Online Form - Community Facility Fund

Introduction

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Organisation Details

Is your group/organisation registered for GST?*
Does your group/organisation hold current public liability insurance?*

Max File Size: 10.00 MB
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Is your group/organisation incorporated?*

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Does your group/organisation have a strategic plan?*

How many participants does your group/organisation have?


Project Details


Max File Size: 10.00 MB
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Construction Details


Max File Size: 10.00 MB
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Insurance Details Contractor

Does the contractor have Workers Compensation Insurance?*

Max File Size: 10.00 MB
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Does the Contractor have Public Liability Insurance to the value of $20m?

Max File Size: 10.00 MB
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Does the contractor have Income Protection or Personal Accident and illness Insurance?

Max File Size: 10.00 MB
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Does the Contractor have Professional Indemnity Insurance? Applicable if advice is being provided.

Max File Size: 10.00 MB
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Does the Contractor have Motor Vehicle Insurance?

Max File Size: 10.00 MB
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Does the Contractor have a handbook and or safety agreement?

Max File Size: 10.00 MB
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Insurance Details - Volunteers

If ‘skilled’ or ‘professional’ volunteers are carrying out works, do they have Public Liability Insurance to the value of $20m?*

Max File Size: 10.00 MB
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If ‘skilled’ or ‘professional’ volunteers are carrying out works, have they provided copies of their qualifications/tickets or certificates?*

Max File Size: 10.00 MB
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Insurance Details - Product and Equipment

Does the product come with Product Liability Insurance or warranty information?*

Max File Size: 10.00 MB
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Project Justification


Community Benefit

Are you partnering with any other groups to deliver the project?*

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Project Budget

Bank account details for electronic transfer of grant monies (if successful).

Expenditure (ex GST)

Please note expenditure and income should be equal


Max File Size: 10.00 MB
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Volunteer Labour Type

Unskilled - Up to $25 per hour

Skilled - Up to $40 per hour

Professional - Up to $60 per hour

Income (ex GST)

Please note expenditure and income should be equal

Other income considerations:

  • Organisation's cash contribution
  • Other grant providers
  • Donations
  • Sponsors
  • Voluntary Labour

Max File Size: 10.00 MB
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Payment Details

Bank account details for electronic transfer of grant monies


Application Declaration

This section must be completed by the incorporated body applying for the grant. If you are not incorporated you must have the auspice organisation complete this section.

I hereby declare that I am authorised on behalf of the organisation to sign this declaration and that the information supplied is, to the best of my knowledge, accurate and complete.

I confirm that I have read and understood the Community Facility Fund Guidelines.

I confirm that the Shire of Murray will be notified of any change to the information supplied and any other information or circumstances arising that may affect this application.


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