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City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. Please answer the appropriate questions below. Everyone must fill out section A. If you are a grower and want funding for a farm/garden (and are not seeking funds to buy land), fill out Section B. If you are a grower and want funding for a farm/garden where you are seeking funds to buy land fill out Section C. If you are an Aggregating Distributor (Food Hub), fill out Section D. Everyone must also provide a line item budget and a brief narrative. Email your completed application to [email protected] If you need assistance beforehand, please feel free to contact Robin at 352-5340 or via email. Please make sure to review the accompanying Program Criteria and Funding Guidelines before filling out this application and submitting your request. SECTION A (Everyone must complete) Date _____________________ Organization Name ____________________________________________________ Address ___________________________________________________ Status (check one): Nonprofit _______ For Profit Corp _______ Other ________ Primary Contact Person/Title ___________________________________________________ Contact Info: Phone (Day) ___________________________ Cell _____________________________ Email _____________________________________________________ By submitting this application I am agreeing that all funds will be used as proposed, unless there is prior approval for a change from OES. I also am agreeing to the Program Criteria and the Funding Guidelines, and that the organization meets the criteria of eligibility. If funds are provided, all invoices will be submitted to OES no later than 5/31/2017. A brief report will also be submitted, outlining the impact of the funds, no later than 5/31/2017. ________________________________________ (signature) _________________________________________ Name/ Title Application Check List: Review Criteria and Funding Guidelines ____ Section A Cover Sheet completed ____ Section B, C or D completed ____ Budget Sheet and Back up Information ____ Narrative ____ Submit application to [email protected] by Monday, March 20th by 5:00 p.m. 1 City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. SECTION B for AGRICULTURAL GROWING/PRODUCTION SITE FUNDING ONLY (No Land Acquisition being sought): Site Neighborhood: ______________________________________________ Location/Address: ___________________________________________ Is this a new or an established garden/farm project? If established, please indicate when you became involved. New Project _______ Established Project __________________ Have you conducted soil testing for lead? Yes _____ No _____ If yes, did results reveal concerns and if so, what steps did you take to remedy any issues? Yes____ Remedy:________________________________________ No_____ If no to sampling, do you plan to test the soil? Yes___ No____ If yes, when? Date__________ Have you received funds from the City’s Urban Agriculture Program Previously? Yes _______ No _______ Amount Requested in this application: $_____________ Using the attached budget sheet, and following the eligible funding expenses, please provide, in order of priority, a line item budget and a description of your garden/farm project funding request (list of materials and respective costs required for your project). Also please include records (copies of cost estimates, quotes, invoices, etc.) to document your request. Using a separate sheet, please include a narrative, not to exceed one page, explaining the problem or opportunity you are addressing, how this funding will make a difference in resolving the problem or seizing the opportunity and the potential impact your project will have on the local food system. Also, please provide information on how the City funding relates to your overall budget. Feel free to include information regarding in-kind contributions, volunteer participation, material donations or partner organizations if applicable. 2 City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. SECTION C for AGRICULTURAL GROWING/PRODUCTION SITE FUNDING ONLY (Where Land Acquisition is being sought): Site: Neighborhood: ______________________________________________ Location/Address: ___________________________________________ To qualify for acquisition funds, the site must currently be a vacant or blighted lot and not in agricultural use. New Project _______ Have you conducted soil testing for lead? Yes _____ No _____ If yes, did results reveal concerns and if so, what steps did you take to remedy any issues? ________________________________________ If no, do you plan to test the soil? Yes___ No____ If yes, when? Date__________ Have you received funds from the City’s Urban Agriculture Program Previously? Yes _______ No _______ Amount Requested in this application: $_____________ Using the attached budget sheet, and following the eligible funding expenses, please provide, in order of priority, a line item budget and a description of your garden/farm project funding request (list of materials and respective costs required for your project). Also please include records (copies of cost estimates, quotes, etc.) to document your request. Using a separate sheet, please include a narrative, not to exceed one page, explaining the problem or opportunity you are addressing, how this funding will make a difference in resolving the problem or seizing the opportunity and the potential impact your project will have on the local food system. Also please provide information on how the City funding relates to your overall budget. Feel free to include information regarding in-kind contributions, volunteer participation, material donations or partner organizations if applicable 3 City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. SECTION D for AGRICULTURAL AGGREGATED DISTRIBUTION (FOOD HUB) SITE FUNDING ONLY: How many farmers participate in your distribution? ________ How many of those farms/gardens are within the City of Cincinnati? _________ How many food artisans working within Cincinnati receive food from your hub, or distribute their products through your hub? _________ How many distribution sites do you currently have in the City of Cincinnati? ______ How many wholesale accounts in the City of Cincinnati receive food from your hub? _______ Amount Requested in this application: $_________ Using the attached budget sheet, and following the eligible expenses guidelines, please provide, in order of priority, a line item budget and a description of your funding request (list of materials and respective costs required for your project). Also please include information (copies of cost estimates, quotes, invoices, etc.) to document your request. Using a separate sheet, please include a narrative, not to exceed one page, explaining the problem or opportunity you are addressing, how this funding will make a difference in resolving the problem or seizing the opportunity and the potential impact you will have on the local food system. Also please provide information on how the City funding relates to your overall budget. 4 City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. BUDGET SHEET URBAN AGRICULTURE FUNDING REQUEST Eligible Funding Expenses for AGRICULTURAL PRODUCTION/GROWING (Garden or Farm) sites: Site Improvement (e.g., soil testing, soil, compost, cover crops, etc.) Growing needs (e.g., plants, seeds, tools, hoses, beds etc.) Infrastructure (e.g., water access, fencing, season extenders, etc.) Lot acquisition (expansion, purchase of vacant lot)* *Land acquisition requests must be pre-approved to be eligible for funding Eligible Funding Expenses for AGRICULTURAL AGGREGATED DISTRIBUTION (Food Hub) sites: Infrastructure/Equipment (e.g., racking/shelving, pallet jack, plastic pallets, reusable crates, packing material, fork lift, large dollies, etc) Supplies (e.g., storage containers, liners, carts, tables, scales, bags, etc.) Marketing Materials (e.g., postcard mailers, local food stickers and magnets, truck decals, signage, social/print/radio ads, etc.) Specifically identify the expenses below and please attach copies of cost estimates or quotes (or receipts) to the budget sheet. ITEM Description of Use Cost TOTAL REQUEST* *Sales tax reimbursement is not eligible for funding 5 City of Cincinnati Urban Agriculture Program Funding Application 2017 Due by Monday, March 20th by 5:00 p.m. 6