Application form for the Fisheries and Aquaculture Clean Technology Adoption Program

Please be advised that all available funding for 2020-21 has now been allocated. Expressions of Interest for new projects are still welcome should additional funding become available. Thank you for your interest in the program.

The plain text form on this page is for information purposes only. To access the fillable form, download the following PDF version. Depending on your browser settings, you may need to save this form to your device and open it using a PDF reader.

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Fisheries and Aquaculture Clean Technology Adoption Program application form

It is the responsibility of the applicant to complete all required sections as accurately and as completely as possible. Failure to do so may preclude FACTAP from considering the application.

A) Application type (Select one)

Expression of interest

Complete project proposal submission
(Including project proposal template and appendices)

B) Applicant profile

1) Applicant information:

a) Business  

Legal name of applicant

Operating name, if different

Business address

City/town, province, postal code

Business number / HST number

Website address

Current number of full time employees

b) Project location

 

Project address: (if different than business address)

Municipality

Longitude

Latitude

2) Primary contact:

Name

Title

Telephone number (business)

Other/cell number

Fax number

Email address

3) Preferred language or correspondence:

English

French

4) Type of organization:

Commercial enterprise

Sole proprietorship (e.g., self-employed)

Partnership

Indigenous organization

Not for profit organization

Other (specify)

   

Organization's activities

Provide a general description of your operations and/or those of your organization/group implementing the project. Include details on the capacity and expertise required to achieve the proposed project results (e.g. background, company history, past challenges, related companies, etc.).

C) Project information

1) Project name

2) Is this a multi-year project?

 

Yes

No

3) Estimated start date (yyyy/mm/dd):

4) Estimated completion date (yyyy/mm/dd):

5) Project team (if applicable)

Name and role

6) Project objective
Note: Make link to the FACTAP program objective - improved environmental performance and identify how these improvements will be measured.

7) Briefly describe the project

a) Provide a brief description of the project with enough detail for us to be able to properly assess it under the program eligibility criteria.

b) Description must include a rationale for why the project requires FACTAP funding support.

8) Provide general project milestones

Indicate the major steps required to complete the project.
For multi-year projects, provide this information for each year funding is being requested.

Fiscal year

Milestones

2019-20

2020-21

D) Financial information

1) Estimated total project cost

2) Total FACTAP funding requested

3) For multi-year projects, provide annual breakdown of FACTAP funding requirements

Fiscal year

Total
project cost

FACTAP
funding
requested
Provincial
funding
Applicant
funding

Other
funding

2019-20

2020-21

4) Has the application received assistance from Fisheries and Oceans Canada (DFO) previously in the last 5 years?  

Yes

No

5) If yes, provide details

Include the DFO program name, project name, and project details.

 

6) Has the applicant made any financial or legal commitments for the project?

 

Yes

No

7) If yes, provide details

8) Has the applicant received or sought any other government funding for this project?

Note: Final project proposals will require a minimum of 10% confirmed
provincial and/or territorial funding (cash or in-kind) to be eligible under the FACTAP.

 

Yes

No

 

9) If yes, provide details
Note: Proof (e.g., letter of confirmation) of other government funding must be provided with completed applications, but is not required for the Expression of Interest step.

E) Disclosures

Yes

No

1) Environment
Is the applicant currently operating in conformity with federal and provincial environmental legislation?
Will the proposed project conform to environmental legislation?

If no, please provide details:

2) Crown duty to consult
Are there indigenous groups or communities in or near the project area?
Could the project potentially impact indigenous groups or communities?

If yes, please provide details:

3) Litigation
Is the applicant involved in any relevant litigation, legal action, suit claim pending or underway or any other proceedings before any court, tribunal, government board or agency?

Are there any judgments outstanding against the applicant?

If yes, please provide details:

4) Material contracts
Is the applicant in default under any contract or any financing arrangement?

If yes, please provide details:

5) Taxes
Is the applicant in arrears in the payment of any income, business or property taxes, sales taxes or any other form of taxes?

If yes, please provide details:

6) Other sources of funding
Has the applicant received or sought any other sources of funding for this project?

If yes, please provide details:

F) Consent and certification

  1. The information entered here and on all attached documents, as well as any other information collected by or on behalf of the Fisheries and Oceans Canada (DFO) to process applications for grants and contributions, is collected pursuant to the Financial Administration Act and the Fisheries Act.
  2. Confidential third party information and personal information is collected under the authority of the Financial Administration Act and subsection 4.4(1) of the Fisheries Act for the purpose of administering the Fisheries and Aquaculture Clean Technology Adoption Program (FACTAP) and determining funding approval. The information collected through this application may be used for policy analysis, research and/or evaluation, promotion and communication purposes. It may also be disclosed to other DFO programs, Regional Review Committees, provincial and territorial governments and other federal institutions of administering and auditing the program. Failure to provide all requested information may result in the application not being considered.
    If you are the owner(s) of a business operating as a sole proprietor or partnership, you have the right to the correction of, access to, and protection of, your personal information under the Privacy Act and to file a complaint with the Privacy Commissioner of Canada over DFO's handling of your information. Personal information collected for the purpose of processing your application is described in the forthcoming Grants and Contributions PIB (DFO PPU#) and can be accessed and assessed for accuracy. For more information visit Info Source.
    For organizations other than sole proprietorships and general partnerships, personal information regarding representatives of organizations is not used for administrative purposes affecting the individuals at any time during the processing of grant and contribution applications or program administration; it is used to support an organization's application. More information about the Grant and Contribution Programs Class of Personal Information is available at Classes of Personal Information.
  3. Projects for which an application for government funding is made are subject to an environmental screening and must comply with the environmental guidelines set out in the Canadian Environmental Assessment Act, 2012. A representative from Public Services and Procurement Canada (PSPC) may contact you to discuss the project.
  4. The names of successful applicants, the amount of funding approved and a description of the project are included in public records and disclosed on DFO's website in accordance with the government's proactive disclosure practices.
  5. DFO may contact any person listed in this application to inquire about the applicant.
  6. I certify that the information provided is, to the best of my knowledge and ability, complete, true and correct, and that this will apply to all information provided in the future in connection with the assessment of the project. Furthermore, I will promptly notify DFO if any of the information changes.
  7. I certify that financial assistance from DFO is a significant factor in the decision to proceed with this project.
  8. I authorize DFO to make any inquiries required, including obtaining corporate and business information about the applicant, to assess this application.
  9. I authorize DFO to make these inquiries of persons, firms, corporations, federal and provincial government departments, agencies, authorities, institutions and non- profit economic development organizations, and consent to the collection of information.
  10. I consent to the use of the information for determining funding approval, policy analysis, research and/or evaluation, promotion and communication of DFO programs and the Fisheries and Aquaculture Clean Technology Adoption Program

I agree to this information being shared with the Government of the province or territory in which the proposed activity will take place as well as other government funding partners. (mandatory)

I have read and understood the above consent and certification. I voluntarily consent to the collection, use and disclosure of information as described, make the certification as stated and authorize the actions indicated.
(Please keep a signed copy of this form for your records.)

Signature of authorized official
Signed at (location)
Print name and title of authorized official
Date