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(SAMPLE ONLY) Building Partnerships Guidelines & Application Form Note: Interested applicants must submit a preliminary assessment form before being invited to apply for this funding. The Building Partnerships program provides up to 35% of project costs (to a maximum of $100,000), to consortia/partners to develop innovative, new-to-market solutions. The solution must use an enabling technology to address a compelling industry need or market gap. ‘Enabling Technologies’ are new technologies or new uses for existing technologies that enable new products, services, or more efficient processes (e.g. mobile, cloud, analytics, sensors, advanced materials). The purpose of the program is to foster collaboration between industry partners toward delivering a compelling, new-to-market offering. This consortia model of Lead Company, Pilot Organisation, and Partner is specifically designed to build relationships that create a solution with a strong opportunity for commercial success. Applicant requirements 1) Technology development small-to-medium enterprises that are ABN registered and based in NSW. 2) Holder of the rights to commercialise, or Intellectual Property rights, for the solution being developed. 3) Is one of the following: a) Resident of a co-working space, incubator or accelerator, which is shared by several individuals with different businesses and provides: mentoring, office space, equipment, networking opportunities, and connections to or direct support from investors. The residence should have the capacity to foster and develop innovative, globally focussed businesses or high potential start-ups. OR b) An established business able to provide the company’s most recent annual financial statements (cash flow, profit/loss, and balance sheet). Project requirements 1) Project must include three members: Each submission must be backed by at least three members – a Lead Company, Pilot Organisation, and Partner Organisation. Submissions by single companies or individuals will not be considered. Only one Lead Company is allowed, however there can be multiple Pilot and Partner Organisations. Lead Company (applicant): NSW-registered technology SME with the ability to commercialise and export the solution being developed. Research and academic organisations are not eligible to be the Lead, but can be Partners. This Lead is the ‘applicant’ and 1) holds the IP or the rights to commercialise the solution, 2) if awarded the grant, is contractually obligated to achieve the project deliverables. Pilot Organisation(s): Pilot Organisations do not have to be based in NSW or Australia. They agree to test the solution and provide valuable feedback during the development process. This is a business customer (end-user which is a business) or channel to market (distributor) that will potentially purchase or on-sell the solution. Partner(s): Partners do not have to be based in NSW or Australia and may be SMEs, multinationals, large Australian enterprises, research organisations, public or non-profit organisations. They provide additional technology or research capabilities (e.g. hardware, technology service, network access, payment fulfilment, database/content, research, etc). 2) Scalable Solutions: The solution must be developed for deployment to multiple customers, rather than for improvement of the applicant’s own business processes. Building Partnerships - August 2016 Page 1 of 8 3) Developed in NSW: at least 80% of project costs must occur in NSW. 4) Project has not commenced: Preliminary design specifications or a prototype can be created prior to applying. Any funding awarded will be for the costs associated with the project development identified in the application; after the date the Business Partnership Grant application is submitted (no retrospective funding will be awarded). 5) Development period: The project must be completed and delivered within twelve (12) months of accepting the grant offer. 6) Supported and non-supported project costs: Only activities directly associated with development and market validation of the solution will be supported. 7) Additional government funding: Projects are eligible that have received previous funding, however funding will not be provided for project components already awarded through another government grant, subsidy, or fund. Evaluation Criteria Economic Benefits to NSW: The potential economic benefits to the State such as jobs created, new investment attracted, export potential, and benefits to regional NSW. Innovative Use of Enabling Technologies: The innovative use of enabling technologies to address a compelling industry sector need. Enabling technologies are new technologies or new uses for existing technologies that enable new products, services, or more efficient processes (e.g. mobile, cloud, analytics, sensors, advanced materials). Strength of the Business Model: This is the financial health, past performance, and ability to develop, commercialise, and export the solution. The business model for the solution is also considered in terms of sustainability, potential for high growth, and capacity to scale the solution across the sector. Industry Sector Benefits: The tangible benefits to a key industry sector, such as reduced costs, faster processing, or a market gap across the sector. Assessment Process Applications are accepted at any time of year, and we endeavour to complete assessments within 6 weeks of submission. Proposals are reviewed according to the Applicant & Project Requirements, and Evaluation Criteria above. Advisors complete an initial assessment and short-list submissions for presentation to an evaluation panel consisting of the Jobs for NSW personnel. This is a competitive process – proposals that meet the Requirements and Criteria will not necessarily be short-listed. Successful Submissions Successful applicants will be notified by Jobs for NSW. The terms and conditions, grant amount, and project deliverables will be discussed with the Lead Company (applicant) prior to issuing an official grant offer. The number of projects to be awarded will be determined by industry response, the program’s annual budget, and the strength of the submissions. How is the money awarded? Grants awarded will be up to 35% of the total project costs to a maximum of $100,000. The grant is separated into three payments after the following: 1) completion of design specifications, 2) completion of development, 3) completion of the pilot/validation with the business customer or channel to market. The Lead Company submits all progress reports and deliverables for each stage. Once each claim is approved, a disbursement is made to the Lead who is responsible for distributing any portions to the Partners (as appropriate). Unsuccessful Submissions Applicants that are not selected by the Evaluation Panel will be contacted and provided with feedback. Unsuccessful submissions will not be allowed to resubmit unless they are invited by the Panel to do so and the project is substantially changed from the original submission. Building Partnerships - August 2016 Page 2 of 8 Business Partnership Grants Application Form Jobs for NSW Advisor (Enter the name of the Advisor that reviewed your ‘Preliminary Assessment Form) Consortia Lead Company Contact name Position Year Commenced ABN Street address State Telephone Email Click here Click here Click here Click Here Click Here Click Here NSW Click Here Click Here Name of coworking space, incubator or accelerator residence (if applicable) Address of coworking space, incubator or accelerator residence Click Here Sector the solution is targeting Click Here Pilot Organisation(s) Click Here – this is the Business customer (business that will be trialing/testing the solution) OR channel to market (distributor that will be validating and on-selling the solution) Click Here – this is the Company/Organisation(s) that will be providing additional technologies or capabilities to the project Partner(s) No of Staff Annual revenue City Postcode Mobile Website Click Here Click Here Click Here Click Here Click Here Click Here Click Here Checklist & Attachments ☐ All questions on the form have been answered. ☐ The declaration has been signed by the project Lead, Pilot Organisation(s), and Partner(s). ☐ Detailed Budget Worksheet, in the formatted template provided. ☐ Evidence of your company’s residence in a co-working space, incubator or accelerator (email from the residence manager confirming this) OR your company’s most recently reported financial statements (cash flow, profit/loss, and balance sheet). ☐ Evidence of capital secured for the project (e.g. company financial statements, bank statement, letter of support from an investor). ☐ (Optional) – Any additional information you’d like to send to support your proposal. 1. Title of the solution Click here 2. Purpose of the solution - What compelling need does it address? Click here Building Partnerships - August 2016 Page 3 of 8 3. Solution description - Briefly list the main features that will be developed. Provide an example/scenario of how it will be used. Click here 4. Industry Sector Benefits - How will this solution drive jobs, innovation, and growth in the customer sector? Click here 5. Innovative Use of Enabling Technologies - What enabling technologies are you using, and how are you using them in an innovative way – beyond current market offerings (e.g. mobile, cloud, analytics, sensors advanced materials)? Click here 6. Robustness of Consortia and Business Model - Discuss how each member of the consortia will contribute to the solution 1) development, 2) commercialisation, 3) export. Click here 7. Sustainable Business Model - Describe the plans for a sustainable business model, including the potential cost and/or revenue sharing between the consortia partners, the marketing plans, and go-to-market strategy. Click here 8. Project Financing - The funds provided through this program are an incentive grant (not seed funding), and are disbursed following completed milestones (see Question 9). Explain how the project will be financed by the consortia members. Also state if there is any other government funding previously received or pending for this project. Click here 9. Project deliverables and key dates Provide the Key Performance Indicators (how success will be measured) for each stage of development. State the expected delivery dates, and provide at least 2(two) deliverables for each milestone.(e.g. Android/iPhone application specifications, database model specifications, initial testing/piloting report, evidence of X number of users of the solution, etc.) Proposed start date: Click Here Anticipated finish date: Click Here Project Milestone Delivery Item (Key Performance Indicator) Date of delivery Completion of specifications (e.g. project requirements, specification documents, etc) Insert list of deliverables Insert Date Building Partnerships - August 2016 Page 4 of 8 Completion of development (e.g. UAT results, revised specification documents, reporting interface completed, Beta testing completed, etc) Insert list of deliverables Insert Date Completion of pilot (e.g. evidence of X number of transactions during pilot, evidence of prototype testing, etc) Insert list of deliverables. For this stage include something that is quantifiable and will demonstrate the solution is working. Insert Date 10. In-Kind Contributions by Pilot Organisation(s) and Partner Organisation(s) - These are contributions to the project made as an exchange of services/goods/time. (e.g. “Handset manufacturer XXX will provide 3 handsets and development resources in exchange for equity in project” or “Pilot Organisation will devote 20% of their time during the project pilot”). You do not need to quantify the cost of these contributions -- they should not be included on your Detailed Budget, and are not reimbursable if a grant is awarded. Click here 11. Core Project Team’s Skills and Capabilities List the core project team members in the consortia below. Organisation Relevant Experience and Skills Click here Name Click here Role Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here Click here 12. Pilot Organisation(s) and Partner(s) These are the organisations/businesses that have agreed to collaborate on the project. A minimum of 1(one) Pilot Organisation, and 1(one) Partner must be committed to the project. Refer to the Guidelines above for requirements. Pilot Organisation Organisation Name: Contact Person: Position Title: Telephone: Email: Website: Core project skills: Building Partnerships - August 2016 Click here Click here Click here Click here Click here Click here Click here Page 5 of 8 Pilot organisation’s contribution: Project benefit to Organisation: Click here Click here Partner Organisation Organisation Name: Contact Person: Position Title: Telephone: Email: Website: Core project skills: Partner contribution to project: Project benefit to Partner: Click here Click here Click here Click here Click here Click here Click here Click here Click here Organisation Name: Contact Person: Position Title: Telephone: Email: Website: Core project skills: Partner contribution to project: Project benefit to Partner: Click here Click here Click here Click here Click here Click here Click here Click here Click here Partner Organisation 13. Business forecast attributable to the project Forecast the financial and operational figures contributed directly by this project. Use the “most-likely” scenario for your forecasting. Consortia Lead Jobs in NSW Total Revenue ($) Export (%) Consortia Partner Insert Name Here Jobs in NSW Total Revenue ($) Export (%) Consortia Partner Insert Name Here Jobs in NSW Total Revenue ($) Export (%) Consortia Partner Insert Name Here Jobs in NSW Total Revenue ($) Year 1 Click here Click here Click here Year 1 Click here Click here Click here Year 1 Click here Click here Click here Year 1 Click here Click here Building Partnerships - August 2016 Year 2 Click here Click here Click here Year 2 Click here Click here Click here Year 2 Click here Click here Click here Year 2 Click here Click here Year 3 Click here Click here Click here Year 3 Click here Click here Click here Year 3 Click here Click here Click here Year 3 Click here Click here Page 6 of 8 Export (%) Click here Click here Click here Terms and Conditions 1. Approval of funding is at the sole discretion of the Crown in the Right of the State of New South Wales acting through the Department of Industry, Skills and Regional Development trading as Jobs for NSW (ABN 72 189 919 072). Submitting an application does not guarantee funding. You will bear the costs for preparing and submitting an application. Jobs for NSW can withdraw program funding for any reason and in any circumstances. 2. Jobs for NSW will treat information received in applications as confidential. However, documents Jobs for NSW holds are subject to the Government Information (Public Access) Act 2009 (“GIPA Act”). This means that the information contained in application forms and other information you provide may be released in response to a request lodged under the GIPA Act. 3. Jobs for NSW reserves the right to determine eligibility for financial assistance based on all information provided to support the application. 4. If your application is successful, the information provided in and supporting this application will form part of an agreement with Jobs for NSW in respect of any assistance provided. 5. It is a condition of any assistance that you must reach an agreement with Jobs for NSW on any public announcement of the project in NSW and the State Government’s role in any official launch of the project. 6. Jobs for NSW reserves the right for the project the assistance is provided to support to be the subject of publicity and/or used for case studies. 7. The information we collect about you may be used to send you communications such as newsletters, flyers, and information about business-related activities. Please refer to website http://www.industry.nsw.gov.au/privacy for more information on Jobs for NSW’s privacy policy and your rights to access or correct the information. 8. Jobs for NSW is collecting this information from you for the purposes of assessing your eligibility for a loan. This information may be disclosed to staff administering the program and any third party advisors or service providers in order to assess and administer this application. If you do not provide this information we will not be able to assess your application. This information will be held by Jobs for NSW. Information on how to contact Jobs for NSW regarding your information is available at http://www.industry.nsw.gov.au/privacy. DECLARATION – To be signed by a representative of each consortia member. Signing this form confirms involvement in development and piloting of the solution, for purposes of this grant application only. It does not form any legal agreement between the consortia members. I have read and understood the Terms and Conditions and Program Guidelines with respect to assistance under this program I am authorised to make this application on behalf of the prospective applicant I certify that the information given in this application is true and correct Building Partnerships - August 2016 Page 7 of 8 Lead (applicant) The signatory for the Lead must be a person who has the authority to sign on behalf of the organisation (e.g. CEO, General Manager or authorised member of the Board of Management). Signature Printed name Click here Date Click here Position title Click here Position title Click here Date Click here Partner Click here – insert Partner Organisation Name Printed name Click here Signature Pilot Organisation The signatory must be at the Director level or higher in the organisation that will be piloting the solution. Click here – insert Pilot Organisation Name Printed name Click here Signature Building Partnerships - August 2016 Position title Click here Date Click here Page 8 of 8