Expression of Interest (EOI) Form

Natural Resource Management Projects

2013-14

Goulburn Broken Catchment Management Authority

Natural Resource Management Projects 2013 - 2014

Expression of Interest (EOI) Form

Closing date: 14thDecember 2012.

CHECKLIST

Please note: To help you prepare the best application possible, all items below need to be considered and ticked off. This will also assist us with assessment of your application.

Have you:

  • Read the Regional EOI Guidelines and understand that this is a general call for project ideas for 2013-14 with no guarantee of funding?
  • Contacted the relevant GB CMA Program Manager(s) to discuss your project proposal?
  • Read and addressed the Goulburn Broken Catchment Management Authority Priorities document?
  • Checked that your group Executive is aware and agrees to the final EOI submitted?
  • Included your contact details, and the group’s ABN (Qn 3) on the EOI?
  • Demonstrated a matching contribution of at least $1:$1, in either an in-kind or monetary contribution (Qn 10)?
  • Prepared the budget, excluding GST (Qn 10)?
  • Signed the EOI (or typewritten if emailed)and checked that you are authorised to sign/submit the form (Qn 13)?
  • Checked that your group has current and adequate public liability insurance to cover the project activities you are proposing?

If you are proposing to employ staff, are you aware of your obligations as an employer to provide adequate insurance, WorkCover, and OH&S for each of those staff, plus employment conditions as recommended in principle under the Landcare Support Persons in Victoria Employment Framework & Toolkit,(2004),where appropriate?

(If No, go to for more information)

EOI No.
Office use only
  1. Project Title: (up to 12 words)
2.Name of Organisation
  1. Organisation/Group contact details

Contact Name:
Address:
Phone: Fax: Email:
Incorporation: Registered for GST: ABN:
4.Geographic location of Project
Within the Goulburn Broken Catchment
Please specify the closest town, region or locality to the proposed project: ______/ Multi-regional
Please specify the other region(s) to be included in the proposed project:
______
  1. Key words(tick as applicable)

Biodiversity and Land Health / Pest Plants and Animals / Rivers/Wetlands / Sustainable Irrigation / Other. Please specify:
______
  1. List the Priority issue(s) to be addressed (refer to GB CMA Priorities Document for Priority direction/actions)

Priority area(eg River Health) / Priority direction/action(s) / Location(s)

Or, this is an innovative idea that does not align with current priorities, but is to be kept on file for future reference

  1. Project Description: Provide a description of your project including any background information, what is the problem being addressed, why you chose the action(s) and location(s), what will be done, how it will be done and by whom(up to 400 words)
  1. What project outcomes and change will result from the project over the short and long term? (include information on how your project would contribute to building resilience(eg ability to withstand shocks such as drought), landscape health (eg improved soil condition) in the face of climate change, and who will benefit from these outcomes)

a)Describe the short term outcomes: 0 to 5 years(eg more trees in the landscape)

b) Describe the longer term outcomes: 5 to 20 years(eg increased population of birds, reduced risk of salinity)

9.What are the key risks to the project being successful and how will these be mitigated?(eg no interest from landowners, adverse seasonal conditions).

10.Provisional Budget 2013-14(do not include GST)

Item / Applicant Funds
(group funds) / Other Contributor
(Who……………) / GB CMA Funds Sought
2013-14 / Total Budget
2013-14
Employment / Project Management / Facilitation
in-kind/volunteer labour
Total employment Costs (GST exclusive) / $ / $ / $ / $
Eg 1. Revegetation and Fencing – add more lines as required / $ / $ / $ / $
Eg 2. Communications / $ / $ / $ / $
$ / $ / $ / $
Total Operating Costs (GST exclusive) / $ / $ / $ / $
Total Capital Costs (GST exclusive) / $ / $ / $ / $
Total Budget 2013-2014(GST exclusive) / $ / $ / $ / $

11.Outputs for Project 2013-14

CATEGORY / ACTION / TARGET 2013-14
WORKS
Stock grazing (ha = terrestrial; km = riparian) / Fence terrestrial remnant vegetation (ha)
Fence wetland remnant(ha)
Fence stream/river remnant (km)
Off-stream watering (no.)
Binding Management Agreement (license, Section 173, Section 69, covenant) (ha)
Stock containment (ha)
Saline water and high watertables
Surface water / Landform/laser grading (ha)
Drain – primary (km)
Drain – community (km)
Irrigation systems – improved or upgraded systems (ha)
Irrigation systems - reuse (ha)
Pasture – plant (ha)
Sub-surface water / Groundwater pumps – public (no.)
Groundwater pumps – private (new and upgrade no.)
Revegetation - Plantation / Farm Forestry (ha)
Nutrient-rich & turbid water & suspended solids / Stormwater management projects (no.)
In-stream and near-stream erosion / Bed and Bank protection actions (km)
In-stream & tributary erosion treated (ha)
Changed flow pattern / Environmental water allocated - eg to wetlands & rivers (ML)
Weed invasion / Weeds – aquatic weeds treated/eradicated (km)
Weed treated in high priority areas (ha)
Pest animals / Rabbits treated in high priority areas (ha)
Foxes treated in high priority areas (ha)
Habitat loss - terrestrial / Revegetation - natives (ha)
Natural Regeneration (ha)
Grazing Regime Change (ha)
Habitat loss – in-stream / Install fishway (no.)
Establish SEAR (Significantly Enhanced Aquatic Refugia) or instream habitat (no.)
Habitat loss – Threatened species / Threatened Species Recovery Plan and Action Statements (no projects)
NON-WORKS
Planning / Whole Farm Plans - irrigation (ha)
Whole Farm Plans - dryland (ha)
Strategies (no.)
Statutory Advice and Referrals (no.)
Properties inspected for pests (no.)
Relationships and Community Capacity / Community Groups Supported (no.)
Knowledge / Studies, investigations or research (no.)
  1. Group signature (Typewritten accepted as signature on emailed forms).

Name: Position:

Signature: Date:

Completed Expression of Interest Forms must be submitted to the Goulburn Broken CMA:

Postal Delivery: Darelle Siekman, Goulburn Broken CMAEmail:

PO Box 1752, SHEPPARTON, 3632

Applications close 5pm Friday 14th December 2012.

Please note that feedback on the Expression of Interest process is welcome. If you have any comments or suggestions for improvement please forward them to Darelle Siekman at the address above.

Information in this form will be used by the Goulburn BrokenCMA to develop funding proposals to the State and Commonwealth Governments. See the Goulburn BrokenCMA Privacy Policy at .