Can the Respondent Yes provide copies of these documents within 7 days of a request by the DHHS? 22. Do any of the Any form of current or pending litigation No Yes following to the Respondent? If the Respondent ticks Any significant financial matter which may No Yes Yes to any of these impact on the organisation (e.g. insolvency or please provide a short voluntary administration) explanation below. Future commitments or contingent liabilities No Yes Further information may that might materially affect the organisation be requested. Comments: 23. Insurances The Respondent must clearly identify insurance details and provide Insurance Certificates in this section (the figures included are the minimum that the Department requires). Insurance Insurer Policy No. Sum Insured Expiry Date Public Liability $20 million per claim Insurance Workers’ compensation Insurance Professional $10 million per claim Indemnity/Negligence Insurance Other Insurances (please list): PART FOUR (E) BUDGET DETAILS ALL QUESTIONS ARE MANDATORY 24. Please provide a breakdown of the planned budget (GST exclusive) using the attached pro-forma (SEE ATTACHED SPREADSHEET). Proposals without a budget may not be considered. (Show whole dollars only)
Can the Respondent provide copies of these documents within 7 days of a request by the DHHS? Yes 22. Do any of the following to the Respondent? If the Respondent ticks Yes to any of these please provide a short explanation below. Further information may be requested. Any form of current or pending litigation No Yes Any significant financial matter which may impact on the organisation (e.g. insolvency or voluntary administration) No Yes Future commitments or contingent liabilities that might materially affect the organisation No Yes Comments: 23. Insurances The Respondent must clearly identify insurance details and provide Insurance Certificates in this section (the figures included are the minimum that the Department requires). Insurance Insurer Policy No. Sum Insured Expiry Date Public Liability Insurance $20 million per claim Workers’ compensation Insurance Professional Indemnity/Negligence Insurance $10 million per claim Other Insurances (please list): PART FOUR (E) BUDGET DETAILS ALL QUESTIONS ARE MANDATORY 24. Please provide a breakdown of the planned budget (GST exclusive) using the attached pro-forma (SEE ATTACHED SPREADSHEET). Proposals without a budget may not be considered. (Show whole dollars only)
RFGP_Request_for_Grant_Proposal_Form.docx