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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