Travel Smart Grant Application Form

TRAVEL SMART GRANT APPLICATION FORM (“Application Form”)

Please read the following instructions carefully before completing this form. 1. Only organisations participating in LTA’s Travel Smart Network can apply for the Travel Smart Grant. By submitting this form, the applicant organisation (“Organisation”) agrees to the terms and conditions of the Land Transport Authority of Singapore (“LTA”) as set out herein (which includes the Information Sheet for Travel Smart Grant and its annexures).

2. All fields in this application are compulsory. Where information is not applicable, a “N.A.” is necessary.

3. The Organisation should demonstrate that the items/services to be reimbursed and listed in its Application Form are either: a. Travel Smart measures proposed as part of their travel demand management action plan (developed using the Travel Smart Consultancy Vouchers); or b. Self-proposed Travel Smart measures (without using the Travel Smart Consultancy Vouchers) which they have pre-consulted with LTA and are substantiated with supporting employee survey data (surveys to be carried out not more than 1 year before date of application indicated in this form). Notes: Priority will be given to companies who already have travel demand actions plans that have been previously approved by LTA as part of the Travel Smart Consultancy Voucher.

4. They should also ensure that the proposed Travel Smart measures mentioned above fulfil at least one of the Travel Smart objectives, which are: a. Re-time: travel during off-peak periods b. Reduce: travel demand (i.e. work off-site/at home instead of travelling to office) c. Re-mode: switch to more sustainable modes of travel (public transport, cycling and/or walking)

5. For Organisations that are applying for the 2nd or 3rd funding year of the Travel Smart Grant, a copy of the Post-Implementation Survey results has to be attached to this application.

6. All supporting documents listed below must be submitted together with the Application Form: a. ACRA Search/Business Profile Search dated within 1 year of application date; b. Vendors’ quotation for all items of the Travel Smart measures the organisation is seeking funding for; c. Post-Implementation Survey results (where applicable); and d. Employee survey data (where applicable).

7. The Organisation shall submit the completed Application Form to: Land Transport Authority of Singapore 10 Sin Ming Drive, Level 5 Singapore 575701 Attn: Travel Smart Project Team, Public Transport Promotion

8. Once the Organisation’s Application Form is approved by LTA, the Organisation should note that the Travel Smart Grant Reimbursement Form must be submitted to LTA no later than 1 year from the date of approval as communicated by LTA. 9. If the Organisation wishes to amend or propose additional measures for each funding year, submission of the revised Application Form must take place no later than 6 months after the approval of the original Application Form.

10. LTA reserves the right to reject the Application Form at its sole discretion and for any reason, including without limitation if the submission is incomplete. In addition, LTA reserves the right not to provide unsuccessful applicants with details of their rejection or entertain any appeals

11. The issuance by LTA of a Letter of Acceptance accepting the Application Form shall create a binding Contract between LTA and the organisation on the terms and conditions as set out in this Application Form (which includes the Information Sheet for Travel Smart Grant and its annexures). Such issuance of the Letter of Acceptance, whether through email or by hand or by post, shall be deemed effective communication of acceptance.

12. All confidential information provided by LTA to the Organisation in connection with the Travel Smart Programme shall be treated by the Organisation on a confidential basis.

13. The Organisation intending to make any press release, public announcements or other publicity materials or disclosure of any matter relating to the Travel Smart Programme shall seek LTA’s prior written consent.

14. For all queries pertaining to the Travel Smart Grant, organisations are to email: [email protected]. SECTION 1 – APPLICANT DETAILS To be completed by the appointed Travel Smart Leader of the participating Organisation i) Organisation ii) Name & IC/Passport No. of Travel Smart iii) Designation Leader iv) DID & HP No. v) Email vi) No. of Employees (according to office location) vii) Travel Smart Consultancy Voucher Application No. (if applicable)

Has Organisation Applied for the Travel Smart Grant Previously? ( Yes / No )

If Yes, Please Indicate the Previous Travel Smart Grant Application Number(s) and Corresponding Year of Application

For Official Use Only Travel Smart Grant Application Number:

SECTION 2 –DETAILS OF MEASURES TO BE FUNDED

To list in detail the Travel Smart measures that each company is seeking funding for

Travel Description of S/No Smart Estimated Unit Estimated Total Items/Services 1 Qty Measure Cost (S$) Cost (S$)

1 Organisations are to indicate the various quotes received before highlighting the selected quotation or to provide justification (attached as an annex) if otherwise. SECTION 3 –DETAILS OF INDIVIDUAL TRAVEL SMART MEASURES

To list in detail which items and/or services the Organisation wishes to seek funding for and how they relate to the overall Travel Smart objectives (Note: Use one copy of this page for each item/service. Organisation is to submit as many copies of this page as appropriate.)

Name of Proposed Item/Service

1. CHALLENGES a) What are the current challenges that your company is facing? …………………………………………………………………………………………… ……………………………………………………………………… What is the existing situation like? …………………………………………………………………………………………… ………………………………………………………………………

2. THE PROPOSED NEW ITEM/SERVICE a) Which Travel Smart objective does this item/service support? …………………………………………………………………………………………… ………………………………………………………………………

b) How does the proposed new item/service contribute towards the above- mentioned Travel Smart objective? …………………………………………………………………………………………… ………………………………………………………………………

3. EXPECTED BENEFITS OF THE NEW ITEM/SERVICE a) Please highlight the quantitative and qualitative benefits where possible and provide justification on how this is achievable? …………………………………………………………………………………………… ………………………………………………………………………

For Official Use Only Record of indicator(s)and deliverable(s) as agreed between the LTA and the Organisation: SECTION 4 – DECLARATION To be completed by applicant Organisation

Yes / No 1. The Organisation is solvent and no liquidation or winding-up proceedings have been commenced or are pending against it. 2. There are no unsatisfied judgments outstanding against the Organisation that will materially impact the solvency of the Organisation. 3. Neither the Organisation nor its proprietor (in the case of a sole proprietorship), directors (in the case of a corporation), partners (in the case of a partnership, limited partnership or limited liability partnership) or members (in the case of any other unincorporated association) has/have been convicted of any offence involving fraud, misrepresentation and/or dishonesty. 4. There have been/are no prosecutorial or civil proceedings commenced/pending against the Organisation or its directors (in the case of a corporation), partners (in the case of a partnership, limited partnership or limited liability partnership) or members (in the case of any other unincorporated association), in the last 10 years preceding the date of this declaration for fraud, misrepresentation and/or dishonesty. 5. The Organisation and/or its directors, shareholders, employees or any other person related to the aforesaid persons has/have not been given any monies, loans, rebates, discounts, refunds, liquidated damages or any other payment, whether in cash or in kind, by consultants or vendors or their directors, shareholders, employees or any other person related to the aforesaid persons, in connection with the Travel Smart programme or this application form; and there is no intention to give such monies, loans, rebates, discounts, refunds, liquidated damages or any other payment. I/We understand that exchange of such monies, loans, rebates, discounts, refunds, liquidated damages or any other payment without seeking LTA’s approval may constitute an offence by law (including under the Penal Code and/or the Prevention of Corruption Act). 6. The facts stated in this application and the accompanying information are true, complete and correct to the best of my/our knowledge and belief and that I/we have not withheld/distorted any material facts. I/We understand that if I/we obtain the grant by false or misleading statements, I/we may be prosecuted, and in addition, LTA may, at its discretion, withdraw or cancel the grant in full or in part and recover immediately from the Organisation any amount that may have been disbursed.

Signature & Organisation Stamp Name

Designation

Note: Only the sole proprietor, partner or director (as Date the case may be) of the applicant Organisation, as registered with ACRA, the Registry of Societies, or any other professional body recognized by LTA, may sign this declaration.