Second Generation Landcare Grants

Group details

Group/Organisation Name / Secretary
Contact Person / Contact Phone Number
Contact Email / Contact Mobile Number
Postal Address / ABN Number
Suburb / Post Code / Group Incorporation Number / FTLA No.
Is your group Registered for GST? Yes No
Is your group Insured? Yes No
Is your group under the auspices of another organistaion? Yes No
If Yes, please provide the organisation’s name and contact information.
Auspice Organsiation Details / Auspice Organisation Contact
Org Name: / Contact Name:
Email: / Phone/Mobile:

Grant funding you are applying for?

Be aware that if you are successful in applying for a Type A grant, over $10,000 you will not receive a support/start-up grant.
Type of grant(s) requested / Amount (ex. GST) / Co-invest (ex. GST)
A – Project Grant (max $30,000 ex. GST) / $ / $
Note: If you are applying ONLY for a Support or Start-up grant you will need to fill in one of the two Surveys online:
-  for Landcare Groups - https://www.surveymonkey.com/r/1516PPWLandcareGROUP;
-  for Landcare Networks - https://www.surveymonkey.com/r/1516PPWLandcareNETWORK

Project Snapshot

Title (10 words max)
Short Description:
Land ownership
Who is/are the owner/s or land manager/s for your proposed project site/s?

Links to the Port Phillip and Western Port Regional Catchment Strategy

Describe how your project contributes to environmental assets identified in the Regional Catchment Strategy. (guidelines page 6)

Project Description (guidelines page 6)

·  Succinctly describe the environmental asset(s) your project will benefit and why these assets are valuable.
o  Include what it is, where it is and evidence of its significance (e.g vulnerable EVC, flora and fauna listed in the Advisory List of Threatened Plants or Advisory List of Threatened Vertebrate Fauna etc)
·  Describe what is/are the things that are threatening these assets that your project intends to address?
e.g. grazing from rabbits, predation from foxes, competition from environmental weeds, isolation from/poor connection to other remnants/populations, lack of knowledge/understanding/skills in community, limited availability of tree hollows for breeding etc.
·  What makes these threats important to address? – e.g. EPBC-listed, identified in a recovery plan/FFG Action Statement/local strategy
·  What approach does your project take to address these threats? This should include how you intend to monitor the impacts of your project on the assets and threats, including measures of success
·  Any links to larger regional projects and how your project aligns/complements their delivery

Delivery Method (guidelines page 7)

This section should be an extension of the approach described above and provide more detail and timing of each of the key activities you will undertake to deliver your project.

Project outputs (guidelines page 7)

What are the outputs you expect your project to achieve? If your application is successful, your agreement will include a list of agreed outputs which you will need to report on when your project is completed.
Outputs
/ Measure
/ Qty
/
Fence / Km
Vegetation (tick)
[ ] Native Indigenous modify (top-up revegetation, i.e. additional plantings in remnant native vegetation)
[ ] Native indigenous establish (new planting of native indigenous plants in a non-vegetated area e.g. paddock shelterbelt) / Ha
No. Plants >2m tall
Pest animal control - Rabbit / Ha
No. sites
Pest animal control – Fox / Ha
No. sites
Pest animal control – Other (describe): / Ha
No. sites
Weed control - Please specify species name: / Ha
No. sites
Plan - Community driven plan/ Action plan / No plans
Engagement event - Awareness raising activity/event (describe): / No. events
No. attendees
Engagement event - Awareness raising activity/event (describe): / No. events
No. attendees
Agricultural Best Land Management Practice Change (describe): / Ha
Management agreement (tick)
[ ] Non-perpetual: Lapse at the end of a fixed term or when the land changes ownership. (e.g. land management agreement)
[ ] Perpetual: An agreement is binding on future landowners as well as the current landowner. (e.g. Covenant) / Ha
No.
Other (For example project signage, monitoring using photo points) describe: / Measure / Qty

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For more information www.ppwcma.vic.gov.au. Ph: 03 8781 7921

Budget (guidelines page 7)

What are the budget requirements for your project? This section should be an extension of the activities described in the Delivery Method above. Each budget line should also clearly state the quantity (with units) and rates (price per unit) for each purchase. Cash contribution could be from project partners, landholder cost share, other funding. In-kind contributions can be volunteer labour ($30/hr), vehicle/machinery usage. Projects seeking more than $10,000 must include at least 50% of expenditure for on-ground works. Add rows as necessary.
GST: The PPWCMA will pay GST to the applicant if they are registered. If the applicant is not registered for GST they are unable to claim it on-top of their funding request. Applicants need to ensure they account for any GST payable to third parties and ensure they request the total amount for the activity. Independent advice should be sought if you are unsure.
Activity
(As per your Delivery Method page 3)
/ Components
(As per your Delivery Method page 3)
/ Unit and unit price
/ Quantity
/ Total Cost for activity
/ PPWCMA Grant funding sought
/ Other Cash Contribution (source and amount)
/ In-kind contribution
/
e.g. Revegetation
/ Site preparation by contractor ripping
/ $55/Hour
/ 100 hours
/ $5,500
/ $3,000
/ Local Government Grant - $2,500
/ 0
/
e.g. Revegetation
/ Planting
/ $30/hr
/ 100 hours
/ $3,000
/ $0
/ $0
/ $3,000
/
Total

For more information www.ppwcma.vic.gov.au. Ph: 03 8781 7921

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Risk Assessment (guidelines page 8)

What are the major foreseeable risks facing your project, and what measures do you have in place to reduce their impact? Describe the main risks associated with the project and the management actions proposed to be adopted to minimise or avoid these risks. Specific risks relating to OHS and potential harm to Indigenous Cultural Heritage must be included. Refer to the risk assessment table below and page 8 of the guidelines to determine the rating.
Risk Description
Describe the risk, its sources and impacts / Likelihood*
Rare, Unlikely, possible, likely, almost certain / Consequence*
insignificant, minor, moderate, major, critical / Rating
Low, Medium, high, severe / Current Controls/Contingency
Describe what you will do to mitigate the risk, source or impact to an acceptable level
CONSEQUENCE
Insignificant / Minor / Moderate / Major / Critical
LIKELIHOOD / Almost Certain / Low / Medium / High / Severe / Severe
Likely / Low / Medium / Medium / High / Severe
Possible / Low / Low / Medium / High / Severe
Unlikely / Low / Low / Low / Medium / High
Rare / Low / Low / Low / Medium / High

Permits, consultation, and legal requirements (guidelines page 9)

Native vegetation damage or removal
Does your project remove, destroy or impact negatively on native vegetation?
Yes [ ] No [ ] (skip next question)
·  If yes, do you have a permit for these activities? Yes [ ] (please attach) No [ ]. If no, please provide evidence of exemption with your application.
Vegetation enhancement or establishment
Does your project involve vegetation enhancement or establishment?
Yes [ ] No [ ] (skip to invasive plants and animals)
·  If yes, have you read and designed your activities in accordance with Vic Veg Best Practice Management for Native Vegetation? Yes [ ] No [ ]
·  Have you attached your proposed species list including number of seedlings/ kilograms of seed of each species used? Yes [ ] No [ ]
·  If your project involves a wildlife corridor, does it exceed 20m in width? Yes [ ] No [ ]
·  Is your project focused on amenity plantings? Yes [ ] No [ ]
·  Does your project contain ongoing monitoring and management? Yes [ ] No [ ]

Invasive Plants and Animals

Is your project addressing Invasive Plants and Animals Yes [ ] No [ ]
If your project involves control of Invasive Plants and Animals, have you sought advice from your local council or Department of Environment, Land, Water and Planning (contact details are in the guidelines)? Yes [ ] No [ ]
Name of person contacted:
Provide a brief summary of the issues discussed:
If you haven’t sought advice, why?

Land Holder / Manager Endorsement

Is your project on Private Land [ ], Public Land [ ], or both [ ]
For Private Land have you attached a list of the land holders agreeing to participate in your project?
Yes [ ] No [ ]. If no, this is determined to be a “devolved grant” and is ineligible for funding through these grants.
For Public Land have you attached evidence of permission granted by the land manager for your project? Evidence must include the following information:
·  Name
·  Position
·  Organisation
·  Email
·  Phone/mobile
·  Reference to your project
Yes [ ] No [ ]. If no, approval from the land manager must be provided to the PPWCMA prior to the release of funds.

Aboriginal Cultural Heritage (guidelines page 10)

Does your project involve disturbance of earth? Yes [ ] No [ ]
Is your project within an area of Cultural Heritage Sensitivity or Registered Place? Yes [ ] No [ ]
If yes to both questions you must check with Office of Aboriginal Affairs Victoria (OAAV) to find out whether your project may cause harm to Indigenous Cultural Heritage. Attach any documentation and the name of person contacted.
If you are unable to provide the information as part of your application, you will need to obtain documentation from OAAV if your application is successful before your project is approved.
You may need to provide OAAV with:
·  a description of the works, including site preparation methods (i.e. how the earth will be disturbed, e.g. rip lines for native vegetation AND
·  GPS coordinates of the boundary of the site and an aerial photo marking the specific location of the works project, including known roads, directional arrow, scale and legend
·  OR a map of the site including all this information.

Occupational Health and Safety (guidelines page 10)

You need to make sure you have a safe system of work in place for your project to protect the health and safety of your group, volunteers and anyone else on your project site.
You can find resources on OHS tailored to community groups on the Victorian Landcare Gateway: http://www.landcarevic.net.au/resources/for-groups/ohs
Have you included a copy of your OHS Plan? Yes [ ] No [ ]

Reporting requirements (guidelines page 13)

Groups receiving a PPWCMA Community Grant will be required to lodge a progress report 6 months from being awarded the grant (approx May 2016) and a Final Report by the 30 November 2016. Groups will need to report on the achievement of agreed activities and outputs, including a map/spatial information for any on-ground works undertaken as documented in the agreement.
Have you read and do you understand the reporting requirements expected if you are successful in obtaining a project grant?
Yes [ ] No [ ]

Previous Funding

Do you have carry over PPWCMA grant funds from the 2014/15 or any previous years? Yes [ ] No [ ]
If yes, what is the amount of funding left over? $
Note: Groups have until the 30 November 2015 to complete and report their 2014/15PPWCMA Community Grant project. If your project is not going to be completed by this date, please contact the Environmental Projects Manager to discuss before submitting this grant application.

Other Funding

Have you applied for funding from another source for this project? Yes [ ] No [ ]
If yes, please detail the fund source .

Project Manager Details (Responsible for project delivery and reporting)

Name:
Postal Address:
Phone Number: / Mobile:
Email: / Fax:

Group acknowledgement

On behalf of the group we understand that this is an expression of interest only and that final project approval will be subject to funding availability and project suitability. Assistance is not available for work completed prior to project approval and the signing of an agreement.
If submitting this form electronically, please type your name in CAPITALS in the signature box and it will deemed that you agree to the terms above.
President/Chair Signature:
Name: Date:
Office bearer signature:
Name: Date:
Position:
Successful groups will be required to enter into a signed agreement with the CMA that will provide a summary of agreed works, timeframes and reporting requirements. This agreement will be a legal document.
Privacy
Personal information supplied by you and/or contained herein is collected, stored and maintained for the purpose of facilitating and administrating this grant process. This information maybe disclosed to relevant government organisations or other agencies for the sole purpose of administering the grant for which the information was collected. The information collected is not traded, sold, licensed nor used for commercial marketing purposes. You have the right to access to this information. Sites are to be made available for auditing, monitoring or demonstration purposes at the request of CMA staff.

Submission Checklist

Have you:
Completed all sections of the application form?
Mapped the project site and submitted it as part of your application?
Obtained all the necessary permits?
Obtained all the necessary signatures?
Read, understood and attached the Insurance, OH&S, and Cultural Heritage Sensitivity requirements?
Read and understood the reporting requirements, including the mandatory spatial data mapping?
Double checked your budget figures?
Attached copies of all relevant documentation?
Asked someone else to proof read your application?
Please send your completed application to:
Community Grants
Port Phillip & Westernport CMA
Lvl 1, Landmark Corporate Centre
454 – 472 Nepean Hwy
Frankston Victoria 3199 / Or email the completed form and documents to:

REMEMBER: APPLICATIONS CLOSE 12th SEPTEMBER 2016

Attachments:

(please list file names)

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For more information www.ppwcma.vic.gov.au. Ph: 03 8781 7921