Climate Disaster Response Fund Application

Access Code
An access code is required to complete the Climate Disaster Response Fund application.

To receive the code, please contact Imogen Goldie, Heritage Planner and Grants Administrator, at [email protected] to verify your project’s eligibility.
Find more information about the Climate Disaster Response Fund here.

Project Summary
Project Title*
Amount requested from the Climate Disaster Response Fund*
Maximum: $8000.00
Project Summary and Scope of Work*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Applicant Contact Information
Contact Name*
Title*
Organization*
Organization Mailing Address*
Street Address City Province Postal Code
Website
Email*
Organization Information
Organization (Legal Name)*
Registration Number*
Date of Registration*
MM slash DD slash YYYY
Supporting Documentation: Recent Financial Statement
Drop files here or

Max. file size: 12 MB.

The Heritage Resource
Name of Heritage Resource*
Address of Heritage Resource*
Street Address City Province Postal Code
Owner of Heritage Resource*
Manager of Heritage Resource*
Overview*
A brief physical description of the Heritage Resource and its location.
Current Condition*
What is the current condition of the Heritage Resource? How has it been impacted?
Supporting Documentation*
- Heritage Resource Owner Authorization (required if applicant is not owner of the Heritage Resource)
- Statement of Significance (if applicable)
- Location Map
- Current Photos (required)
- Other
Upload Supporting Documentation Here*
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Max. file size: 12 MB.

Project Details
Conservation Planning*
Has a professional assessment and/or conservation plan been prepared for the heritage resource to determine immediate conservation requirements as a result or climate disaster impacts? When was it prepared and by whom? If not, please indicate how the scope of work was determined and defined.
Conservation Priorities*
What urgent remedial action is needed? Please list in order of priority and describe the work that may be addressed through this funding opportunity.
Conservation Standards*
The Standards and Guidelines for the Conservation of Historic Places in Canada is the benchmark for heritage conservation. How is this project consistent with these guidelines? List the applicable sections of the guidelines and how the conservation work for this project fits into these guidelines.

Eligible Work & Quotes
Scope of Eligible Work*
Describe the eligible work you are requesting funding for. See the Program Guidelines for a definition and examples of eligible work.
Specify Eligible Costs and Quotes*
Provide an itemized list of the eligible work; a description of tasks, products and/or quantities; who will be responsible for managing the work; and a minimum of one quote (excluding GST), if applicable, provided on supplier letterhead. Upload any drawing, specifications, or additional documents used in defining the scope of work.
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Max. file size: 12 MB.
Project Budget

Complete the project budget indicating project expenditures and revenue. Project costs may include both hard costs (construction, materials, labour, equipment), as well as soft costs, including administration, management, and permits. Total project revenue must equal total project costs.

Expenditures

ELIGIBLE COSTS List each eligible work item/category and use one of the quotes (if applicable) submitted previously in Section 4. If you have more than one quote and are not using the lowest quote, specify the reasons for selecting the preferred quote. Eligible costs include salaries and wages directly related to the project, consultant fees and travel, equipment rental, temporary storage costs, materials and supplies and minor capital costs in relation to the project, and administrative costs linking to the project.

INELIGIBLE COSTS Costs not associated with urgent remedial action and not directly involved in carrying out the project are not eligible. This includes ongoing operation (for example: salaries, wages, travel, supplies, material, minor capital assets, fundraising, marketing, governance, and other costs related to ongoing operations), day-to-day collections management activities, development of project proposals, grant applications, strategic planning, or climate adaptation planning, and GST.

OTHER PROJECT COSTS If the proposed work is part of a larger project, this may include additional ineligible costs or costs not considered Heritage work. However the budget for this specific project must be clearly indicated. In-kind costs must be matched by equal in-kind revenues

Revenue

APPLICANT CONTRIBUTIONS The applicant is not required to contribute to the costs of the project but if there are funds directed to the project indicate how much and whether its in-kind or in cash.

OTHER SOURCES OF REVENUE Other sources of revenue are not required but if there are funds from another source being used to match eligible costs, such as insurance coverage or other grants, indicate which are secured and which are pending. The applicant must verify if the remedial action is addressed in the organization’s insurance policy. Also indicate here the amount requested from the Climate Disaster Response Fund as a requested source of revenue.
Upload Project Budget Here*
Max. file size: 12 MB.

Project Management
Expertise*
Explain how your organization has the necessary expertise to successfully address the priorities cited in the project? List all project volunteers, professional consultants, and knowledge keepers, and their related expertise.
Permits*
Provide details about any building and/or work permits required, and identify which are confirmed and which are still pending.
Ongoing Costs*
Will there be any ongoing operating and maintenance costs for the project? If yes, explain what the costs are and who will pay for them.
Long Term Viability*
What is your plan for addressing climate adaptation and future protection of the Heritage Resource and/or for your site?

Certification

I/We Certify That:
- To the best of my/our knowledge all the information contained in this application is true and complete.
- When the project is complete, I/we will send a report outlining the results of the project to the Heritage BC office.
- The financial records for this project will be available for audit.
- Permission is given for on site inspection by any person whom Heritage BC authorizes.
- All funding by the Heritage BC through the Heritage Legacy Fund will be properly acknowledged in print materials and other media, publicity related to the project, and at the project site if appropriate and where possible.
This application and supporting materials are public documents, and may be made available to members of the public under the disclosure rules of the Freedom of Information and Protection of Privacy Act.

TWO AUTHORIZED MEMBERS OF THE ORGANIZATION MUST CERTIFY THE APPLICATION. If the Heritage Resource is leased, one authorization must be the Owner’s.
Name*
First Last
Title*
Organization*
Name*
First Last
Title*
Organization*

Climate Disaster Response Fund Application

Climate Disaster Response Fund

Step 1 of 7

Project Summary

Applicant Contact Information

Organization Information

The Heritage Resource

Project Details

Eligible Work & Quotes

Project Budget

Expenditures

Revenue

Project Management

Certification