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Commemorative Partnership Program Community War Memorial Funding Application Instructions • We strongly encourage you to complete the form electronically. It includes features to help simplify the application process (e.g., automatic calculations). You may also print off the application form and complete it by hand.
• Any changes made by hand after the form is completed and printed must be initialled by the individual authorized to sign the form.
• If you do not have enough space to answer a question, please attach a separate sheet.
• Quarterly deadlines: January, April, July and October (1st business day of the month).
• It is strongly recommended that applications be submitted at least three (3) months before the start date of the proposed project to allow for processing and notification of funding. For example, if your project start date is May 1, you should submit your application by the first business day of the January deadline.
• Ensure budget information is complete and calculated correctly.
• All signatures must be handwritten.
• Remember to include all required documents with your application (please refer to the checklist outlined in Part I of this application form).
• You must complete all required fields before submitting your application. Once completed, this form can be scanned and transmitted by e-mail or sent by mail. It must be received or post- marked no later than the stated deadline date.
• Keep a copy for your records.
Contact information If you have questions or require assistance with the application, please contact the Partnerships Unit by calling toll free at 1-866-522-2122 or by email at [email protected].
Please send your completed application and all accompanying documentation to Veterans Affairs Canada:
Veterans Affairs Canada Commemorative Partnership Program 191 Great George Street, Room 304 PO Box 7700 Charlottetown, PE C1A 8M9
By e-mail: [email protected]
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Commemorative Partnership Program Community War Memorial Funding Application Part A - Applicant information Name of organization*
Organization's status Registered charitable No. GST/HST/BN No. profit non-profit Mr. Mrs. Ms. Miss Other (specify) Contact person (last name, first name) Title
Preferred language of communications Telephone (Country Code, Area Code, No.) English French Canada/US Other ( ) Other telephone (Country Code, Area Code, No.) Facsimile No. (Country Code, Area Code, No.) Canada/US Other ( ) Canada/US Other ( ) Mailing address (No., Street, Apartment No., PO Box, RR No.) City/Town/Village
Country Province/Territory/State Postal Code/ZIP
E-mail address Organization's Website (if applicable)
Part B - Organization objective and history Brief description of organization's mandate/objectives
Has your organization previously received partnership funding from Veterans Affairs Canada (VAC)? Yes No If yes, project name
Date of project (yyyy-mm-dd) Funding amount $
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Part B - Organization objective and history (continued) If no , has your organization successfully completed other projects? If yes, explain
Part C - Project information How will this project recognize all those who served in Canada's efforts during war, military conflict and peace? How will it engage youth, Veterans, Canadian Armed Forces members and/or the general public? (Please attach a separate sheet if necessary.)*
Total anticipated target audience (please indicate total number of Number of people expected to access the monument or addition over a one-year period) Veterans Number of Canadian Armed Number of youth Forces members Other What are the planned outcomes of the project? What does this project hope to accomplish?*
How will you determine that you successfully achieved your planned outcome(s)? Note: A final report must be submitted at the conclusion of the project. The report will enable the organization to fulfill its obligation of accountability to VAC.*
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Please indicate by checking one of the boxes below:
The project is for the restoration of an existing memorial (go to Part D).
The project is to build a new memorial or an addition** to an existing memorial (go to Part E). ** For the purpose of this program, an addition is a project involving new construction directly or complementary (e.g., walls and columns) to an existing memorial.
Part D - Restoration of an existing memorial Name of memorial
National Inventory of Canadian Military Monuments registration no. (if applicable)
Ownership of memorial (e.g., municipality, Royal Canadian Legion, etc.)
Street address or nearest cross streets City Province/Territory
Description of the location (e.g., in a park, on a street corner) Country
Who does this memorial commemorate? (check all that apply) local citizens all Canadians those who lost their lives those who served Specify conflicts/wars/peacetime efforts
Year of construction (if known)
Describe any previous conservation work or repairs. (If known, include the type of work and date completed. Also provide photographs of the memorial before and after construction work, and copies of any repair/conservation drawings, if available.)
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Part D - Restoration of an existing memorial (continued) Estimated project start date (yyyy-mm-dd) Estimated project completion date (yyyy-mm-dd)
Describe the current condition and issues affecting the memorial. (Please include a copy of any condition assessment/report (if applicable), and contractors' quotes for all planned restoration work.)
Describe in detail the scope of the planned conservation work to address the problems affecting the memorial (step-by-step solutions).
How will your organization support the ongoing maintenance once the memorial has been restored?
Note: For restoration projects, please proceed to page 7 to complete Part F (financing section).
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Part E - Construction of a new memorial or addition Estimated project start date (yyyy-mm-dd) Estimated project completion date (yyyy-mm-dd)
Describe the project in detail, including location. (Please attach required photographs of the proposed site.)
Proposed name for the new memorial or, for additions, name of existing memorial*
Ownership of the new memorial or addition. (Please attach required document to identify ownership, as outlined in the Program Guidelines.)*
Note: The Government of Canada will not, under any circumstance, assume any ownership or responsibilities related to the ownership of cenotaphs, monuments or major additions constructed through the Commemorative Partnership Program. Will the new memorial or addition be constructed on Crown land? (This includes land owned by any federal government department, agency or organization.) Yes No Who does this memorial commemorate? (check all that apply) local citizens all Canadians those who lost their lives those who served Specify conflicts/wars/peacetime efforts: Will individual names be inscribed on the major addition? Yes No If yes, approximately how many? Please indicate proposed text below (if applicable)
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Part F - Project budget Planned expenditures • Include all expenditures related to the project, including in-kind. • Refer to the guidelines for eligible and ineligible expenditures. • Note: Please include percentage of taxes not already reimbursed as an eligible expense. • Copies of all contractors' estimates and/or quotes for labour and materials must be included with this submission. Support from VAC may be requested for up to 50 percent of the eligible expenses, not exceeding a maximum of $50,000. Only 25 percent of the overall budget can be contributions in-kind.
In-kind $ Planned expenditures Cash $ (must also be reported as a revenue)
Subtotal Contingency (maximum 10%) Total project cost - Cash and in-kind Total planned expenditures (A) $
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Part F - Project budget (continued) Anticipated revenue Indicate in the table below the sources of revenue you have secured/enlisted for this project. • Financial support from other organizations, federal departments and agencies (excluding the funding requested from VAC), and municipal and provincial/territorial governments.
• Donations in-kind (itemize and list estimated donations). • Organization's own funding. • If more space is required, submit the information on a separate document. Amount $ Other Government of Canada funding (specify if pending or confirmed)
Municipal/provincial/territorial support
Private sector support
Donations
Fundraising
Organization's own funding
In-kind support (e.g., labour, materials, consulting fees)
Other (specify)
Total anticipated revenues (B) (If total revenue covers or exceeds expenditures, VAC is unable to fund the project.)
Funding required
Total planned expenditures (A) $
Minus total anticipated revenue (B) $
Funding required (C) $
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Part F - Project budget (continued) Important reminder: complete the table below, list items that may be covered by Commemorative Partnership Program funding. Refer to the guidelines for eligible and ineligible expenditures. List specific project costs/items to be paid for with VAC funding: Amount $
Funding requested from VAC (If there is a shortfall, please explain how the remaining funds will be secured.) (D) $
Does your organization have an employee or board member involved in this project who is a current or former public servant/public office holder (within the Yes No last 12 months)?
Part G - Privacy Notice The information you provide is collected under the authority of the Order-in-Council PC 1965-688 for the purpose of confirming eligibility and the processing of an application for funding under the Commemorative Partnership Program. The information provided to Veterans Affairs Canada (VAC) will be treated in accordance with the Access to Information Act and the Privacy Act. Information pertaining to approved funding and a description of the project are included in public records and disclosed on VAC’s website in accordance with the government’s proactive disclosure practices. Additional information about how the Department handles this information can be found in the VAC Section of the Info Source publication in the Class of Personal Information - Partnerships and Collaborations (http://www.veterans.gc.ca/eng/about-us/organization/access-to-information- privacy/info-source/3-0).
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Part H - Attestation To be considered for funding, all boxes must be checked. I hereby attest that: The information contained in this application is accurate and complete. If there is a change in authorized signatory(ies) and/or their contact information, the organization will notify the Department of Veterans Affairs. Departmental funding may be used only for the purposes specified in this application. Once the Department has agreed to provide financial assistance, no change can be made to the project without Departmental approval (the Department shall determine what constitutes a change).
Funds not used for the specified purposes must be returned to the Department.
The Organization, by its authorized agents, consents and authorizes the Department to disclose any information received in the application within the Department and the Government of Canada or to outside entities for the following purposes: to reach a decision on this application, and to administer, monitor, and evaluate the project after completion. The disclosure of any information received in this application may also be used to reach a decision on any other application of the applicant for funding under any other program of the Department.
The Organization will take all necessary actions to maintain itself in good standing, to preserve its legal capacity and to inform the Department without delay of any failure to do so. The Organization will comply with all applicable provincial/territorial and federal legislation. The Organization will obtain all the necessary authorities, permits, licences and consents to undertake the proposed project and, if required, will provide them to the Department. No current or former federal public servant or public office holder who is not in compliance with the Conflict of Interest Act, the Policy on Conflict of Interest and Post Employment, the Values and Ethics Code for the Public Sector and the Veterans Affairs Canada Code of Conduct shall derive a direct benefit from the requested funding. The Organization and any person lobbying on its behalf to obtain funding are in compliance with the Lobbying Act. The Organization agrees to comply and be in accordance with the following government legislations and policies: the Official Languages Act, the Federal Identity Program, the Financial Administration Act and the Policy on Transfer Payments. In accordance with section 40 of the Financial Administration Act, the Organization agrees that the Department will issue payment in any fiscal year (01 April - 31 March) subject to there being an appropriation for that same fiscal year.
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Part H - Attestation (continued) To be considered for funding, all boxes must be checked. I hereby attest that: VAC retains the right to establish the communications roles and responsibilities of the parties involved, with respect to official languages, corporate identity, visibility, publishing, marketing and promotional activities. The Minister and his employees and agents shall not be held liable for any injury, including death to any person, or for any loss or damages to property incurred or suffered by the Organization or its employees, agents or voluntary workers in carrying out the Project. The Organization shall indemnify and save harmless the Minister and his employees from and against all claims, losses, damages and costs attributable to any injury or to death or a person or damage to or loss of property arising on the part of the Organization or its employees, agents or voluntary workers in carrying out the Project. The Organization agrees that no agency relationship will result from the Department contributing toward the activities funded. The Organization agrees to submit a final report, and where required, financial accounting, to allow the Department to evaluate the activities funded. This application constitutes a legally binding agreement between the Organization and Her Majesty the Queen in Right of Canada as represented by the Minister of Veterans Affairs and is effective the date the grant or contribution is approved by the Minister.
Name of person authorized to sign for the organization (last name, first name) Title*
Signature Date (yyyy-mm-dd)
Name of person authorized to sign for the organization (last name, first name) Title
Signature Date (yyyy-mm-dd)
Name of person authorized to sign for the organization (last name, first name) Title
Signature Date (yyyy-mm-dd)
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Part I - Document checklist Completed and signed application and attestation.
Complete project budget expenses and revenues.
For Restoration Projects Copies of all contractors' estimates for all planned project expenses, including in-kind contributions. Written verification that the applicant has the authority to undertake the restoration work (required if the owner of the monument differs from the applicant). Photographs of the memorial in its current condition (quality close-up photographs of the problem areas, as well as photos showing the site and setting of the memorial are required).
Drawings, specifications, assessments and/or investigative reports (if applicable).
For projects involving new builds or additions Drawings and specifications of the proposed new memorial or addition. A photograph of the proposed site where the new memorial will be built or, in the case of an addition, a photo of the existing site. An original, signed document to identify ownership of the new or expanded memorial An original, signed document to identify roles and responsibilities related to the ongoing maintenance of the new or expanded memorial.
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