Cornwall Marine Capital Fund (CMCF) Application Please refer to the CMCF Application Guidance Notes for assistance and tick this box to confirm that you have read and understood the contents The information that you provided in the online survey has been transcribed across to this application form. Please review this carefully and complete the form as fully as possible: the information provided by you here will be used to assess your investment application. You will be asked to give evidence and justify any assertions made in the application. For Office Use Only Date full application submitted: Reference: Pre-appraisal check: Date passed to PFS: CMCF 1. Project Name 2. Applicant organisation Organisation name (include trading name if different to registered company name) Registered business address Business website Type of organisation Select from list If other please specify: Company number (if applicable) Charity number (if applicable) VAT registration number (if applicable) Name of contact for this investment Contact telephone number Contact email address Alternative contact & contact number Tel: CMCF Application v.10 August 14 Page 1
Correspondence address (if different from above) How long has your business been established? In what month does your business financial year end? Select from list Select from list Year End 2013 (last year) Year End 2014 (actual/predicted this year) Year End 2015 (forecast next year) Financial trends Turnover Gross profit Net profit before tax Total assets less total liabilities Current full time equivalent employee headcount Describe your main business activities and provide an outline of your products and services What percentage of your turnover is based in the following areas? (Totalling 100%) Cornwall % Regional % National % International % Does your organisation hold the following current policies? Equal Opportunities/Equality & Diversity Procurement Policy 3. Investment Proposal What are you seeking investment towards? (select all that apply) Capital build of new premises Capital investment to bring back existing buildings into use Capital investment to modernise buildings and facilities, including access Capital investment to fit out new or existing buildings Modernisation of equipment Marine Renewables technology development Clearly and concisely describe your project and explain what CMCF funding will be used for. How does this project fit within your overall strategic business plan for the next 3 years? Please provide a copy of your business plan. 4. Need Clearly set out what market you are aiming for that this CMCF investment will help you access, and what market research and analysis you have undertaken to understand the level of demand that the project will enable you to meet, or the market opportunity that the project will enable you to take. Who are your main competitors and how will this project and CMCF investment set your business apart from them? CMCF Application v.10 August 14 Page 2
Which of the following would the CMCF investment enable that would not be possible without it? (select all that apply). The size of the project to be substantially increased The scope of the project to be substantially increased The total amount spent on the project to be substantially increased A substantial increase in the speed of completion of the project The project would not be carried out as planned in the location concerned without CMCF investment The receipt of the CMCF investment would affect none of the above Provide further detail on each of the criteria selected above. (Large Enterprises only) Please tick to confirm that you have submitted with the application an internal analysis of the viability of the project with and without CMCF investment, refer to Guidance Notes for detailed requirements. (All applicants) What would happen if you were unsuccessful in your application? 5. Project Delivery Please insert key milestones in the delivery of the project together with projected dates. These should be sufficient in number to enable the progress of the project to be monitored. Milestones Date achieved by Project start (cannot be before CMCF approval) (When do you plan to start the project?) Financial completion Monitoring Year 1 Monitoring Year 2 Project closure 6. Job Outcomes You stated how many jobs your project would create/safeguard in the online survey. Please provide more detail on the type of jobs below (continue on additional sheet if necessary). CMCF Application v.10 August 14 Page 3
Job title Qualification Level (see guidance notes) Salary FTE Permanent (expected to last at least 1 year), or Safeguarded? (at risk of being lost within 1 year) Date achieved by How long do you expect the job to last? Will any of your direct jobs created: Be created in the absence of this project? Yes No Be moved from elsewhere in the UK? Yes No If you have ticked Yes in either of the boxes above please explain below: CMCF Application v.10 August 14 Page 4
7. Costs and Funding Double click in the table below to enter information: some figures will calculate automatically. Click outside of the table to return to the rest of the form. If approved you will be required to cashflow the project and claim the CMCF investment at intervals to be agreed with Cornwall Marine Network on the basis of your cashflow requirements. Please confirm that your organisation is able and prepared to do this by ticking this box Capital build projects may include non-eligible costs, for example those incurred before the project has been approved. To confirm that you are able to deliver the whole project, please ensure that your cashflow includes any preliminary and/or non-eligible costs as appropriate. Project Costs Please provide itemised project costs here: these should be based on the optimum quote provided following your procurement process. See the application guidance notes for further information. Cost Item Cost Total Project Costs 0 Funding Please confirm the amount of funding requested from CMCF: CMCF Funding Requested CMCF Intervention Rate 0% Available CMCF 10%-40% (CMCF not to exceed 40% small companies; 35% medium companies; 25% large companies in Cornwall, please refer to guidance notes for thresholds in other areas) Please set out the sources of private sector funding that are going to be used to pay for the balance of the project costs: Match Funding Source Total Funding inc CMCF 0 Is this funding secured? Yes/No Yes/No Yes/No If 'no', when will it be in place? CMCF Application v.10 August 14 Page 5
8. Statutory Consents Do you have detailed planning permission in place? Yes (please provide copies) No Not applicable Do you have all relevant building regulations in place? Yes (please provide copies) No Not applicable Do you have all other statutory consents in place, for example listed building consent? Yes (please provide copies) No Not applicable If the answer is no to either of these questions, what timetable is in place to secure the permissions? 9. Risks What are the main risks to your project and how do you propose to mitigate them? Capital build projects - please also provide a copy of your construction risk register. Risk Likelihood (H/M/L) Severity (H/M/L) Mitigation how can the risk be minimised? Cost overruns Time overruns Where will the project records be kept? (NB - Project records must be maintained even after the project has finished until 31 st March 2027) 10. State Funds The assistance for the Regional Growth Fund supported Cornwall Marine Capital Fund constitutes State Aid and must be made in accordance with certain provisions of the European Commission Regulation (EC) No. (2013/C 209/01) of 1 July 2014 declaring certain categories of aid compatible with the common market in application of Article 107(3)(a) of the Treaty (General Block Exemption Regulation). Specify financial year Year 1 Year 2 Year 3 2012/13 2013/2014 2014/2015 Total Value of aid received Please provide the detail of any State Aid received. This could include any grants or advice/business support received during this period, if you are in any doubt whether these counts as State Aid please declare it and it will be checked. Have you received professional State Aid advice in relation to this application? Yes No CMCF Application v.10 August 14 Page 6
Can you confirm that your project and organisation is permitted to receive State Aid in the form of Regional Growth Fund? 11. Enclosures Please ensure you include copies of the following documents with your application: An application processing fee of 100, cheques should be made payable to Cornwall Marine Network Ltd A Business Plan explaining the direction of the business over the next 2-3 years Large companies only included in the business plan, a detailed analysis of the viability of the project with and without CMCF investment A 2 year cash-flow and P&L forecast capturing project delivery; business activity and projected job creation Last set of accounts (audited if available) Evidence of match funding from external source (if available) CMCF Procurement record detailing quotes/tenders sought and selected Actual quotes/tenders obtained in line with CMCF procurement requirements and/or your procurement policy Assurances regarding second hand purchases (if applicable - see guidance notes) Permissions including planning & building regulations (if applicable) Capital build projects only evidence of land ownership or permission to make changes to building Capital build projects only a construction risk register State Aid advice (if available) Procurement policy (if available) Equal Opportunities policy (if available) Authorisation for external intermediary to liaise on behalf of applicant (if applicable) 12. Sign off Data Protection: Yes No All information provided in connection with an application to the Cornwall Marine Capital Fund will be used for assessing and if appropriate monitoring your project and evaluating the scheme. It will be held and used by Cornwall Marine Network/Cornwall Development Company (as project delivery partner) and stored on their internal computer and/or filing systems; such information will be collected and processed and held securely in accordance with the principles of the Data Protection Act (1998). Signposting: Where business or skills development is required you may also be signposted to other providers for potential additional support. If you don t wish your details to be shared with appropriate other bodies that may help support your business please tick this box Applicant declaration: Completion and submission of this Application certifies that the applicant organisation is a Small, Medium or Large sized Enterprise, please declare as appropriate below. Please note the maximum aid ceilings which apply to small, medium and large companies in section 8. Small - having a headcount of less than 50 employees; a turnover in the last full financial year of 10m or less and a balance sheet in the last full financial year of 10m or less; and holds less than a 25% interest (capital or voting rights) in another organisation and/or another organisation holds less than a 25% interest in the applicant organisation. CMCF Application v.10 August 14 Page 7
Medium - having a headcount of less than 250 employees; a turnover in the last full financial year of 50m or less and a balance sheet in the last full financial year of 43m or less; and holds less than a 25% interest (capital or voting rights) in another organisation and/or another organisation holds less than a 25% interest in the applicant organisation. Large having a headcount of more than 250 employees; turnover in the last full financial year greater than 50m; or a balance sheet in the last full financial year greater than 43m. I/we certify that the information provided in this Application (inclusive of Eligibility Survey) is correct. I/we understand that neither Cornwall Marine Network, Cornwall Development Company, the Investment Panel nor any of its representatives or partners is liable for any expense incurred by me/us in the making of this Application. I/we understand that the investment is discretionary and that the acceptance of this Application is not a guarantee that investment will be awarded. Signed: Position: Date: Please send the completed application form with all enclosures by post to: Cornwall Marine Capital Fund Cornwall Marine Network Maritime Business Centre, Units 7 A & B Falmouth Business Park Bickland Water Road Falmouth Cornwall TR11 4SZ Please also send a Word version by email to: marinecapitalfund@marinecornwall.net Tel: 01326 211382 Mob: 07402 414404 Fax: 01326 318250 If you require this form in any other format please contact Cornwall Marine Network on 01326 211382 CMCF Application v.10 August 14 Page 8