Eligibility *I have read the guidelines to ensure the applicant is an eligible business and the YES NO project adheres to the eligibility criteria. *Funding requested is for no more than 50% of the cost of the resource productivity assessment quoted by the chosen supplier from the Preferred YES NO Supplier List. *All mandatory fields of the application form are complete. YES NO Attachments: Supporting Information Information Supplied Attachment Number YES NO *Proof of Public Liability Insurance (mandatory) PENDING *Proof of Workers Compensation Insurance YES NO (mandatory) PENDING *Documents required as evidence of trade waste volume and load (i.e. SA Water customers must provide permission to disclose information; non-SA Water or EPA-licensed applicants must supply evidence of trade waste YES NO volume and load) OR copy of EPA licence (for non-SA customers that are unable to provide evidence of trade waste volume and load) *Resource productivity assessment proposal from supplier chosen from the Preferred Supplier List, which includes measurable YES NO timelines and deliverables (milestones) and a project costing and fee schedule for each milestone (i.e. a breakdown of project costs). Evidence / copy of formal written agreement with your chosen supplier to undertake the YES NO NA resource productivity assessment. (e.g. evidence of previous assessment(s) undertaken at the site) YES NO NA (Please Specify) (Please Specify) YES PENDING Other (Please Specify) YES PENDING
Eligibility *I have read the guidelines to ensure the applicant is an eligible business and the project adheres to the eligibility criteria. YES NO *Funding requested is for no more than 50% of the cost of the resource productivity assessment quoted by the chosen supplier from the Preferred Supplier List. YES NO *All mandatory fields of the application form are complete. YES NO Attachments: Supporting Information Information Supplied Attachment Number *Proof of Public Liability Insurance (mandatory) YES NO PENDING *Proof of Workers Compensation Insurance (mandatory) YES NO PENDING *Documents required as evidence of trade waste volume and load (i.e. SA Water customers must provide permission to disclose information; non-SA Water or EPA-licensed applicants must supply evidence of trade waste volume and load) OR copy of EPA licence (for non-SA customers that are unable to provide evidence of trade waste volume and load) YES NO *Resource productivity assessment proposal from supplier chosen from the Preferred Supplier List, which includes measurable timelines and deliverables (milestones) and a project costing and fee schedule for each milestone (i.e. a breakdown of project costs). YES NO Evidence / copy of formal written agreement with your chosen supplier to undertake the resource productivity assessment. YES NO NA (e.g. evidence of previous assessment(s) undertaken at the site) (Please Specify) YES NO NA (Please Specify) YES PENDING Other (Please Specify) YES PENDING
DBpnJEAeee_Application-Form-(Round-4).docx