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APPLICATION FORM FOR SMALL CRAFT HARBOURS ABANDONED AND WRECKED VESSELS REMOVAL PROGRAM

This form is for information purposes only. To fill out a copy of this form, please download the Word doc version.

 Download the application form
SECTION 1: APPLICANT INFORMATION
SECTION 1A: CONTACT INFORMATION

LEGAL NAME OF APPLICANT – Harbour Authority, City/Town/Municipality, Band Council, Indigenous Group, etc. (the “Applicant”):

NAME AND POSITION OF THE PRIMARY CONTACT(S) FOR APPLICANT:

Primary Phone Number:

Secondary Phone Number:

FAX:

Email Address:

MAILING ADDRESS FOR NOTIFICATION AND PAYMENT:

City/Town:

Province/Territory:

Postal Code:

SECTION 1B: GOAL(S)/MANDATE OF THE APPLICANT’S ORGANIZATION
SECTION 2: STATEMENT OF PURPOSE AND OBJECTIVE FOR WHICH THE FUNDING IS BEING SOUGHT

Funding objective (check all that apply):

  •  To obtain funding to take legal possession of abandoned/wrecked vessel(s)
  •  To obtain funding to assess abandoned/wrecked vessel(s) (note: must have legal possession prior to assessment)
  •  To obtain funding to remove abandoned/wrecked vessel(s) (note: must have legal possession prior to removal)
  •  To obtain funding to dispose of abandoned/wrecked vessel(s) (note: must have legal possession prior to removal)
Multiple vessels: If removal/disposal of multiple vessels at once is more economical, applications may include multiple vessels. Applicants seeking funding for multiple vessels must ensure that each vessel is accounted for throughout the application, including in the project plan and costing sheet.

Total number of vessels included in this application:

SECTION 3: DESCRIPTION OF THE ORGANIZATION’S PROPOSED ACTIVITIES

SECTION 3A: DESCRIPTION OF VESSEL(S)

Applicants seeking funding for multiple vessels must complete the Small Craft Harbours Abandoned and Wrecked Vessels Removal Program Additional Vessel Form for each additional vessel and include with this application.

Indicate if vessel appears to be:

  •  Abandoned (see definition in Application Guide)
  •  Wrecked (see definition in Application Guide)
  •  Both

Length of time (in years) the vessel has appeared in this state:

Vessel Location

Harbour Name:

Vessel Location:

  •  In water
  •  On land
Vessel Information

Length (approximate metres):

Vessel Name:

Vessel Type:

  •  Fishing
  •  Recreational
  •  Other (please specify):

Registration Number:

Vessel Construction Material:

  •  Wood
  •  Steel
  •  Aluminum
  •  Fibreglass
  •  Concrete
  •  Other (please specify):

Vessel Condition:

  •  Drifting
  •  Anchored/moored
  •  Partially sunk/sunk
  •  Dilapidated
  •  Beached
  •  Other (please specify):
Vessel Situation

Describe how and when the vessel became abandoned or wrecked.

Approximate value of vessel in current condition (in Canadian dollars), if known:

 
Vessel Photos
  •  Photos of the vessel’s location and state from various, distinct angles are included.
SECTION 3B: ESTABLISHING LEGAL POSSESSION (see Application Guide for more information)

Has the applicant received legal possession from the owner to access and remove the vessel?

  •  Yes: the applicant must provide proof that they have obtained legal possession in order to receive funding to remove or dispose of vessel(s). Proceed to section 4C to continue the form.
  •  No: the applicant must obtain legal possession before removing or disposing of the vessel, which is an eligible activity under this program. Proceed with filling out this section.
Vessel Owner Information and Contact

Is the owner known?

  •  Yes
  •  No

If the owner is known, has the owner been contacted regarding the vessel?

  •  Yes
  •  No

If yes (the owner has been contacted):

Date of last contact:

Method of last contact:

If no (the owner has not been contacted), provide reason:

SECTION 3C: RISK POSED BY VESSEL

Select one or more of the following risks pertaining to the vessel in its current state and explain below.

  •  May pose a danger to human health and safety
  •  May pose risk to the environment
  •  May impact organizational operations
  •  May cause damage to Small Craft Harbours infrastructure
  •  May pose obstruction to navigation
  •  Other (please specify):
  •  N/A

Based on your selection(s) above, describe the risk(s) in additional detail.

SECTION 4: PROJECT PLAN AND BUDGET

SECTION 4A: PROJECT PLAN

The purpose of this section is to describe in detail the project plan from start to finish. Your project plan should clearly outline the planned schedule with key activities and timelines, from planning and preparation (i.e. assessments, surveys, possession activities), to project delivery (i.e. removal and disposal). You may apply for reimbursement of costs related to all or parts of your project and your plan should be drafted accordingly. If your application is for the removal and disposal of multiple vessels, they should all be addressed in this section as a single project. However, costs should be broken down per vessel (in Section 5).

This may include activities related to obtaining legal possession, surveys and assessments, removal and disposal.

While a project plan is mandatory, it is not mandatory to use this template. Please refer to the application guide to ensure you have accounted for all necessary information required in the project plan

Deliverables Key Activities Description/ Resources (who, what, when, where, how) Expected Start Date (Month Day, Year) Expected End Date (Month Day, Year)
Legal Possession Examples: Hire lawyer for civil process (where owner unknown); undertake 31 day public notification as required by Transport Canada; pay legal fees Example: name of law firm; where a will notification be posted; when does the lawyer expect legal fees to be due    
Assessment/Surveys Examples: hire marine surveyor to assess risks; draft mitigation strategy for identified risks; ensure surveyor has insurance Example: name of chosen surveyor    
Removal Examples: develop contract for removal/disposal; obtain proof of liability insurance for company; mitigation activities Example: name of chosen removal/disposal company; removal of fuel by X company    
Disposal Examples: transportation of vessel to disposal site; disposal of vessel (describe) Example: method of transportation/who will be responsible; name of disposal site    
Reporting Final report sent to DFO indicating proof of undertaking/proof of payment to vendors      

SECTION 4B: PROJECT BUDGET AND CASH FLOW

Describe the entire budget for this project. You must provide information on how the organization will meet the cost-sharing requirements of the SCH Abandoned and Wrecked Vessels Removal Program. This may include cash contribution from the organization, other funding sources, and/or in-kind contributions.

If your application is for the removal and disposal of multiple vessels, costs should be broken down per vessel.

Project Budget - Legal Assessment and Possession / Removal and Disposal

Eligible Cost Category Details Vessel #1 (insert name) Vessel #2 (insert name) TOTAL
Salaries and wages (provide details)        
Travel (see Note in Application Guide under eligible costs)        
Communications services        
Insurance        
Professional services        
Rental of space and equipment        
GST/HST (see Note in Application Guide under eligible costs)        
Total Eligible Costs      

Cash Flow and Source of Funds

Source of Funds 2019-20 2020-21 2021-22 TOTAL
Applicant contribution - Cash        
Applicant contribution - In-kind        
Fisheries and Oceans Canada abandoned and wrecked vessels removal contribution funds        
Other government source of funds - Cash (specify organization, and add lines for each organization)        
Other government source of funds - In-kind (specify organization, and add lines for each organization)        
Other source of funds - Non-government - Cash (specify organization, and add lines for each organization)        
Other source of funds - Non-government - In-kind (specify organization, and add lines for each organization)        
TOTAL CASH FLOW        
SECTION 5: DISCLOSURE STATEMENT

The applicant presents and warrants that no individual, for whom the post-employment provisions of the Conflict of Interest and Post-Employment Code for Public Office Holders or the Values and Ethics Code for the Public Service apply, will derive a direct benefit from this agreement unless that individual is in compliance with the applicable post-employment provisions.

The applicant confirms that any person lobbying on its behalf in respect of the Agreement and required to be registered pursuant to the Lobbyist Registration Act, R.S.C. 1985, c. 44 (4th supp.) is so registered.

The applicant confirms that there are no Fisheries and Oceans Canada officials on any committee or board related to this proposed project.

Initials of official representation:
 

SECTION 6: ELIGIBILITY

This will confirm that the applicant is an eligible recipient as per Section 1.

This will confirm that the proposed project will result in the applicant’s stated purpose and objective as outlined in Section 2. This will confirm that planned projects costs are “eligible costs” as outlined in the guidelines for the SCH Abandoned and Wrecked Vessels Removal Program. Specific costs under this project are provided in Project Budget and Cash Flow.

Initials of official representation:
 

SECTION 7: DECLARATION

In order for your application to be eligible for funding, it must be completed and signed by the official representative(s) of the organization in accordance with the organization’s by-laws or other constituting documents.

The person(s) signing this form certify(ies) the following:

  •  I certify that I have the capacity and that I am authorized to sign and submit this application on behalf of the organization named in Section 1;
  •  I certify that the information provided in this application and supporting documentation is true, accurate, and complete to the best of my knowledge;
  •  I certify that effort has been made to address risks by contacting appropriate federal authorities, and documentation from authorities is attached; and,
  •  I certify that effort has been made to determine the owner of the vessel, including but not limited to searching federal registries such as Transport Canada Ship Registry.

Name (please print)
 

Signature
 

Title (please print)
 

Signature Date (yyyy-mm-dd)
 

Date modified: