Expression of Interest: Building Community Vaccination Awareness

Funding Option A

This Expression of Interest (EOI) is for the provision of the Building Community Vaccination Awareness program (funding option A) across the Central and Eastern Sydney PHN (CESPHN) region.

 

The Building Community Vaccination Awareness program aims to expand awareness of the importance of vaccination in vulnerable communities. The aim is to build the capacity of community driven organisations to equip their communities with the necessary knowledge to make an informed decision about vaccination.


Please read and familiarise yourself with the following prior to completing this application form:

This form contains questions that require responses for the submission to be considered. The application should capture in Attachment A all the relevant financial components that are in scope for funding.

This application requires you to upload the following documents:

  • Current certificate of organisation ABN

  • Certificate of Currency for your Public Liability Insurance

  • Certificate of Currency for your Professional Indemnity Insurance

  • Evidence of legal entity status of your organisation

  • Attachment A (Financial Submission)


Applications close at 12.00pm Friday 16 December 2022.


If you have any questions please email immunisation@cesphn.com.au  

Clarification Questions

If you have any questions please email immunisation@cesphn.com.au  

Any clarification questions asked by potential applicants will be posted on the CESPHN webpage. Please review answers before continuing your application.

Timeline

04 November 2022: EOI released

21 November 2022: Deadline for questions from potential applicants
Questions may be emailed to immunisation@cesphn.com.au 

22 November 2022: Deadline for CESPHN to respond to questions from potential applicants
All questions asked by potential applicants and answers provided by CESPHN will be available on the CESPHN webpage. Please review before submitting your application.

28 November 2022: Deadline for EOI application submission

DEADLINE EXTENDED: NEW CLOSING DATE 12PM FRIDAY 16 DECEMBER 2022.

Applicant Organisation Details












Leave blank if your postal address is the same as your residential address




Please indicate legal entity type and ensure that you list your entity name as it appears against your ABN











5. Applicant Contact Details

The principal contact person is the person who is legally authorised to enter into contracts on behalf of your organisation. The principal contact person must complete the declaration at the end of this

application and will be required to sign a Services Agreement for the Provision of Funding if your

application is successful.










The project contact person is the person who will be involved in leading the project/service enhancement and would generally be the manager or project manager of the applicant or implementing organisation.


Leave blank if same as above.










Applicants must provide details of two referees with which the applicant organisation has been engaged in providing similar services within the past 2 years. One of these referees must be the most recent entity for which you received funding.

Please provide details of your first referee:







Please provide details of your second referee:






Mandatory Attachments








b. If you did not submit Audited Financial statements in the previous section, please submit the following in this section:






Scored Selection Criteria 

Applicants must address each of the following selection criteria.






















Declaration

By submitting this form, I hereby agree:

  • I have read the Central and Eastern Sydney PHN (CESPHN) Building Community Vaccination Awareness Application Guidelines and my organisation is eligible to apply.

  • I declare that the organisation is financially viable and able to manage the project/ service within the timeframe and within budget. 

  • I declare that all information provided in this application is true and correct.

  • I acknowledge, understand and accept that this application does not create a legal or binding commitment, arrangement or understanding between CESPHN and the applicant organisation. Any such commitment, arrangement or understanding will be the subject of further negotiation and documentation, including an agreement for the provision of funding. Additional specific conditions may be included in future agreements.

  • I acknowledge, understand and accept that incomplete applications may not be considered.

  • If and where any personal details of a third party are included, the third party has been made aware of and given their permission for those details to appear in this application.

  • I acknowledge, understand and accept that CESPHN may require additional information to support this application. 

  • I acknowledge, understand and accept that CESPHN may negotiate changes to an applicant’s proposal including funding to meet the desired outcomes.

  • I  acknowledge, understand and accept that information provided in this application will be stored by CESPHN in various formats including hard copy and/or electronic storage.