Market Access Grant: Application Form Enterprise Ireland will not release any information received as part of this application except as may be required by law, including the Freedom of Information Acts 1997 and 2003. In the event of a Freedom of Information request, the client will be given reasonable advance notice in order to contest such disclosure

Any personal information which you provide to Enterprise Ireland will be obtained and processed in compliance with the Data Protection Acts 1988 & 2003. The information in Application Forms will be used by Enterprise Ireland in the processing of your application and for ongoing administrative purposes between you and Enterprise Ireland.

To ensure consistency, this document uses protected form fields which are limited in length and which only allow use of plain text (ie. no bolding, underlining, bulleting, etc).

1. Applicant Company Details 1.1. Company Details

Registered Company Name .... Company Registration Number .... Company Business Address ....

Company Web Address .... Company Telephone Number .... Company Fax Number .... Principal Business of the Applicant (include product/service key words for online search) ....

Company Contact Name .... Contact’s Job Title .... Contact’s Email Address .... EI Development Adviser .... Company’s Primary Bank .... Project Summary - Please state the Market that is .... (Max one sentence) the focus of this research project Critical Market – where a larger geographic region or several markets are the target of this research .... (Max one sentence) project, please identify the most critical market 1.2. Eligibility Criteria

See Reference Document for further details. Yes No

I confirm that: The Company employs more than 10 employees:

Market Access Grant Application Form March 2014 Page 1 of 10 2. Company Profile 2.1. Company Overview

o Please give a brief outline of the company history.

o Please briefly summarise your current product/service and key markets (more detail is requested later).

o Where relevant, please provide information on group structure, etc. Type here ... (Max 1500 characters)

2.2. Company Ownership

Type* Share Class % Shareholding Amount Invested Name

Total * For Type use: Promoter, Family/Friends, Domestic VC, Overseas VC, Trade Investor, Business Angel, BES/EII Fund, BES Individuals or other.

o If any group structure exists, please describe here and attach group diagram separately. o Identify any connected companies and related parties and outline their relationships. Type here ...(Max 1000 characters)

3. Business Strategy 3.1. Product/Service and Market

o What is the product/service that you supply now and what is its Unique Selling Point (USP)? o What is your specific target market? Please quantify? o Who are your main competitors? o Why is your product/service better than that of your competitors i.e. price, functionality, service etc.? Type here ...(Max 3000 characters)

Market Access Grant Application Form March 2014 Page 2 of 10 3.2 Business Model

o What channels do you use to bring your product/service to your customers and markets? o What is the pricing model used to achieve your sales revenue? o If there is a successful outcome on this Market Research project does the company have additional capacity in terms of staff, equipment and buildings to meet a likely increased level of operations? If not please comment on possible capacity issues facing the company. Type here ...(Max 1500 characters)

3.3 Management

o Outline the current management structure. o What are the key skills and track record of the current management team and advisers? o Are there any potential gaps in this management structure arising out of the assignment of an in-house executive to the new market research project for up to 6 months? Type here ...(Max 1500 characters)

4. Proposed Development Project 4.1. Project Description

Start Date of Project .... End Date of Project .... Current level of sales in target market(s). ....

Market Validation

Does the market research project relate to (1) an existing product/service in a new geographic market OR (2) a new product/service in a new geographic market, or (3) a new product /service in an existing geographic market? What is the specific target market to be addressed? How was this identified? Provide also any information available on the size of this market and how the market environment may significantly differ from the company’s current markets. Have there been any level of sales to this market in the past – please outline whether direct / indirect (distribution channels) What is the rationale for choosing this new particular geographic target market? Has there been test marketing of any type carried out on the proposals to date? Please note that the focus of the proposal should be an in-depth research and market validation for a key potential market. Type here ...(Max 3000 characters)

Project Team

Market Access Grant Application Form March 2014 Page 3 of 10 Internal Employees assigned to the project: A key element of a Market Access Grant is developing your company’s knowledge and experience of the target market. Please provide details below on the staff assigned to the project, their experience, and duration that they will spend in the market during the assignment. Please note that the CEO/MD's salary costs are not eligible if the CEO relocates to the market. If the CEO is involved in the project from Ireland their costs can be supported at a maximum of 30% of salary which is capped at €80K.

Type here ...(Max 3000 characters)

External consultants assigned to the project: The Market Access Grant supports the use of consultants with specific expertise in the target market. Please outline below how the consultants that you have chosen meet this criterion: (Please specify the location of the consultancy firm chosen)

Type here ...(Max 3000 characters)

Work Programme Outline/Activities

Please provide the following that will be used in assessing your proposal: o List of actual tasks and activities (and associated staff/consultants) that are likely to be part of the proposed market validation programme, together with brief description of same; o Highlight any particular milestones that will be aimed at during the course of the research; o If the company is proposing to research what may be considered to be more than one market, full details should be provided in the proposal; o A suggested outline of the programme of activities is provided below – outcomes of each stage will be need to be agreed with the Development Advisor and the Market Advisor – interim and final reports will be requested at grant payment stage: - Research to determine market opportunity - Research to identify route to market - Research to identify partners - Identify potential end customers - Market Development to create tools and processes to deliver an implementation plan - Implementation of Marketing Plan

Type here ...(Max 3000 characters)

Market Access Grant Application Form March 2014 Page 4 of 10 Project Costs

Total EI Use Only Salaries Maximum eligible salary is €80,000 per annum (excl of PRSI and bonuses). (Up to a maximum eligible expenditure of €1,500 per person per week, or €300 per day verified by employee payslips). Only time spent on the proposed project by employees of the company can be applied for. Completed time sheets will be required for all staff active on the project. Support for external consultants must be applied for in the Consultancy Fees section. Employee time spent attending Trade Fairs is ineligible. The CEO/MD's salary costs are not eligible if the CEO relocates to the market. If the CEO is involved in the project from Ireland their costs can be supported at a maximum of 30% of salary which is capped at €80K. Employees listed below must be on the payroll of the Company at the time claim. If not they must be entered as consultants.

Name Function / Role in company Cost / Week or # Weeks / Days (specify) Total EI use day

Sub-total Overheads (may not exceed 30% of salary costs) Total EI use Note: overheads to support travel, subsistence, accommodation and any other employee out of pocket costs.

Sub-Total Consultancy 1 – 20 days inclusive @ €1,500 per day; €900 per day for days 21-30 and €700 per day for all subsequent days. The rates apply to each consultancy firm. Daily rate is to be inclusive of Consultant’s time and all associated travel, subsistence and out of pocket expenses. Consultancy costs can only be claimed for non-company management / employee costs. Management / shareholders of the company may not act as consultants to this project. If the consultant is not identified at the time of application, the company must provide Enterprise Ireland with details of the consultant to be engaged and the daily rate to be paid. Appointment of a consultant(s) is subject to Enterprise Ireland being satisfied with the daily rate and that the consultant(s) is suitably qualified. Name Function Cost / Day # Days Total EI use

Sub-total Rental Costs Up to a max. of €25,000 for rental of a new office in the new market for a max. of 18 consecutive months where the office is used solely for the purposes of the Market Access project only. Note: rent can not be used to for purposes of sales or distribution activities.

Location Cost / Week # Weeks Total EI use

Sub-total Trade Fair Costs: Not available to Large Companies. Only the cost of a company's first-time participation at a particular Trade Fair/Trade Show in any one country is eligible. Maximum of 5 people can be supported. Attendees must be company employees. Only ONE Trade Fair may be applied for in this application.

Market Access Grant Application Form March 2014 Page 5 of 10 Name of Trade Fair Location Dates Has the company Yes / No participated in this trade fair previously?

List of attendees Max 5 employees Name Position

Set-up/installation costs Note: This can include transportation costs for products/exhibit, installation costs at the event (excluding own employee labour). Rental cost of equipment/ICT for the stand e.g. Lighting, Projectors, Laptops, Display Monitors etc. Note the following costs are ineligible -Costs relating to stock/samples or purchase of equipment/ICT Details Total EI USE

Trade Fair Entrance Fee/ Rent of exhibition space Total EI USE

Sub-total Market Research Materials/Collateral: Max €25,000 Cost of purchasing reports and databases relating to a new market/sector are eligible. Prior to the purchase of any report, the company shall advise Enterprise Ireland of the nature, scope and cost of the report and EI shall be satisfied that the report is in line with the Market Access Grant. Marketing Collateral: The development cost of marketing collateral for use in new market is eligible. The cost can include designing collateral, localisation, market specific value proposition messaging and translation. Please itemise details of reports or collateral: Total EI USE

Sub-total Total Expenditure

Market Access Grant Application Form March 2014 Page 6 of 10 Amount of Aid Sought from EI

Please provide detail on the requested amount of aid sought (amounts in €’000) Total Expenditure Percentage Support Grant Type (refer to Project Costs Sought Grant Sought € Above) (Max is 50%) Market Access Grant

EU regulation stipulates that this section 4.3 must be completed in full. EI will return applications that are incomplete.

Finance 4.2Trading Position (Please ask your Development Advisor if a Financial Data Sheet (FDS) is required).

Base Year-2 Base Year-1 Base Year Current Year Base Year+2 Note: Base Year is the last complete financial year unless 10 months have passed in the current year, in which case Base Year is the current year. Fin. Year End ...... (dd/mm/yy) Sales ...... (€000’s) Exports ...... (€000’s) Net Profit After ...... Tax (€000’s) Net Assets / ...... S’holder Funds (€000’s) Employees ...... (# FTE’s) Productivity ...... (Sales/ Employee) o Please outline how the company has performed against previous targets (last 3 years). o Comment on any issues (eg. a major decline in sales). Type here ...(Max 1500 characters)

4.5 Sources of Funding o Please detail sources of existing finance e.g. bank loans, shareholder/director loans, venture capital, leases, overdraft, invoice discounting, etc. o Outline where the funding will come from to implement the development plan e.g. bank loan, additional equity from promoters/existing shareholders or from other sources and the likelihood of securing the funding. o Detail any revisions negotiated/proposed to existing facilities from banks, VCs, etc. Original Current Remaining Interest Provider Facility Balance Term / Renewal Security Rate Amount Amount Date

Market Access Grant Application Form March 2014 Page 7 of 10 5 Benefits of and need for EI support

o Outline the reasons why EI should support your application? o If successful, what would be the likely business impact to the company? o What would be the impact of not receiving financial support from Enterprise Ireland? o Include information on any additional economic benefits to Ireland (local suppliers, etc). Type here ...(Max 1500 characters)

6 Milestones on Completion of the Project o Please specify milestones to be achieved on completion of the project – these must relate to the stated aims of the Market Access Grant i.e.  Detailed validation of the target market to be undertaken  Development of a Go To Market strategy  Validation of potential opportunities with target customers/partners  Development of a detailed implementation plan. Type here ...(Max 1500 characters)

Please Note: All companies are required to submit an interim report to Enterprise Ireland when 50% of the grant has been claimed.

7 Declaration by Authorised Officer of the Applicant (Note: All questions must be answered, declaration signed and dated otherwise the application will be deemed incomplete). DECLARATION BY APPLICANT Yes No An Authorised Officer of the Company or the Promoter should complete this Declaration. I confirm that the Company:

Market Access Grant Application Form March 2014 Page 8 of 10 Is a Small Enterprise (SE).

Is a Medium Enterprise (ME). Is a Large Company. Is part of a Group structure. Has submitted a current Annual Business Review (ABR). If YES, please state year. eg. 2009 Is currently availing of the Audit Exemption. Has submitted our most recent Audited Accounts to our Development Advisor. If NO, I confirm that I will now submit our most recent Audited Accounts to our Development Advisor (softcopy versions are preferred). Has submitted Management Accounts no more than 3 months old to our Development Advisor. IF NO, I confirm that I will now submit our Management Accounts no more than 3 months old to our Development Advisor (softcopy versions are preferred). Has NOT sought aid from any other State Agency in respect of this expenditure. IF NO, I confirm that the Company/Promoter will not seek aid from any other State Agency in respect of this expenditure.

De Minimis Aid Received1in the last three years:

Note: A false declaration by a company/group resulting in the threshold of €200,000 being exceeded could later result in the aid being recovered with interest. If YES, how much De Minimis Aid has been granted to your company in the last 3 years (list the Type, Amount & Date received). Type Amount Date ...... Declaration on EU directive

The Company represents and warrants that it is not directly or indirectly, by way of funding or shareholding, covered by Articles 1 and 2 of the European Council decision, (2014/145/CFSP) of 17 March 2014, and subsequent Regulations (960/2014, 1290/2014 and 833/2014) concerning restrictive measures in respect of actions undermining or threatening the territorial integrity, sovereignty and independence of Ukraine. See http://eeas.europa.eu/cfsp/sanctions/docs/measures_en.pdf for further information. Name of Company’s Authorised Officer/Promoter: .... Date: ....

Checklist of Information Needed by EI

Document Note

Application Form. Formal Enterprise Ireland Application Form (this document).

Include the latest signed Audited accounts including notes. Audited Accounts Please provide consolidated accounts for the Group if part of a group. Latest Management Accounts This will facilitate the assessment of current year projections. (P&L and Balance Sheet)

Financial Data Sheet (FDS) if

1 Please refer to previous grant agreements to identify if any previous aid was classified as De Minimis. See http://www.enterprise-ireland.com/EI_Corporate/en/About-Us/Services/De-Minimis-.html for more information.

2 Applicable only to SMEs in BMW counties and funding for Capital Expenditure and /or Key Manager - BMW regions include the following counties: Donegal, Leitrim, Cavan, Monaghan, Louth, Longford, Westmeath, Offaly, Laois, Galway, Mayo, Roscommon, Sligo

Market Access Grant Application Form March 2014 Page 9 of 10 necessary Please provide a diagram outlining the companies in the group – showing the Group Structure shareholding of each and the relationship. (if applicable) Indicate which company owns any IP and provide supporting evidence.

Please provide all information in soft copy, where available The application form must NOT be a pdf document.

When the application has been completed, it, along with the additional information listed, should be emailed to: [email protected]

If you don’t have soft copies of the company’s audited and management accounts, please send hard Submission of copies of the accounts to your Development Advisor: Applications Enterprise Ireland, The Plaza, East Point Business Park, Dublin 3. Please note, for successful applicants, only eligible expenditure incurred after the application is submitted to Grant Applications will be considered for funding by the approval committee.

Market Access Grant Application Form March 2014 Page 10 of 10