Application for Future Mobility Lab Fund Round Two

Applicant Entity NameTrading NameABNContact PersonMobile #EmailAddressGrant Amount SoughtCont. Matching Funds YES / NO – Amount:More than one Application

YES / NO – provide contact details

Consistent with the objectives of the Future Mobility Lab Fund. Provides a clear description of the technology and the benefit it will

provide or the challenge it will address. Clearly sets out to scope of the project and a delivery plan for the

project, with timeframes and costings. Provides a framework for KPIs to measure success of the project. Provides a risk management strategy proportional to the risk of the

project. The project takes place in South Australia. Any attachments to this application are provided in .pdf or URL

formats.

1. Describe your project proposal, its scope, the benefits it will provide or challenges it will address. 2. Provide the proposed project delivery plan with timeframes and costs.

Provide detailed delivery plans as an attachmentProvide detailed financials cash/in-kind as an attachmentNote: FML grant monies are only available to 30 June 2019

3. Describe the framework for key performance indicates to measure your projects success.

KPIs need to be quantifiable and measurable

Applicant Entity Name Page X of X

4. Describe the risk management strategy for your proposed project.

Applications for exemption approval for on-road trials can be found at www.dpti.sa.gov.au/driverlessvehicles applicants need to prepare safe work statements and traffic management plans to accompany the on-road trial applicationEnsure that appropriate insurance is provided noting that for on-road trials they will not be covered by SA Third Party Insurance Scheme.

5. Set out the source of funding for the project (include the amount applied for under this application, any other government funding as well as any private sector capital).6. To what extent will your proposed project contribute to building an industry around connected and autonomous vehicles and other future mobility technologies?7. Does your project involve importation of autonomous vehicle? If yes, please provide information regarding timeline for procuring the autonomous vehicle.

Vehicle importation information can be found at Importing Vehicles into Australia https://infrastructure.gov.au/vehicles/imports/

8. Other comments.Please list attachments to your application

Attach detail proposal

Applicant Entity Name Page X of X