Subsidy Application

SUBSIDY APPLICATION

Applicant Name:    Grantor Name:

WHEREAS

WHEREAS, Applicant seeks financial assistance to undertake the project described in this application and submits the information herein in support of a conditional subsidy award; and

WHEREAS, Grantor administers subsidy funds and may, subject to review and compliance with applicable terms, enter into a funding agreement that obligates Grantor to disburse funds to Applicant upon satisfaction of specified conditions; and

WHEREAS, the parties intend that upon approval of this application and execution of any required funding agreement, the terms contained in that agreement together with the representations and certifications in this application shall govern the receipt and permitted use of subsidy funds.

APPLICANT INFORMATION

Nonprofit For-profit Individual Other:

PROJECT INFORMATION

SCOPE OF WORK

Describe the work, deliverables, milestones, and measurable outcomes to be achieved under the proposed subsidy. Include timelines, responsible parties, and acceptance criteria where applicable.

BUDGET & PAYMENT TERMS

Requested Subsidy Amount:    Total Project Cost:

Late Payment Fee:

Disbursement Conditions: Applicant certifies that disbursement is conditioned on Grantor approval of invoices, compliance with milestones, and submission of required documentation and certifications.

TERM AND TERMINATION

Project Start Date:   Project End Date:

Either party may terminate any subsequent funding agreement for material breach, insolvency, or failure to perform. Termination for convenience requires written notice delivered at least days prior to the effective termination date.

CONFIDENTIALITY

Applicant and Grantor acknowledge that certain information submitted in this application may be proprietary or confidential. Unless otherwise required by law, the receiving party shall hold such confidential information in strict confidence and shall not disclose it except to those employees, agents, or contractors who have a need to know and who are bound by confidentiality obligations no less protective than those set forth herein. Confidential information does not include information that is or becomes publicly available other than through unauthorized disclosure by the receiving party, independently developed without use of the other party's confidential information, or rightfully received from a third party without restriction.

GOVERNING LAW

This Application, and any subsequent funding agreement executed in reliance upon it, shall be governed by and construed in accordance with the laws of the State of without regard to conflict of law principles.

ENTIRE AGREEMENT

Applicant acknowledges that this Application, together with any resulting funding agreement, representations, certifications, attachments, and expressly incorporated documents, constitute the entire understanding between the parties with respect to the subsidy and supersede all prior negotiations and understandings. No amendment shall be effective unless in writing and signed by authorized representatives of both parties.

CERTIFICATIONS AND AUTHORIZATIONS

By signing below, Applicant certifies under penalty of perjury that the information provided in this Application is true, accurate, and complete to the best of Applicant's knowledge; that Applicant will comply with all applicable laws, permit requirements, and funding conditions; and that funds received will be used solely for the purposes approved by Grantor. Applicant further agrees to provide documentation and allow audits to verify use of funds and project compliance.

Certification: I certify the above statements and agree to the terms set forth in this Application.

ATTACHMENTS (CHECK ALL THAT APPLY)

Detailed Budget Project Timeline Certifications / Licenses Support Letters

ADDITIONAL INFORMATION

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