community hubs application - final · web viewif you have answered yes to the question above,...
TRANSCRIPT
Please read the Information and Guidance Notes carefully before completing this form.
1.About your OrganisationOrganisation Contact Details (if applying as a consortium please provide details of the lead partner and the names of the consortium members)Name of organisation Charity Number (if applicable)Company Number (if applicable)Main contact personJob titleAddress
WardTelephoneEmail addressWebsite addressFrom where in Islington do you currently deliver activities/services? (if different from above or if delivering across multiple sites)Partners/Consortium members (if applicable)Are you a formally constituted consortium or a partnership? (if applicable)If applicable, please outline the nature of your consortium or partnership, providing details of any agreements that have been reached in relation to service delivery and access to the premises.
Please describe how funding will be divided between members of the consortium?
Chairperson’s Contact Details (If consortium please provide details of the chair of the lead organisation)NameAddress
TelephoneEmail address
Page 1 of 24
Page 2 of 24
Please provide us with an overview of your organisation(s) Maximum 300 words for individual application/ 500 words for consortium bids - Not Scored
Page 3 of 24
2.Minimum RequirementsThis is a self-declaration, made by you (the partner), that you do not meet any of the grounds for exclusion.
If there are grounds for exclusion, there is an opportunity to explain the background and any measures you have taken to rectify the situation (this process is referred to as ‘self-cleaning’).
A completed declaration provides a formal statement that the organisation making the declaration has not breached any of the exclusions grounds.
Please answer the following questions in full.
Grounds for mandatory exclusionRegulations 57(1) and (2) The detailed grounds for mandatory exclusion of an organisation are set out on this webpage, which should be referred to before completing these questions. Please indicate if, within the past five years you, your organisation or any other person who has powers of representation, decision or control in the organisation have been convicted anywhere in the world of any of the offences within the summary below and listed on the webpage.Participation in a criminal organisation
Yes ☐No ☐
Corruption Yes ☐No ☐
Fraud Yes ☐No ☐
Terrorist offences or offences linked to terrorist activities
Yes ☐No ☐
Money laundering or terrorist financing
Yes ☐No ☐
Child labour and other forms of trafficking in human beings
Yes ☐No ☐
If you have answered yes to any of the questions above, please provide further details, including:
Date of conviction, specify which of the grounds listed the conviction was for, and the reasons for conviction.
Identity of who has been convicted.
If the relevant documentation is available electronically please provide the web address,
Page 4 of 24
issuing authority, precise reference of the documents.
If you have answered yes to any of the points above, have measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion? (Self-Cleaning)
Yes ☐No ☐
Has it been established, for your organisation by a judicial or administrative decision having final and binding effect in accordance with the legal provisions of any part of the United Kingdom or the legal provisions of the country in which the organisation is established (if outside the UK), that the organisation is in breach of obligations related to the payment of tax or social security contributions?
Yes ☐No ☐
If you have answered yes to the question above, please provide further details. Please also confirm that you have paid, or have entered into a binding arrangement with a view to paying, the outstanding sum including where applicable any accrued interest and/or fines.
Please Note: The authority reserves the right to use its discretion to exclude a potential provider where it can demonstrate by any appropriate means that the potential provider is in breach of its obligations relating to the non-payment of taxes or social security contributions.
Page 5 of 24
3.Minimum Criteria Before proceeding with your application, please confirm that you meet all of the essential criteria outlined in the information and guidance document notes. If you answer no to any of these questions then you will not meet our essential criteria and your application will not be considered.Minimum Criteria Yes/No?Are you a not-for-profit organisation listed below?
Registered Charity Community Group Co-operative Faith and Equalities Group Social Enterprise* Community Interest Company
*That reinvests 100% of surplus income into the organisation and that does not have a ‘profit distribution’ clause in its governing documents, which allows it to pay Executive Directors as shareholders.
Yes ☐No ☐
What is your registered charity number?Are 75% or more of the beneficiaries that you plan to support through this core grant Islington residents?
Yes ☐No ☐
Are you operating from an established base in Islington? Yes ☐No ☐
Do you pay all of your employees or contracted staff the London Living Wage as a minimum (currently £10.75 per hour)?
Yes ☐No ☐
Are you able to supply us with the key governance, policy, safeguarding, data protection and financial documents requested at the bottom of this application form?
Yes ☐No ☐
Are you able to provide us with an organisational work plan for 2020/2021?
Yes ☐No ☐
Do you deliver projects and services that contravene the Equality Act 2010?
Yes ☐No ☐
If you are a council tenant, is the lease of the property agreed and signed?
Yes ☐No ☐
Page 6 of 24
4.Suitability Assessment In assessing your suitability for a grant, we will assess your responses to the questions in the ‘Suitability Assessment’ section of the application form in line with the following criteria. We will require a minimum core of 3 or above for all criteria.
4.1 Your organisation’s financial viability and your track record of securing income Scored 0-5
What was your organisation’s income in 2018/19? £What was your organisation’s expenditure in 2018/19? £What non-committed cash reserves did your organisation have on 31/3/19? £
Does this equate to three or more months operating costs? Yes ☐ No ☐
Is your organisation currently operating in deficit? Yes ☐ No ☐
Does your organisation have any financial liabilities? (e.g. loans) Please provide details and amounts. Maximum 250 words
Total Word Count:Please provide details of the grants or contracts that you have secured in the last 12 months. Maximum 250 words
Total Word Count:What percentage of your income in 2018/2019? was from:
Grants and contracts from Islington Council % Other Funders/Trusts? % Other Contracts % Earned income (e.g. office rental, sale of
services) % Other (Please State) %
4.2 What you will use the core grant for and the difference it will make to your organisation Scored 0-5
How much funding are you requesting? (per annum)
Page 7 of 24
Please outline how you anticipate spending the amount of funding requested (per annum)Item Amount
£££££££££
Total £Please tell us what difference the award of a core grant will make to your organisation Maximum 500 words.
Total Word Count:
4.3 What are your objectives/articles of association and how do these relate to the Council’s Corporate Priorities? Maximum 500 words. Scored 0-5
Total Word Count:
Page 8 of 24
Page 9 of 24
5.Award Criteria Provided that you meet our minimum criteria and score three or higher in each question in the suitability assessment, we will assess and score your responses against the following criteria:
Criteria Percentage of Overall Score1. Needs, Issues and Beneficiaries 20%2. Outcomes, Services, Activities and
Risks20%
3. The Difference We Want You to Make 30%4. Organisational Development 20%5. Evaluating and Communicating Impact 10%
It is important that your answers to these questions are realistic, as subject to your application being successful, they will form the basis of the grant agreement and monitoring arrangements.
Criteria 1 – Needs, Issues and Beneficiaries
5.1 Please tell us about the needs and issues that your organisation seeks to address and how these were identified?Maximum 500 words. Scored 0-5
Total Word Count:
Page 10 of 24
5.2 Please tell us about your beneficiaries, including the number of people you work with. Please also tell us how you ensure that your services are accessible to Islington’s diverse communities and residents with ‘protected characteristics’ as defined by the Equalities Act 2010. Maximum 300 words. Scored 0-5
Total Word Count:
5.3 Please tell us how you have or how you plan to involve and consult your beneficiaries in designing your services. Maximum 300 words. Scored 0-5
Total Word
Page 11 of 24
Count:
Criteria 2 – Outcomes, Services, Activities and Risks
5.4 Please tell us the outcomes that you are seeking to achieve for your beneficiaries. Maximum 300 words. Scored 0-5
Total Word Count:
5.5 Please tell us how you will deliver these outcomes, providing an overview of your services and activities. Maximum 500 words. Scored 0-5
Page 12 of 24
Total Word Count:
5.6 What risks do you foresee in delivering the activities and services that you have outlined and how do you intend to mitigate and manage these risks? Maximum 300 words. Scored 0-5
Total Word Count:
Criteria 3 – The Difference We Want You to Make
Further information about the specific role we envisage for Community Hubs is outlined in the Information and Guidance Notes, under the section ‘The Difference We Want You to Make’.
5.7 Please tell us how you will demonstrate strategic leadership within the area, identify and meet the needs of the local community?Maximum 500 words. Scored 0-5
Total Word Count:
Page 13 of 24
Page 14 of 24
5.8 Please tell us what engaging neighbourhood based services/activities you will offer residents to enable residents to thrive.Maximum 500 words. Scored 0-5
Total Word Count:
5.9 Please tell us how you will reduce and challenge inequality to make sure that your offer is inclusive for all and promotes cohesion and diversity in the community.Maximum 500 words. Scored 0-5
Page 15 of 24
Total Word Count:
5.10 Please tell us how you will ensure local community facilities and assets are utilised to their full potential and how you will secure external funding.Maximum 500 words. Scored 0-5
Total Word Count:
Criteria 4 – Organisational DevelopmentPage 16 of 24
5.11 What are your organisation’s plans for fundraising and diversifying its income? Maximum 300 words. Scored 0-5
Total Word Count:
5.12 How will your organisation ensure it maintains the highest level of commitment to safeguarding children, adults, employees and volunteers. Maximum 300 words. Scored 0-5
Page 17 of 24
Total Word Count:
5.13 What are your organisation’s plans for supporting staff, volunteer and trustees’ development? Maximum 300 words. Scored 0-5
Total Word Count:
5.14 What risks and challenges does your organisation face to its viability and how do you propose to overcome these?
Page 18 of 24
Maximum 300 words. Scored 0-5
Total Word Count:
Criteria 5 – Evaluating and Communicating Impact
5.15 How do you propose to monitor and evaluate your work? Maximum 500 words. Scored 0-5
Total Word Count:
Page 19 of 24
5.16 How will you communicate your work and its impact to beneficiaries, stakeholders and funders? Maximum 500 words. Scored 0-5
Total Word Count:
Page 20 of 24
6.Supporting DocumentsAs part of your application, the following documents will need to be submitted if you are successful prior to a grant agreement being signed. Please complete the checklist below to confirm that you will be able to provide this upon request.
Governance documents: Comments (if any)Copy of Constitution ☐Copy of minutes from most recent AGM ☐Copy of minutes from most recent Board/ Management Committee Meeting
☐
List of members in key management committee positions ☐Copy of Public Liability Insurance, Employers Liability Insurance and Professional Indemnity Insurance
☐
Key policy documents: Equal Opportunities Policy ☐Data Protection Policy ☐Financial Management and Procedures Policy ☐Financial Reserve Policy ☐Safeguarding documents: Whistle Blowing Policy ☐Safeguarding Policy ☐Finance and accounting documents: Annual Audited Accounts 2018/19 ☐Financial Management Accounts for last quarter ☐Copy of most recent Bank Statement ☐Reference: Name, address and contact details of current or previous landlord. ☐Other: Annual work plan 2020/2021 ☐If you do not currently have any of the above supporting documentation, please detail why here and when you anticipate having them:
Page 21 of 24
Page 22 of 24
7.DeclarationIn submitting this Application Form, the named contact is agreeing to the following statement on behalf of your organisation.
“The information I have provided is accurate as far as I know. If I discover that the information is inaccurate I will notify the Council immediately and will provide the accurate information as soon as possible. I confirm that my organisation meets all the basic Eligibility Criteria listed in Guidance Notes. I am aware that I may be asked to provide further evidence to support the information provided and agree to do so if requested.”
Please email your application form to Islington Council’s Voluntary and Community Sector Team at: [email protected] The closing date for applications to be submitted is 23:59 15 March 2020
Applications submitted after this deadline will not be accepted.
Page 23 of 24