ARTS AND CULTURAL GRANTS PROGRAM CATEGORY TWO: PUBLIC ART GRANTS Round 2 (Up to $8,000) 2015 2016 APPLICATION FORM Please read the information on the next page before commencing the application process Applications close Friday 16 October 2015 (for projects commencing from January 2016). Name of Applicant (Organisation or Individual) Address Phone Email Contact Person Position Name of Project Proposal Amount of Funding Sought Project Start Date Project End Date ABN GST status Registered Not Registered OFFICE USE ONLY Date Application Received File Number Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 1 / 19
ARTS AND CULTURAL GRANTS PROGRAM CATEGORY TWO PUBLIC ART GRANTS: Funding will be provided for artists emerging and established to create temporary public artworks within the public realm. CHECKLIST Before submitting your application make sure you have: Read the Arts and Cultural Grants Guidelines in particular please note the Arts and Cultural Program priorities, the City of Adelaide Strategic Plan priorities, and the eligibility criteria (pages 4 6) Fulfilled any previous grant or sponsorship obligations with Adelaide City Council Made contact with the relevant grants officer to discuss your project prior to commencing an application: Danielle Walpole Public Art Administrator Phone: 8203 7281 Email: D.Walpole@adelaidecitycouncil.com Included a copy of your organisation's (or your auspicing organisation s) Certificate of Incorporation (excludes individuals in the Public Art category) Included a fully costed Income and Expenditure Budget (including all applicable permits and fees for your project) Included a completed Risk Assessment for your proposal Included written evidence of permission to use a site which is privately owned (if applicable) Included key artists CVs and/or links to their websites (if applicable) Completed all sections of the application form including details about your ABN and GST status Signed the application form Kept a copy of your application for future reference Submitted two copies of your application to: by post Danielle Walpole, Public Art Administrator Adelaide City Council GPO Box 2252, Adelaide SA 5001 (application must be postmarked on or before closing date) in person Danielle Walpole, Public Art Administrator c/o Customer Service Centre Adelaide City Council 25 Pirie Street, Adelaide SA 5000 (Applications can be lodged in person until 5.30pm on the closing date) 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) noting Adelaide City Council as an interested party and a copy of my organisation s Workcover confirmation of registration (if applicable) before my grant can be paid; Please note that late, faxed or emailed applications will not be accepted Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 2 / 19
PROPOSAL OVERVIEW (PLEASE SELECT THE PROJECT TYPE/S THAT BEST DESCRIBES YOUR PROPOSAL) Light / Film Projection Soundscape Sculptural Installation Mural / Street Art Other (please provide details)... Name of Project Short Description Please describe your project in one or two sentences Project Start Date Project End Date 1. Please describe your project and the concept behind your project. e.g. four ephemeral projected artworks on the pavement based on the history of the local area. It will include a 5m x 14m mural and a sculptural installation in a shopfront window. 2. What is the aim/s of your Public Art project? Please detail any identified need/s for the project to take place (if relevant) Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 3 / 19
3. Please provide a timeline for your project, including dates and times of specific events. 4. Where will the proposal take place? Your project must take place within the City of Adelaide boundary 5. How does the project relate to the site? e.g. it improves a degraded site or area Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 4 / 19
6. Will your project activate any underutilised spaces and/or Council priority areas? Please refer to the City of Adelaide Placemaking Strategy for information on place making pilot areas. 7. Will your project be held in one of the City s Park Lands or Squares? Yes have you completed a Park Lands Booking Form? Yes No No Note: If you are holding your project in one of the City s Park Lands or Squares you are required to make a booking with the Adelaide City Council Events Team prior to submitting this grant application. Submission of your grant application does not represent a booking for your event. Park Lands booking forms are available from the Adelaide City Council website: www.adelaidecitycouncil.com/explore the city/city information/city spaces and venues for hire/ 8. Please identify which of Council s Strategic Outcome/s your project aligns with. Outcome 1 City of Great Places How does this relate to your project? Outcome 2 Accessible City How does this relate to your project? Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 5 / 19
Outcome 3 Creative City How does this relate to your project? Outcome 4 Liveable City How does this relate to your project? Outcome 5 Prosperous City How does this relate to your project? Outcome 6 Environmentally Sustainable City How does this relate to your project? Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 6 / 19
9. Please identify which Arts and Cultural Program Priorities your project aligns with. The priorities of the Arts and Cultural Program are to support projects that: Co create vibrant city places full of exciting and popular cultural and artistic activities and events; Enable creative endeavours and talent to thrive; Enhance city living, build community identity and foster social cohesion by increasing access for the community to an artistic, cultural or multicultural experience; Effectively engage young people, Aboriginal and Torres Strait Islander people, new arrivals and people experiencing disadvantage; Promote accessibility; Demonstrate environmentally sustainable practices; Are free or provide a free component; Are original and of high artistic and conceptual standard; Reflect a diversity of artistic practice; Reflect the diversity and cultural richness of the City; Are innovative; Activate underutilised City streets, public spaces and key priority areas for Council to create places for creative and social activities; Develop partnerships with business and the non arts sector; Develop a vibrant street culture along main pedestrian routes and spaces where people gather. 10. Will you implement any environmentally sustainable practices in your project? Please provide details 11. How will the installed artwork change or impact on the use of the site? Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 7 / 19
12. What are your construction and installation requirements? 13. Please demonstrate how your project will benefit and/or involve the community (local business / community organisations / groups / general public) 14. How will your project engage with young people, Aboriginal and Torres Strait Islanders and/or people experiencing disadvantage? 15. Is your project free or ticketed? Free Ticketed Combination What percentage is free? % What percentage is ticketed? % Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 8 / 19
16. Please demonstrate how your project will increase access to an arts and culture experience and attract visitors to the City. 17. What is your marketing strategy / plan for your project? 18. Please identify how you will acknowledge Council support of your project Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 9 / 19
19. What demonstrated experience do you have in delivering public art projects? 20. Who will project manage / oversee your project? Incorporated Association Company limited by guarantee Auspiced by an Incorporated Association Aboriginal and Torres Strait Islander Corporation Individual applicant Other Please specify... 21. Certificate of Incorporation I have included a copy of the Certificate of Incorporation for my organisation I have included a copy of the Certificate of Incorporation for my auspicing organisation N/A I am an individual in the Public Art category 22. 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) noting Adelaide City Council as an interested party 23. Workcover I am aware that should my application be successful, I will be required to provide a copy of my organisation s Workcover confirmation of registration (if applicable) N/A I am an individual in the Public Art category 24. What are the estimated fees and charges imposed by the Adelaide City Council for your project? Please see Attachment A for further details on fees and charges. You must include these charges in your Income and Expenditure Budget and include them as part of your funding request as Council will not provide in kind support via the waiving of fees. Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 10 / 19
25. Preliminary Risk Assessment Please see Attachment B for further details. I have attached my completed Preliminary Risk Assessment for my project 26. Landowner/ Landlord Approval Please attach written permission to this application if your project is to take place on private property My project will take place on private property and I have attached written permission from the building / land owner My project will take place on Council land 27. Working with children Does the activity (at any stage) involve working with children and young people aged under 18 years? Y N If yes, have you read, and do you comply with Arts SA'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/ Y N 28. Please provide CV s and images of relevant artists work, concept images / designs for your project, evidence of consultation with affected businesses / stakeholders and any other applicable letters of support. Please list below the support material attached to your application (5 documents maximum). 1) 2) 3) 4) 5) 29. Please provide any other information you think is relevant to your proposal Please only add additional information if directly relevant (maximum of 2 pages) Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 11 / 19
INCOME AND EXPENDITURE BUDGET Please complete the Income and Expenditure Budget below, indicating in bold what Council funds will be directly used for. Please include fees and charges for Adelaide City Council services as Council will not provide in kind support via the waiving of fees. See Attachment A: Contact and Costing Details for Council Services for more information. INCOME $ EXPENDITURE $ GRANTS / DONATIONS WAGES / ASSOCIATED COSTS Adelaide City Council Wages please provide breakdown Grants other Artist fees please provide breakdown Grants other... Administration fees Grants other Accounting / Audit fees OTHER INCOME In kind support * Applicants $ Other Applicants in kind support * HIRES Other $ Marquees Other in kind support * Furniture Exhibition fees Venue Stall holder fees Staging / sound equipment Performance fees Security Sales (i.e. artworks / other) In kind support * Membership subscriptions Other Other MARKETING & PROMOTION Other Advertising please provide breakdown Promotion printed material Promotion online / digital Postage In kind support * Other INSURANCES Public Liability Insurance Other... Other... COUNCIL FEES Development Approvals Permits Park Land fees Waste Road closure Other... MISCELLANEOUS Catering Art materials please provide breakdown Other materials please provide breakdown Documentation In kind support * Other Other... TOTAL INCOME TOTAL EXPENDITURE Please note a) In kind support (income) also requires a corresponding expenditure item * b) Total income must equal total expenditure Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 12 / 19
Budget details Please provide a detailed breakdown of any relevant budget items here (e.g. wages, art materials) 30. Has Council funded you/ your organisation over the last two (2) years If yes, please provide details below: Date Funded Amount For What Purpose? 2014 2015 2013 2014 31. Who else is funding the project and what will their contribution be? Type of Support $ Value Status (Confirmed/Pending) Adelaide City Council Grant Pending Applicant Financial In kind Other Financial In kind Total Amount 32. Could your project proceed if only partial funding was received? Please explain. Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 13 / 19
GOODS AND SERVICES TAX (GST) The entity applying for a grant must supply an Australian Business Number (ABN) and state whether it is registered for GST (on page 1). Entities should be aware that the GST legislation deems you / your organisation as providing the supply for GST purposes. As such, any liability for GST arising as a result of any non compliance issue rests with you / your organisation and the Corporation has no obligation to contribute to that liability. Entity Registered For GST Registered Entity, prior to receiving a grant, must complete and return the Recipient Created Tax Invoice (as provided when notified of successful application) for the agreed amount of the grant plus GST. Entity Not Registered For GST Amount to be paid is the agreed grant amount only. Payment documentation must state that the payment does not include any GST component. All applicants are encouraged to obtain independent advice as to their position under GST legislation. APPLICANT CERTIFICATION I certify to the best of my knowledge that the statements made in this application are true. I have read the Adelaide City Council s 2015 Arts and Cultural Grants Program Guidelines. I understand that, should this application be approved by the Adelaide City Council, I would be required to accept the conditions of the grant in accordance with the Council s accountability and reporting requirements. Name of Delegated Officer Signature Today s date If this grant is to be auspiced by another organisation please complete the following details: Name of Auspicing Organisation Name of Delegated Officer I certify that we are to be the auspicing organisation for this project Signature Today s date Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 14 / 19
ATTACHMENT A: CONTACT AND COSTING DETAILS FOR COUNCIL SERVICES When organising your project, activity or event you may need to apply for a service from the Adelaide City Council. Below is a list of some applicable Council services. It is important that you fully cost your activity or event including all the services listed below as Council will not provide additional support. Should your application be successful, the amount allocated will be the total of Council s contribution and no further request (cash or in kind) will be considered. SERVICE MORE INFORMATION & FEES MINIMUM LEAD TIME 6 weeks 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: 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 On street Activities 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.adelaidecitycouncil.com/planningdevelopment/building renovating/developmentapprovals/what is development approval www.adelaidecitycouncil.com/city business/businessresponsibilities/permits licences for business/cityworks/ www.adelaidecitycouncil.com/explore the city/cityinformation/city spaces and venues for hire/ www.adelaidecitycouncil.com/onlineservices/permits and licenses/approvals permitslicenses/road closures/ http://www.adelaidecitycouncil.com/citybusiness/business support/flags banners www.adelaidecitycouncil.com/city business/businessresponsibilities/permits licences for business/objectson footpath/ www.adelaidecitycouncil.com/city business/businessresponsibilities/permits licences for business/onstreet activities/ 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 2 weeks Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 15 / 19
ATTACHMENT B: HOW TO COMPLETE A PRELIMINARY RISK ASSESSMENT 1/3 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 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. Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 16 / 19
ATTACHMENT B: HOW TO COMPLETE A PRELIMINARY RISK ASSESSMENT (cont) 2/3 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) 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 PPE Incorrect storage Elevated exposure levels 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 fire fighting equipment Employee fire fighting 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 PPE (hearing protectors) All personnel informed with regard to correct handling and product sheets as required Staff provided with appropriate PPE Hazardous substances stored and labelled correctly Provide mechanical ventilation Struck Against Protruding objects in access routes Protruding objects are removed or marked Not wearing appropriate PPE Provide appropriate PPE and training Struck by Object Objects falling from work platforms Debris from grinding operations Windblown particles Loads slung from cranes All work platforms fitted with toe boards Fence off areas below to prevent access Materials stacked securely All personnel wear appropriate PPE (hard hats) Secure loose objects to structure Loads not slung over personnel Loads slung correctly Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 17 / 19
ATTACHMENT B: HOW TO COMPLETE A PRELIMINARY RISK ASSESSMENT (cont) 3/3 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 Council as part of the application process. See example below: Specify Task/Activity Painting wall using a ladder or scaffolding Potential Hazards/Consequences Ladder slipping while in use Objects falling from a height causing injury to passersby Artist falling off ladder/scaffolding due to slippery surfaces Class of Risk 2 2 2 Action Required To Control Risk/s Secure ladder into position Secure objects on ladder/scaffolding Fence off areas below to prevent access Objects stacked securely Loads not slung over personnel Surfaces to be kept dry Harnesses to be available on scaffolding Awareness of OHS behaviour on site Wearing appropriate footwear Ensure good lighting Using aerosol spray paint Poor visibility leading to fall High intensity of fumes create potential OHS issues 2 2 Use mask and adequate ventilation Operate where and when environmental impact most minimal by working out of office hours in CBD Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 18 / 19
PRELIMINARY RISK ASSESSMENT FORM Grant applicant to complete Applicant: Proposal name: Phone: Email: Signature: Date: Task or Activity Potential Hazards/Consequences Class of Risk Action Required To Control Risk/s Arts and Cultural Grants Program 2015 2016 Category Two (2) PUBLIC ART Grant Application Page 19 / 19