4179 ATT02 - Standard Grant Application for Funding (SGAF)Employment and Emploi et
Social Development Canada Developpement social Canada
For Official Use Only:
CSGC # RC No.
Program:Enabling Accessibility in Workplaces and Communities
name of program to which you are applying for funding)
Protected B When Completed
Standard Grant Application for Funding (SGAF)
The funding program under which your organization is applying has specific eligibility requirements. The
Standard Grant Application for Funding should clearly show how the proposed project meets these
requirements. Also, if applying in the context of a Call for Proposal or another time -sensitive process
Employment and Social Development Canada (ESDC) must receive the Standard Grant Application for
Funding by the closing date. Documentation received after a posted closing date will not be accepted.
Before completeing this Standard Grant Application for funding, please read both of the following thoroughly:
The Applicant Guide, which contains information on how to complete and submit this form; and
The funding program's website.
Unless otherwise indicated in the Applicant Guide, all parts of the application must be completed.
This document contains the following sections:
Section A - Notice to Applicants
Section B - Application
Part 1 Organization
Part 2 Project
Part 3 Funding
Part 4 Additional Information (Optional)
Part 5 Signatures
Section C - Articles of Aareement
Schedule A - Project Description and Signatures
Thank you for your interest in our program.
ESDC EMP5585 (2016-04-003) E Page 1 of 21 Canada
SECTION A - Notice to AQalicants
Please note that this document is a combined Application for Funding and Articles of Agreement. The
Application is subject to an assessment by Employment and Social Development Canada (ESDC) officials.
The applicant will be notified of the results of the review. Further, activities started prior to approval of the
Application will be deemed ineligible for funding.
When submitting the Standard Grant Application for Funding, applicants must have the capacity and be
authorized to sign and submit this Grant Application Package on behalf of the Applicant Organization.
The information collected in this Standard Grant Application for Funding will be used, and may be disclosed,
for the purposes of assessing the merits of your application. As part of the assessment process, the
information may be shared with external consultants, review committee members, officials in other
departments, federal, provincial and/or territorial governments or Members of Parliament.
It may also be used and/or disclosed for policy analysis, research, and/or evaluation purposes. In order to
conduct these activities, various sources of information under the custody and control of ESDC may be
linked. However, these additional uses and/or disclosures of information will not impact on your proposed
project.
In the event that the application contains personal information, the personal information will be administered
in accordance with the Privacy Act and the provisions governing the protection of personal information that
are set out in the Department of Employment and Social Development Act.
The application is also subject to the Access to Information Act ("ATIA'). The ATIA provides every person
with a right of access to information under the control of the department, subject to a limited set of
exemptions. Instructions for obtaining access to this information are outlined in the government publication
entitled Info Source, which is available at the following website address: http://www. infosource. a_ c. ca. Info
Source may also be accessed on-line at any Service Canada Centre.
ESDC EMP5585 (2016-04-003) E Page 2 of 21 Canada
SECTION B - Part 1 - Organization
A. ORGANIZATION IDENTIFICATION
1. Legal Name
The Corporation of the Town of Tillsonburg
3. CRA Business Number
126 587 195
5. Organization Type
Small Municipality
8. Organization Address
200 Broadway, 2nd Floor
9. City or Town *10. Province or Territory
Tillsonburg Ontario
13. Telephone Number Ext. 14. Fax Number
519-688-3009 519-842-9431
16. Mailing Address (if different from Organization Address)
Same as above
17. City or Town 18. Province or Territory
21. Telephone Number Ext. 22. Fax Number
2. Operating (Common) Name (if different from legal name)
Town of Tillsonburg
4. Other Registration Number (specify from where)
6. Organization Category *7. Year Established
N/A
1872
11. Country (if not Canada) 12. Postal Code
N4G 5A7
15. E-mail Address
info@tillsonburg.ca
19. Country (if not Canada ) 1 20. Postal Code
23. Organization's Mandate
Located in the heartland of Southwestern Ontario, Tillsonburg is a small Town with broad
shoulders ... a unique and vibrant community that has proven to be a safe environment to live,
work, play and invest in. Diversified housing options, excellent education and hospital
facilities, comprehensive municipal services, exceptional recreational facilties and a vibrant
community spirit are only a part of what makes Tillsonburg a place people want to call home.
The Town's Recreation, Culture & Parks Department delivers programs and facilities that are, or
provides space for other organizations that deliver:
Seniors group programs or activities;
Recreation, fitness and sports activities for children, adults and seniors;
Health and wellness programs and services for women;
Training and education services for people with disabilities; and,
Multi -disciplinary programs such as dance, drama, music and visual arts for all ages.
B. ORGANIZATION CONTACT This should be our primary contact person in respect to this application for ig.
24. Given Name *Surname
Richard Cox
25. Position Title 26. Preferred language of communication
Director of Recreation, Culture & Parks Written: Q English 0 French Spoken: 0 English D French
27. ORGANIZATION CONTACT - ADDRESS
Q Same as Organization Address F-] Same as Organization Mailing Address F-] Different (include below)
28. Contact Address
29. City or Town
33. Telephone Number Ext.
30. Province or Territory
34. Fax Number
31. Country (if not Canada)
35. E-mail Address
32. Postal Code
Denotes mandatory fieldCmaaa 1
ESDC EMP5585 (2016-04-003) E Page 3 of 21
C. ORGANIZATIONAL CAPACITY
36. How many employees does your organization currently have?
37. Does your organization owe any amounts to the Government of Canada? Yes No
If 'Yes', please complete the fields below for each amount owinq: 38. If an amount is
Amount Nature of the amount owing Department or agency owing, is a payment
Owing (e.g. taxes, penalties, overpayments) to which amount is owed plan in place?
A. [:] Yes No
B. [-] Yes No
C. Yes No
D. Yes No
SECTION B - Part 2 - Project
A. PROJECT IDENTIFICATION
39. Project Title
Connecting to Canada - An Accessible Connection to the Trans Canada Trail
40. Planned Project Start Date (yyyy/mm/dd) 1 *41. Planned Project End Date (yyyy/mm/dd)
2018/01/01
B. PROJECT DESCRIPTION
2018/12/31
42. Project Summary (Please provide a short description of the proposed project including main objective)
This project is submitted under the Community Accessibility Stream.
The main objective of this project is to provide a convenient and safe barrier -free route
connecting the Town's Fourth -to -North RecreationalTrail with the brand new Tillsonburg to Delhi
Trans -Canada Trail connection which connects Tillsonburg to the rest of Canada. The two
recreational facilities intersect at an overpass with a significant (greater than 251) vertical
separation but both pathways are heavily used as active transportation routes to workplaces,
shopping and entertainment and for recreational use by families, couples, seniors, folks with
mobility issues and visitors to the community. There is a much longer, sidewalk -based barrier -
free connection that can be used as an alternative but this route adds significant distance and
time for individuals with mobility issues, as well as the increased risk of roadside travel.
This project will safely connect the two facilities where they cross which will save time and
effort and consequently increase utilization and opportunities for anyone with mobility issues
to get to work, to shopping and entertainment destinations, and for recreational enjoyment.
The Tillsonburg Accessibility Advisory Committee has identified this project as the top
priority to submit for this funding opportunity.
Denotes mandatory field CanadaESDCEMP5585 (2016-04-003) E Page 4 of 21
43. Project Activities (Please provide details on the activities that will be taking place)
1. Secure funding - July 2017 through January 2018
Apply to EAF Community Accessibility Funding
Request funding contribution from Oxford County through the 2018
Confirm funding contribution from the Town of Tillsonburg through
2. Design & procure the work - January through April 2018
Secure topographical and boundary line survey (2 weeks)
Secure design and construction tender specifications (8 weeks)
Procure and award construction contract (8 weeks)
3. Execute construction - May through August 2018
Clear brush and tree growth (2 weeks)
Execute groundworks and retaining walls (8 weeks)
Install railings and signage (6 weeks)
4. Report September through December 2018
budget process
the 2018 budget process.
44. Please describe how the proposed project addresses the program objectives, and please identify the call for proposal priority under which you are applying
if applicable).
This project will improve accessibility and/or safety for people with disabilities in
Tillsonburg. The improvement will involve construction and retrofit activities in a community
facility where programs and/or services are offered and will be offered to people with
disabilities. The project will improve Tillsonburg as an accessible community and workplace as
well as increase access for people with disabilities to services, programs and employment
opportunities in Tillsonburg. The project will provide increased opportunities for people with
disabilities to participate in and contribute to Tillsonburg's community life and economy.
45. Ifthe proposed project involves construction or renovation activities, does your organization own the building? Yes n No
If 'Yes', please provide proof of building ownership (i.e. property tax bill, property assessment notice, purchase agreement).
If 'No', please provide a copy of your lease, indicating that you are responsible for capital improvements as well as a letter from the landlord stating that he/
she is agreeable to these improvements.
Denotes mandatory field C
ESDC EMP5585 (2016-04-003) E Page 5 of 21Cmaat-
46. Approximately, how many individuals will benefit from the proposed project activities, and how? .
In 2015, an Elgin -Oxford Community Profile developed by the Elgin -Oxford Legal Clinic
identifies one in five residents as "living with a disability or limitation on activity."
In 2016, the Oxford Community Wellbeing Survey based on the Canadian Index of Wellbeing found
that:
A higher percentage(22.6%) of Tillsonburg residents walked or biked often or all of the
time instead of taking a car than residents in other parts of the County.
31.1% of respondents from Tillsonburg found cost a barrier to access to recreation.
Estimates indicate between 10 and 20 individuals with mobility limitations will benefit from
the accessibility improvement EVERY SINGLE DAY through three seasons of the year. In addition,
the improvement will be able to be used by many more individuals with no mobility limitations.
The improvement will be utilized several thousand times per year, mostly by residents of
Tillsonburg and the surrounding area. Cost is not a barrier as this improvement is free to use
by all. All users will benefit from a safe, convenient connection between these two recreation
facilities that can be used year-round if weather permits.
47. Please describe the community support for this project.
The primary driver for this project is the Town's Accessibility Advisory Committee which
reviewed many potential projects and prioritized this one for submission to this funding
program. (Resolution attached). Tillsonburg Accessibility Advisory Committee; www.tillsonburg.
ca/en/town-hall/Accessibility-Advisory-Committee.aspx; c/o Tricia Smith, Deputy Clerk;
tsmith@tillsonburg.ca; 519-688-3009 Ext. 3221; English correspondence preferred; Advisory
Committee to Council.
Community Living Tillsonburg is also very supportive of this initiative (correspondence
attached). Community Living Tillsonburg; www.communitylivingtillsonburg.ca; Greg Bruckler;
gbruckler@communitylivingtillsonburg.ca; 519-842-9000; English correspondence preferred; Not -
for -Profit organization.
Oxford County administration is supportive of this project (correspondence attached). Oxford
County; www.oxfordcounty.ca; Frank Gross; fgross@oxfordcounty.ca; 1-800-755-0394, Ext 3120;
English correspondence preferred; Upper Tier Municipality.
48.Please indicate how the proposed project will increase opportunities for the target group (Seniors for New Horizons for Seniors Program and people with
disabilities for Enabling Accessibility Fund) to participate in and contribute to community events and programs.
This project will increase accessibility and safety for people with disabilities in an outdoor
recreation facility where the Town and other organizations provide informal recreation
opportunities and formal active living and environmental educational programs for residents.
This project will increase opportunities for people with disabilities to participate in and
contribute to community life by enhancing the active transportation network that supports no -
cost and barrier free travel from home to work, shopping and entertainment destinations.
This project will support the expected outcomes of the EAF by:
enhancing Tillsonburg as an accessible community and improving access to workplaces;
enhancing access for people with disabilities to services, programs and employment
opportunities in Tillsonburg; and
enhancing opportunities for people with disabilities to participate in and contribute to
Tillsonburg's community life and economy.
Denotes mandatory field CanadaESDCEMP5585 (2016-04-003) E Page 6 of 21
49. If applicable, please indicate how the target group (Seniors for New Horizons for Seniors Program and people with disabilities for Enabling Accessibility
Fund) will be involved in the design and/or realization of the project.
This project will involve people with disabilities in the design of the project through
ensuring that Tillsonburg's Accessiblity Advisory Committee provides review and input on the
design. Once constructed, employees of the Town with mobility limitations will be involved in
the testing/commissioning and ongoing maintenance of the facility.
50. Will this project allow your organization to offertiintroduce new activities and/or programs? Ifso, please explain how.
When this project is completed, the Town's Recreation, Culture & Parks will be able to
introduce new walking and nature education programs that are targeted at individuals with
mobility limitations.
Denotes mandatory field Can
ada1
ESDC EMP5585 (2016-04-003) E Page 7 of 21
51. Will the proposed project or any of its activities involve or benefit to people in English or French -language minority communities? Yes 0 No
If 'Yes', please provide an explanation and any details on the measures taken to communicate with the targeted audience of your proposed
project.
52.Will any ofthe proposed project activities be delivered in a different location than where the head office of your organization is located? Q Yes F No
If 'Yes', please include your main address and an address for every other location where project activities will occur:
Main Address
A.200 Broadway, 2nd Floor
Secondary Address
B.CASO Railway Overpass
C.
D.
E.
City or Town
Tillsonburg
City or Town
Tillsonburg
Province or Territory
Ontario
Province or Territory
Ontario
Postal Code
N4G 5A3
Postal Code
N/A ------
Denotes mandatory field CanadaESDCEMP5585 (2016-04003) E Page 8 of 21
SECTION B - Part 3 - Funding
1 A. ANTICIPATED SOURCES OF FUNDING
53. Source Name
ESDC
The Town of Tillsonburg
Total Funding for the Project
BUDGET
58. Cost Category
Survey
Landscape Architectural Services
kngineering Design Services
Groundworks including tree/brush clearing
ketaining wall construction
Gravel and materials
kailings and safety barriers
Signage
ontingency & net taxes payable (10%)
I
I
I
Total Planned Expenditures
54. Source Type 55. Cash 56. In-kind *57. Confirmed
value) Cash In-kind
ESDC 50,000
Muncipality 37,000 3,000 Yes Yes
187,000
59. ESDC
20,000
20,000
10,000
50,000
Planned Expenditures ($)
60. Other - Cash *61. Other - In kind
2,200
7,500
7,500 2,000
2,000
1,800
8,000
8,000
37, 000
1,000
3,000
Denotes mandatory field -11,01CanadaESDCEMP5585 (2016-04-003) E Page 9 of 21
C. BUDGET DETAILS
62. Capital Assets: Will capital assets be among your planned expenditures with ESDC funding?
If yes, please explain how the purchases are necessary to carry out the project activities:
63. Further Budget Details:
F] Yes No
Activity Estimated duration Cost per activity
Survey 2 weeks 2,200 labour
Design & Engineering 8 weeks 15,000 labour, $2,000 in-kind
Tree & brush clearing 2 weeks 8,000 labour and machine time
Groundworks 2 weeks 12,000 labour and machine time,
Retaining wall 6 weeks 13,800 labour and machine time,
Railings & barriers 6 weeks 3,000 labour, $5,000 materials
10,000 materials
10,000 materials
Denotes mandatory field CanadaESDCEMP5585 (2016-04-003) E Page 10 of21
SECTION B - Part 4 - Additional Information (Optional)
Additional Information
Instructions: For each block of text you include below (if any), please specify the section it is meant to continue.
Section B Part 1:Organization
Additional Organizational Contact
Janelle Costantino, CPA, CA
Manager of Finance/Deputy Treasurer
Town of Tillsonburg
200 Broadway, Suite 204
Tillsonburg, ON N4G 5A7
Phone: 519-688-3009 Ext. 3236
jcostantino@tillsonburg.ca
Denotes mandatory fieldCanaaa 1
ESDC EMP5585 (2016-04-003) E Page 11 of 21
Denotes mandatory field CEMacia° ESDC EMP5585 (2016-04-003) E Page 12 of 21