Community Beautification Application

Community Beautification Application Form

Application Deadline: LAST Monday in September, at 4 pm. Please read carefully all eligibility criteria, conditions and requirements contained in the Community Beautification Program Guidelines. Prior to completing your Application, contact 905-318-5932, ext. 6119 or partnerships@haldimandcounty.on.ca to discuss your project. Ineligible submissions will not be considered. BE CREATIVE!

Step 1 of 2

Have you connected with the Community Partnerships Liaison prior to starting this application?(Required)

If no, please use the above noted contact information to contact the Community Partnerships Liaison before continuing.

Yes

Are your supporting documents completed and ready to be uploaded?(Required)

Yes

Supporting Documents Include:

Proposed Project Budget;
Work Plan outlining the proposed timeline and activities to complete the project;
Specifications, drawings or photos of proposed structures;
Written Quotations for any purchased project supplies, materials and services (minimum two (2) quotes). Please provide specifications to contractors to ensure consistency between quotes;
Site Map of proposed location for structures, flower beds, etc.;
Hold Harmless Agreement (signed);
Valid Certificate of Insurance (minimum $2 million liability insurance with Haldimand County named as additional insured);
Confirmation of WSIB participation by any contractors hired to complete work on the project;
Financial Statements and/or Fund-Raising Plan to prove readiness of project funding; and,
‘Before’ Photos of the project location.

1.0 Applicant Information

Organization(Required)

Organization Phone:(Required)

Organization Email:(Required)

Organization Address:(Required)

Street Address City Province Postal Code

Project Partner Organization:

Project Partner Contact Name:

First Last

Project Partner Email:

Project Partner Organization:

Project Partner Contact Name:

First Last

Project Partner Email:

Project Partner Organization:

Project Partner Contact Name:

First Last

Project Partner Email:

Lead Project Coordinator(Required)

First Last

Lead Project Coordinator Email:(Required)

Lead Project Coordinator Phone:(Required)

Alternate Project Coordinator:(Required)

First Last

Alternate Project Coordinator Email:(Required)

Alternate Project Coordinator Phone:(Required)

2.0 Project Details

Does the Project Take Place on Haldimand County Property?(Required)

Yes

No. If you respond 'No', this project is NOT eligible (please see guidlelines)

Project Category(Required)

Choose 'Other' if your application involves more than one category and note which categories are included in your application.

Category 1 - Community Signage

Category 2 - General Community Beautification

Category 3 - Community Streetscape/Park Improvements

Category 4 - Other innovative Community Beautification Projects

Other

Project Description(Required)

Please describe the details of the proposed project (what, where, who will do the work, when), including your community group’s contribution to the project. Keep in mind all projects must take place on property owned by Haldimand County. Attach additional documentation to this form, if necessary

Benefits to Community and County

Please list and describe the benefits of the proposed project to your community and Haldimand County (why). Attach additional documentation to this form, if necessary.

Benefits to Community and County

Optional file upload for additional documentation.

Max. file size: 512 MB.

Project Budget

Please complete – Community Beautification Documentation Forms.

A Sample Budget is included to provide guidance on completing the form.

Attach additional documentation, including at least two quotations, preferably three, for any planned work, unless it is in-kind. In-kind labour should be calculated at $16.50 per hour.

Note: The grant from Haldimand County for Community Beautification proposals cannot exceed $4,000, or 50% of the total project cost per project/per lead organization, whichever is lower. (For example, if the total project cost is $6,000, the maximum amount which can be requested from Haldimand County is $3,000.)

If the cost of the proposed project is larger in scope and the project will be completed in phases over more than one year, the request for funding may be specific to assisting with the cost of one or more phases of the total project.

Projects must include financial statements or written confirmation as to how the balance of the funding will be secured (for example, a fund-raising plan outlining revenue sources, confirmed or anticipated donations, etc.).

Proposed Project Budget and Workplan Upload(Required)

Drop files here or

Max. file size: 512 MB.

Other Relevant Project Information

Many submissions to the Community Beautification Fund may be for permanent structures such as signs, benches, flower boxes, etc. and will require additional information for review and approval. Please keep in mind that Haldimand County may have specific standards regarding the purchase and installation of certain assets (e.g. benches, waste receptacles). Please contact County Staff to discuss any permanent amenities you would like to install on County property.

Applicants must include the following additional documentation with their Application Form:

REQUIRED Supporting Documentation:

Specifications (e.g. dimensions, building materials), drawings or photos of proposed structures;
Written Quotations for any purchased project supplies, materials and services (minimum two (2) quotes). Please provide specifications to contractors to ensure consistency between quotes;
Site Map of proposed location for structures, flower beds, etc.;
Work Plan outlining the proposed timeline and activities to complete the project;
Hold Harmless Agreement (signed);
Valid Certificate of Insurance (minimum $2 million liability insurance with Haldimand County named as additional insured);
Confirmation of WSIB participation by any contractors hired to complete work on the project;
Financial Statements and/or Fund-Raising Plan to prove readiness of project funding;
‘Before’ Photos of the project location.

Other Relevant Project Information upload

Specifications, drawings or photos of proposed structures; Written Quotations for any purchased project supplies, materials and services (minimum two (2) quotes). Please provide specifications to contractors to ensure consistency between quotes; Site Map of proposed location for structures, flower beds, etc.; Work Plan outlining the proposed timeline and activities to complete the project; Hold Harmless Agreement (signed); Valid Certificate of Insurance (minimum $2 million liability insurance with Haldimand County named as additional insured); Confirmation of WSIB participation by any contractors hired to complete work on the project; Financial Statements and/or Fund-Raising Plan to prove readiness of project funding; ‘Before’ Photos of the project location.

Drop files here or

Max. file size: 512 MB.

3.0 Maintenance and Sustainability

Demonstrate financial ability to maintain and sustain the proposed project:

The lead applicant (and its partners) must clearly demonstrate financial ability to maintain and sustain the proposed project prior to final approval of County funding. Please describe how the proposed project will be maintained and sustained following implementation.

4.0 Regulatory Requirements

All proposed projects are subject to County, provincial and federal by-laws, policies and regulations. By signing this Application Form the lead applicant (and its partners) acknowledges and accepts that not all proposed projects may be eligible.

Note: Applicants are strongly encouraged to discuss their plans with County Staff in advance of the submission deadline (and prior to submitting their application) to ensure the eligibility of the proposed project as well as to allow sufficient time for review by any relevant departments and/or agencies. This will assist in streamlining the review process and is especially important for projects involving signage or permanent structures.

Please note: All proposed projects must meet the facility and operating standards of Haldimand County.

In situations where groups are unable to complete the work approved through the Community Beautification Program, those groups will be required to return to Haldimand County any funding which has been received by them for that project. As well, if projects are completed and reconciled for less than the budgeted amount, groups will be required to return any unspent portion of the Haldimand County funding.

5.0 Previous Applicant

If you are a previous recipient of Community Beautification funding, please ensure you have submitted a Final Report and financial reconciliation for previous project(s) including copies of invoices, bills, etc. which are associated to the project(s). Failure to do so may result in new requests for funding being declined.

Community groups interested in submitting an application for Community Beautification funding are encouraged to contact County Staff. We are happy to answer any questions you may have regarding the Community Beautification Program or the Community Partnership Program (e.g. eligibility, review process, approvals, etc.).

6.0 Authorization

This section must be completed, signed and dated by two (2) authorized representatives of the Organization.

Name of Organization

Project Coordinator Signature(Required)

Date

Alternate Project Coordinator Signature(Required)

Date

Name

This field is for validation purposes and should be left unchanged.

Community Beautification Application