Arts and Cultural Grants Program 2016/2017

Arts and Cultural Grants Program 2016/2017

ARTS AND CULTURAL GRANTS PROGRAM 2016/2017

CATEGORY 2: PUBLIC ART (ROUND 2)APPLICATION FORM

Maximum amount per application: $8,000

Applications close Friday 21October 2016 (for projects commencing from January 2017).

Name of Applicant
Address
Phone
Email
Contact Person
Position
Name of Project
Grant Amount Sought
ABN
GST status / Registered Not Registered
OFFICE USE ONLY
Date Application Received
File Number

ELIGIBILITY CRITERIA

a)Will your project be held within the Adelaide City Council 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 Adelaide City Council’s website –

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 6.5.
d)Is your organisation not-for-profit?
Yes No N/A (I am an individual in the Public Art category)
e)How is your organisation constituted?
Incorporated Association
Please provide a copy of your organisation’s Certificate of Incorporation
Unincorporated group auspiced by an Incorporated Association
Please provide a copy of your auspicing organisation’s Certificate of Incorporation
N/A (I am an individual in the Public Art category)
Other - Please specify ______
f)How is your organisation managed?
Management Committee
Board of Management
Advisory Board
N/A (I am an individual in the Public Art category)
Other - Please specify ______
g)Do you / your organisation have any outstanding reporting or debts to Council?
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 SA's Protocols for working with children in art?
Protocols can be downloaded from:

Yes No

ASSESSMENT CRITERIA 1 - Fully Developed Proposal

1.1Please select the description/s that best describes your project.

Performance Event/s
Workshop/s
Mentorship/s
Public Art Project (please provide details)
…………………………………………………………………... / Community Art Project/s
Multicultural Festival
Community Event/s
Other (please provide details)
…………………………………………………………………………...
1.2 Project Dates
Please note: projects that take place in the off-peak season are viewed more favourably / Start Date ______End Date ______
Please select which season your project will take place in:
Off-peak season Peak season
(April - September) (October – March)
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 of Park Land
1.5 Please provide a timeline for your project
Please include dates and times of specific events
1.6How will the proposed artwork impact or change the use of the site?
e.g. improves a degraded site or area
1.7 Please provide details on 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 6.5
1.8Please 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
1.9Please identify how you will acknowledge Council support of your project
1.10What are the estimated fees and charges imposed by the Adelaide City Council for this project?
Please see Attachment B for further details on fees and charges.
1.11 Preliminary Risk Assessment
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

ASSESSMENT CRITERIA 2 - Strategic Plan Alignment:Smart

A world smart city with a globally connected and opportunity rich economy

2.1Does your project help to boost local business economy?

(e.g. rejuvenates the area resulting in increased foot traffic)

YesNo

If yes, please provide details.

2.2Does your project work with city businesses and other partners / sectors (eg, creative, arts, business, university, education, entrepreneurial) to bring creativity to and/or activate the City?

YesNo

If yes, please provide details.

2.3Does your project use City businesses to supply products or services?

YesNo

If yes, please provide details.

2.4How many people will be employed in 2016/2017 to deliver your project on a:

Full time basis (paid)______

Part time basis (paid)______

Casual basis (paid) ______

Volunteer basis (unpaid)______

ASSESSMENT CRITERIA 3 - Strategic Plan Alignment: Green

One of the world’s first carbon neutral cities and an international leader in environmental change.

Will your project undertake any of the following?

3.1 Promote public transport and/or cycling to and from your project?

(e.g. provide public transport information on website, provide bicycle storage racks for patrons)

YesNo

If yes, please provide details on this initiative.

3.2 Reduce carbon emissions and/or purchase carbon offsets?

(e.g. partner with environmental organisations to offset carbon emissionsand/or purchase carbon offsets)

YesNo

If yes, please provide details on this initiative.

3.3 Use recycled materials where possible in the delivery of your project?

(e.g. look at creative use of materials using reusable or recyclable materials)

YesNo

If yes, please provide details on this initiative.

3.4 Implement initiatives to save water and minimise water pollution?

YesNo

If yes, please provide details on these initiatives.

3.5 Provide messaging on environmental sustainability issues?

YesNo

If yes, please provide details on this initiative.

3.6 Other

Please provide details on any other environmentally sustainable practices
(e.g. source local / organic produce, implement 3-bin recycling system, use compostable food serving containers)

ASSESSMENT CRITERIA 4 - Strategic Plan Alignment: Liveable

A diverse welcoming capital city, with an enviable lifestyle and strong community

4.1Does your project cater to a multicultural community?

(e.g. brings people together, fosters a sense of belonging, forms new friendships)

YesNo

If yes, please provide details.

4.2Please demonstrate how your project will benefit and/or involve the city community

(e.g. increases awareness and understanding of different cultural beliefs, encourages interaction between different communities)

4.3Does your project engage with people experiencing disadvantage?

(e.g. isolated / marginalised groups)

YesNo

If yes, please provide details.

4.4Is 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
Ticketed/Cost

Combination - What percentage is free? ------%

- What percentage is ticketed/cost? ------%

4.5Does your project provide access for people with a disability?

(e.g. acceptance of companion card, accessible toilets, wheelchair accessible seating/viewing platforms, sign language interpreters, accessible parking)

Yes No

If yes, please provide details on specific provisions.

4.6Are the Kaurna Peoples, the Traditional Owners, recognised and acknowledged in your project?

(e.g. Welcome to Country and Acknowledgement of Country through spoken word in Kaurna language and English, Traditional Dance and/or Smoking Ceremony)

Yes No

If yes, please provide details.

ASSESSMENT CRITERIA 5 - Strategic Plan Alignment: Creative

A city of authentic and internationally renowned experiences

5.1What is the total anticipated attendance at your project? ______

5.2Please explain how you have you calculated the attendance figure above?

5.3If your project has been held in previous years, has your project’s attendance increased over the last three years?

YesNoN/A (first time project has been held)

If yes, please provide attendance numbers for the last 3 financial years.

2015/2016 2014/2015 2013/2014

______

5.4How many active participants are involved in your project?

Artists / performersStudents / mentees Other – please detail ______

______

5.5Does your project activate City streets, laneways, urban public spaces or the Park Lands with creative and cultural activities?

YesNo

If yes, please provide details on the identified space(s) and how you will activate them.

5.6Does your project activate any of the Council priority areas listed below?

Riverbank Adelaide Railway Station to Adelaide Central Market Link

North Terrace BoulevardMarket District

Rundle Mall Laneways (incl. Gawler Place)

5.7Does your project showcase multiculturalism and/or Aboriginal culture?

YesNo

If yes, please provide details describing how.

ASSESSMENT CRITERIA 6 - Ability and Originality

6.1What 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 6.5.

6.2Does your project involve collaborations with other artists or organisations?

YesNo

If yes, please provide details, including information on any previous collaborations with these co-creators if relevant.

6.3Does your project incorporate any new and / or innovative approaches, in either project development or presentation?

(e.g. uses new technologies)

YesNo

If yes, please provide details.

6.4If your project has been held in previous years, will you be undertaking anything new / different as part of this proposal?

YesNoN/A (first time project has been held)

If yes, please explain how this proposal differs from any previous iterations.
(e.g. project hasexpanded, new programs and activities to cater for different audiences)
6.5Support Material
Please provide up to 5 attachments to support your proposal.
These may include:
-CV’s/ bios for key project personnel
-images / portfolios of relevant artists work
-concept rationale / research / designs
-site / installation plans
-URL links to vimeo, youtube or other websites
-letters of support
-reviews
-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)

ASSESSMENT CRITERIA 7 - Other Council Strategies

7.1Does your project contribute to activating the city after 5pm?

Yes No

If yes, please provide details.

7.2Does your project employ local SA musicians?

Yes No

If yes, please provide details.

7.3Does your project activate public spaces or venues with live music?

Yes No

If yes, please provide details.

ASSESSMENT CRITERIA 8 - Financial Viability

8.1 Has Council funded you / your organisation over the last two (2) years

Yes No

If yes, please provide details below:

Date Funded / Amount / For What Purpose?
2015-2016
2014-2015

8.2 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
Others * / Financial
In-kind
Total Amount

*Others refer to funding partners and other partners that provide monetary and/or in-kind support to your project.

8.3Could your project proceed if only partial funding was received?

Yes No

Please provide details.

INCOME AND EXPENDITURE BUDGET
8.4 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 B: 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 / 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
COUNCIL FEES
Development Approvals
Permits
Park Land fees
Services (eg, gas, electricity)
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) In-kind support (income) also requires a corresponding expenditure item *

b) Total income must equal total expenditure

Budget details
Please provide a detailed breakdown of any relevant budget items here (e.g. wages, art materials)

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 2016/2017 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 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

CHECKLIST

Please acknowledge the following checklist before submitting your application:

I have read the Arts and Cultural Grants Program Guidelines.

I have discussed my project with a Public Art team memberprior to commencing my application:

Email:

Phone: 8203 7210 or 8203 7154

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 Adelaide City Council as an interested party

Return to Work SA / Employee Insurance

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, if paid staff are employed

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 -

Public Art

Adelaide City Council

GPO Box 2252

Adelaide SA 5001
(Application must be postmarked on or before closing date)

In person to -

Public Art

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)

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

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.

Risksshall 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 Hazardeg: offsite cutting of panel work

Substitute the Hazardeg: replace ladder with scissor lift, substitute solvent based paint with water based
paint

Engineering Controlseg: reverse alarms/lights fitted to plant, exhaust ventilation to removefumes

Administrative Controlseg: job rotation, work instructions, safety inspections

Personal Protectiveeg: 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 Formrequires 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.

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 / Working in close proximity to roads / 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
Manual Handling / Handling of heavy objects / Use of lifting aids
Imposed restrictions on certain activities
Contact with Heat / Hot materials
Fire in the Workplace
Exposure to sun / 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
Contact with Electricity / 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 / 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
Exposure to Noise / Not wearing appropriate noise protection / All personnel to wear appropriate PPE (hearing protectors)
Contact with dangerous substances (chemicals) / Incorrect handling procedures
Lack of information
Not wearing appropriate PPE
Incorrect storage
Elevated exposure levels / 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
Not wearing appropriate PPE / Protruding objects are removed or marked
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
Fall from Height / No handrails
Working outside handrails
Floor penetrations not covered
Ladders not secured
Unsafe area / 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
Slips and Falls / Access routes obstructed by materials
Leads/hoses across access routes
Slippery surfaces
Safety footwear not appropriate
Poor visibility / 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 thePreliminary Risk Assessment Form provided and submit to Councilas part of the application process.
See example below: