Low Carbon Lake District Grants Application Form

PRIVATE AND CONFIDENTIAL
DATA PROTECTION AND FREEDOM OF INFORMATION ACT STATEMENTWe need to store your data on our database in order to give you the full assistance under this scheme.All information given will be held for a period of 7 years and only used in line with the Data Protection Act 2018 and the General Data Protection Regulations 2016.As a requirement of our grant funding, we will need to share your information with our funding providers, the Ministry of Housing, Communities and Local Government, the European Court of Auditors, the European Commission Auditors and the National Audit Office (and if required to their auditors). It may be necessary to share your information within the Low Carbon Lake District project partnership which includes your Local Authority, in order to offer the full support service.Whilst we will use our best endeavours to ensure that commercially sensitive information remains confidential, you should be aware that some information relating to this public funded project may be declared to third parties under the Freedom of Information Act 2000.
Agreement for us to hold and share your information.*
- I acknowledge and agree that the LDF need to hold and share information provided in this form.
Please note that if you do not agree to us sharing your information, we will be unable to offer you full assistance under the scheme.
Business Details
Business / Organisation Name*
Address*
Street Address Address Line 2 City ZIP / Postal Code
Name*
First Last
Position in Organisation:*
Phone*
Email*
Project Details
Purpose of Grant*
In no more than 500 words, please explain what the grant is for, in particular how the project will deliver annual carbon savings.
Quotes*
Please upload at least one quote per project. Please note that the maximum size allowed for each file is 64MB.
Drop files here or
Max. file size: 64 MB.
Procurement Process*
Please tell us how you acquired these quotes (where did you advertise, or who did you invite, and who responded).
Specification*
Please provide a summary of the specification which quotes are based upon and a summary of all costs.
Carbon Footprint Data*
Please insert here your Carbon Footprint (CO2 equivalent) baseline, and predicted reduction after the project.
Permissions Required*
Please list all required legal permissions, including planning permissions, and their current status.
Proof of Permissions*
Please upload proof of permissions, or plans and maps if permissions have not yet been received.
Drop files here or
Max. file size: 64 MB.
Project Implementation Plan*
Please detail how the project will be managed and what support is required.
Bank Details
Account Holder Name*
Account Number*
Sort Code*
Enter the 6 digits without hyphens.
Please attach copies of the last two years accounts
Drop files here or
Max. file size: 64 MB.
Value of Grant Requested*
Please enter a number from 0 to 20000.
Client Declaration
- I confirm that I am authorised to sign this form on behalf of the business / organisation.
- I agree to provide updated information in the future to enable the full impact of support to be evaluated. This may include financial information or information about employees such as jobs that have been created or safeguarded as a result of the support provided.
- I understand the need to retain audit evidence and state aid information in relation to this support.
Name*
Position*
Date*
DD slash MM slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

PRIVATE AND CONFIDENTIAL

Business Details

Project Details

Bank Details