"*" indicates required fields 1Contact Information2Asset Information3Financial Information4Prioritization Information Contact Information1. Contact Full Name*2. Organization Name* Asset Information3. Please provide an overview of the project that is being proposed*4. Facility Name*5. Identify the type of capital project* New – A new asset is created, or a new section is added on to an existing asset. New asset would require additional operations and maintenance costs. Renewal – A renewal is a replacement of an asset like for like. Removal – Removal of an asset and not replacing. This would also remove any operations and maintenance requirements. 6. Identify the type of asset*Examples: Arena, Pool, Curling Rink, etc.7. Has an asset review been completed within 3-5 years for this facility?* Yes No 7.1 Upload a copy of the completed Asset Review Drop files here or Select files Max. file size: 200 MB, Max. files: 10. 8. Has a business plan or review been completed within 3-5 years for this facility?* Yes No 8.1 Upload a copy of the completed Business Plan or Review Drop files here or Select files Max. file size: 200 MB, Max. files: 10. 9. Please describe any additional major capital projects you anticipate undertaking in the next 3-5 years.*Note: If no funding requests for projects are expected in the next 3 to 5 years, please enter “None”. Financial Information10. What year are the funds required for the project?*11. What is the total square footage of the building or asset?12. What is the total estimated cost of the project?*13. What is the financial contribution requested from Sturgeon County?*14. What is the total financial contribution from grants obtained from any other funding source available for the project?*Note: Other funding sources include Federal or Provincial Agencies. If there are no other financial contribution obtained from other sources, please enter “0”.15. Please describe what funding opportunities have been explored related to this project both successful and unsuccessful.*Note: If no other funding sources have been explored, please enter “None”.16. What is the total financial contribution from sponsors allocated for the project?*Note: If no sponsor funds have been allocated, please enter “0”.17. What is the estimated monthly cost to operate and maintain the facility?* Include utilities, insurance, preventative, and reactive maintenance costs.18. Please add any further information you feel is relevant.19. What is the estimated total hourly usage of the facility per month?*Include booked events and drop-in activity.20. What is the estimated monthly revenue generated from the asset?* Prioritization Factors Information 21. How does the project contribute and align with local and county values and resident needs?* Social value has not been considered for this project. There is no social value either anecdotally or data-driven for this project. The project does not support cultural or historic values. Social value has anecdotally been considered for the project. Social value as been determined by professional judgment. The project supports the agency’s cultural and historic values. Social value has been determined by data driven analysis. It has been determined that the project will positively influence the agency’s social value. The project supports the County’s cultural and historic values. 22. What is the current asset condition rating for the facility?* Very Poor or Failure: Asset is in very poor condition or has completely failed and is no longer functional. Poor: Asset is in poor condition, requiring significant repairs or replacement soon. Fair: Asset is in fair condition, showing signs of moderate wear and may require some repairs or maintenance. Good: Asset is in good condition, with only minor wear or maintenance required. New or Excellent: Asset is new or in excellent condition, requiring minimal to no repairs or maintenance. 23. How does the project support sustainability of the county Regional Efficiencies and Economic Impact?* The project has minimal or no demonstrated effect on workforce growth and does not increase regional catchment. The new facility will replace one facility and maintain the service provision for an individual third-party agency. The third-party agency will require additional resources for service provision and resources to operate the new facility. The facility has limited or no features or programs that external partners such as schools, and business community to leverage and increase enrollment and development. The project may provide demonstrated workforce growth and increased regional catchment. The new facility will replace one facility and maintain the service provision for an individual third-party agency. External partners including schools, and business community can leverage a portion of the facility and programs to increase enrollment and development. The project will provide demonstrated workforce growth and increased regional catchment. It will replace more than one facility and extend the service provision between two or more third-party agencies. The facility and programs can be leveraged by schools, and business community to increase enrollment and development. 24. How will this project eliminate barriers to foster a community where every person, of all abilities, age, and financial status can engage and participate in a variety of activities both recreational and non-recreationally?*Example: wheelchair-accessible ramps, barrier free washrooms, lifts, sensory-friendly environments, and accessible and inclusive programming, etc. The project does not eliminate barriers for any identified group, will not accommodate any activities or programming, and has unknown or very low usage. The site supports one or two recreation activities with no plans for expansion or alignment with the County Strategic Plan. The project eliminates barriers for a single identified group, will accommodate a single use activity and loosely aligns with County Strategic Plan. accommodate a wide variety of activities. Usage is captured through a data-driven process (e.g. counters or booking/reservation data) and is high attendance. The site facilitates a wide variety of sporting and recreational events. The project eliminates barriers for a portion of identified groups, accommodates a limited number of activities, and aligns with the County Strategic Plan. Usage is estimated at an average level, with the site supporting three or four recreation activities and no plans for expansion. The project eliminates barriers for all identified groups, accommodates a wide variety of activities, and aligns with the County Strategic Plan. Usage is high and measured through a data-driven process, with the site supporting a diverse range of sporting and recreational events. 25. What is the current demand (usership) for the facility?* Insignificant – Project will address little to no change in accommodating current demand management issues. Small – Project will address small changes in accommodating current demand management issues. The project may address a small region or community of a town or localized area. Medium – Project will address medium changes in accommodating current demand management issues. The project may address a town specific demand management issue. Large – Project will address large changes in accommodating current demand management issues. The project may address a town or neighbouring towns specific demand management issue. Extensive – Project will address extensive, county-wide changes to accommodate current demand management issues. The project may address multiple town specific demand management issues as well as County wide demand management issues. 26. What is the future demand (usership) for the facility?* Insignificant – Project will address little to no change in accommodating current demand management issues. Small – Project will address small changes in accommodating current demand management issues. The project may address a small region or community of a town or localized area. Medium – Project will address medium changes in accommodating current demand management issues. The project may address a town specific demand management issue. Large – Project will address large changes in accommodating current demand management issues. The project may address a town or neighbouring towns specific demand management issue. Extensive – Project will address extensive, county-wide changes to accommodate current demand management issues. The project may address multiple town specific demand management issues as well as County wide demand management issues. 27. How does the project incorporate Sustainable Design?* The facility design incorporates no sustainable features / elements and will have a negative impact to the adjacent natural ecosystems and landscape. There will be a net loss in local biodiversity and no climate resilient benefits during the life of the facility. The facility design incorporates a minimal number of sustainable features / elements, that have no net benefits the adjacent natural ecosystems and landscape. There will be no increase in local biodiversity and climate resiliency during the life of the facility. The facility design incorporates a select number of sustainable features / elements, that have limited benefits the adjacent natural ecosystems and landscape. There may be an increase in local biodiversity and climate resiliency during the life of the facility. The facility design incorporates sustainable features / elements, and supplements or improves the adjacent natural ecosystems and landscape. There will be an increase in local biodiversity and climate resiliency during the life of the facility. 28. What risks will the project address or mitigate?*Such as safety, financial, environmental or reputation The risks have not been identified, assessed, or documented. There is no demonstrated value or connection between the future facility and mitigating risk. The risks have been identified, informally assessed, and not documented. The project and future facility will moderately reduce the documented risks. The risks have been identified, formally assessed, and documented. The project and future facility will eliminate or significantly reduce the documented risks. 29. What are the funding sources for this project?* Limited (>25%) capital and operating costs are from external sources, other levels of government, partnerships, or other grants. Some (25%-49%) capital and operating costs are from external sources, other levels of government, partnerships, or other grants. Majority of (50%-89%) capital and operating costs are from external sources, other levels of government, partnerships, or other grants. Nearly all (90-100%) capital and operating costs are from external sources, other levels of government, partnerships, or other grants. 30. Has your agency received capital funding from Sturgeon County?* No, our agency has never received capital funding from Sturgeon County. Yes, our agency has received capital funding from Sturgeon County within 3 years. Yes, our agency has received capital funding from Sturgeon County within 4-5 years. 30.1 Provide the amount of prior capital funding your agency received from Sturgeon County within the last 3 years.*30.1 Provide the amount of prior capital funding your agency received from Sturgeon County within the last 4-5 years.*31. Please provide any additional documents related to the request(e.g. concept plans, etc.) Drop files here or Select files Max. file size: 200 MB. 32. Is the project located within the CAP Levy area?*If unsure of the location of your project, please consult with Administration via email (ehartman@sturgeoncounty.ca) or phone (780-939-8336). Yes No 31. Privacy Policy Agreement*Personal information is collected under the authority of Section 4(c) of the Protection of Privacy Act (POPA) and will be used to process the Community Facility Capital Project Grant Application. If you have any questions about the collection, use, and disclosure of this information, please contact the Sturgeon County Access and Privacy Advisor at 9613 – 100 Street, Morinville, Alberta, T8R 1L9, (780) 939-1306 or accessandprivacy@sturgeoncounty.ca. I agree to the privacy policy.
