AGIEI Application Form 2015-16

AUSTRALIAN GOVERNMENT INTERNATIONAL
EXHIBITIONS INSURANCE (AGIEI) PROGRAMME
APPLICATION FOR FUNDING 2015-16
CONFIDENTIAL WHEN COMPLETED
PLEASE READ THE PROGRAMME GUIDELINES BEFORE COMPLETING THIS
APPLICATION FORM.
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APPLICATION
Please read the Australian Government International Exhibition Insurance (AGIEI)
Programme guidelines before completing this application form and ensure the
exhibition for which funding is being sought meets the eligibility requirements
detailed in those guidelines. Please note that the programme guidelines have
been revised and include changes to eligibility requirements.
APPLICATION PROCESS
The application process for funding under AGIEI is in two-stages.
Stage 1 requires applicants to complete and submit Part 1 as an Initial Application.
Stage 2 requires organisations which have received written notification of in-principle
support for the exhibition proposed in the Initial Application to submit an updated Part 1
and a completed Part 2 as a Final Application no later than 60 business days prior to the
commencement of that Exhibition.
Please ensure a completed Application Checklist and Certification are submitted at both
application stages.
This form is to be used for both Stage 1 and Stage 2 Applications. Applicants should tick
the relevant box below to indicate whether they are providing an initial or final
application.
This is an Initial Application and contains Part 1 only.
Do not complete Part 2 at this stage.
This is a Final Application and contains Part 1 and Part 2.
If successful, the Final Application will form part of the Agreement.
CLOSING DATE FOR APPLICATIONS
Initial Applications:
1 April 2015 for Exhibitions commencing on or after
1 January 2016.
Final Applications:
No later than 60 business days prior to the commencement
of the exhibition.
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APPLICATION CHECKLIST
Legal name of organisation:
Confirm you have provided the following documents:
Original Application with signed Certification (mandatory)
Yes
No
Electronic copy of the Application (mandatory)
Yes
No
Most recent Organisations Annual Report (mandatory)
Yes
No
Exhibition content lists and value of loans (mandatory)
Yes
No
Exhibition risk management plan (optional)
Yes
No
Insurance premium quotes (mandatory)
Yes
No
Exhibition budget attachments (mandatory)
Yes
No
5 year forward schedule (mandatory)
Yes
No
SUBMITTING YOUR APPLICATION
By Email:
[email protected]
By Post:
Programme Officer
AGIEI Programme
Ministry for the Arts
Attorney-General’s Department
3-5 National Circuit
BARTON ACT 2600
By Hand:
Programme Officer
AGIEI Programme
Ministry for the Arts
Attorney-General’s Department
4 National Circuit
BARTON ACT 2600
For further information please go to www.arts.gov.au/collections/agiei.
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EMAILED APPLICATIONS SHOULD BE FOLLOWED BY A SIGNED HARD COPY
WITHIN 3 WORKING DAYS.
CERTIFICATION
I consent to all information and material in this Application, and any other information
provided for the purposes of this Application, being used by the Australian Government
represented by the Ministry for the Arts in seeking additional advice from state/territory
governments and other relevant agencies and organisations. The Ministry for the Arts
may also use the information to provide the Minister and State and Territory
governments with advice on the general administration of the Programme.
I understand that this Application may not be accepted if it is not received by the
specified closing time and date, or if it is not provided in the correct format.
I agree that:
•
I have read the Australian Government International Exhibitions Insurance
Programme Guidelines and certify that my organisation meets the eligibility
requirements detailed in those Guidelines;
•
I have answered all the questions in the Application and provided any applicable
supporting material;
•
all details provided in this Application are true and correct;
•
the information in the Application and other support material is not misleading or
deceptive;
•
the Application has been submitted with the full knowledge and agreement of the
management of the applicant organisation;
•
I will inform the Ministry for the Arts immediately if I suspect or know that any of
the assurances (however described) contained in this statement or in the
Application are not, or are no longer, correct;
•
I am authorised to sign the Application on behalf of the organisation;
•
my organisation may be required to repay any funding which is not expended in
accordance with the Funding Agreement and for the purposes for which it is
provided;
•
I understand that the Australian Government will rely on the information provided
in this Application;
•
I understand that under section 137.1 of the Criminal Code Act 1995 (Cth) giving
false or misleading information is a serious offence;
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•
I understand that if the Minister, or their delegate, gives in-principle approval for
funding for this Exhibition, the organisation must, not later than 60 business days
prior to the commencement of the Exhibition, submit a Final Application for
funding and that the Exhibition must continue to meet the Programme Guidelines
to qualify for further funding consideration. I understand that in-principle approval
does not guarantee that funding will be granted for the Application; and
•
I acknowledge that my organisation may NOT be eligible for AGIEI Programme
funding if the details contained in the Final Application differ substantially from
those contained in the Initial Application
………………………………………………………
Signature
Date
Please print name
Position in institution:
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PART 1 – INITIAL APPLICATION
PART 1 – QUESTION 1: APPLICANT DETAILS
Organisation
Legal name of organisation:
Trading name, if applicable:
Australian Business Number (ABN):
Australian Company Number (ACN):
GST registered:
Address
Street number and name:
Suburb/ city:
State / territory:
Postcode:
Mailing address, if different from above:
Applicant representative (should be the Director, CEO or equivalent)
Title:
First Name:
Surname:
Position in organisation:
Telephone, including area code:
Email:
Primary AGIEI contact
Title:
First Name:
Surname:
Position in organisation:
Telephone, including area code:
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Email:
PART 1 – QUESTION 2: ORGANISATION CATEGORY
Funding is available to Commonwealth, State and Territory Government Collecting
Institutions, incorporated not-for-profit Australian collecting organisations, and
incorporated not-for-profit organisations specialising in touring international art and/or
collection exhibitions.
Please indicate which of the following categories your organisations falls into. It is
mandatory to provide the Incorporation Number and/or the legislation under which your
organisation is established.
Incorporated under an Associations Incorporation Act of a State or Territory
Incorporated under the Corporations Act 2001 (Cth) as a not-for-profit company
Aboriginal or Torres Strait Islander corporation
University
Commonwealth Government body
State Government body
Territory Government body
Local Government body established in accordance with a
Local Government Act of a State
Other incorporated body, please specify below
Type of incorporated body:
Incorporation number:
Legislation:
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PART 1 – QUESTION 3: PROPOSED EXHIBITION INFORMATION
Note: All amounts are to be provided in Australian dollars.
Proposed exhibition title
Exhibition type (fine art or museological)
Total value of works in the exhibition
Note the value thresholds for fine art and
museological exhibitions.
Total cost of insurance premium
Insurance period (dd/mm/yy – dd/mm/yy)
Requested amount of funding from AGIEI
If you are not requesting the full insurance
costs from AGIEI, please detail other
funding sources.
Is there an indemnity programme
(however described) operating in your
state/territory?
If yes, is this exhibition eligible for funding
under that scheme?
Please provide details on whether you
have applied for funding and if you have
been successful in receiving funding
support?
Is there an indemnity programme
operating in any State/Territory other than
your own to which your exhibition will be
touring?
If so, please provide details.
If there is an indemnity programme in
your State/Territory and you wish to apply
for AGIEI funding because you believe
there are exceptional circumstances,
please describe them here.
Supporting material can be supplied as an
attachment.
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Please label all attachments with the relevant question number and indicate its
attachment by ticking the box provided.
PART 1 – QUESTION 4: CONTENT OF EXHIBITION AND VALUE OF LOANS
As an attachment, please provide a proposed list of works for the exhibition, including
details of the artist, title, medium, name of the lending institution, valuation, and any
special conditions that are attached to the loans.
Exhibition content list attached
PART 1 – QUESTION 5: FIVE YEAR FORWARD SCHEDULE
In an attachment, please submit a five-year forward schedule of your organisation’s
planned exhibitions for which AGIEI funding may be sought.
Five-year forward schedule attached
PART 1 – QUESTION 6: ANNUAL REPORT
Please provide a copy of your organisation’s most recent Annual Report.
Annual Report attached
PART 1 – QUESTION 7: SELECTION CRITERIA
You should address all the selection criteria listed in the programme guidelines. Please
keep your responses concise – approximately 200 words per criterion.
7.1 EXHIBITION DESCRIPTION AND BENEFITS
Please provide a summary of the proposed exhibition for which funding is sought and
discuss how exhibiting this cultural material will be of benefit to the Australian public.
Your response should address your curatorial rationale, content of the exhibition,
cultural significance, and any other relevant factors.
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7.2 AUDIENCE ACCESS
How will this exhibition appeal to and attract audiences?
7.3 AUDIENCE ACCESS LIMITING FACTORS
If there are any aspects of the exhibition that may limit broad public access or otherwise
prevent or discourage potential visitors from attending the exhibition (e.g. culturally
sensitive material or material that may be considered inappropriate by some audiences),
please provide details and indicate how this will be communicated to potential
audiences.
7.4 PROPOSED ITINERARY
Please provide your proposed itinerary for the exhibition and details of all proposed
venues.
Potential
State or
Venue
Opening date
Territory
Closing date
audience
numbers
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7.5 EXHIBITION MANAGEMENT EXPERIENCE
Please briefly describe two recent high value exhibitions developed by your
organisation including at least one example of a touring exhibition and address both the
development and touring aspects of that exhibition.
7.6 RISK MANAGEMENT
Please provide details of your Risk Management Plan for the exhibition, or provide in an
attachment.
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7.7 INSURANCE
You should ensure that your insurance estimate is based on a quote from an insurance
provider and provides value for money. Where the broking services of the Australian
Government broker are not used, the Ministry for the Arts may seek an independent
quote for comparison.
At the ‘in-principle approval’ stage, it may not be possible for your organisation to
provide a firm quotation for the insurance premium. However, you will need to provide
the most accurate estimate possible and explain the basis for the amount of funding
requested. Note that where you seek funding for both static and transit insurance costs,
your quotation should outline each cost and each venue separately.
Attach details of all insurance quotes obtained including the one selected. A minimum of
two quotes should be provided.
Insurance quotes attached
7.8 BUDGET
Please provide a copy of the exhibition budget as an attachment. The budget must be
itemised to clearly indicate the insurance costs. It must also detail, if applicable, the
amount of funding expected from other sourced, including State/Territory indemnity
schemes, for meeting the cost of insurance.
Budget details attached
7.9 DUTY OF DISCLOSURE
Please provide details of any factors that you know about but that you have not told us
that may impact on our decision to provide you with funding.
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PART 2 – FINAL APPLICATION
Only to be completed if applicant has been advised in writing of in-principle support. The
Final Application is to be submitted at least 60 business days before the exhibition is
due to commence.
The Final Application requires you to resubmit an updated Part 1 and a completed
Part 2, detailing where circumstances and/or figures have changed since the
Initial Application.
The proposed exhibition must continue to meet the AGIEI Programme guidelines to
remain eligible for funding.
Have there been any changes since the Initial Application?
Yes
No
All changes must be reflected in Part 1 of this application.
If you answered yes, please indicate what areas changed below and provide a summary
of those changes in the space provided below:
General exhibition information
Content of exhibition and value of loans
Exhibition description and benefits
Audience access
Audience access limiting factors
Exhibition itinerary
Risk management
Insurance
Budget
Duty of disclosure
Please provide a summary of the changes.
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