From: (Name of Proponent)



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Date16.01.2018
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Atlantic Innovation Fund – Competitive Round 2013

Letter of Intent
Date:
To: Atlantic Canada Opportunities Agency

From: (Name of Proponent):



Address:


With this letter of intent, our organization wishes to advise ACOA of its intention to submit a formal project proposal for consideration under the current round of the Atlantic Innovation Fund.


  1. Proponent Information


Business Number:

The Business Number (BN) is a 9-digit federal numbering system which is assigned to a business (one business, one number) to deal with the Canada Revenue Agency.
Organization Type (check only one):
Non-profit: Private Sector:
o University o Incorporated Company

o College o Sole Proprietorship

o Other Post-Secondary o Limited Partnership

o Research Centre o Cooperative

o Industry Association

o Other Non-Profit



  1. Project Information




Project Name or Title:



Contact Name:
Title:
Telephone Number:
Principal Project Location:


  1. Applicable Sector (check only the most prevalent one) - Note: Normally, ACOA will assign projects to the sector in which the technology is being applied (e.g. an innovative application of computer software for environmental monitoring would be assigned to the environment sector and cross-referenced to the software sector.




  • Aquaculture

  • Energy

  • Environment

n Information Technology:

o E-commerce

o Software

o Wireless

o Geomatics

n Life Sciences:

o Biotechnology


  • Genomics

  • Health/Medical

o Manufacturing/Processing

o Natural Resources

o Ocean Industries

o Defence and Aerospace

o Physical Sciences (Physics, Chemistry, Engineering)

o Other, specify ___________________________


2. General Description of the Research Proposal - include the project objectives, anticipated deliverables and challenges. (Approximately 1 ½ page)


  1. Project Financing - demonstrate progress toward having a realistic financing plan in place to undertake the project in its entirety, without interruptions due to lack of or delays in securing appropriate financing. Identify confirmed financing by inserting a checkmark where appropriate in the “Confirmed?” column of the budget table.



Estimated Project Costs and Financing




Estimated Project Costs

Estimated Project Financing







Total Amount

Contributor

Total Amount

Confirmed?




Building / Renovations
















Other Capital Costs
















Wages and Salaries
















Other Operating Expenses






















Requested AIF Contribution







Total Project Costs:




Total Project Financing:










  1. Key Project Collaborators (½ - 1 page)




    1. Research Team - list the team members, identified as key to the project’s success, and demonstrate progress toward having their participation confirmed or indicate the likelihood that their participation will be confirmed.




    1. Key Collaborators - identify key project collaborators and demonstrate progress towards having partnership details sufficiently discussed to reasonably expect that partnership agreements could be executed within six (6) months of project approval.




  1. Commercialization Potential of the Research - identify the proposed resulting product, process or service and associated market potential. (½ - 1 page)




  1. Project Governance - demonstrate progress toward the development of a governance model for the project, which outlines team members’ roles and responsibilities, including the project management function. (ACOA strongly recommends that project management be held by someone other than the lead researcher.) (½ - 1 page)




  1. Regulatory Approval - if applicable, proponents must demonstrate progress toward receiving regulatory approval, or that a strategy has been developed to obtain this, for any phase (e.g. R&D, production, commercialization) of the proposed project.




  1. Qualified Independent Scientific/Technical Reviewers:

In order to help facilitate the project evaluation process, could you suggest the preferred academic/professional background of independent scientific/technical reviewers to assess your project proposal:


For our consideration, provide the names below of at least two (2) individuals or organizations that you consider leaders in your area of endeavour that would be competent to review the scientific/technical aspects of your project proposal and not be in a conflict of interest.


Scientific/technical reviewers must not be current or recent (within the last twelve (12) months) partners/collaborators, colleagues, students, employees or supervisors.
Suggested reviewers may be from Canada (preferably from outside Atlantic Canada) or another country, and should be able to evaluate the proposal in the language in which it is written.
ACOA reserves the right to select from this or its own list of reviewers.


  1. Name and/or organization, telephone and email address:




  1. Name and/or organization, telephone and email address:




  1. Name and/or organization, telephone and email address:




  1. Name and/or organization, telephone and email address:

Provide the names of specific scientific/technical reviewers or organizations, if any, who should not be engaged to undertake a review of your proposal due to potential conflict of interest:




  1. Name and/or organization:




  1. Name and/or organization:




  1. Name and/or organization

I hereby consent to ACOA sharing the information contained in this letter with other federal departments or agencies that may be called upon to help in the assessment of AIF project proposals. This information will be treated in accordance with the Access to Information Act and the Privacy Act.


Name of Signing Authority for Proponent:

(Please Print)


Signature of Signing Authority for Proponent:




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