ARTS AND CULTURAL GRANTS PROGRAM 2017/2018 ROUND 3 APPLICATION FORM

ARTS AND CULTURAL GRANTS PROGRAM 2017/2018 ROUND 3 APPLICATION FORM CATEGORY 5: LIVE MUSIC ENTERPRISE (Up to $5,000) Applications close Friday 16 February 2018 (for projects commencing from April-June 2018). Applicants are encouraged to discuss their project with the grants officer before applying as they can provide helpful advice on how to complete the application form and any permits that may be required for the project. Name of Applicant Address Phone Email Contact Person Position Name of Project Grant Amount Sought ($5,000 maximum) ABN GST status Registered Not Registered OFFICE USE ONLY Date Application Received File Number City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 1 / 19

ELIGIBILITY CRITERIA Please note, your project must meet this criteria in order to proceed to the assessment stage. a) Will your project be held within the City of Adelaide boundary? Yes No b) Is your project taking place in one of Adelaide s Park Lands or Squares? Yes No If yes, please confirm you have submitted an Events in the City Booking Application. Applications are available from the City of Adelaide s website www.cityofadelaide.com.au/explore-the-city/city-information/city-spaces-and-venues-for-hire/ Yes, I have submitted an Events in the City Booking Application. c) Is your project taking place on private property? Yes No If yes, please confirm you have approval from the land / building owner. Yes, I have approval from the land / building owner and a copy has been provided in writing as part of my support material at section 3.5. d) Is your organisation not-for-profit? Yes No e) How is your organisation constituted? Incorporated Association Unincorporated group auspiced by an Incorporated Association A company registered with an Australian ABN or CAN or an organisation as defined by the Corporations Act 2001 Other - Please specify f) How is your organisation / auspicing organisation managed? Management Committee Board of Management Advisory Board Social Enterprise Commercial Organisation Other - Please specify City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 2 / 19

g) Do you / your organisation have any outstanding reporting or debts to the City of Adelaide? Yes No If yes please provide details. h) Working with children Does the project (at any stage) involve working with children and young people aged under 18 years? Yes No If yes, have you read, and do you comply with Arts South Australia's Protocols for Working with Children in Art? Protocols can be downloaded from: www.arts.sa.gov.au/protocols-for-working-with-children-in-art/ Yes No City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 3 / 19

ASSESSMENT CRITERIA 1 - Fully Developed Proposal (40% of assessment) 1.1 Please select the project type/s that best describes your project Performance Event/s Workshop/s Mentorship/s Multicultural Festival Community Event/s Other (please provide details)... Start Date End Date 1.2 Project Dates Please note that projects must take place between April and June 2018 1.3 Project Description Please describe your project, its aims and what it will deliver 1.4 Proposed location(s) of project e.g. where your project is taking place - street(s), venue name, name of Park Land 1.5 Is there a cost for the public to attend your project? Please note: projects that are free or provide a free component are viewed more favourably. Free (100%) Cost (100%) Combination (please complete percentages below) What percentage is free? ----------- % What percentage is full price? ------------% What percentage is concession or reduced price? ------------% City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 4 / 19

1.6 What is the total anticipated attendance at your project? Please explain how you have calculated your attendance figure. 1.7 Please provide a timeline for your project Please include dates and times of specific events 1.8 Please respond to the following question(s): a) How will your project increase opportunities for musicians to play in city venues and/or in the public realm contribute to the City as a welcoming and dynamic place for people to live, work and visit? AND b) How will your application support live music small to medium enterprises and/or early career entrepreneurs to start-up and trial new music ventures? City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 5 / 19

1.9 Please provide details of any consultation you have undertaken with businesses / stakeholders that may be affected by your project Evidence of this consultation can be provided as support material at section 3.5 1.10 Please provide details on the marketing you will undertake for your project e.g. social media campaign, printed promotional material distributed, paid advertising, press release distributed, acknowledgement at event 1.11 Please identify how you will acknowledge the City of Adelaide s support of your project City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 6 / 19

1.12 Preliminary Risk Assessment Please identify any risks / hazards associated with your project by completing the form below. Please see Attachment A for instructions on how to complete this form. Task or Activity Potential Hazards/Consequences Class of Risk Action Required to Control Risk/s City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 7 / 19

INCOME AND EXPENDITURE BUDGET 1.13 Please complete the Income and Expenditure Budget below, indicating in bold what the City of Adelaide s funds will be directly used for. Please include fees and charges for City of Adelaide services as the City of Adelaide will not provide in-kind support via the waiving of fees. See Attachment B: Contact and Costing Details for City of Adelaide Services for more information. INCOME $ EXPENDITURE $ GRANTS / DONATIONS WAGES / ASSOCIATED COSTS City of Adelaide grant Wages - please provide breakdown Grants - other Artist fees - please provide breakdown Grants - other Administration fees Grants - other Accounting / Audit fees OTHER INCOME Other Applicants $ HIRES Applicants in-kind support * Marquees Other $ Furniture Other in-kind support * Venue Exhibition fees Staging / sound equipment Stall holder fees Security Performance fees Other Sales i.e. art works / other MARKETING & PROMOTION Membership subscriptions Advertising - please provide breakdown Other Promotion - printed material Other Promotion - online / digital Postage Other INSURANCES Public Liability Insurance Other CITY OF ADELAIDE FEES Development Approvals Permits Park Land fees Venue hire Waste Road closure Other MISCELLANEOUS Catering Art materials - please provide breakdown Other materials - please provide breakdown Documentation Other Other in-kind support * TOTAL INCOME TOTAL EXPENDITURE Please note - a) Your total contribution in cash or in-kind must be equal to or greater than the amount being sought from the City of Adelaide. b) In-kind support (income) also requires a corresponding expenditure item (see sections marked *) c) Total income must equal total expenditure City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 8 / 19

Budget details Please provide a detailed breakdown of any relevant budget items here (e.g. if multiple artists are to be engaged please a breakdown of artist fees) 1.14 Who else is funding the project and what will their contribution be? Type of Support $ Value Status (Confirmed/Pending) City of Adelaide Grant Pending Applicant Financial In-kind Others ^ Financial In-kind Total Amount ^ Others refers to funding partners and other sources of financial and/or in-kind support. 1.15 Could your project proceed if only partial funding was received? Yes No Please provide details. 1.16 Has the City of Adelaide funded you / your organisation over the last two (2) years? Yes No If yes please provide details below: Date Funded Amount For What Purpose? 2016-2017 2015-2016 City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 9 / 19

ASSESSMENT CRITERIA 2 - Strategic Plan Alignment (35% of assessment) Please indicate which of the City of Adelaide s strategic actions your project addresses. (Select multiple boxes if relevant and please ensure that details are provided to support your response) Smart: A smart city with a globally connected and opportunity rich economy Showcase the City s unique heritage and character Bring together the creative, arts, business, university, education and entrepreneurial sectors Rejuvenate laneways and pedestrian connections Please provide details on how your project will address the Smart actions selected above Green: One of the world s first carbon neutral cities and an international leader in environmental change Promote sustainable transport options, such as public transport, cycling and walking Utilise low carbon or renewable energy sources Promote environmental issues Increase public and private greening with trees, gardens, green walls and roofs Reuse and recycle equipment, consumables and materials Reduce mains water use through utilising recycled and reused water Please provide details on how your project will address the Green actions selected above City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 10 / 19

Liveable: A beautiful, diverse city with an enviable lifestyle that is welcoming to people at all stages of life Develop and celebrate strong and resilient City communities that are welcoming and encourage people of all ages, cultures and means to participate in City life, including through volunteer opportunities Support vulnerable members of the community Enable people to use the City safely and seek to reduce crime Enhance the role of the Park Lands in increasing levels of physical activity and wellbeing through formal and informal sport and recreation opportunities Please provide details on how your project will address the Liveable actions selected above Creative: A multicultural city with a passion to create authentic and internationally renowned experiences Contribute to the development of Adelaide as the premier international arts market, especially within the Asian region Increase opportunities for live music and performers Increase the number and diversity of audiences and visitors at festivals and events Support businesses, community groups and individuals to grow their contribution to the creative, cultural and artistic life of the City Bring creativity and smart technology into the everyday experience of our City Partner with cultural institutions to increase visitations in the City and Park Lands Surprise, delight and attract people through dynamic and changing urban public spaces, heritage, art, laneways, streets, facilities and activities Promote and showcase multiculturalism and Aboriginal culture Please provide details on how your project will address the Creative actions selected above City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 11 / 19

ASSESSMENT CRITERIA 3 Cultural and Creative Value (25% of assessment) 3.1 What experience do you / your organisation have in delivering similar projects to the one proposed in this application? Detailed CV s / bios can be attached as support material at section 3.5. 3.2 Does your project involve collaborations with other creative and / or cultural practitioners? Yes No If yes please provide details, including information on any previous collaborations if relevant. 3.3 Does your project involve the creation of new artistic work or incorporate any new and / or innovative approaches? Yes No If yes please provide details. City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 12 / 19

3.4 If your project has been held in previous years, will you be undertaking anything new / different as part of this proposal? Yes No N/A (first time project has been held) If yes please explain how this proposal differs from any previous iterations. 3.5 Support Material Please provide up to 5 attachments to support your proposal. These may include: - CV s / bios for key project personnel (max. 2 pages) - images / portfolios of relevant creative practitioners work (max. 5 images) - concept rationale / research / designs (max. 2 pages) - site / installation plans - URL links to vimeo, youtube or other websites - letters of support (2 max.) - reviews (3 max.) - evidence of consultation with affected businesses / stakeholders - any other relevant documentation Please list below the support material attached to your application (5 documents maximum). a) b) c) d) e) City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 13 / 19

APPLICANT CERTIFICATION I certify to the best of my knowledge that the statements made in this application are true. I have read the City of Adelaide s 2017/2018 Arts and Cultural Grants Program Guidelines. I understand that, should this application be approved by the City of Adelaide, I would be required to accept the conditions of the grant in accordance with the City of Adelaide s accountability and reporting requirements. Name of Applicant / Delegated Officer Signature Today s date An Auspice Organisation receives the grant on behalf of the applicant and is legally responsible for ensuring the project is delivered. If this grant is to be auspiced, please complete the following details for the Auspicing Organisation: AUSPICING ORGANISATION Name of Auspicing Organisation Address Phone Email ABN GST status Registered Not Registered Name of Delegated Officer Role of Delegated Officer I certify that we are to be the auspicing organisation for this project Signature Today s date City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 14 / 19

CHECKLIST Please acknowledge the following checklist before submitting your application: I have read the City of Adelaide s Arts and Cultural Grants Program Guidelines I have discussed my project with the Arts and Cultural grants officer prior to commencing my application: Felicity Edwards / Phone: 8203 7435 / Email: F.Edwards@cityofadelaide.com.au Public Liability Insurance I am aware that should my application be successful, I will be required to provide a copy of my Public Liability Insurance Certificate of Currency (minimum $20million), or my auspicing organisations insurance, noting the City of Adelaide as an interested party Return to Work SA / Employee Insurance (if paid staff are employed) I am aware that should my application be successful, I will be required to provide a copy of my Return to Work SA certificate of registration or similar employee insurance policy I have answered all questions in the application and signed the Applicant Certification I have submitted two copies of my application by one of the following methods: By post to - Felicity Edwards, Senior Partnership & Projects Officer City of Adelaide, GPO Box 2252, Adelaide SA 5001 (Application must be postmarked on or before closing date) In person to - Felicity Edwards, Senior Partnership & Projects Officer c/o Customer Service Centre, City of Adelaide, 25 Pirie Street, Adelaide SA 5000 (Applications can be lodged in person until 5pm on the closing date) Please note that late, faxed or emailed applications will not be accepted I have kept an additional copy of my application for my future reference City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 15 / 19

ATTACHMENT A: HOW TO COMPLETE A PRELIMINARY RISK ASSESSMENT The primary objectives of the Preliminary Risk Assessment are to: identify hazards associated with undertaking the work determine the level of risk establish the appropriate risk control measures Each major or significant task or activity associated with the proposal shall be assessed in terms of the potential risk factors and the most likely outcome as a result of an incident. Risks shall be classified according to the following schedule: Class 1: potential to cause death or permanent injury to one or more people Class 2: potential to cause one or more injuries requiring medical treatment; and Class 3: potential to cause an injury treatable with first aid The aim of the Preliminary Risk Assessment shall be to eliminate Class 1 and 2 risks associated with the proposal. Applicants should detail risk control measures which address all identified Class 1 and 2 risks. When determining risk control measures, the hierarchy of controls summarised below must be considered: Eliminate the Hazard eg: offsite cutting of panel work Substitute the Hazard Engineering Controls eg: replace ladder with scissor lift, substitute solvent based paint with water based paint eg: reverse alarms/lights fitted to plant, exhaust ventilation to remove fumes Administrative Controls eg: job rotation, work instructions, safety inspections Personal Protective eg: hearing protective devices, respirators, equipment hard hats When safe work procedures or instructions are developed they must: outline a work sequence highlight the procedures required to control the identified Class 1 and Class 2 risks inform all people involved in the activity about safe work procedure The Preliminary Risk Assessment Form requires the applicant to: 1. Specify each Task/Activity associated with the proposal in the sequence in which it will be performed from the beginning to the end product/or its installation. 2. Name the Potential Hazards associated with each activity or task to be carried out. 3. Evaluate each Hazard as a level of risk, described as Risk Class 1, 2 or 3 defined above to prioritise the risk control measures. 4. Identify a Control Measure necessary to eliminate or minimise the hazards that may lead to accident, injury or occupational illness. City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 16 / 19

Hazard Identification and Control Table The following table provides examples of control measures for a range of generic hazards. These examples are provided as a guide only and important site specific factors must also be considered. Note also that this table of examples does not include all possible hazards. Hazard Possible Cause Control Measure Traffic Hazards Manual Handling Contact with Heat Contact with Electricity Exposure to Noise Contact with dangerous substances (chemicals) Struck Against Struck by Object Working in close proximity to roads Handling of heavy objects Hot materials Fire in the Workplace Exposure to sun Faulty electric leads and tools No earth leakage detectors Electric leads on ground Electrical leads in damp areas Electric leads tied to metal rails Contact with underground or overhead cables Not wearing appropriate noise protection Incorrect handling procedures Lack of information Not wearing appropriate personal protective equipment Incorrect storage Elevated exposure levels Protruding objects in access routes Not wearing appropriate personal protective equipment Objects falling from work platforms Debris from grinding operations Windblown particles Loads slung from cranes Installation of temporary traffic signals Use of Safety Signs Speed restriction signs displayed and enforced Use of witches hats or temporary barriers to cordon off sections or whole of road Use of lifting aids Imposed restrictions on certain activities Provide appropriate protective clothing and training Remove flammable materials or store correctly Provide adequate firefighting equipment Employee firefighting awareness Provide protective clothing and sunscreen Reduce exposure time Tools and leads inspected and tagged Residual current devices in all circuits and tested Electrical leads kept elevated and clear of work areas All electric leads kept dry All electric leads are kept insulated Location of services and overhead cables to be established Services to be isolated when working in proximity Establish safe clearance distances All personnel to wear appropriate personal protective equipment (hearing protectors) All personnel informed with regard to correct handling and product sheets as required Staff provided with appropriate personal protective equipment Hazardous substances stored and labelled correctly Provide mechanical ventilation Protruding objects are removed or marked Provide appropriate personal protective equipment and training All work platforms fitted with toe-boards Fence off areas below to prevent access Materials stacked securely All personnel wear appropriate personal protective equipment (hard hats) Secure loose objects to structure Loads not slung over personnel Loads slung correctly City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 17 / 19

Fall from Height Slips and Falls No handrails Working outside handrails Floor penetrations not covered Ladders not secured Unsafe area Access routes obstructed by materials Leads/hoses across access routes Slippery surfaces Safety footwear not appropriate Poor visibility All work platforms have secure handrails Persons wear full fall arrest type harness All floor penetrations covered or barricaded All ladders secured to prevent movement Ladders to extend at least 1m above landings Tag and fence to prevent access All access routes kept clear of materials and debris All leads kept clear of ground or covered All access surfaces kept dry and in good condition Personnel wear appropriate safety footwear Provide adequate lighting Using the Hazard Identification and Control Table, complete the Preliminary Risk Assessment Form provided and submit to the City of Adelaide as part of the application process. See example below: Specify Task/Activity Potential Hazards/Consequences Class of Risk Action Required to Control Risk/s Painting wall using a ladder or scaffolding Ladder slipping while in use Objects falling from a height causing injury to passersby 2 2 Secure ladder into position Secure objects on ladder/scaffolding Fence off areas below to prevent access Objects stacked securely Loads not slung over personnel Artist falling off ladder/scaffolding due to slippery surfaces 2 Surfaces to be kept dry Harnesses to be available on scaffolding Awareness of OHS behaviour on site Wearing appropriate footwear Poor visibility leading to fall 2 Ensure good lighting Using aerosol spray paint High intensity of fumes create potential OHS issues 2 Use mask and adequate ventilation Operate where and when environmental impact most minimal by working out of office hours in CBD City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 18 / 19

ATTACHMENT B: CONTACT AND COSTING DETAILS FOR CITY OF ADELAIDE SERVICES When organising your project you may need to apply for a service from the City of Adelaide. Below is a list of some services that may be applicable for your project. It is important that you fully cost your project including all the services listed below as the City of Adelaide will not provide additional support. Should your application be successful, the amount allocated will be the total of the City of Adelaide s contribution and no further request (cash or in-kind) will be considered. Hire of City Spaces City Library Development Approvals Required if you are planning to alter a building, erect a sign on a building (includes murals and paste-ups), any tree damaging activity, etc. City Works Required for any kind of installation, maintenance or construction work in the public realm. Park Lands / Squares bookings, site fees, power, signage, stalls, marquees, amusement rides, temporary structures, fireworks display, clean up Closure of a street or road City banners, Across street banners and Flags Objects on Footpath SERVICE MORE INFORMATION & FEES MINIMUM LEAD TIME All booking requests www.cityofadelaide.com.au/your- must be made at least 7 Hire of City Spaces community/community- development/community-centres/ intended date of days before the Community Centres booking www.cityofadelaide.com.au/yourcommunity/library-services/home-libraryservice2/book-a-city-library-space/ www.cityofadelaide.com.au/planningdevelopment/buildingrenovating/development-approvals/what-isdevelopment-approval www.cityofadelaide.com.au/citybusiness/business-responsibilities/permitslicences-for-business/city-works/ www.cityofadelaide.com.au/explore-thecity/city-information/city-spaces-and-venuesfor-hire/ For approximate costs and further details regarding road closures please call the Road Events Coordinator on (08) 8203 7332 or visit the following web page for more information: www.cityofadelaide.com.au/explore-thecity/visit-adelaide/city-spaces-and-venues-forhire/road-events/ www.cityofadelaide.com.au/citybusiness/business-support/flags-banners www.cityofadelaide.com.au/citybusiness/business-responsibilities/permitslicences-for-business/objects-on-footpath/ All booking requests must be made at least 5 days before the intended date of booking 6 weeks 2 weeks 14 days for minor events 3 months for medium events 6 months for major events 2 months 3 months Check for site availability up to 12 months in advance 2 weeks City of Adelaide - Arts and Cultural Grants Program 2017/2018 - Round 3 Category 5 Grant Application - Page 19 / 19