EXPRESSION OF INTEREST FORM

Engaging NSW communities in coastline conservation:
Small-s c ale ( $ 5 , 0 0 0 -$ 2 0 , 0 0 0 ) C o as t al P r o j e c t s
Northern Rivers Region
EX P R ESSI O N O F I NT ER EST F O R M
This form must be read & completed in conjunction with
Project Brief AC4C2000101G
Office use only
EOI no:
Please answer each question concisely. The cells in the following tables can be expanded to
allow for additional text if required. However, once completed, the Expression of Interest form
with your location map attached should be no more than 11 - 12 pages.
NAME OF YOUR
PROJECT:
1 . C O N T A C T S
Name of your
Community Group/
Organisation:
Contact person 1: Contact person 2:
Position in Group
Phone No.:
Mobile No:
E-mail:
Your
Organisation’s
Postal Address
Position in Group:
Phone No.:
Mobile No:
E-mail:
2 . G R O U P / SP O N SO R O R G A N I SA T I O N D E T A I L S
Is your group/ org.
registered for GST
Yes/No
If No for GST, what
is the name of the
GST- registered
sponsor
organisation that
will manage the
project funds
Sponsor organisation
Contact (person) and
their position in the
organisation :
Sponsor organis’n
Contact person’s
Ph number/ Mobile
Your Group/ Sponsor
organisation’s ABN
(state which)
Sponsor
organisation’s
Postal Address
(if applicable):
Sponsor
organisation email
address:
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m
Does your group or
sponsor organisation
have current Public
Liability Insurance
Yes/No
Does your group or
sponsor organis’n
have Workers’
Compensation
Insurance
Yes/No
3 . P R O J E C T L O C A T I O N - i n c lu d i n g L an d o w n e r & s i t e d e t ai ls
Site /Location name:
Nearest town and approximate
distance:
Total area of proposed
works / project site in
hectares (ha) or square
metres (m 2 )
Who owns the land
Please provide the name of
the site’s land management
organisation/ land owner
Do you have the
Landowner’s approval
Name of person who
provided this approval &
position in organisat’n if known
Does the proposed project site
have a Management or site
plan or similar
Yes/No
If so, please provide the name
of the plan/s
Please indicate the Coastal
Environment/s your project
will address
(see Project Brief, Section 3 for
full list).
Yes / No
(Verbal approval is sufficient at this stage)
Using tick the Coastal environment/s relevant to your
project:
beaches
dune systems &
headlands
estuaries or inlets
coastal lakes
intertidal zones
coastal wetlands
i slands & r eef s & th ei r
associ ated coastal
v eg etati on, i nclu di ng
ang r ov es, coastal
woodlands & h eath lands.
near -sh or e coastal water s
& th ose ar eas i m m edi ately
landwar ds of th e coastal
water s wh er e th er e ar e
p r ocesses or acti v i ti es th at
af f ect th e coast & i ts
v alu es
4 . M A P SH O W I N G L O C A T I O N O F P R O J E C T SI T E / S
PLEASE PROVIDE AS AN ATTACHMENT a simple plan/ map of your project site/s, including:
- Location of proposed on-ground works;
- Boundary of the project site;
- North point and Scale; and
- Name of nearby road/ beach/ town or other notable landmark or feature.
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5 . C U L T U R A L H E R I T A G E
Cultural Heritage
Please indicate if you know of
any Aboriginal cultural
heritage studies/surveys of the
area that have been
undertaken in or around the
proposed project site Yes/No
Provide any details (if known)
Do you know if there are any
known Aboriginal objects or
sites that might occur on the
project work lands Yes/No
6 . SP E C I A L SI T E I N F O R M A T I O N
Presence of Threatened
Species & EECs Yes/No
Please list (if known)
Presence of (coastal) Weeds
of National Significance
(WoNS) ie Lantana, Bitou
Bush Yes/No
Please list any WoNS present
7 . P R O J E C T D E SC R I P T I O N
In completing this table note that small scale projects are likely to be approved by early March 2010
and so should be ready to commence around that time & be completed by 31 May 2011.
Proposed start date for your
Project (on-ground works
and associated activities)
Briefly describe your
project.
Outline the types of
activities that your project
will deliver (see list of
activities in Project Brief,
Section 3.) including:
the specific works and
activities that will allow
your organisation to meet
the Outputs you list
below (see Project Brief
Section 6), and
the methods you will
use to deliver these works
and activities.
Proposed finish date
Specific works and activities
Methods to be used
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8. PROJECT OU TPU TS
NB The following table must be completed in conjunction with Section 6 of the project Brief. For each output that your project will
address, please replace the crosses in the three right hand columns with the Output numbers that will be delivered by your project.
Simply delete those Output descriptions rows that will not be addressed in your project (or else mark N/A for Not Applicable)
1
2
3
4
5
6
7
8
Output D e s c r i pti o n
(based on wording of Commonwealth Caring for our Country Targets)
Area of Littoral Rainforest with Coastal Vine Thickets, managed to
reduce critical threats to biodiversity and enhance their condition,
connectivity and resilience
Area treated to reduce the impacts of WoNS (Weeds of National
Significance) including bitou bush and lantana.
Area of WHA (World Heritage Areas) managed to mitigate threats.
Area of HCVAE (critical aquatic habitats) protected by addressing the
threats posed by invasive plant and animal species.
Area of Coastal Hotspot protected by addressing the threats affecting their
environmental values
Number of community organisations engaged in coastal rehabilitation,
restoration and conservation projects.
Number of farmers/ landowners with improved NRM (Natural Resource
Management) knowledge.
Number of local communities provided with access to knowledge and
skills in managing natural resources by providing at least Y knowledge and
skills training opportunities
TOTA L OU TPU TS
to be delivered by this
p roj ec t
X
hectares of Littoral
Rainforest managed
X
hectares of WoNS
treated
X
hectares of WHA
managed
X
hectares of HCVAE
protected
X
hectares of Coastal
Hotspot protected
X
community
organisations engaged
X
farmers/ landowners
with improved NRM
X
local communities
Outputs to be
delivered by 25%
Milestone date ie
30 June 2010
X
hectares
X
hectares
X
hectares
X
hectares
X
hectares
X
community
organisations
X
farmers/
landowners
X
local
communities
Outputs to be
delivered by 60%
Milestone date ie
30 November
2010
X
hectares
X
hectares
X
hectares
X
hectares
X
hectares
X
community
organisations
X
farmers/
landowners
X
local
communities
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Y
knowledge and skills
training opportunities
Y
opportunities
Y
opportunities
9
1 0
1 1
1 2
Number of Volunteers recruited and retained as participants in managing
natural resources.
Number of Short term members or visitors contribute to and partake in
the protection and management of natural resources through the delivery of
at least Y on-ground and capacity building opportunities.
Number of Coastal community groups undertaking Local projects
through devolved grants.
Number of Indigenous partnerships developed
X
volunteers recruited
and retained
X
short term members or
visitors participating
Y
on-ground and
capacity building
opportunities delivered
X
coastal community
groups to undertake
local projects
X
Indigenous
partnerships developed
X
volunteers
X
short term
members
Y
opportunities
X
groups
X
partnerships
X
volunteers
X
short term
members
Y
opportunities
X
groups
X
partnerships
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9. P R O J E C T Q U A L I T Y & S U S T A I N A B I L I T Y O F P R O J E C T O U T C O M E S
(including project maintenance over time)
Briefly demonstrate that your
organisation has the
appropriate skills,
qualifications & capacity to
deliver the proposed Project’s
on-ground works to reach
quality outcomes within the
agreed timeframe.
Please provide a very brief
overview of your organisation’s
experience in effective
project management,
including financial
management, monitoring,
record keeping and reporting
and any management of
workers/ staff.
Describe how, and by whom,
the project outcomes will be
maintained ie briefly describe
how your organisation will
maintain the project Outcomes
and Outputs following
completion of the project -
including how your organisation
has demonstrated it’s capacity
to successfully undertake this
type of project/ site
maintenance.
1 0 . P r o j e c t M o n i t o r i n g , E v a l u a t i o n & P r o m o t i o n
Briefly describe how the
project will be monitored
NB it is proposed to run a
series of workshops in
2010/11 within the NRCMA
region providing training in
the use of some basic site
monitoring methodologies.
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How will your project
achievements be evaluated
How will your project
achievements be
communicated/ promoted
and to whom
1 1 . P r e v i o u s F u n d i n g
Is the project site currently
funded or has there been
other funding in the past for
works at this location
Yes/No
If yes, please provide brief
details.
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12. P R O J E C T B U D G E T
P l e a s e r e f e r t o t h e c o m p l e t e d s a m p l e N R C M A p r o j e c t B u d g e t w h i c h i s a v a i l a b l e a t
h t t p : / / w w w . n o r t h e r n . c m a . n s w . g o v . a u / f u n d i n g _ p r o j e c t _ d o c u m e n t s . p h p ( t h e n c l i c k o n “S a m p l e W o r k p l a n & B u d g e t ”)
NRCMA Funds
Sought
Applicant
Contribution
Other
Contribution –
Insert Name
here
Other
Contributions –
Insert Name
here
Other
Contributions –
Insert Name
Here
Total
INCOME & CONTRIBUTIONS
Cash
In-kind
TOTAL
EXPENDITURE (all costs associated with the Project)
(Insert additional rows as required to accommodate all cost categories)
Administration Costs (eg office
expenses)
Education and Awareness
On-ground Works (includes works in
aquatic environments)
Monitoring, Evaluation & Reporting
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13. S U B M I T T I N G Y O U R C O M P L E T E D E X P R E S S I O N O F I N T E R E S T FO R M
I M P O R T A N T : B e f o re s u b m i t t i n g t h i s E x p re s s i o n o f I n t e re s t f o rm , p l e a s e c h e c k t h a t
y o u h a v e :
Completed all questions and tab les in th is f or m
Inc luded th e loc ation map as an A 4 attac h ment: A simple A4 map or diagram
showing project location with project works site/s clearly defined & labelled, and
including north point, approx scale and names of any nearby roads & direction of
nearest town.
P E R S O N S U B M I T T I N G T H I S FO R M
NAME
Position in
Organisation
(or applicable)
Postal Address
Phone and/or
Mobile
E-mail
Signature
E x p re s s i o n s o f I n t e re s t u s i n g t h i s f o rm w i l l b e re c e i v e d u p t o
4 p m Fri d a y 2 2 J a n u a ry 2 010
E x p r e s s i o n s o f I n t e r e s t c a n b e s e n t e i t h e r b y p o s t or e l e c t r o n i c a l l y t o :
R S
N R h M A
P O B 2 2 8 K N S W 2 4 4 0
O R
R . @ c . g .
Coastal small-scale project applications
og er tanley
or th er n iv er s Catc ment anag ement uth or ity
ox empsey
og er stanley ma. nsw ov au
Expressions of Interest sh ou l d b e postm
th a n th e d u e d a te.
a rk ed b y no l a ter
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