -Energy Conservation Projects or Internal Energy Generation Projects How will this project conserve energy or displace energy from the provincial grid or other less “green” energy sources?

Does the project represent a proven technology? Explain

Will energy savings directly lower the operating cost of the Applicant’s business? Explain

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Are the buildings/facilities and land related to the project owned or leased? Explain

Complete the following section for Emerging Technology ProjectsWill this project address current gaps in cellular and high speed service in the communities or region? Explain

Will completion of this project significantly enhance the quality of life, economic prosperity, and/or safety for residents of the community? region and beyond? Explain

Will this project strengthen existing connectivity networks in the community or region? Explain

13. SUBMISSION PROCESS

Once you have completed your project proposal, please forward two copies to the Project Officer assigned to your file, or, if no Project Officer has been assigned, forward the proposal to your local Ministry of Northern Development and Mines office. 

If you have any questions or need assistance, please contact the NOHFC at 1-800-461-8329 or 705-945-6700 or the Ministry of Northern Development and Mines office in your community.

Kenora Area 810 Robertson Street, Suite 104Kenora ONP9N 4J2Tel: 1-866-711-8304(807) 468-2937Fax: (807) 468-2930Email: Kenoraarea@ontario.ca

Thunder Bay Area 435 James Street South,Suite 332Thunder Bay ON  P7E 6S7Tel:  1-866-711-8304 (807) 475-1648Fax: (807) 475-1589Email: Thunderbayarea@ontario.ca

Timmins Area Ontario Government ComplexP.O. Bag 3060Hwy 101 E.South Porcupine ON  P0N 1H0Tel:  1-866-711-8304(705) 235-1664Fax: (705) 235-1660Email: Timminsarea@ontario.ca

Sault Ste. Marie Area 70 Foster Drive, Suite 200Sault Ste. Marie ON P6A 6V8Tel:  1-866-711-8304(705) 945-5914Fax: (705) 945-5931Email: Saultstemariearea@ontario.ca

Sudbury Area 159 Cedar Street, Suite 601Sudbury ON P3E 6A5Tel: 1-866-711-8304(705) 564-7517Fax: (705) 564-7583Email: Sudburyarea@ontario.ca

North Bay Area 447 McKeown Avenue,Suite 203 North Bay ON  P1B 9S9Tel: 1-866-711-8304(705) 494-4045Fax: (705) 494-4069Email: Northbayarea@ontario.ca

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APPENDIX A

TYPE OF ASSISTANCE REQUESTED

Identify type of assistance requested

Conditional Contribution: NOHFC funding that is non-repayable if the objectives of the project are met and the Proponent has completed all obligations including reporting requirements. The conditions of the NOHFC’s funding are outlined in the NOHFC’s legal agreement with the client.

Forgivable Performance Loan: NOHFC funding that may be forgiven and does not have to be repaid, if certain performance targets are met. For example, if a client receives NOHFC funding on the basis of ten jobs being created, and ten jobs are subsequently created, the NOHFC funding does not have to be repaid. If the performance target is not met, the NOHFC is in a position to demand repayment.

Repayable Loan: NOHFC funding that is repayable. The loan may be interest bearing or non-interest bearing. In some cases the loan may be given as an incentive term loan. The incentive refers to the option of deferring interest and/or principle payments for some period of time possibly including, an elimination of interest for some period. An example of an incentive term loan is NOHFC funding that is interest free with the principle to be paid back over ten years.

COMPLIANCE WITH LAWS AND PERMITS

Laws At all times, Recipient, its officers, directors, partners, employees agents, subcontractors

or volunteers shall comply with all applicable federal, provincial and municipal laws, ordinances, statutes, regulations, rules and orders in respect of the performance of the project and the agreement.

Permits At its own expense, Recipient shall obtain all permits, licences, approvals and

authorizations required to perform the project and the agreement and shall comply with all federal, provincial and municipal laws, ordinances, statutes, regulations, rules and orders in respect of same.

InsuranceRecipient shall comply with all provisions and requirements of any of Recipient’s insurance policies applicable to the project and with all rules and regulations concerning safety and the proper conduct of work.

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APPENDIX B

INSURANCE REQUIREMENTS

If your project is approved, you will be required to provide a certificate of insurance that indicates the organization has a commercial general liability insurance policy on an occurrence basis for third party bodily injury and property damage, to an inclusive limit of not less than $5 million per occurrence.If the organization does not have a $5 million limit, include a quote from your insurance company for increasing your limit, to the $5 million required.

Insurance Recipients shall arrange for and keep current while carrying out the project or during the

term of the agreement, whichever is longer, the following insurance policy with an insurer acceptable to NOHFC:

A commercial general liability insurance policy on an occurrence basis for third party bodily injury, personal injury and property damage, to an inclusive limit of not less than $5,000,000 per occurrence, $5,000,000 products and completed operations aggregate. The policy is to include the following:

NOHFC and its officers, directors, employees, subcontractors and agents as additional insureds with respect to liability arising in the course of performance of Recipient’s obligations under, or otherwise in connection with, the agreement;

cross-liability clause; thirty (30) day written notice of cancellation, termination or material change; contractual liability coverage; tenants legal liability coverage (if applicable and with applicable sub-limits); non-owned automobile coverage with blanket contractual coverage for hired

automobiles; and employer’s liability coverage, if Recipient is not insured by the Workplace Safety and

Insurance Board of Ontario (WSIB).

Recipient shall provide to NOHFC a valid certificate of the insurance prior to the start of the project and thereafter as may be subsequently requested during the course of the project or the term of the agreement, whichever is longer.

If Recipient is subject to the Workplace Safety and Insurance Act, 1997 (WSIA), it shall submit a valid WSIB clearance certificate to NOHFC prior to the start of the project. Recipient shall, if NOHFC so requests, provide additional WSIB clearance certificates from time to time. Recipient shall pay when due, and ensure that each of its contractors pays when due, all amounts required to be paid by it/its contractors under the WSIA.

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Third-Party Insurance Recipient shall ensure that any third-party contributors and contractors retained to

perform any part of the project shall have adequate insurance in place that is appropriate to the project risks and to the third party.

Evidence of Insurance Recipient shall provide to NOHFC without delay, on receipt of a written request by

NOHFC, a certified copy of the policy of insurance.

Notes for Insurers, Brokers and Recipients of Funding from the Northern Ontario Heritage Fund Corporation (NOHFC):How to complete a Certificate of Insurance to comply with NOHFC’s requirements

i. Review the sample certificate that appears below, and the explanations that follow afterwards.

ii. Complete your Certificate of Insurance accordingly.

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How to fill out a Certificate of Insurance to comply with NOHFC’s requirements

(Keep the insurance clauses in NOHFC’s contract handy while you do this. See section 9.2 of Schedule A in the NOHFC contract.)

Number* What is required

1. Insert the legal name and address of the Recipient of NOHFC funds (must match the name on the NOHFC contract)

2. Insert the expiry date of the insurance policy

3. Insert “Northern Ontario Heritage Fund Corporation and its officers, directors, employees and agents” (not a Ministry) as the name of the additional insureds.

4. Insert the types and amounts of insurance provided by the policy. For example: “Commercial general liability insurance on an occurrence basis for $XXX.” Unless NOHFC has agreed to a lower amount, your insurance amount must be at least $5 million on an occurrence basis.

5. List all the endorsements required by the NOHFC contract (examples appear in the sample certificate above; see your contract for the particular endorsements required for your project).

6. Include a statement that the insurer will endeavour to notify the certificate holder (NOHFC) of any cancellation or material change within 30 days.

7. The certificate must be signed by an authorized insurance representative.

* numbers correspond to the circled numbers on the sample certificate of insurance.

June 24, 2009

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