Application ID - The Salvation Army

Transcription

Application ID - The Salvation Army
The Salvation Army
Communities for Children
Facilitating Partner
Logan
EXPRESSION OF INTEREST
Subcontracted Service Delivery Activities
Guidelines and Submission Form
For Local Not-For-Profit and Non-Government Service Providers operating
in the Logan Local Government Area
Expression of Interest Submission must be received
By 5 pm EST Friday 17th of April 2015
PLEASE NOTE: No late lodgements will be accepted
For further information and support:
Debbie Miscamble
Communities Program Manager
Communities for Children Logan
Ph: 0417 610 387
debbie.miscamble@aue.salvationarmy.org
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Communities for Children Facilitating Partner Logan
Expression of Interest for Subcontracted Service Delivery Activities
Note:
Completed application forms should be emailed to: elise.parker@aue.salvationarmy.org
Please note that only not-for-profit and non-government service providers delivering services in the
Logan Local Government Area (LGA) should complete this form.
Application ID
Questions and Answers
Your Application Identification number (Application ID) is the number you will be allocated in
acknowledgement of receipt of your lodged Expression of Interest. It will be used to track and monitor
the movement of your application through the assessment process.
Please make note of your Application ID and use this when providing any information and making
enquiries regarding your EOI
Direct any questions to The Communities for Children Facilitating Partner (FP) Logan
Communities Program Manager Debbie
Miscamble: debbie.miscamble@aue.salvationarmy.org 0417 610 387
You should read the Communities for Children Facilitating Partner Operational Guidelines
before proceeding. Copies of these documents can be found by clicking on the following
links:
Department of Social
Services
Critical Documents
Communities for Children Guidelines:
https://www.dss.gov.au/our-responsibilities/families-and-children/programs-services/familysupport-program/communities-for-children-facilitating-partner-operational-guidelines
Families and Children Guidelines Overview:
https://www.dss.gov.au/sites/default/files/documents/07_2014/families_and_children_
programme_guidelines_overview_final_15_july_2014_2.pdf
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As stipulated in the Families and Children Guidelines Overview, the following entity
types meet the eligibility requirements to apply for a grant in this activity:
Eligibility Criteria
a. Incorporated Associations (incorporated under state/territory legislation, commonly
have ‘Association or ‘Incorporated’ or ‘Inc.’ in their legal name)’
b. Incorporated Cooperatives (incorporated under state/territory legislation, commonly
have ‘Cooperative.’ in their legal name)’
c. Companies (incorporated under the Corporations Act 2001 – May be a propriety
company (limited by shares or by guarantee) or a public company)
d. Aboriginal Corporations (incorporated under the Corporations (Aboriginal and
Torres Strait Islander) Act 2006)
e. Organisations established through a specific piece of Commonwealth or
state/territory legislation (public benevolent institutions. churches, universities,
unions etc.)
I.e. Queensland Religious, Education or Charitable Institutions Act 1861
f. Partnerships
g. Trustees on behalf of a Trust
The Communities for Children Facilitating Partner (CfC FP) Operational Guidelines state
that:
"It is important that children and families have access to effective programmes that lead
to sustained improvements in outcomes. To ensure that programmes are effective an
assessment of the available evidence is required. Evidence-based programmes have
been empirically proven to improve outcomes for children and families and represent the
best value for money for government."
Evidence Based
Practice
New grant agreements for CfC FPs require that from 1 July 2015, at least 30% of funding
for direct service delivery should be used to provide high quality, evidence-based
programmes.
.
Please familarise yourself with the evidence based programme profiles listed on the
Australian Institute of Family Studies website:
https://www3.aifs.gov.au/cfca/information-service-providers#communities
As outlined in the Communities for Children Facilitating Partner Operational Guidelines
(page 9):
Cultural Competency
and Diversity
Services should provide flexible, culturally sensitive and accessible service delivery
models and practices, ensuring accessibility to any people who face perceived or real
barriers to receiving assistance. You must be able to provide evidence of these strategies
and must provide services equally, without bias or prejudgment about clients. Services
must be accessible to all target groups including Indigenous and culturally and
linguistically diverse populations.
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Communities for Children – Expression of Interest
Part 1 – Eligibility Criteria – Please mark the appropriate box with an X
1a
Organisation type or lead entity type
Non – Government
Not-for-profit
1b
Does your organisation have an ABN or ACN?
Yes
No (not eligible for funding)
If Yes, what is your an ABN or ACN?
ABN
ACN
Organisation or entity type
Incorporated Association
Incorporated Cooperative
Companies - Commonwealth Corporations Act 2001 (non-profit objectives)
Aboriginal Corporations
Organisation established through a specific piece of Commonwealth or state/territory legislation (e.g. many
public benevolent institutions, churches, universities, unions etc.)
Partnership
Trustee on behalf of a Trust
If you have not crossed any box from the list above your organisation is NOT eligible to submit an Expression of
Interest. You can refer to the Families and Children Guidelines Overview for more information.
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Communities for Children Logan – Application
Part 2 – Applicant Details
2a
What is the legal name of your organisation?
This is the name that appears on all official documents and legal papers. It may be different to your trading name. If the
project will be performed by a consortium, this must be the lead entity of the consortium (see Part 3).
All further responses within this application form must relate to this entity. This is the legal entity that, if successful, will
be required to sign The Salvation Army Communities for Children – Facilitating Partner subcontracted funding agreement.
2b
What is the trading name of your organisation?
This is the name your organisation trades or provides services under.
If it is the same as your entity’s legal name, mark the following box with an X
Same as question 2a
2c
What is your organisation’s physical address?
Address
Suburb/Town
State
Postcode
2d
If different, what is the postal address of your organisation?
Address/PO Box
Suburb/Town
State
Postcode
2e
If applicable, what is the outlet name where the proposed project/activity will be delivered?
Name
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Application ID
2f
If more than one outlet is going to be used to deliver the service, please list the name of the additional suburb/s
below
Suburb 1
Suburb 2
Suburb 3
Suburb 4
Suburb 5
2g
Who are the authorised contact persons for this Expression of Interest?
Preferred contact
Alternative contact
Title
First name
Surname
Position in organisation
Telephone number
Mobile number
Business email address
Part 3 – Consortium Details (complete if you are partnering with one or more other organisations)
Consortium Definitions
Lead entity
This is the legal entity, specified in Part 1, which if successful, will sign the funding agreement.
Consortium
Requirements
A project may be proposed if an application is being implemented by a consortium. However,
the applicant, and each consortium member, must meet the eligibility requirements in Part
2.3 of the Families and Children Guidelines Overview.The lead entity for the consortium must
be the agency that completes and submits this application form.
If the consortium's project is approved the lead entity, as the applicant, will be required to
enter into a contract with The Salvation Army Communities for Children FP (The Salvation
Army (Queensland) Property Trust), and will be responsible for ensuring the performance of
the project/activity and it’s completion.
Applicants may determine that efficient or effective service delivery is best achieved through
the use of a network of providers through a sub-contracting arrangement. This can be recorded
in Part 3a of this document.
A successful provider who uses an authorised sub-contracting arrangement will be held
liable for all obligations contained in the terms and conditions of the funding agreement. This
includes review, management, financial performance, service outcomes, and specifically
insurance coverage.
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Application ID
3a
Please list the legal names, ABNs/ACNs of all members of the consortium and provide a brief description of each
member’s role in the delivery of the services
(Lead entity details must be completed in Part 1 of this application)
Organisation legal name
ABN/ACN
Please describe their role in consortium
ABN
1
ACN
ABN
2
ACN
ABN
3
ACN
ABN
4
ACN
ABN
5
ACN
3b
I confirm that the proposed consortium members have agreed to enter into a consortium arrangement for the
purposes of this agreement, and have attached the required evidence (Please mark the appropriate box with
an X)
Further evidence of the consortium arrangements must be included as an attachment accompanying your
Expression of Interest (e.g. letter confirming your arrangement and signed by all consortium members)
Yes
No
3c
Does your organisation plan to sub-contract any of the proposed Communities for Children FP Community
Partner project activities not identified in the information provided above (Part 2a) about consortia
arrangements?
(Please mark the appropriate box with an X)
Yes
No
If Yes, please provide details
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Application ID
Part 4 – Financial Viability and Governance
4a
Please provide the following audited financial statements
(Please scan your audited financial statements and attach electronically)
Most recent audited financial statements (with previous year for comparison).
Are these statements fully compliant with all applicable Australian accounting standards?
Yes
No
Please explain any areas of non-compliance and the reasons for non-compliance.
4b
Current financial statement (Please scan and attach electronically the following documents)
Current financial statement (income and expenditure, balance sheet, and statement of equity – this statement does not
need to be audited).
4c
Please indicate below if either of the following apply to your organisation
(Please mark the appropriate boxes with an X)
Any significant financial matter which may impact on the organisation (e.g. insolvency or any form of external
administration).
Future commitments or contingent liabilities that might materially affect the organisation.
If you have marked any of the above boxes please provide a short explanation here (further information may be
requested)
4d
Has your organisation applied for funding from any other source to deliver the proposed subcontracted activity or
a similar activity?
Program or funding source name Contact officer
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Email address
Date of application
Application ID
Part 5 – Details of the Subcontracted Activity
5a
Mark the appropriate Statistical Area Level 3 box where the proposed subcontracted activity will be provided.
Please refer to the additional resources (5a - Statistical Area Information) in your EOI Application Pack for more
details on the proposed service areas.
Beenleigh
Browns Plains
Beenleigh, Eagleby, Edens Landing – Holmview, Mount Warren Park,
Wolffdene – Bahrs Scrub
Boronia Heights – Park Ridge, Browns Plains, Chambers Flat –
Logan Reserve, Crestmead, Greenbank Military Camp, Hillcrest,
Marsden, Munruben – Park Ridge South, Regents Park – Heritage
Park
Jimboomba
Loganlea – Carbrook
Greenbank, Jimboomba, Logan Village (including Yarrabilba)
Bethania – Waterford, Cornubia – Carbrook, Loganholme – Tenah
Merah, Loganlea, Shailer Park, Waterford West
Springwood – Kingston
Daisy Hill, Kingston, Logan Central, Rochedale South – Priestdale,
Slacks Creek, Springwood, Underwood, Woodridge
5b
Please describe how the subcontracted activity will address priority 1 and AT LEAST ONE of the following
priorities. Please refer to the additional resources (5b - Communities for Children – FP Logan Priorities Flow
Chart) in your EOI Application Pack for more details on the Priority Areas. Please mark the box with an X
Priority 1: Logan Charter – Community Collaboration and Resilience (400 words)
NB: You must complete this section
If applicable, Please describe how you have addressed this priority in the past
$0
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$0
$0
$0
Application ID
5c
Priority 2: Education and School (Learning for All) (400 words)
In your response please provide a summary description of your subcontracted activity including how you
intend to meet the identified priority, proposed target groups, how you will assist them, indicative number of
people who will benefit, the timeline for implementation, and the intended outcomes
If applicable, Please describe how you have addressed this priority in the past
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Application ID
Priority 3: Strengthening Family Relationships (400 words)
In your response please provide a summary description of your subcontracted activity including how you
intend to meet the identified priority, proposed target groups, how you will assist them, indicative number of
people who will benefit, the timeline for implementation, and the intended outcomes
If applicable, Please describe how you have addressed this priority in the past
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Application ID
Priority 4: Collaborative Family Centered Practice (400 words)
In your response please provide a summary description of your subcontracted activity including how you
intend to meet the identified priority, proposed target groups, how you will assist them, indicative number of
people who will benefit, the timeline for implementation, and the intended outcomes
If applicable, Please describe how you have addressed this priority in the past
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Application ID
Part 6 – Previous Experience
Please describe examples of where you have previously been involved with (lead, managed, cocreated/delivered etc.) activities/services
Part 7 – Expenses associated with delivery of your proposed subcontracted activity
7a
Please indicate the cost components and estimated value – please indicate in-kind expenses
Description of Cost Item
Funding from other
Sources ($AUD)
Including in kind from your
organisation and your
partners/stakeholders (e.g
resources, existing funded services
which will be delivered as part of
your proposal, staff involved in
service delivery, premises, assets)
Total cost of proposed subcontracted activity
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Cost component of
subcontracted activity
requested from CfC – FP
Logan ($AUD)
2015 - 2016
2016 - 2017
Application ID
Part 8 – Selection Criteria
8a
Criterion A: What will prevention and early intervention activities look like in your proposed subcontracted
activity? (250 words)
8b
Criterion B: 30% of CfC – FP subcontracted funding is allocated for the delivery of high quality, evidence based
programs as identified by the Expert Panel. Please refer to the additional resources (8b – Information regarding
evidence based programs) in your EOI Application Pack for more details on the evidence based programs.
How would you go about building evidence based practice into your proposed subcontracted activity? What would this look like? How
would this improve outcomes for children and families? (300 words)
8c
Criterion C: How will your proposed subcontracted activity actively develop strategies to encourage access
and engagement by vulnerable and at risk children and families? Please provide examples of where you
have done this in the past. (250 words)
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Application ID
8d
8e
Criterion D: How will you ensure your organisation has appropriately qualified staff and is committed to staff
supervision, development and training? Please provide examples of how you have done this in the past. (250
words)
Criterion E: How will your proposed subcontracted activity demonstrate cultural competency? Please
give examples of how you have done this in the past. (250 words)
Criterion F: Are you willing to collaborate with other organisation/s to co-create and/or co-design and/or
co-deliver agreed subcontracted activities, deliberately taking a whole of community approach, in the
same statistical area (Level 3) that you have identified in your application?
Yes
No
Please describe how you see your organization’s role in collaborating with Communities for Children and
other local organisations to join in this whole of community approach? (250 words)
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Application ID
Part 9 – Conflicts of Interest
Please describe all actual or potential conflicts of interest and why you feel this is a conflict of interest e.g.
someone in your organisation is a CfC committee member or board member of another organisation operating
in Logan, your organisation is represented on another steering committee or reference group in Logan.
State the Conflict
Why is this an actual/potential conflict of interest?
Part 10 – Referees
Please provide the details of 2 external professional referees which can be contacted if required
Referee 1
Name
Position
Organisation
Contact phone
Email
Referee 2
Name
Position
Organisation
Contact phone
Email
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Application ID
Part 11 – Declaration
Please complete the declaration
I confirm/understand that:
• the information, including financial information, contained in this application form is true and accurate,
• incomplete Applications may not be considered,
• applications received after the closing date will not be considered,
• Tax Invoices will need to be submitted to the Facilitating Partner should this application be successful,
• The consortium members (if applicable) for the proposed project will be and remain those specified in the application
until the completion of the project,
• consortium members (if applicable) have given permission for their organisation’s information to be made available,
and
• if and where any personal details of a third party are included, the third party has been made aware of and given their
permission for those details to appear in this application.
I confirm/understand
I do not confirm/understand
Name
Date
Position in organisation
Part 12 – Application Checklist (Please mark the appropriate boxes with an X)
Part 1
Eligibility Criteria
Part 2
Applicant Details
Part 3
Consortium details (if applicable)
Part 4
Financial viability and governance including electronic attachments of statements
Part 5
Details of subcontracted activity
Part 6
Previous Experience
Part 7
Expenses
Part 8
Selection Criteria
Part 9
Conflicts of interest
Part 10
Referees
Part 11
Declaration
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Yes