Viridor Application Form 2008

Project Application Form For consideration by the East Sussex / West Sussex / Whitehead / Sheffield / Hampshire / Dorset / Thames / Essex / Kent / Somerset (Walpole) or Somerset (Dimmer) panel (please circle as appropriate) Total Project Cost

£

Amount Applying For

£

% of total cost

%

It is important to read the Guidance Notes before you fill out this form. If the form is not completed in full it will be returned and your application delayed. Please return form to:

For Office Use Only

Bob Attwood Administrator Viridor Credits Environmental Company Aintree House Blackbrook Park Avenue Taunton Somerset TA1 2PX 01823 624 656 : [email protected]

Date Received Reference No

Applicant

1

SECTION 1 ORGANISATION DETAILS a. Name

of Organisation or Applicant

___________________________________________________________________________________

b. Contact

Details

Name_______________________________________________ Address_____________________________________________ ___________________________________________________ ___________________________________________________Postcode_________________ Position____________________________________________ Telephone________________________ Fax__________________ E-Mail_______________________________ ______________________________________________________________________________________________________

c. How is your group constituted? E.g. Voluntary organisation, company, trust, other (please specify) ______________________________________________________________________________________________________

d. Provide details on the background to your group and its aims and objectives

______________________________________________________________________________________________________

e. Date of establishment of your organisation_____________________________ f. Provide details of relevant insurance policies _____________________________________________________________________________________ 2

SECTION 2 PROJECT DETAILS A. GENERAL

Name of Project ____________________________________________________________________________

Name of and Distance from landfill site. – ______________________ We only look at applications that are within a maximum 10 mile radius of a Viridor Waste Landfill Site. In the case of the Thames, Beddington Landfill site this radius is reduced to 5 miles.

Location of Project e.g. Address, Post code etc.

____________________________________________________________________________________ Is your project registered with ENTRUST? If yes, please give project approval number. (Please provide copy of approval) (Registration with ENTRUST is not a prerequisite as we can register for you). _____________________________________________________________________________________ Describe your project including its aims and objectives

_____________________________________________________________________________________ Describe why there is a need for the project

_____________________________________________________________________________________ Provide a proposed timetable of work including project start date and date of completion (projects must be started within 12 months of application)

____________________________________________________________________________ 3

Indicate which objectives your project contributes to (you may tick more than one box) Reclamation, remediation, restoration or decontamination of land for economic use

for environmental use

for social use

to reduce or prevent pollution

_____________________________________________________________________________________ Public Amenities and Parks provide a new local amenity

protect an existing amenity

improve an existing amenity

other

_____________________________________________________________________________________ Building / Type of Facility of historical interest

for residential use

of architectural interest

for educational use

for social or recreational use

other

____________________________________________________________________________ Environment improve local environment

a

improve access

increase public awareness

increase biodiversity

habitat environment

other

____________________________________________________________________________ Community Involvement encourage local participation

allow local decision making

involve community in development

meet a local need

take into account under-represented groups

other

____________________________________________________________________________

4

CATEGORY d/da

ONLY

Category d allows for the provision and maintenance of public amenities and parks. Such projects must be within the vicinity of a Viridor Waste landfill site and the facility must be open to the public and not operated for profit. We are unable under the regulations to fund school projects.

Category da allows for the conservation and promotion of biological diversity. This must be connected to a specific natural habitat or a specific species. Such projects must be within 10 miles of a registered landfill site. We are unable under the regulations to fund school projects. How large a community will benefit? ____________________________________________________________________________ Could this community be considered an adversely affected or deprived area? ____________________________________________________________________________ Does the project cover the natural or social environment? ____________________________________________________________________________ Is the ongoing maintenance of the projects focus or the projects area already agreed? ____________________________________________________________________________ What proportion of the total funding for the project are you applying to Viridor Credits for? ____________________________________________________________________________ What steps have been taken to ensure community support for the project?

____________________________________________________________________________

5

CATEGORY da

ONLY complete if relevant

What type of habitat and/or species are you working upon or with at this site? Projects must be linked to specific areas at a site or a specific species. We cannot register multi site applications.

____________________________________________________________________________ ‘The protection of the environment’. Please explain how this project will be for the protection of the natural environment ?

____________________________________________________________________________ ‘The conservation of biodiversity’. Please explain how your project will lead to conservation or promotion of biodiversity in relation to this specific habitat or species ?

____________________________________________________________________________ ‘Please indicate what support you have from partners in the biodiversity or conservation sphere?

___________________________________________________________________________

CATEGORY e ONLY Category e allows for the restoration and repair of buildings and structures that are for religious worship or of architectural or historical interest. To qualify under this category the project must be within the vicinity of a Viridor Waste Management landfill site, be open to the public and must be operated on a not for profit basis. Why is this building or architecture unique? How special? How high profile?

____________________________________________________________________________ How urgent are the repairs and if not undertaken how significant would any damage be to the whole structure?

____________________________________________________________________________ 6

ALL CATEGORIES Does the project have spin-offs in other categories? ____________________________________________________________________________ Indicate how the project will be managed, maintained and funded in the long term ____________________________________________________________________________ How do you intend to promote and publicise the project and in particular the award that we may make towards it?

____________________________________________________________________________ Has LCF funding been received before. If so how much, from whom and when?

____________________________________________________________________________ Have you applied to other LCF funders for this project? If so who and when do you expect to hear? ____________________________________________________________________________ Please indicate below whether the project will result in any volunteer, training or employment benefits

Output

Estimated Number

Detail

Voluntary Opportunities Vocational Training opportunities

Full-Time Jobs Part-time/Seasonal Jobs Other

7

Youth Volunteering In 2006 the scheme was challenged by the Government to create new youth volunteering

opportunities. Consequently all applicants are required to provide the following information with regard to the project. Outline definition for use with youth volunteering statistics: • A youth is someone who is between the ages of 16 and 25 when they start working on a project. • A volunteer is somebody who has offered their time to participate in the project and will receive nothing more than reasonable out of pocket expenses whilst carrying out works on the project site.

Number of youth volunteers working on this project

Number of youth volunteering days created by this project

SECTION 3 SITE BASED/BUILDING PROJECTS ONLY Who owns the land and/or building on which the project is sited?

_____________________________________________________________________________________ If you do not own the land and/or building, who has control over the land?

____________________________________________________________________________ If you have a lease or tenancy agreement please advise how many years remain – we are unable to fund projects where short-life ownership rights exist.

Does the project require planning permission or other form of consent? Give details (attach copy)

____________________________________________________________________________ Designation of land eg. SSSI, AONB or of building eg. Grade II listed

____________________________________________________________________________ Do you have the relevant permission to carry out the Project?

(provide details)

____________________________________________________________________________ 8

If the outcome of the project will enhance the value of the land, have you arranged for an independent assessor to establish the current value of the land? Give details and provide evidence. ___________________________________________________________________________ Please provide details of how the project will utilise sustainable and environmentally friendly materials.

____________________________________________________________________________

Please provide an access statement This should be on your organisation’s headed paper and include the following information: a) Explain how the general public will have access to the project site. b) Please detail availability to the site by the general public in any one week. c) Explain if there are any restrictions on the use of the facility. d) What charges are made for the use of the facility? e) Please outline how you will advertise the availability of this amenity. f) Please confirm that the facility will be available to the general public for the foreseeable future.

This is obligatory for all applications – failure to provide this will delay your application Note. This statement relates to the organisations building/land not just the part relevant to the project

9

SECTION 4 FINANCE How is your organisation currently funded? Give details of general income and funding, and of grants received in the past year. Also list contacts and partnership organisations which contribute to your income. Income/grant

Source/contact

Timescale

What is the total cost for this particular project? (Please demonstrate how the total was calculated in quotes section at end)

____________________________________________________________________________ How much are you applying for from Viridor Credits?

£ ____________________________________________________________________________ Third Party Contribution – This is payable to Viridor Waste Management as they do not get 100% tax relief (Only 90%) for the amount they give to the scheme. Therefore a third party contribution, equal to 10% of the grant awarded, is required. (This means that this sum is not available for the project)

Who will make this contribution?

____________________________________________________________________________

10

If you are applying for a grant of less than £5,000, specify expenditure below, with timescales Item

Cost

Timescale

If the grant you are applying for is greater than £ 5,000 also enclose a detailed costing budget with timeframes clearly identified. If requesting more than £ 20,000 a more comprehensive business plan will be required. _____________________________________________________________________________

List other funding for this project Source of funding

Amount requested

Amount confirmed/ expected date of decision

Total

Please give details of the organisation’s bank account

Bank

Sort Code

Branch

Account No

Title of Account

11

Enclosures (Tick if supplied) Constitution, Trust Deed or Memorandum & Articles of Association (compulsory) Note of formal agreement of the organisation to apply for funding, e.g. relevant minute of meeting (compulsory) ENTRUST Enrolled Environment Body registration letter (if registered) – in most instances Viridor Credits will act as the Environmental body for you

ENTRUST Project registration letter (if obtained) Evidence of other contributions and specific partner support for project (compulsory)

Evidence of Local Support (compulsory) – this shows evidence of the projects worth to the local community

Documentation in evidence of the need and support for the project (compulsory) Audited annual accounts (for last 2 years, where appropriate) Quotations(s) for work to be undertaken on the project (compulsory) - a Minimum of 3 Quotes are required by ourselves to satisfy the scheme regulations. Failure to provide these may lead to a delay in consideration of your project Please provide details below (Breakdown)

Grant Payments Schedule (if more than £5,000) Capital works specifications (if requesting more than £5,000, if appropriate) Job description/s for salaried posts – please note however that only in very exceptional circumstances will we provide funding for salaried posts.

Budget and Cash flow plan (if requesting more than £5,000) Business plan (if requesting more than £20,000) Planning permission/consents/other relevant permission (if appropriate) Site plans (if available) Photographs (if available) Please include a few relevant photographs of the project site/area etc. They always help give our panels a feel for what you are asking for

Other relevant material (please specify) Access Statement (provide on headed paper) – this is compulsory for all projects and failure to provide will lead to your application being delayed

12

Quotes

Details

Total

From 1 – Name

2 - Name

3 - Name

If the committee agrees to provide funding will you: •

Be prepared to sign a formal agreement guaranteeing the proper use of such funds in accordance with the Landfill Tax regulations;

Yes/No

•

Agree to provide progress reports to an agreed format and frequency;

Yes/No

•

Provide any information required by ENTRUST;

Yes/No

•

Provide and put in place an agreed publicity programme;

Yes/No

•

Keep proper audited accounts for the project and make them available to us or our advisors on request;

Yes/No

•

Make the first draw down of payment within 3 months of award approval, subject to project start date.

Yes/No

Declaration I confirm to the best of my knowledge that the above information is correct and that the project will be carried out as described. Signature

Date

Name Position

13