Community Partnership Minor Capital Program
Grant Application
City of Ottawa
Recreation, Cultural and Facility Services Department
Parks and Facilities Planning Services
100 Constellation Crescent, 8th Floor West
Ottawa, ON K2G 6J8, Mail Code 26-51
FAX: 613-580-9612
Attention: Donna Williams or Renée Proteau
Instructions:
Mail, fax, email or deliver the completed application to:
Information:
Refer to the Community Partnership Minor Capital Program Guidelines and Principles for more detailed
information on eligibility and criteria. If you require assistance completing the form, or have inquiries contact:
Donna Williams, 613-580-2424, ext. 23169, Donna.Williams@ottawa.ca
Renée Proteau, 613-580-2424, ext. 26967, Renee.Proteau@ottawa.ca
1. Applicant Information
Name of group:
Postal Code:
Province:
City:
Address:
Type of group:
Email:
Phone Number:
Contact Person:
Application Received (dd/mm/yyyy):
Note :
attach sketch or plan showing location of proposed project including existing structures, buildings or
other significant features
require written verification of matching funds by applicant
require community association letter of support
City of Ottawa tax receipts are available for individual or corporate donations for approved projects
labour credit based on value of equivalent contracted services
application deadline dates: May 1 and September 1, 3:00 p.m. Late applications will not be
considered.
2. Project Description
Project Title:
Postal Code:
Province:
City:
Address:
Council Ward:
Project Description:
(provide a detailed project description listing components)
Anticipated Users:
(children, youth, adults, families, seniors – neighbourhood, community, city-wide)
Rationale For Project:
b) project:
a) location:
3. Other Information
Has your group received a grant previously under the Community Partnership Minor Capital Program?
d) city contribution:
c) completion date:
NoYes
e) year grant was awarded
4. Financial Information
Expenditures (Actual or Estimated)
site preparation costs
costs for major components (specify)
freight
installation
taxes
reinstatement costs
other costs (i.e. required permits)
Total Project Cost
1.
2.
Sources of Revenue
funds raised by applicant group
other revenues (specify)
labour credit (based on value of contracted services)
Community Partnership Minor Capital Grant Request
Total Revenues
1.
2.
If yes, describe previous project(s):
Date
Municipal Freedom of Information and Protection of Privacy Act
Signature of Representative
6. Authorization
Personal information provided by the applicant on the application form is collected for the purposes of
the City of Ottawa’s Community Partnership Minor Capital Program approved by Council on an annual
basis. The information will be used internally within the city to administer your application.
I attest that all information contained in this application is accurate to the best of my knowledge.
5. Project Implementation
Yes No
Note: Grants will not be awarded to applicants commencing work prior to submission of a program
application and receiving final project approval from the department.
Is this a phased project?
anticipated project start date (month/year)
anticipated project completion date (month/year)
If applicable, when will the next phase begin/finish?
As an authorized representative of
,
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