Canada 150 Community Infrastructure Program - Final Report

Instructions

The purpose of the Final Report is to detail the outcome of the project.

To complete the Final Report, please download the MS Excel file provided. Once you have downloaded the file, provide a response for each of the questions listed and submit the form to your project officer.

Text from the report including some examples may be found below.

Fillable Excel version

Final submission for the project must include this form.

Recipient Name:
Project Number:
Project Location (City/Town):
Project Completion Date:

  1. Project Summary Please select Yes or No from the dropdown boxes for all Yes/No questions:
    1. Has your Project experienced any variances either in project scope, budget or schedule? If Yes, please provide details below:
    2. Have all costs claimed been paid to the suppliers? If No, please provide details below.
    3. Have all costs been claimed at actual arm's length cost or at fair market value, net of any refunds or other consideration provided by any supplier?
    4. Are there any present or potential liens or claims known to you, which could put the ownership of project assets at risk? If Yes, who is this party.
    5. Is the Project in compliance with environment protection measures, which satisfy the requirements of all regulatory bodies of appropriate jurisdiction?
    6. Have all special and general conditions stated in the Contribution Agreement been satisfied?
    7. Have you disposed of, leased to other parties, or ceased to use in the operation any Project assets?
    8. Have you spent the entire approved Contribution amount?
  2. Breakdown of Project Costs
    • Planning, Design, Engineering:
    • Repair, Construction:
    • Project Management:
    • Contingency:
    • H.S.T.:
    • Gross Project Total:
    • Less H.S.T.:
    • Net Project Total:
  3. Statement of Total Government Assistance
    • CIP 150 Funding Amount:
    • Recipient Funding Amount:
    • Other Sources of Funding/Revenue (Please list any other sources of funding in the rows below):
    • Total:
  4. Project Benefits Provide a detailed description of the benefits arising from the project.
    • Benefits to the community:
    • Economic Impact (additional economic activity, spin-off impacts for the community):
    • Any other relevant information:
  5. Communication Requirements (Please select Yes or No)
    Have all signage requirements been met, and has a photograph or URL of the signage been sent to your FedDev Ontario Program Officer?
  6. Project Certification
    I, space to insert name, space to insert title for the Recipient, certify that:
    • I have examined the Canada 150 Community Infrastructure Contribution Agreement for the above Project and that the above responses are true and correct;
    • The project has been completed in accordance with the Contribution Agreement and that, where applicable, all identified environmental mitigation measures have been satisfactorily addressed and that supporting invoices and records are available for audit, if required; and,
    • The summary of funding amounts includes only costs paid and properly chargeable to CIP 150; the amounts listed in Other Sources of Funds/Revenue represents all provincial and federal funding (with exception to the CIP 150 funding) and any contribution from developers or other sources received or receivable, applicable to the above project.

Name and Title: space to insert signature
Date: space to insert date

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