COMMUNITY BASED CCTV SCHEME APPLICATION FORM...

COMMUNITY BASED CCTV SCHEME

APPLICATION FORM FOR GRANT AID

Stage 2

Operational Funding

2006

CCTV Stage 2 Application Form

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Important Notes on the Stage 2 Application Process

This form is for applications under Stage 2 (operational) of the Community-based CCTV

Scheme. A different form is required for Stage 1 (pre-development) applications.

Applicants should familiarise themselves with the documentation listed below and decide whether

they wish to apply under Stage 1 or Stage 2 of the scheme, before submitting their proposals.

A separate application must be submitted in respect of each proposed CCTV system in an area.

Before completing the application form, please ensure that you have read the:

1. ‘Community Based CCTV Scheme Guidelines for Application and Appraisal Process’

2. ‘Code of Practice for Community Based CCTV Systems, Section 38 (3)(C) Garda

Síochána Act 2005

3. ‘Technical Specification for Community Based CCTV Section 38 (3)(C) Garda

Síochána Act 2005’

The following requirements are MANDATORY. Failure to meet any of these requirements will result

in the application being deemed ineligible for consideration.

� The proposed CCTV system must have the written approval of the local Garda

Divisional Officer.

� The proposal must meet the minimum technical specification for the scheme.

� The proposal must have the written approval of the Local Authority.

� The applicant must have secured the written agreement of the Local Authority to act

as Data Controller for the CCTV system.

Before forwarding the application to Pobal, please ensure that you have:

1. Answered all of the questions on the form that apply to your application;

2. Ticked the comprehensive CHECKLIST at the back of this form;

3. Included all required documentation.

Two copies of completed application form together with one full set of supporting

documentation should be forwarded to:

Community Based CCTV Scheme

Pobal

Holbrook House

Holles Street

Dublin 2 Note: One of these forms (the one with signatures) should be presented in ‘hard copy’. The second should be

sent electronically, where possible, to: [email protected].

Phone: 01 – 2400754 Fax: 01 – 6610411 E-mail [email protected] website:

http://www.pobal.ie

THE CLOSING DATE FOR RECEIPT OF APPLICATIONS IS 5.00 P.M. WEDNESDAY, 28TH FEBRUARY

2007.

LATE APPLICATIONS WILL NOT BE ACCEPTED.


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Assessment and notification of outcome to applicants. All applications received by the closing date will be assessed by a Selection Committee. The

Minister for Justice Equality and Law Reform will make the final decision on project funding and

all applicants will be informed of the outcome of the assessment process as soon as possible after

the closing date.

Successful projects will be required to enter into a contract with Pobal and shall undertake to

comply fully with taxation, public procurement and Government accounting rules in the

expenditure of any grant monies awarded.

Payment of Grants to Successful Applicants Before grants can be paid all successful Stage 2 applicants will be required to:

• Consult with the local joint policing committee regarding their CCTV proposals

• Secure the approval of the local authority for proposals

• Secure authorization for same from the Garda Commissioner


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Community Based CCTV Stage 2 Application Form

Reference Number

For office use only

PART 1 Details of Applicant Organisation

This section relates to information about the lead organisation applying for a grant under the

scheme.

Note: The Lead Organisation must be the ‘Fund Holding’ organisation.

1.1 Lead Organisation proposing the project.

Name of Organisation:

Address:

Phone: Fax: E-mail address:

1.2 Identify the type of agency/organisation which best describes the lead organisation (e.g.

Local Community, Statutory, National, Community Development Project, CCTV

Development Group, Local Authority, Chamber of Commerce/Business Association,

Area Partnership, Enterprise Development Group, etc.).

1.3 Contact person (in block capitals) for all queries or correspondence in connection with

this proposal.

Name:

Address:

Phone No: Mobile: Fax: E-mail:

Role of contact person in the organisation:


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1.4 Please state your Organisation’s Aims and Objectives.

1.5 Describe briefly your organisation’s current activities.

1.6 Please outline the management and decision-making procedures that are in place with

particular reference to financial management and control.

1.7 When was the organisation founded? Month □ □ Year □□□□

1.8 Does the organisation have a Constitution or Articles & Memorandum of Association?

(Please tick relevant box) Yes 1 No Newly Formed

If ‘Yes’, please enclose a copy.

1.9 Legal status of the organisation:

1.10 Does the organisation have a current Tax Clearance Certificate?

(Please tick relevant box) Yes □ No □

If ‘Yes’, please enclose a copy.

1 Box can be activated by double clicking on it ‘ tick the checked box’ in the menu and close


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If ‘No’ does your organisation have a Charitable Status (CHY) Number?

(Please tick relevant box) Yes No

If ‘Yes’ please state number

1.11 What is the most recent year for which audited accounts are available?

Please enclose a copy of the most recent accounts including balance sheet.

1.12 Does your organisation employ staff? Yes No

If ‘Yes’, how many are employed :

on a full-time capacity?

On a part-time capacity?

1.13 Does your organisation have experience of managing running publicly funded projects?

Yes No

If ‘Yes’ please provide details of the types of projects, the budgets involved and

provide/attach supporting documentation to illustrate the level of involvement.

1.14 If a dedicated management/steering committee is proposed to guide the project, please

list the membership, the organisations/groups they represent (if any) and describe links to the lead organisation (attach a separate page if necessary).

Name of Organisation Address

Please describe the nature of the links of each individual group/organisation to the lead

organisation


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Name of Organisation Nature of Links to Lead Organisation

Name of Group Address

Role in the Community






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1.15 Is the proposed project located in a RAPID2 area? Yes No

If ‘Yes’, please name the RAPID Area

and provide:

(i) written confirmation of this status from your local RAPID co-ordinator and

(ii) written confirmation that the Project has been endorsed by the Area Implementation

Team.

Are these enclosed? Yes No

1.16 Is your group registered for VAT? Yes No

If ‘yes’ please state VAT No.

2 RAPID (Revitalising Areas by Planning, Investment and Development) is a focused Government initiative to target the 45 most

disadvantaged urban areas and provincial towns in the country. The implementation of the RAPID programme is led by the

Department of Community, Rural and Gaeltacht Affairs. Pobal coordinates programme implementation on behalf of the department.

Details of RAPID areas are available from Pobal.


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Part 2 Project Proposal

This section relates to information about the CCTV system which you propose to install.

2.1 Describe how your proposal addresses the Objectives of the Scheme as set out in the

Guidelines.

2.2 Please outline your overall CCTV proposal, stating the Operational Priorities.

2.3 Outline the reason(s) why there is a need for this project including whether there is

objective data available to support the proposal. (A separate assessment of need will be

requested from the Garda Síochána).

2.4 What concerns, issues or problems would the project attempt to address?

2.5 Describe how you consider installation of a CCTV system will benefit your community/

area.


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2.6 Please provide full details of the purposes for which the CCTV system will be used.

2.7 Describe the geographical area that the proposed CCTV will cover and what the focus

of attention will be directed at.

Please attach a scaled map, showing the area the proposed system will cover and the proposed camera positions for effective coverage for each camera.

2.8 Outline how the scheme will add value or complement other existing services and

initiatives in the community.

2.9 Is the organisation linked to any existing community based measures regarding crime

prevention and/or support measures for persons who are considered to be ‘at risk’?

Yes No

If ‘Yes’, please name the measures and outline the nature of the links.


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2.10 Please give details of any links this proposal has with other CCTV schemes or wider

strategies to regenerate an area or improve the local economy and the quality of life of

people living there.

2.11 Provide details and supporting evidence/documentation of the consultation process you

have undertaken, in order to ascertain that the residents in the area affected by the

proposed CCTV system are broadly supportive of the system.

2.12 Is it proposed to monitor the CCTV system?


If ‘Yes’ please describe the type and location of the monitoring centre.

2.13 Does the installation of any aspect of your proposed system require planning

permission?

Yes No

If ‘Yes’, has permission been applied for? Yes No

Granted? Yes No

Please state planning register Number:


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2.14 Please describe the data transmission method e.g. fibre-optic, wireless, hardwire etc.

that will be used between camera locations and the central recording/monitoring

station. (You will need to consult your technical adviser/supplier in this regard).


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Part 3 Implementation of the Proposal

3.1 How will the day-to-day operation of the CCTV system be managed?

3.2 Describe how the monitoring will be carried out i.e. system and structure.

3.3 What staffing arrangements (if any) will be put in place/are required to operate the

system effectively?


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Part 4: Project Costs

Note: All quotes/costs must state/include VAT separately, where applicable.

Initial Capital Set-up Costs

4.1 Construction/Adaptation of premises for monitoring centre

4.2 Purchase of CCTV equipment/materials

4.3 Installation of CCTV Equipment

Provision of radio links

Radio Licences( if required)

Fibre-optic cabling (including cost for materials, ducting/installation of

cables)

Connections to electricity supply

4.4 Total Overall Cost of Project

Please attach quotations. VAT

4.5 Percentage of the overall capital cost of the project has been raised by the organisation?

___________%

4.6 Please state the amount of grant you are requesting

4.7 Outstanding balance required (if any)

€

€

€

€

€

€

€

€

€

€


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Part 5 Matching Funding

Note: Applicants from RAPID areas are not required to provide matching funds where the overall cost of the

proposal does not exceed €2000,000

5.1 Please provide full details how your organisation will supply any balance of funds

required to implement the project, within the specified timeframe?

5.2 What committed matching funding has the organisation available immediately towards

the establishment of the project?

Please provide details of the sources and amounts of the matching funds with letters of

confirmation:

Amount Source

5.3 Have any of the funds listed above originated from a Government Department or Local

Authority, or body wholly funded from such sources?


If ‘Yes’, please give the amount and source and amount of such funding below:

Please provide details of the sources and amounts of the matching funds:

Amount Source

With reference to Sections 5.2 and 5.3 above, where funds have been collected, or commitments to

funding the proposed project have been secured, from a body other than a Government Department

€

€

€

€

€

€

€


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or Local Authority, or body wholly funded from such sources, please attach documentary evidence

of same in the form of letters of undertaking, bank statements or similar.

Part 6 Operational / Staffing Costs

Note: While each project will incur operational costs it may not necessarily incur staffing

costs.

6.1 Estimated Annual Operational Costs (please specify):

Heat / Light / Power €

Maintenance €

Rent €

Administration €

Telephone €

Repairs €

Other: €

€

Total €

Note: Section 6.2 needs to be completed only where the project will involve the employment of

staff.

6.2 Estimated Salary Costs (incl. PRSI).

Job Title No. of

Persons

Year 1 Year 2 Year 3 Year 4 Year 5

€

€

€

€

Total €

Five Year Funding Sources Analysis

6.3 How will your organisation fund the operational, maintenance and running costs of the

CCTV system for at least five years from the date of the commissioning of the CCTV

system?


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6.4 Please provide details of the sources and amounts of committed funding for the project

over the five-year period. Attach letters of confirmation

Sources Year 1 Year 2 Year 3 Year 4 Year 5

€

€

€

€

€

€

Total Committed Funds €

6.5 Please list potential sources of funding which you have identified for the five year period

of the project.

Sources Year 1 Year 2 Year 3 Year 4 Year 5

€

€

€

€

€

€

€

Part 7 Project Timeframe

7.1 What is the earliest start-up date for the project?

months from grant allocation

7.2 What is the completion period for the project?

months from grant allocation

Please note that work must be commenced within the time frame indicated above.


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Part 8 Mandatory Requirements

The following requirements are MANDATORY. Failure to meet any of these requirements will

result in the application being deemed ineligible for consideration.

8.1 Has the proposed CCTV system been approved by the local Garda Divisional Officer?


Please attach a signed letter from the Garda Divisional Officer to the above effect.

8.2 Does your proposal meet the minimum Technical Specification for the Scheme?

(Please read the document “Technical Specification for Community Based CCTV Section 38

(3)(C) Garda Síochána Act 2005’, carefully)


Please attach copy of Technical Specification for the equipment.

8.3 Has the Local Authority agreed to act as Data Controller for the CCTV system?


Please attach a signed letter from the Local Authority confirming this.

Note:

Payment of Grants to Successful Applicants

Before grants can be paid, all successful Stage 2 applicants will be required to:

• Consult with the local joint policing committee regarding their CCTV proposals

• Secure the approval of the local authority for proposals

• Secure authorization for same from the Garda Commissioner


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Part 9 Checklist for Stage 2 Applicants

PLEASE ENSURE THAT YOU HAVE ENCLOSED ALL OF THE ITEMS LISTED

BELOW WHEN SUBMITTING YOUR APPLICATION.

Tick each box, ensuring that the relevant material is enclosed, before forwarding your

application.

1. Completed Application Form.

2. Details of the group that will act as the fund holding body.

3. A letter of approval for the proposed CCTV system signed by the local Garda Divisional

Officer.

4. An undertaking signed by, or on behalf of, the Local Authority stating that the Local

Authority undertakes to act as Data Controller for the scheme for the purposes of Data

Protection legislation.

5. Supporting evidence that the proposal has broad support and acceptance from the local

community.

6. The ‘Technical Specification’ for the proposed CCTV system.

7. A scaled map, showing the area the proposed system will cover and the proposed camera

positions for effective coverage for each camera.

8. Copy of the applicant organisation’s most recent set of audited accounts.

9. Copy of the applicant organisation’s Tax Clearance Certificate or Charitable Status (CHY)

number (as applicable).

10. Copy of the applicant organisation’s Constitution, Memorandum and Articles of

Association.

11. Letter of confirmation that the organisation is located in a RAPID area from RAPID Co-

ordinator (if applicable).

12. RAPID AIT endorsement letter (If applicant organisation is located in a RAPID area).

13. Evidence of funding available.

14. Detailed costings (estimates/quotations) for the proposed CCTV system.

15. Any other relevant supporting documentation.

16. Signed Declaration.


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Part 10 Declaration This section should be completed by the duly authorised person to whom all correspondence will be

addressed.

On behalf of _______________________________________________ I, the undersigned, apply for a grant

towards the project described in this application and declare that all the information given is true and

complete to the best of my knowledge and belief. I acknowledge that any funds awarded must be used for the

purpose stated. I also understand that the information supplied in or accompanying this application may be

made available on request under the Freedom of Information Acts 1997 and 2003.

I have read and understand the items contained in the Code of Practice for Community Based CCTV

Systems, and the Technical Specification under Section 38(3)(C) Garda Síochána Act 2005 as well as Tax

Clearance Procedures, Data Protection Act, Disclosure under the Freedom of Information Act, and agree to

be bound by them.

I understand that the organisation takes responsibility for the supply, installation and commissioning of the

proposed CCTV system in full compliance with the Code of Practice under Section 38(3)(C) of the Garda

Síochána Act 2005 and for carrying out all contractual requirements with Pobal.

I accept as a condition for the award that:

� Only persons who have received Garda authorisation will be permitted access to the control area where

monitoring of the CCTV system takes place or to recorded images.

� Members of the Garda Síochána shall be allowed access to the CCTV system as required for the

purposes of supervising and controlling the operation of the CCTV system and information retrieval as

required by section 38(7) of the Garda Síochána Act 2005.

� The Garda Commissioner may issue directions to authorised persons in relation to installation and

operation of CCTV and may with the Minister’s consent, revoke, for failure to comply with the terms

and conditions or with a direction issued by the Commissioner”.

I also accept, as a condition for the award of a grant that it involves no commitment to any other grants from

Pobal, the Department of Justice, Equality and Law Reform or the Department of Community Rural and

Gaeltacht Affairs. The project sponsors are agreeable to have the project monitored by Pobal, Garda

Síochána or its agents and to allow access to its premises and records as necessary, for that purpose.

Contact name for all correspondence in connection with this application:

Name of Organisation (BLOCK CAPITALS):_______________________________________

Signatory (BLOCK CAPITALS):

Signed: Date:

(Duly Authorised by applicant organisation))

Position in Organisation: ______________________________________________________

Address:

Phone No: Fax:

E-mail Address:


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Part 11 Disclosure under the Freedom of Information Act The Department of Justice, Equality and Law Reform wishes to remind applicants that the information

supplied in the application form and supporting documentation may be released, on request, to third parties,

in accordance with the Department’s obligations under the Freedom of Information Act 1997 and 2003.

You are asked to consider if any of the information supplied by you in applying for funding under the

Scheme not be disclosed because of sensitivity. If this is the case, you should, when providing the

information, identify same and specify the reasons for its sensitivity. The Department will consult with you

about sensitive information before making a decision on release of such information. The Department will

release, on request, information to third parties, without further consultation with you, unless you identify the

information as sensitive with supporting reasons.

If you consider that some of the information is sensitive, please identify clearly such information when

submitting your application.

If you consider that none of the information supplied by you is sensitive, please complete the statement

below to that effect. Such information will be released in response to a Freedom of Information request.

Name of Organisation: ___________________________________ hereby agrees that none of the

information supplied is sensitive, and acknowledges that any, or all, of the information supplied, will be

released in response to a Freedom of Information request.

Signed: _____________________________ Date: _____________________________

Position within Organisation/Organisation: ______________________________________

Part 12 Disclaimer

Please read carefully It will be a condition of any application for funding under the terms and conditions of the Community Based

CCTV Scheme that the applicant has read, understood and accepted the following:

i. The Department of Justice, Equality and Law Reform shall not be liable to the applicant or any other

party in respect of any loss, damage or costs of any nature arising directly or indirectly from:

a) the application or the subject matter of the application:

b) the rejection for any reason of any application.

ii. The Department of Justice, Equality and Law Reform, its servants or agents shall not at any time in

any circumstances be held responsible or liable in relation to any matter whatsoever arising in

connection with the development, planning, construction, operation, management and/or

administration of individual projects.

Signed: _____________________________ Date: _____________________________

(Duly Authorised)

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