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SWMIF Expression of Interest

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Funding Opportunities
Solid Waste Management Innovation Fund
SWMIF Expression of Interest

This expression of interest is used to determine whether your organization and project is suitable for the Solid Waste Management Innovation Fund (SWMIF). Before submitting this form, please read the SWMIF Guidelines for program guidelines and eligibility criteria.

Confidentiality

The information provided in this application (including any supporting documents) is subject to the Government of Newfoundland and Labrador’s Access to Information and Protection of Privacy Act (ATIPPA), as applicable. Applicants are encouraged to consult ATIPPA for additional details. The applicant should indicate any information that it considers confidential. It is the responsibility of the applicant to complete all required sections as accurately and as completely as possible. Failure to do so may prevent MMSB from considering the application. MMSB may require further information and/or consents from the applicant to fulfill requirements.

Applicant and Contact Information

Legal Name of Organization:*	Operating Name, if different (optional):
Mailing Address:*
City/Town:*	Postal Code:*
Phone Number:*	Email:*
Website (optional):
Form of Organization:* CorporationCo-operativeNon-ProfitIndustry AssociationOther
If "Other" is selected, please specify:
Jurisdiction of incorporation:*
Corporation number:*	Date of incorporation:*
CRA Business number (optional):
# of full-time employees or equivalents:*
Annual revenue:* Less than $10 millionGreater than $10 million
Has the organization received funding from MMSB in the past?* YesNo
If yes, please provide the year, funding program, and a brief description of the project(s) (optional, max 1000 characters): 0/1000
Does your organization have a current commercial insurance policy?* YesNo

Key Contact

Name:*	Position/Title:*
Phone Number:*	Email:*

Project Details

Project Name (max 100 characters):* 0/100	Project Location (max 100 characters):* 0/100
Start Date:*	End Date:*

Project Summary Provide a brief overview of your project (max 2500 characters):*

0/2500

Innovation/Uniqueness Identify what makes this project innovative or unique to managing solid waste in Newfoundland and Labrador (max 5000 characters):*

0/5000

Potential Identify the benefits and anticipated opportunities to be realized by this project (max 5000 characters):*

0/5000

Organization Provide information about your organization’s business/mission, history, capabilities, and experience implementing projects of similar scope and complexity (max 5000 characters):*

0/5000

Partners and Stakeholders Identify any partners or stakeholders and their role (max 5000 characters) (optional):

0/5000

Budget

Estimated project cost (max 20 characters):*

0/20

Amount requested from MMSB (max 20 characters):*

0/20

What will the funding from MMSB be used for? (max 1000 characters):*

0/1000

Contribution from your organization (identify cash or in-kind, and the amount, max 1000 characters):*

0/1000

Other funding sources (list source, amount, and whether the funding is confirmed or tentative, max 1000 characters) (optional):

0/1000

Additional Information Describe any regulatory approvals required for your project. Identify whether these approvals have been granted, are in-progress, or not-yet submitted (Max 2000 characters) (Optional):

0/2000

Identify any affiliated or associated companies that share directors, shareholders, or Affiliates with your organization. Include the name of the organization and corporation number. (max 1000 characters) (optional):

0/1000

Do you or any affiliated or associated companies have any existing debt, or debt settled or written off in the last six years with the Provincial Government?* YesNo

If yes, provide details. Include all amounts due, settled, or written off to Provincial Government departments and/or agencies by the applicant, its shareholders and its affiliated/associated companies. (max 3000 characters) (optional):

0/3000

Attachments Please include any additional information relevant to your application. (optional):

Applicant's Declaration/Consent and Disclosure I have read and understand the funding and eligibility requirements identified in the program guidelines.
I confirm that all documents, including funding applications and Project information, submitted to MMSB become the property of MMSB and could be subject to disclosure under the Access to Information and Protection of Privacy Act.
I confirm that the information given in this application is, to the best of my knowledge and ability, complete, true and correct. I acknowledge that failure to disclose relevant information may result in cancellation of this application by MMSB.
I certify that neither the applicant, affiliated/associated companies nor its officers are involved in any litigation, or in any proceedings before any government board, agency or tribunal which have not been disclosed in writing as an attachment to this application.
I consent to MMSB sharing the information contained in this application and supporting documentation with other entities, including Federal and Provincial Government Departments for purposes of the assessment of this application.
I will provide all information required by MMSB to complete the assessment of this project. I authorize MMSB to make inquiries of such persons, firms, corporations and shareholders or other government agencies as it deems necessary to reach a decision on this application.
I certify that all debts owing to Provincial Government Departments and/or its agencies, by the applicant and its affiliated/associated companies, corporations and shareholders have been disclosed in this application, including any amounts settled or written off by the applicant, its affiliated/associated companies and its shareholders in the last six years.
I understand that if this application is approved to proceed, I will be invited to submit a full proposal. Failure to submit the proposal within the timelines specified by MMSB may result in the application being terminated.
I give permission to officers of MMSB to use information contained in this application for assessing my (the applicant's) eligibility; coordinating and for program evaluation and research to improve the quality of programs and services offered.

Application Submitted By:*

Title:*

SMWIF Guide and Terms of Reference
SWMIF Expression of Interest

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