Community Investment Program Application

Orica Kooragang Island is committed to contributing to the safety, resilience and prosperity of our community.

Through our Community Investment Program (Program) we aim to support initiatives that will create meaningful social, environmental and economic impact with enduring value. We seek to provide targeted investment, focusing on projects which are responsive to our community's needs and priorities. Fostering positive partnerships and engagement opportunities with our community, customers, suppliers and employees is vital to our business.

The Community Investment Program is operated and administered by Orica Australia Pty Ltd (Orica). It provides funding to local organisations and groups to support their good work primarily in the Newcastle local government area (LGA), Fern Bay and Fullerton Cove.

Decisions regarding the distribution of funding are made by the Funding Committee, which consists of three representatives from Orica Kooragang Island and three representatives from the local community. Orica will determine the total available funding on an annual basis.

You can save your progress at any time and return later to complete your application.

1. Refer to the Application Guidelines of the program for full details of the areas of focus, eligibility requirements and funding limitations.

2. Complete this online application form and upload all supporting documentation in section 9.

3. Submit your application.

If you need help to complete the application please email: kooragang@orica.com

We encourage applications aligned with our areas of focus:

• Environment and sustainability
• Education and lifelong learning
• Strong communities

1.1 Application Organisation's details

Complete this section only if your group is not incorporated.

The Auspice Association will be responsible for managing the funds and contractual arrangements in its own name, on behalf of the Application Organisation should this application be successful.

An authorised representative of the Auspice Association must acknowledge this arrangement in section 9 of this Application Form.

If the funding amount is subject to GST, we will require you to issue us with a tax invoice that complies with the GST law before we will make payment. Please seek tax advice if you are unsure as to whether the funding amount is subject to GST.
If your organisation is not registered for GST we cannot pay GST even if your proposal is subject to GST.

2.1 Application Category - see the Objectives of the Program

Please note that funds may take two to three months from the application close date to be issued.

4.4 List all the income and expenditure details relating to your proposal. Be as specific and as accurate as possible and ensure that the budget balances (income is equal to expenditure).

This declaration must be completed by an authorised representative of the Applicant Organisation.

I declare, on behalf of the Applicant Organisation:

• the information provided in this Application Form is complete and correct and the Applicant Organisation supports the proposal;
• where applicable, the Auspice Association supports the proposal and agrees to the terms and conditions of this Application, as detailed in section 9 of this Application Form [if applicable];
• the Applicant Organisation will promptly inform the Program of any changes to any information regarding the proposal;
• the Applicant Organisation undertakes to comply with the terms and conditions of funding from the Program as detailed in this Application Form and the letter of offer of funding from the Program, including any progress reporting requirements imposed under the Program from time to time;
• individuals or organisations mentioned in this Application Form may be contacted as part of the assessment of this application;
• photographs, details and any other project collateral associated with the proposal may be published by Orica to promote the Program;
• the Orica name and brand will not be used by the Applicant Organisation or anyone associated with the Applicant Organisation without prior consent from the Orica Kooragang Island Community Relations Specialist;
• the Applicant Organisation will advise its insurers of the proposal and acknowledges that any award of funding from the Program is conditional upon proof of appropriate insurance being obtained and proof of cover being produced to the Program Assessment Committee prior to any payment or part payment of any grant. The Program Assessment Committee may consider, in its absolute discretion, the adequacy of the insurance and any award of funding from the Program is conditional on any such insurance being acceptable the Funding Committee;
• payment of money may be on such terms and conditions detailed in the letter of offer, including instalment payments upon satisfaction of agreed targets, and/or milestones or receipt of additional funding from third party organisations as detailed in this Application Form and/or associated Proposal documentation;
• Orica will not be liable for any act or omission of any kind in relation to the Program, including any act or omission of the Applicant Organisation or Auspice Association in relation to the proposal or in completion of any project funded in whole or in part by the Program and the Applicant Organisation, the Auspice Association and any persons associated with these organisations will not make a claim against Orica based on any act or omission by any person or entity of any nature;
• the Applicant Organisation will indemnify Orica in respect of any claim or liability made by or to any third party in relation to the proposal which is the subject of this Application or any project funded in whole or in part by the Program on a full indemnity basis;
• the Applicant Organisation will repay any money paid by the Program where the Applicant Organisation fails to fulfil the terms and conditions of funding from the Program; and
• without limiting the above, Orica will not be liable to fund any future or ongoing costs of the proposal; it is acknowledged and agreed that the Applicant Organisation will not receive any funding over the maximum amount of any funding, or any agreed instalment payment of funding, unless a new application for further funding is later successful on the merits of that separate application.

This declaration must be completed by an authorised representative of the Auspice Association.
I declare, on behalf of the Applicant Organisation:

• the Auspice Association supports the proposal and acknowledges that it will derive benefit from any grant provided by the Program and undertakes to act as 'auspice' to the Applicant Organisation with respect to the Program, undertaking all legal and financial responsibility in relation to the Application and any grant from the Program;
• accepts all the terms and conditions of this Application;
• the Auspice Association will advise its insurers of the proposal and acknowledge that any award of a grant from the Program is conditional upon proof of appropriate insurance being obtained and proof of cover being produced to the Program Assessment Panel prior to any payment or part payment of any grant. The Program Assessment Panel may consider, in its absolute discretion, the adequacy of the insurance and any award of funding from the Program is conditional on any such insurance being acceptable the Program Review Panel;
• Orica will not be liable for any act or omission of any kind in relation to the Program, including any act or omission of the Applicant Organisation or Auspice Association in relation to the proposal or in completion of any project funded in whole or in part by the Program and the Applicant Organisation, the Auspice Association and any persons associated with these organisations will not make a claim against Orica based on any act or omission by any person or entity of any nature;
• the Auspice Association will indemnify Orica in respect of any claim or liability made by or to any third party in relation to the proposal which is the subject of this Application or any project funded in whole or in part by the Program on a full indemnity basis;
• the Auspice Association will repay any money paid by the Program where the Applicant Organisation or Auspice Association fail to fulfil the terms and conditions of a grant from the Program; and
• without limiting the above, Orica will not be liable to fund any future or ongoing costs of the proposal; it is acknowledged and agreed that the Applicant Organisation will not receive any funding over the maximum amount of any grant, or any agreed instalment payment of a grant, unless a new application for further funding is later successful on the merits of that separate application.

I hereby certify that I have been authorised to agree to and sign this Application Form by: