Ontario Biogas Systems Financial Assistance Program

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Ontario Biogas Systems Financial Assistance Program
Phase 2 Application Form - Construction, Implementation and Commissioning

Author:	OMAFRA Staff
Creation Date:	06 September 2007
Last Reviewed:	26 October 2009

The Ontario Biogas Systems Financial Assistance Program is designed to provide financial assistance to eligible Applicants to encourage the growth of the biogas sector in the agri-food and rural sectors in Ontario. Without limitation by the generality of the following, Phase 2 of the Program provides financial assistance for eligible construction, implementation, and commissioning expenses for new biogas projects or the expansion of existing biogas projects.

In the event of any discrepancy between this application form and O.I.C. 1702/2007, the latter prevails.

Please refer to the application instructions and the website for valuable information that will help you complete your application. This Application for Phase 2 financial assistance and any supporting documents must be submitted by September 30, 2009 by e-mail, fax, or regular post to:

Ontario Biogas Systems Financial Assistance Program
1 Stone Road West, 4^th floor NW
Guelph, ON N1G 4Y2
Tel: 1-888-588-4111
Fax: (519) 826-4336
e-mail: biogas.program@ontario.ca
Website: www.ontario.ca/biogas

Language preferred for correspondence (please select one):

[ ] English [ ] français

A. Applicant Information

1. Contact Information

Name: ____________________________________________________

Business Name: ____________________________________________

Organization or Business (full legal name): ________________________

Mailing Address (street): ______________________________________

P.O. Box: __________________________________________________

City/Town: _________________________________________________

Region/County: _____________________________________________

Province: __________________________________________________

Postal Code: _______________________________________________

Telephone: ________________________________________________

Fax: ______________________________________________________

E-mail: ____________________________________________________

2. Sector Information

Please select the option(s) that best describe the operation(s) associated with the proposed biogas system:

__ livestock

__ field crops

__ vegetable/fruit/greenhouse/horticultural crops

__ flowers and ornamentals

__ waste management

__ munciipality

__ meat processing

__ fruit and vegetable processing

__ milling and baking

__ dairy processing

__ other food processing

__ other (specify)

B. Project Information

1. Project Description

Note: Please attach additional documentation as necessary to describe your project.

Provide a general description of the proposed biogas system and where it will be located:

__________________________________________________________

2. General Eligibility:

What inputs do you intend to use in the biogas system?

__________________________________________________________

How do you intend to manage the biogas produced by the biogas system?

__________________________________________________________

How do you intend to manage the digestate produced by the biogas system?

__________________________________________________________

3. Please provide further details about the proposed biogas system that may help the ministry in its evaluation.

__________________________________________________________

C. Construction, Implementation and Commissioning Information

1. Timeline of Activities

In Table 1 please tell us how and when you plan to complete your project. For each major activity or expense shade the boxes for the duration of that activity or expense. If you require more space, please add additional sheets. Note that invoices for eligible project expenses need to be dated prior to or on March 31, 2010 to be eligible for reimbursement.

**Table 1. Timeline of Activities**
Activity	2007				2008				2009				2010
Activity	Q1	Q2	Q3	Q4	Q1	Q2	Q3	Q4	Q1	Q2	Q3	Q4	Q1	Q2	Q3	Q4

2. Description of Eligible Expenses

Details regarding eligible expenses are found in the application instructions. If you require more space for this or any other table, please add more lines to the table or provide the information in an appendix.

Please list all eligible Phase 2 project expenses, with a brief description, in Table 2.

**Table 2. Eligible Expenses**
Equipment or Activity	Description	Amount ($)






Total ($)

3. Description of Ineligible or Non-Funded Expenses

Please list all relevant ineligible Phase 2 project expenses, with a brief description, in Table 3.

Details regarding ineligible or non-funded expenses are found in the Phase 2 instructions.

**Table 3. Ineligible or Non-Funded Expenses**
Equipment or Activity	Description	Amount ($)






Total ($)

4. Eligible Expenses Timeline

**Table 4. Eligible Expenses Timeline**
	(Jan - Mar) ($)	(Apr - Jun) ($)	(Jul-Sep) ($)	(Oct - Dec) ($)	Annual Amount ($)
2007
2008
2009
2010
Total ($)

D. Sources of Funding

Phase 2 Funding

**Table 5. Phase 2 Funding Requested From Program**
	Amount ($)
1. Total Eligible Phase 2 Expenses (from Table 3)
2. 40% of Total Eligible Phase 2 Expense (Line 1 above)
3. Maximum Allowable Project Funding	$400,000
4. Phase 1 Program Funds Received for this Project (if any)
5. Maximum Allowable Funding Available for Phase 2 Expenses (Line 3) - (Line 4)
6. Total Phase 2 Funds Requested: Lesser of (Line 2) and (Line 5)

Please list the other sources of funding for your proposed Phase 2 equipment and activities in Table 6.

**Table 6. Sources of Funding**
Sources of Funding	Amount ($)
1.
2.
3.
4.
Total ($)

E. Economic Benefits

Outline the anticipated economic benefits using specific numbers if available with respect to the following:

**Table 7. Other Benefits Anticipated From Project**
Parameter	Benefits of your project
Number of jobs created/retained
Total investment
Purchases of inputs
Sales of by-products
Benefits to local economy
Benefits to regional economy
Benefits to Ontario economy

Table 8. Biogas System Sustainability Plan

Please describe your plan for the sustainability of the biogas system.

__________________________________________________________

F. Construction Readiness

Please check the appropriate box demonstrating construction readiness. Attach relevant documents as an appendix.

[ ] Project activities include components that will require a building permit. A copy of a building permit for the project is attached.

or,

[ ] Project activities will not require a building permit. A letter from the local building official is attached indicating that a building permit is not required for all the activities in this application proposal.

G. General Applicant Information, Confidentiality, Consent and Certification

1. General Applicant Information

Please provide the following information:

Full legal name of your company/organization/farm. Provide proof of current status, (i.e. a certificate of status) and constituting documents (i.e., articles of incorporation or letters patent, etc.), which indicate the full and proper name of the organization as well as the proper signatories to the agreement.

__________________________________________________________

__________________________________________________________
Type of legal entity [ ] Sole Proprietorship [ ] Partnership [ ] Corporation [ ]

Other _____________________________________________________
Do you have a parent company? No [ ] Yes [ ]

If yes, please provide name and address:

__________________________________________________________

__________________________________________________________
Do you have other related companies? No [ ] Yes [ ]

If yes, please specify:

__________________________________________________________

__________________________________________________________
Attach a list of owners and directors (if applicable) of your company/organization (use a separate sheet)
Does your company/organization have an interest in any of the companies/organizations listed as co-applicants? No [ ] Yes [ ]

If yes, please list separately the project partner, the percentage interest, and whether there are consolidated financial statements available.

2. Confidentiality

Application forms and supporting material submitted to the Province of Ontario will be subject to the Freedom of Information and Protection of Privacy Act. Any information submitted in confidence should be clearly marked "confidential" by the applicant.

3. Consent

All applicants hereby consent to inspection of their premises and/or documents that pertain to this project as described in the agreement by the Province of Ontario or its designate. Successful applicants consent to having their names, funding amounts and short summaries of their projects and results made available to the public.

4. Certification

I hereby certify to the Province of Ontario that the information contained in this Phase 2 application is true and complete in all respects to the best of my knowledge. If the Province of Ontario discovers that this application contains a material misrepresentation, it shall be deemed to be ineligible for funding and withdrawn immediately by the Applicants.

I agree to provide any additional information that the Province of Ontario or its authorized administrator may reasonably require for purpose of assessing this application and administering the Program.

Applicant Name (print):__________________________________________

Organization: _________________________________________________

Signature: ____________________________________________________

Date: ________________________________________________________

For more information:
Toll Free: 1-877-424-1300
Local: (519) 826-4047
E-mail: ag.info.omafra@ontario.ca

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