- 1 -

l

SASKATCHEWAN AGRI-VALUE INITIATIVE (SAVI)APPLICATION FORM

[This becomes Appendix “A” of your contract if your application is approved.]

Return completed application electronically to: evaluation.coordinator@gov.sk.caAgriculture Research Branch 3085 Albert StreetREGINA, SK S4S 0B1PH: 306-787-6566 / FX: 306-787-2654

Applicant InformationName of Organization:

Mailing Address:

Telephone: Email:

Fax: R.M.#:

Name(s) of Applicant(s)/Contact Person(s):

Additional Applicant Information:Please attach a biography for each applicant and any co-applicant(s)

Confidentiality:Do you wish the results to be confidential? Yes No

All information contained in this application and appendices is subject to the Freedom of Information and Protection of Privacy Act of Saskatchewan. Information is disclosed, in confidence, to ADF Advisory Committee members and reviewers, for the sole purpose of reviewing applications and making recommendations for funding. Please note that the applicant’s name, project title, objectives and total amount funded are a matter of public record. If application does not meet SAVI eligibility requirements, an assessment will be made as to potential eligibility under the Ministry’s International Market Development Program, unless applicant states in writing that they do not wish to be considered under other programs. Applicant should refer to the broader ADF confidentiality policy for additional information.

Project Title:

How did you find out about the SAVI program?

For office use only:Project Number:

- 2 -

Funding Component Amount ($ Requested)

Prototype and/or Product Development

Marketing/Business Partnerships

Skills and Training

Enhanced Labour Training

*Complete Section B only for Skills and Training*Complete Section C only for Enhanced Labour Training

Please attach your business plan or completed Business Proposal.

Your application will be considered i n complete if it does not contain one of these documents.

Section A:Background Information – complete all section s . Provide as much information as possible and respond to the questions to the best of your abilities. Failure to provide adequateinformation may impact project evaluation.

1) Describe the opportunity and its uniqueness, including actions you have taken to capitalise on this opportunity prior to applying to SAVI.

- 3 -

2) Outline your growth strategy.

3) Demonstrate how the proposed project links with your business plan and growth strategy.How will this project help achieve your goals?

4) Current number of employees. Will the project impact employee numbers? If so, what is the time frame for the impact?

For new processors (defined as a new company or one with fewer than two products in the market):

1) Where are you planning to process your product?

2) What are your long-term plans for developing a processing plant?

For established processors (defined as a company with more than two products in the market):

1) Provide information on products you have in the market, which markets you currently have access to, your annual utilization of Saskatchewan commodities and your processing capacity. Markets accessed and/or commodity utilization is expected to increase during or following project completion and will be used if further applications are considered.

2) Will your current processing facility handle the introduction of a new product line?

3) Can you commercialize a new product in-house or do you plan on commercializing the new product off-site?

- 4 -

Description of Project (Please describe the major objectives, related activities, and the timeline for each activity).

# Objective Activity Start/Finish time

1

2

3

4

5

Project Costs (Using the objectives listed previously, please indicate the estimated TOTAL cost for each activity).

Objective†Funding

Component*Fees

(consulting)Equipment

RentalMaterials

and Supplies

EligibleTravel

Other(Specify) TOTAL

Objective #1

Objective #2

Objective #3

Objective #4

Objective #5

TOTAL COSTS

In-kind/Salaries/Benefits - costs paid for in-house staff are not eligible for re-imbursement.†Please select one of the four funding components for each objective, Product Development (PD), Marketing(MK), Training (TR) or enhanced labour training (ELT).*Fees (consulting)-represents all costs paid to third parties (including salaries, etc.).

- 5 -

Budget Details - For each objective identified above, provide details on the cost of each activity, including:

1) Charge out rate of professional fees and the time required.

2) Equipment planned for rental, rental rate and duration of rental.

3) Materials required, source of materials, cost per unit (if applicable).

4) If applicable - Point of origin and destination for travel, mileage rate, nightly cost for hotels, daily cost for vehicle rental, flight details.

5) If attending tradeshows or undertaking sales missions, why were the specific show(s) and/or mission(s) chosen? Who do you plan on connecting with?

6) Costs under “Other” must be specified as above.

- 6 -

Contributing Sources (Please list all sources of project funding for each objective).

Contributed by Applicant Requested from SAVI SAVI %

Objective #1

Objective #2

Objective #3

Objective #4

Objective #5

TOTAL COSTS

Project Impacts1. Please describe the potential impacts to you, your company/organization, the

agricultural industry and the province of Saskatchewan.

2. What percentage of your total materials for production will originate from Saskatchewan?

3. Have you engaged any Saskatchewan producers or organizations in the value chain, either to source supplies (including, but not limited to, raw material, intermediate products)? If so, whom?

4. Will the project impact employee numbers? If so, what is the time frame for the impact?

- 7 -

Commercialization or Technology Transfer Plan

1. How will new products be commercialized?

2. How will your marketing efforts be used to advance your business?

3. What marketing plans or research will you utilize to reach your goals?

Capability (Please describe the technical/business expertise of the applicant(s) and co-applicant(s) and details of other resources that are available to the project, including partners and/or contractors).

- 8 -

Section B: (To be completed for skills and training for less than three people only)

Name of Course/Event:

Name and location of institution/organization offering this course/event:

Costs (please specify registration fees, tuition, books):

Internet link to course:

Skills and Training Impacts (Please describe the potential benefits to you, your company/organization and how this will meet the needs of your project)

NOTE: Upon approval and completion of the training activity, a copy of receipts from books, tuition and/or registration will be required for reimbursement.

- 9 -

Section C: (To be completed for enhanced labour training objectives from corporations requiring a set of skills for a set of employees only with a minimum request of $5,000 and a maximum of $100,000)

Specific l a b o ur ne e ds

1) What specific training do your employees require?

2) Does any institution in the province offer this training? Which institutions have you contacted?

3) Which Saskatchewan educational institution will you work with to develop course material?

4) Who will develop the course? Who will deliver it?

5) What is the cost per employee taking this training?

6) How many employees would undergo this training during the project?

7) What impact will this have on your business in terms of cost savings and impact to the provincial economy?