Application Form Spark Fund And Transform Fund

Spark Fund and Transform Fund are support schemes for Gwynedd businesses to recover and develop, stabilise and prepare for the future. The aim is to enable businesses to increase profits either through savings or increased income. ~~The Spark Fund supports grants from £2,500 to £25,000~~ (APPLICATIONS PAUSED) The Transformation Fund supports grants from £25,001 to £250,000

The following is the information you will need to provide in addition to this form:

	Transform Fund	Spark Fund
	Every Business	New business or less than 12 months of operation	Business has been operational for more than 12 months
Business plan	✓ (detailed – see the guidelines)	✓	✗
2 year financial forecast	✓	✓	✗
Balance sheet and profit and loss statement for the last two years	✓	✗	✓
Current bank statement of the business	✓	✓	✓
Confirmation of any relevant consent including statutory legal requirements	✓	✓	✓
All quotes	✓	✓	✓

Application Details

Business / Company Name *

Name of applicant *

Address of Applicant(s) *

E-mail address *

Confirm E-mail address *

Phone number *

Business address *

Business Telephone No *

E-mail address *

Website

Does the business operate from any other address? *

Yes

Reason For Grant

For what purposes is the grant required? Please explain why you need the grant, i.e. without the grant you could not undertake the activity outlined in your application: - At all - To the same extent - Within a reasonable timescale

What is the grant required for? *

Place of Business

Are you the freeholder of the property? *

Yes

If you have a lease, how much of the lease is left before it expires?

If relevant:

Have you obtained planning permission?

Yes

Have you obtained building regulations permission?

Yes

Schedule / Finance

(a) Total cost of equipment/services *
(b) Grant requested (70% or 50% for some vehicles - see the guidelines)	Capital: £ * Revenue: £ * Total: £ *

Source Name	e.g. savings, business account etc	Amount	Status – secured / applied for / to apply for
Myself
Bank Loan
Bank Overdraft
Other Borrowings
Other Grants
You MUST provide evidence of all sources of funding you intend to use for your application

Project Breakdown

Please provide a breakdown of how the grant will be used and provide details of quotes: (Original projections / quotes must be attached) - At least 3 for each item if it is £5,000 or higher for each supplier. - For items over £50,000 please contact us for further procurement instructions

Item	Supplier	Cost (Ex.VAT)	Cost (INC.VAT)

Have all of the items above been sourced from a supplier based in Gwynedd? *

Yes

If not, what steps were taken to investigate using suppliers from Gwynedd and what was your reason for not using them? *

Value for Money

Will the equipment/service(s) you are seeking a grant for enable your business to make more profit? *

Yes

Please provide details *

How much more profit do you expect to make over the next three years?

Yr1 (£) *

Yr2 (£) *

Yr3 (£) *

Please provide a simple explanation of how you have calculated the above *

Will the equipment/service(s) you are seeking a grant for enable your business to reduce costs? *

Yes

Please give details *

How much savings do you expect to make over the next three years?

Yr1 (£) *

Yr2 (£) *

Yr3 (£) *

Please provide a simple explanation of how you have calculated the above *

Employment Details and Linguistic Profile

	Current Jobs		Jobs created as a direct result of receiving this grant	Timeline for creating jobs (months)	Jobs protected as a direct result of this project
	Male	Female	Jobs created as a direct result of receiving this grant	Timeline for creating jobs (months)	Jobs protected as a direct result of this project
Directors / Owners
Full Time
Part Time

What is the main administrative language of the business? (tick the most suitable box) *

All Welsh

More Welsh than English

Fully bilingual

More English than Welsh

All English

How many of your staff can speak Welsh fluently? *

How many of them can use some Welsh when talking to customers? *

In what language do you create marketing material? *

Welsh only

English only

Bilingual

Turnover

Most recent annual turnover (to the nearest £1) *

Projection of turnover for next two financial years as a result of the grant (to the nearest £1)

Year 1 *

Year 2 *

Business Bank Details

Account Name *

Name and Address of the Bank *

Account number *

Sort code (xx-xx-xx) *

Additional Details

Environmental Sustainability

Do you have an Environmental Policy? *

Yes

Do you have a formal Environmental Management System? *

Yes

Equality, Diversity and Inclusion Policy

Do you have an Equality, Diversity & Inclusion Policy? *

Yes

Welsh language and culture

Do you have a Welsh Language Policy? *

Yes

If the answer is 'Yes', you may need to provide a copy of these policies.

Business Location

Do you, or do you intend to run your business from home? *

Yes

Value for Money

Will receiving this grant allow you to grow your business? *

Yes

Will recieving this grant allow your business to be more competitive? *

Yes

Will receiving this grant allow the business to be more sustainable? *

Yes

Is receiving this grant likely to stimulate further investment in your business? *

Yes

Will receiving the grant allow you to introduce new products, services or reach new markets? *

Yes

Employment Details and Language Profile

If you noted that receiving this grant would safeguard jobs, explain how (e.g. why would this/these job(s) be under threat without the grant?)

Statement and Understanding

Have you or any of your associates ever been disqualified from being a company director under the Company Directors Disqualification Act (1986) or ever been the proprietor, partner or director of a Business that has been subject to an investigation (completed, current or pending) undertaken under the Companies , Financial Services or Banking Acts? *

Yes

Has any director/partner ever been bankrupt or subject to an arrangement with creidtors or ever been the proprietor, partner or director of a Business subject to any formal insolvency procedure such as a receivership, liquidation or administration, or subject to an arrangement with its creditors? *

Yes

Has any director/partner ever been the proprietor, partner or director of a Business that has been requested to repay a grant under any government or local government scheme? *

Yes

If you have answered Yes to any of the above, this will not necessarily ffect your chances of receiving Support. However, please give details below of he person(s), the Business(es) and the circumstances:

Additional Details

Environmental Sustainability

Have you committed to the Green Growth Pledge? *

Yes

Equality, Diversity and Inclusion Policy

Have you committed to the Equality Pledge? *

Yes

Operational Standards

Do you have any Operational Standards Accreditations (such as ISOs)? *

Yes

Documents to be Included

• Business Plan (if applicable) • 2 year Financial forecast • Balance Sheet and profit and loss statement for the last two years • Bank Statement for the Business • Confirmation of any relevant consent including statutory legal requirements • All quotes • Evidence of match funding

Declaration

• I authorise the Council to make any enquiries necessary to confirm any information needed to reach a decision on my application. The information contained in this application may be shared with a colleague in other departments and other business support organisations to assess the application; • I declare that all information in this form is accurate to the best of my knowledge, and that the Council may take action against the signatory to reclaim the grant and any costs, charges or expenses involved; • I also confirm that I have the full right and authority to act on behalf of the business/organisation making this request; • I confirm that this grant is necessary to do what the grant will support, either at all, to the same degree, or within a reasonable timeframe • I confirm that all purchased items will be properly insured; • I confirm that all items will be adequately preserved and maintained; • I confirm that all necessary statutory permissions are in place • I confirm that any public material funded by the grant (such as signage) will comply with Cyngor Gwynedd's Language Policy; • I confirm that the money will be spent in accordance with this request and that items will not be sold within the monitoring period;

I agree to ALL the above declarations *

Application Form Spark Fund And Transform Fund

Application Details

Structure of the Business

Reason For Grant

Place of Business

Schedule / Finance

Project Breakdown

Value for Money

Employment Details and Linguistic Profile

Turnover

Business Bank Details

Additional Details

Environmental Sustainability

Equality, Diversity and Inclusion Policy

Welsh language and culture

Business Location

Value for Money

Employment Details and Language Profile

Statement and Understanding

Additional Details

Environmental Sustainability

Equality, Diversity and Inclusion Policy

Operational Standards

Documents to be Included

Declaration