FOR OFFICE USE ONLY
Date received: / File No.:

Abattoir Competitiveness Program (ACP)

INITIAL PAYMENT APPLICATION FORM

An Applicant’s Guide is available at If you require assistance completing this form, contactAAFC using the contact information provided at the end of this form.

APPLICANT DETAILS
1. Applicant Information(applicants must be Canadian legal entities)
Organization Type
For-profit Corporation Partnership Incorporated Co-operative
Non-profitCorporation Sole Proprietorship Other ______
Legal Organization Name / «Operating As» Name
2. Contact Information
Title / Legal Family Name / Legal Given Name / Primary Tel. No.
Ext.
E-mail / Fax No. / Secondary Tel. No.
Ext.
Language of correspondence English French
3. Mailing Address - Canada
Unit/Suite/Apt. / Street Number / Number Suffix / Street Name / Street Type
Street Direction / PO Box or Route Number / Municipality (City, Town, etc.) / Province / Postal Code
4. Mailing Address of Organization (if different from mailing address of main contact) –Canada
Unit/Suite/Apt. / Street Number / Number suffix / Street Name / Street Type
Street Direction / PO Box or Route Number / Municipality (City, Town, etc.) / Province / Postal Code
5. Name of Signing Official / Name
Title
6. CanadaRevenue Business Registration No.
7. Type of Facility / Federally Inspected
Provincially or Territorially Inspected / Establishment Number:
Provincial /Territorial Plant Number:
  1. Do you slaughter over thirty months (OTM) animals at more than one plant?
/ No
Yes. List all plant locations.
  1. Size of your facility
Defined on the basis of number of OTM cattle slaughtered from January to December 2009 at all of your plants. / Large (5,000 or more)
Small (less than 5,000)
10. Enter the number of OTM cattle slaughtered at all of your plants from January 1 to December 31, 2009.
11. Enter the number of OTM cattle slaughtered from January 1 to June 30, 2010 at all plants.

If you are a “Large Facility” as defined in question 9, also complete questions12, 1314.

  1. Large facilities are required to maintain their share of 2010 Canadian OTM slaughter at a minimum of 85% compared to their share of 2009 OTM slaughter.

Yes I intend to maintain share of OTM in 2010 at no less than 85% as compared to 2009.
No I do not expect to maintain share of OTM slaughter at this level
  1. Are you participating in the AAFC-CFIA Industry Enhanced Feed Ban Working Group?

Yes No
  1. Describe your plan for improving the management of specified risk materials (SRM).In the space below provide a brief summary of your plan (50–100 words) and attach a more detailed description of your plan (1–4 pages). See guide for more information.

DECLARATION OF THE APPLICANT

Definition of AAFC: For the following statements, AAFC means the Minister of Agriculture and Agri-Food or any person authorized to act on his or her behalf.

I/We confirm that I/We have read and understood the objectives, principles and criteria outlined in the Program Guide of the Abattoir Competitiveness Program (ACP), and I/We understand that the following conditions must be met for funding eligibility:

  • If the applicant is an organization, this application has been approved by the Organization's Board of Directors (if applicable) and that the signature below is that of the CEO / Chairperson / President or Senior Financial Officer / Treasurer;
  • The applicant agrees that this application form creates no obligation on the part of AAFC to provide funding.
  • The applicant agrees that the information provided on this application form is being collected for the purpose of assessing and reviewing the applicant’s eligibility for funding under the Abattoir Competitiveness Program (ACP) and that such information will be disclosed only to the extent necessary for application assessment and review purposes, including verification of the information submitted as well as program review, statistical purposes and performance reporting. The applicant consents to the disclosure of this application form to other federal or provincial officials and other third partiesfor the purposes of verification of data.
  • The applicant agrees that any personal, financial, commercial, scientific or technical information provided in this application will be treated in accordance with the Access to Information Act and the Privacy Act.
  • The applicant agrees that all data provided on this application is accurate and may be verified by a third party appointed by AAFC.
  • The applicant agrees that, if approved, information provided about the project, including the applicant’s name, amount awardedmay be posted on AAFC’s website.
  • The Canada Revenue Business Registration Number is collected for the purpose of the Income Tax Act.

Recipient’s Obligations

  1. The recipient agrees that, unless otherwise agreed to by AAFC, all announcements, by way of news releases, news conferences or communications materials and products, related to this grant or reporting on accomplishments and results arising out of or related to matters covered in this agreement shall be approved by AAFC.
  1. The recipient agrees that, pursuant to sub-section 7(1)[Annual and additional reports to the House of Commons] of the Auditor General Act, the Auditor General of Canada may, at his or her own cost, conduct an inquiry respecting the recipient’s compliance with the terms and conditions of this grant or an inquiry into the recipient’s procedures to measure and report on performance with respect to this grant. The recipient shall cooperate with the Auditor General and his or her representatives or agents relative to any such inquiry, and shall grant the Auditor General access to the documents, records and premises for purposes of any such inquiry. The Auditor General may, at his or her discretion, discuss any concerns raised in such inquiry with the recipient and with AAFC. The results may be reported to Parliament in a report of the Auditor General.
  1. The recipient agrees that AAFCmay conduct an audit of its compliance with the terms and conditions of this grant, including without restriction compliance with its financial provisions. AAFC may direct that an audit be carried out by an independent and accredited auditor or other representative appointed by AAFC. The recipient shall cooperate with AAFC relative to any such audit and shall grant them access to the documents, accounts, records, and premises as required by AAFC for purposes of any such audit. AAFC shall pay for any audits undertaken under this provision.
  1. The recipient agrees that any payment by AAFC is subject to cancellation or reduction of payments in the event that departmental funding levels are changed by Parliament. The recipient agrees that any payment by AAFC is subject to an appropriation of funds by Parliament for the fiscal year in which any commitment thereunder would come into the course of payment.
  1. The recipient agrees to indemnify and save harmless Canada, AAFC, his or her officers, servants and agents from and against all liability, loss, damages, costs and expenses, including reasonable solicitor/client fees, administrative fees and disbursements, and all claims, demands, actions, or any other proceeding whatsoever and by whomever made, for personal injury, death, environmental effect or property damage, arising directly or indirectly and whether by reason of anything done or omitted to be done, as a result of negligence or otherwise, from the performance or any default or delay in performance of the recipient’s obligations under this grant program.
  1. The recipient agrees that nothing in this grant is to be construed as authorizing the recipient to contract or incur any obligation on behalf of AAFC or to create a partnership or agency relationship between the recipient and AAFC. The recipient shall not represent itself or hold itself out as being a partner or agent of AAFC.
  1. The recipient agrees that any amount which constitutes an overpayment shall be repayable to the Crown and until repaid constitutes a debt due to the Crown. The recipient shall repay the amount within thirty (30) days of written notification by AAFC. Interest shall be due and payable upon any amount not repaid after the thirty (30) day delay, in accordance with the Interest and Administrative Charges Regulations.
  1. The recipient agrees to keep all records, information, databases related to this grant program for a period of six (6) years from the date last payment is paid by AAFC.
  1. The recipient agrees to declare any amounts owing to the Crown under any legislation or any agreement with the Crown before the signing of this grant if such an amount becomes due to the Crown. The recipient acknowledges that any amounts due to the recipient pursuant to this grant may be set off against any such amounts owing to the Crown.

Program/Legislation: / Unpaid Debt: $
Not Applicable
  1. The recipient agrees that individuals who are subject to the provisions of the Conflict of Interest Act, 2006, c. 9, s. 2, the Conflict of Interest and Post-Employment Code for Public Office Holders, the Value and Ethics Code for the Public Service cannot derive any direct benefit resulting from this grant unless the provision or receipt of such benefit is in compliance with such legislation and codes. The recipient agrees that no Member of the Senate or House of Commons shall be allowed to derive any financial advantage resulting from AAFC’s contribution under this grant that would not be permitted under the Parliament of Canada Act.
  1. The recipient agrees to ensure that a person lobbying, as defined in the federal Lobbying Act, on the recipient’s behalf is registered pursuant to the Act. For more information, please go to the Office of Commissioner of Lobbying of Canada’s website at

I/We declare that the information given in this application is to the best of my/our knowledge, complete, true and correct.

I/We declare that I/we will abide by the terms and conditions of the Abattoir Competitiveness Program (ACP) as stated in this Application Form and its corresponding Program Guide, if this application is approved by AAFC.

SIGNATURE: Applicant – To be signed and submitted to AAFC with the application form.
Individual/ Authorized Representative (print)
Title Organization
Name
Signature Date

Provincially or territorially inspected slaughter plants must also complete the statutory declaration form at the end of this application in order to attest to the accuracy of the data provided. You will need to sign it before a commissioner of oaths, notary public or a lawyer.

Data provided by federally inspected slaughter plants will be subject to verification against AAFC data.

BEFORE SUMBITTING YOUR APPLICATION:
Make sure that theACP Application form is completed and that you have read and understood the Declaration before signing and dating it. If you are a provincially or territorially registered slaughter plant, ensure that you have also completed and signed the statutory declaration.
CONTACT US
For more information contact the ACP administration at by phone at 1-877-290-2188.Applications may be faxed or mailed. Mail or couriera signed original of the application form and any attachments to:
Agriculture and Agri-FoodCanada
c/o ACP
1341 Baseline Road
Tower 7, 8th Floor, Room 242
Ottawa, ON K1A 0C5 / Phone: 1-877-290-2188
Fax Number: 613-773-1922
E-Mail:
Visit the ACPwebsite for more information: .

Abattoir Competitiveness Program (ACP)

STATUTORY DECLARATION

(For Provincially or Territorially Registered Applicants)

CANADA
Province/Territory of ______
City of______ / In the matter of the application for funding by ______
under the Abattoir Competitiveness Program sponsored by the Minister of Agriculture and Agri-Food

To Wit:

I, ______, of the County/City of ______in the Province / Territory of ______SOLEMNLY DECLARE that the information contained in the application, which this declaration forms part of, is accurate in all respects.

I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Declared before me at the ______

in the ______

in the Province/Territory of ______

this____day of ______2010 (Signature of Applicant)

______

Commissioner of oaths, Notary public or a lawyer

NOTE: A person may be guilty of an offence if she or he makes a false statutory declaration.

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