Application for Prioritized Funding
Communities at Risk: Security Infrastructure Program - Severe Hate-Motivated Incident Support

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Section 1 of 7: Verify Your Eligibility

To verify if you meet the minimum criteria in order to qualify for funding, please confirm the current circumstances regarding your organization and the proposed project site in this section. All statements must be true to your circumstances in order to proceed with an application under the SHMIS stream. Successful completion of this section does not guarantee your eligibility for this program. Your eligibility will be confirmed by Public Safety Canada upon receipt of your application.

Q1.4: Has your organization been a direct victim of a severe hate-motivated crime in the last six (6) months which required the involvement of law enforcement?

Yes
No

Selecting 'No' renders you ineligible to participate in the program's SHMIS prioritized funding process. You may still apply under through an annual Call for Application should you meet all other eligibility criteria.

Q1.5: Please confirm that the following statements are true as they pertain to the severe hate-motivated event in question:

The event must meet all below criteria to qualify. This is to ensure fairness, transparency and integrity of the program for other applicants.

• The organization has been the victim of a severe incident related to a hate or bias-motivated crime resulting in bodily harm, injury, death, significant threat of physical violence (e.g. presence of armed intruder) or significant property destruction that took place at their physical location;
• The severe incident occurred within the last six (6) months;
• The severe incident was reported to police and involved a police response;
• A police report was filed; and,
• The severe incident had demonstrated links to hate crime, terrorism or extremist factions

Q1.6: Please confirm that all the following statements apply to your organization:

All statements must be true in order to continue. An organization's primary mandate and activities constitutes the foundation of what an organization must accomplish to fulfill its vision and mission.

Your organization and/or project site:

• Belongs to or serves an identifiable community at-risk of hate-motivated crime/incidents (this includes gender-based violence);
• Is currently incorporated as a not-for-profit organization or registered as a charity;
• Is currently operating in Canada, and in compliance with filing, reporting and other requirements as established by the Canada Revenue Agency and/or by Revenu Québec;
• Owns, leases or rents a permanent facility/site, or portion thereof, in Canada to fulfill its mandate to host religious, spiritual or culturally significant gatherings or support individuals experiencing gender-based violence;
• Is not a sports organization, team or recreational, athletic, hobby or games-oriented club;
• Is not a government department or agency, for-profit corporation, crown corporation, or police service;
• Does not have a primary mandate of providing health care, social services or housing, with the exception of gender-based violence shelters and its transitional housing;
• Does not have daycare as a primary activity;
• Does not have hosting organizational or administrative meetings  as a primary activity; and,
• Does not engage in practices and observances that are hateful, incite hatred or violence against other individuals or groups, or contravene criminal law.

Q1.7: Please confirm that your organization is:

• Authorized to install security equipment and conduct minor construction at the project site;
• Willing to report on the project to the Government of Canada; and,
• Has privately sourced funding available to support a security infrastructure project that would be partially funded through the Security Infrastructure Program.

Q1.8: Is your project site primarily considered as a:

Please note that your application will be assessed according to the category selected.

• Place of Worship
• Community Centre
• Gender-Based Violence Shelter
• Provincially/Territorially recognized private educational institution

Q1.8a: You identified your project site as a Provincially/Territorially Recognized Private Educational Institution. Please confirm that all the following statements are true:

Your organization and/or project site (i.e. the recognized private school):

• Hosts, as a primary activity as part of their mandate, regular gatherings of religious, spiritual or cultural significance;
• Has a primary mandate related to regular education and training, and which identifies with a specific cultural, spiritual or religious community (e.g., faith-based schools, cultural schools, seminaries and other institutions that provide theological instruction);
• Is recognized or accredited by the province or territory in which it operates as a private educational institution for the current and upcoming academic year;
• Is not a post-secondary institution (e.g. universities and colleges);
• Is not a Collège d'enseignement général et professionnel (CEGEP; Québec only); and,
• Is not a publicly funded Catholic primary or secondary school (Ontario, Alberta, Saskatchewan, Nunavut, NWT and Yukon only).

Please attach documentation that confirms that your private educational institution is recognized  at the Provincial or Territorial level in the field below:

Failure to provide satisfactory evidence of provincial or territorial recognition will result in your application being deemed ineligible. To attach a file, select the upward arrow and follow the prompts.

Accepted Formats: .PDF, .JPG, and .PNG. Submissions using other formats will not be considered.

Q1.8b: You identified your project site as a Place of Worship. Please confirm that the all following statements are true:

Your organization and/or project site (i.e. the place of worship):

• Hosts, as a primary activity as part of their mandate, regular gatherings  of religious or spiritual  significance; and,
• Refers to itself as a church, mosque, synagogue, temple, meeting house, or other non-residential permanent building or site used primarily for religious worship.

Please identify the type of place of worship:

• Christian Church
• Islamic Mosque
• Jewish Synagogue
• Hindu Temple
• Sikh Gurdwara
• Buddhist Temple
• Indigenous Place of Worship / Sacred Site
• Shinto Shrine
• Other
  Please specify:

Q1.8c: You identified your project site as a Community Centre. Please confirm that all the following statements are true:

Your organization and/or project site (i.e. the community centre):

• Hosts, as a primary activity as part of their mandate, regular culturally significant  activities and programming; and,
• The community activities promote the culture and well-being of those who occupy the space such as camps, arts, crafts, physical, social, charitable, educational activities, primarily directed to an identifiable community.

As a community centre, please describe how your organization's gathering(s) fulfil the requirement of having "religious, spiritual or cultural significance":

Q1.9a: You identified your project site as a Gender-Based Violence (GBV) Shelter. Please confirm that the following statements are true:

Your organization and/or project site (i.e. the GBV shelter):

• Supports as a primary activity as part of their mandate, at risk individuals, victims and survivors of gender-based violence (including members of 2SLGBTQI+ communities);
• Provides housing support to individuals fleeing gender-based violence through a temporary emergency shelter facility and/or transitional housing;
• Is a publicly accessible facility that operates 24 hours a day/7 days a week (i.e. 24/7);
• Is not a private residence (such as an apartment) being leased for the purposes of longer-term transitional housing;
• Offers counselling services and other forms of relevant support tailored to gender-based violence; and,
• Is not a community drop-in centre.

Q1.10: Is your project site  considered as a primary stage support (temporary emergency shelter) or as a secondary stage support (transitional housing) in supporting individuals experiencing gender-based violence?

• Primary Stage Support - Emergency Shelter
• Secondary Stage Support - Transitional Housing
• Both (primary/secondary)

Q1.11: You indicated that your project site  includes transitional housing. Please confirm that the following additional statements are true:

If the following statements related to your organization's second stage supports are not true but your organization also has an emergency shelter at the site, you may revise your response in Q1.7e to indicate only having a primary stage support at the project site. Note that only the emergency shelter portion of the facility would be covered as part of your project proposal.

• The transitional housing is not a private residence (such as an apartment) being leased by the organization on behalf of the survivor/victim of gender-based violence; and,
• The facility is legally owned by and in the name of your organization and used solely for the purposes of providing secondary stage support as transitional housing.

Section 2 of 7: Applying Organization and Contact Information

Please provide information about your organization in this section. Ensure the information in this section is accurate and complete. This information is required in order to identify you as the applicant.

Section 2.1: Organization Identification

Please provide identifying information pertaining to your organization in this subsection.

Q2.1: Is this application being submitted on behalf of another organization?

Yes
No

If selected for funding, funds will only be distributed to the eligible organization who operates the project site. Please note that program funds may not be used to cover expenses related to the completion of this application.

Q2.1a: Please confirm the following:

Public Safety Canada will confirm this information if selected for funding. The organization applying for funding is the intended recipient which operates the facility at the project site.

• The organization that is applying (i.e. the intended recipient) for this funding has authorized me to apply on their behalf.
• The intended recipient for this funding is in agreement with all of the information that is provided in this application.
• If the project is selected for funding, the intended recipient understands they will be required to sign the contribution agreement and will be bound by its terms and conditions.

Please complete this application form using only the information of the applying organization (i.e. the intended recipient).

Q2.2: Will your organization be financially capable of covering 50% of the costs for your project using non-government financial sources?

Your response will not impact your application for funding. Please note that funding under this program is generally provided in the form of reimbursement at the end of your project, covering up to 50% of eligible project costs. Organizations must ensure the necessary funds are available by the time an agreement is signed with the Department.

Yes
No

Please ensure that if your application is approved, funds are readily available to cover the costs for the entire duration of your project by the time you are asked to sign an agreement. If you have any concerns or questions, please contact the Program mailbox.

Q2.2a: As an authorized representative of the applying organization (i.e. intended beneficiary), please indicate whether your organization claims tax rebates:

Yes, the organization claims federal and/or provincial tax rebates.
No, I attest that the organization does not claim federal and provincial tax rebates.

Q2.3: Does your organization operate under a different name other than its legal name?

Yes
No

Please complete this application form using only the information of the applying organization (i.e. the intended recipient).

Q2.4: Organization's Operating Name:

Q2.5: Organization's Corporate Legal Name:

Make sure to include any capital/lower case letters, periods or commas that are part of the name. This will be used for verification purposes.

Organization's Address:

Street address:
Mailing address (if different than street address):
City/town:
Province/Territory:

• British Columbia
• Alberta
• Saskatchewan
• Manitoba
• Ontario
• Quebec
• New Brunswick
• Nova Scotia
• Newfoundland and Labrador
• Prince Edward Island
• Yukon
• Northwest Territories
• Nunavut

Postal code (e.g. X1X 1X1):
Telephone number (e.g. 555-555-5555):
Website (If applicable):

Q2.7: Please briefly describe the mandate of your organization:

Q2.8: Please provide your organization's incorporation information:

Corporate Registry Identification:

Please indicate under which government authority your organization is primarily incorporated by.

A business in Canada can be incorporated federally or in the province or territory where it operates.

• Federal Government
• British Columbia
• Alberta
• Saskatchewan
• Manitoba
• Ontario
• Quebec
• New Brunswick
• Nova Scotia
• Newfoundland and Labrador
• Prince Edward Island
• Yukon
• Northwest Territories
• Nunavut

Business/Charity Number:
9-Digit GST/HST Number (if applicable):

Q2.9: Will the proposed project activities only take place at the organization address identified above?

The project site is the physical location where your organization intends to install the proposed security measures. Only one application may be submitted for each project site and each project site requires a separate application.

Yes, it is the project site.
No, the project is taking place at another location.

Section 2.2: Additional Organization Information

Please provide some additional information regarding your organization in this sub-section.

Q2.10: Please identify the employment size of your organization: 

Including staff and volunteers.

• 1 to 4
• 5 to 9
• 10 to 19
• 20 to 49
• 50 to 99
• 100 to 199
• 200 to 499
• 500 +

Q2.11: What is the average annual revenue of your organization?

• Less than $25,000
• $25,000 to $50,000
• $50,000 to $100,000
• $100,000 to $500,000
• $500,000 to $1,000,000
• $1,000,000 to $5,000,000
• More than $5,000,000

Q2.12: Does your organization's staffing composition identify as any of the following:

Select all that apply.

• Indigenous Peoples
• Ethnic, linguistic, cultural or religious minorities
• Persons with disabilities or health issues
• 2SLGBTQI+
• Children or Youth
• Newcomers
• Located in Region/Urban Area
• Located in Remote/Rural Area
• Women
• Men
• Students
• Seniors
• Veterans
• Individuals of particular socio-economic status
• Individuals of particular educational level
• Individuals of particular familial characteristics (e.g. marital or family status)

Please explain (socio-economic status):

Please explain (educational level):

Please explain (familial characteristics):

Section 2.3: Designated Organizational Contact Information

Please provide the contact information for the individual who will serve as liaison for your organization with Public Safety Canada for the duration of the process. Only the Designated Organizational Contact will receive communications regarding this application. Should this contact change, please inform Public Safety Canada as soon as possible. Please be sure to check junk/spam folders regularly so communications are not missed.

Q2.12: Please identify the Designated Organizational Contact for this Application:

The designated organizational contact will be the primary contact point between Public Safety Canada and the organization in regards to this application. This contact will receive all information pertaining to the status of this application. Email is the default method of communication.

First Name:
Last Name:
Position/Title:
Daytime telephone (e.g. 555-555-5555):
Cell phone (optional) (e.g. 555-555-5555):
Email address:

Section 3 of 7: Project Site Information

Please provide more information about your project site in this section. The project site is the physical location where your organization intends to install the proposed security measures. Ensure the information in this section is accurate and complete.

Section 3.1: Project Site Location

Please identify the project site's location in this subsection. The project site is the physical location where your organization intends to install the proposed security measures.

Q3.1: You previously indicated that project activities will not take place at your organization's address but would take place at a different address. Please confirm and identify the project site below:

Yes, project activities are occurring at a different address.

Please identify the project site:

The project site is the physical location where your organization intends to install the proposed security measures.

Project site's name:
Street address:
Mailing address (if different than street address):
City/Town:
Province/Territory

• British Columbia
• Alberta
• Saskatchewan
• Manitoba
• Ontario
• Quebec
• New Brunswick
• Nova Scotia
• Newfoundland and Labrador
• Prince Edward Island
• Yukon
• Northwest Territories
• Nunavut

Postal code: (e.g. X1X 1X1)

Section 3.2: Project Site Information

Please describe the project site in relation to its usage, age and other circumstances in this subsection.

Q3.3: In what decade was the facility at the project site constructed?

• Currently under construction
• 2000s to present (about 20 years ago to recently)
• 1990s (about 30 years ago)
• 1980s (about 40 years ago)
• 1970s (about 50 years ago)
• 1960s (about 60 years ago)
• 1950s or later
• Unknown

Q3.4: Does the project site share its real-estate with other businesses or tenants besides your organization?

Yes
No

Please provide details regarding the other uses of the building (e.g. daycares, venue spaces, commercial shops etc.), including whether the spaces are shared or physically segmented, frequency of use for these purposes and who accesses the spaces (e.g. public, private members etc.)

Q3.5: Please enter the year (yyyy) your organization began operating and providing its services at the project site:

Q3.6: Do you have any physical security measures currently in place at your project site?

Yes
No

Please list and describe the physical security measures currently installed at your project site:

Section 3.3: Project Site Funding History

Please provide information on your project site's funding history as well as your organization's general funding history in this subsection.

Q3.7: Has this project site previously received and benefited from funding provided by the federal Security Infrastructure Program (SIP)?

Yes
No

Please identify the calendar year (yyyy) in which funding was provided (if known):

Please identify the file number associated with past SIP funding (if known):

Q3.8: Is this request for funding in order to undertake new project activities, or is it a request for funding for a continuation or next phase of a previously funded project?

New
Existing

Q3.9: Has your organization ever received funding from Federal Provincial/Territorial or Municipal governments?

Yes
No

Please identify which government(s) your organization have received funding from previously:

Please briefly describe your organization's previous publicly-funded project(s):

You may describe experience in developing, implementing, monitoring and managing projects (regardless of funding sources) within a specified timeframe and budget.

Q3.10: Has your organization applied, or intends on applying to another government program related to security infrastructure to support this project?

Please review program Terms and Conditions for more information on limitations.

• Yes, we intend to apply
• Yes, we applied and are awaiting decision
• Yes, we have received the funding
• No

Section 4 of 7: Community Risk

Please provide information regarding the severe hate-motivated event against your organization in this section.

Section 4 Additional Completion Requirements:

• Provide one (1) Letter of Support which is provided by a member of the community. The letter cannot originate from the applying organization or its own staff.
• Provide one (1) Police Report which serves as evidence that your project site experienced a severe and direct hate-motivated incident/crime. Additional Supporting Documentation is optional.

Please note that an organization's project site does not have to have been directly victimized by a hate-motivated incident/crime to be considered eligible for program funding under an annual Call for Application. However, it is required to participate in the prioritized process under the SHMIS stream.

Section 4.1: Severe Incident Against the Project Site

You indicated that a severe hate-motivated incident/crime occurred at your proposed project site. Please provide the police report and any additional supporting documentation regarding the severe hate-motivated event against your organization. Examples of supporting documentation can include media reports and photographs, which demonstrate the severe hate-motivated incident/crime occurred at your project site. Failure to provide a police report will render your application ineligible for prioritized funding under the SHMIS stream.

Please provide the police report for the severe incident:
Accepted Formats: .PDF, .RTF, .JPG, .PNG and Microsoft Word (.DOC and .DOCX). Submissions using other formats will not be considered.

Q4.1: Do you need to attach additional documents? (Optional)

Additional documents can include news articles, images and other information pertaining to the event.

Yes
No

Please attach any additional supporting documentation:

Q4.2: Please briefly describe the contents of all documents submitted in this section and how they illustrate that your project site was a victim of a severe hate-motivated incident/crime. We encourage you, if possible, to provide additional detail on the events that took place:

Section 4.2: Community Support (Optional)

Optional. Please provide one (1) Letter of Support provided and signed by a member of the community . The letter from your community should show support for your proposed security project and/or acknowledge existing security challenges at your site in order to be considered for funding. A letter template is available for your convenience.

The letter cannot originate from the applying organization or its own staff and volunteers. For more information, we encourage you to review the SIP Application Guide to ensure your letters are acceptable and avoid conflicts of interest. Failure to provide a letter of support which meets our requirements as part of your application will render your application ineligible.

Q4.3: Would you like to submit your letter of support from the community at this time?

Selecting 'No' will not invalidate your application. Submission of your letter will not increase your chance for approval. You can provide your letter at a later time should you be accepted.

Yes
No

Please attach your Letter of Support:
Accepted Formats: .PDF, .RTF, .JPG, .PNG and Microsoft Word (.DOC and .DOCX). Submissions using other formats will not be considered.

Section 5 of 7: Financials

Please provide an estimate on the amount of federal funding which will be requested by your organization for the realization of your SIP project in this section. You may also provide a brief description of your project if you have one.

A detailed outline of project activities, your work plan and your completed budget for the project will be requested at a later time should your application be successful. Your organization will also be required to seek out estimates and select the vendors who will be realizing the project. Please refer to the SIP Application Guide for additional guidance.

The Department will require all recipients of contributions to disclose all sources of funding for a proposed project before the start and at the end of a project. Funding cannot be used in combination with any other federal/provincial/territorial/regional/municipal government assistance for the same purpose and eligible expenses.

Federal Funding Request (Estimate)

Q5.1: Do you have a general idea of what your security infrastructure project will entail?

Selecting 'No' will not invalidate your application. This information is collected to better serve you at the onset should your request for funding be approved.

Yes
No

Q5.2: Have you completed a security assessment for your project site in the last year?

Yes
No

Please attach a copy of your security assessment (Optional):

Q5.3: Briefly describe the proposed activities of your project:

Q5.4: How much funding is your organization anticipating to request from Public Safety Canada on this project?

Only an estimated cost range is required at this time. Public Safety Canada covers 50% of total eligible project costs, with a maximum Public Safety Canada contribution of $100,000.

Please review program Terms and Conditions for more information on limitations.

• Under $10,000
• Between $10,000 and under $25,000
• Between $25,000 and under $50,000
• Between $50,000 and under $75,000
• Between $50,000 and under $100,000 (max)
• Unsure

Section 6 of 7: Demographic Information

Please provide information regarding the communities your organization serves and/or represents in this section. Information provided in this section is for statistical purposes only and will not impact your application. However, completion of this section is mandatory. Should you have questions about this section, please refer to the SIP Application Guide or contact the Program mailbox

Please provide information regarding the demographics of the population your organization represents.

Q6.1 Your community feels most vulnerable to hate crimes motivated by:

Please select one:

• Race, Nationality or Ethnicity
• Religion
• Sexual Orientation
• Language
• Disability
• Sex and/or Gender
• Age
• Other similar factors
• Unknown motivation

Q6.2 Please identify the most commonly used language(s) by the population serviced by your organization at the project site:

Please select only those that specifically apply to your project site.

• English
• French
• Mandarin
• Cantonese
• Punjabi
• Spanish
• Arabic
• Urdu
• Indigenous Languages/Dialects
• Other

Please specify the language(s) used:

Q6.3 Please identity up to four (4) demographical categories that best describe or are the most applicable to your organization (at the project site). In particular, this proposal is primarily designed to benefit:

Please select only those that specifically apply to your project site.

• Men
• Women
• 2SLGBTQI+
• Indigenous Peoples
• Particular race(s), ethnicity(ies) or nationality(ies)
• Religious or spiritual communities
• Persons with disabilities or health issues or their caregivers
• Children and Youth
• Students
• Seniors
• Veterans
• Newcomers or Immigrants
• Individuals of particular socio-economic status
• Individuals of particular educational level
• Individuals of particular familial characteristics (e.g. marital status, family status)

Please explain (optional | 1-2 sentences):
Exceptionally, if none of the options above can adequately reflect the intended group of the proposal, please use this explanatory box to provide further details.

Q6.4 Which race(s), nationality(ies) or ethnic group(s) does your organization (at the project site) best identify with? Please specify up to four (4):

Please select only those that specifically apply to your project site.

• Black (e.g., African, Haitian, Jamaican, etc.)
• Arab
• Chinese
• Filipino
• Japanese
• Korean
• Latin American
• West Asian (e.g., Iranian, Afghan, etc.)
• South Asian (e.g., East Indian/Indian, Pakistani, Sri Lankan, etc.)
• South East Asian (e.g., Vietnamese, Cambodian, Laotian, Thai, etc.)
• White (Caucasian)
• Other

Please specify:

Q6.5 Which religious or spiritual belief does your organization (at the project site) best identify with? Please select one (1) of the options:

Please select the one that specifically applies to your project site.

• Buddhism
• Christianity
• Hinduism
• Judaism
• Islam
• Sikhism
• Traditional (North American Indigenous) Spirituality
• Other religion(s) or spiritual tradition(s)

Please specify:

Q6.6 You selected 'Indigenous Peoples', please select all that apply:

Please select only those that specifically apply to your project site.

• Inuit
• Métis
• First Nations

Q6.7 Does your organization (at the project site) identify itself as part of the 2SLGBTQI+ community?

• Yes
• No

Q6.8 You selected 'Newcomers and Immigrants', please select all that apply:

Please select only those that specifically apply to your project site.

• Immigrant
• Non-permanent status

Q6.9 Classification of Immigration Status:

Please select only those that specifically apply to your project site.

• 1st generation
• 2nd generation
• 3rd generation or more

Section 7 of 7: Disclosures and Feedback

Please disclose information pertaining to debts, official language requirements and potential conflict of interests in this section. You may also provide feedback on this application process and include any additional details or special circumstances you would like us to know about your application.

We sincerely appreciate you taking the time to complete this section as accurately as possible to support this important work.

Section 7.1: Declarations and Disclosures

Please disclose pertinent information regarding potential or known conflicts of interest as it relates to this application in this subsection. You are also asked to declare any current outstanding debts to the crown and how your project will respect the Official Languages Act.

Q7.1: Does your organization have outstanding amounts owing to the Government of Canada?

Answering yes to this question will not invalidate your application.

Yes
No

Please indicate the total amount owing ($):

Please provide the name of the department or agency it is owed to:

Q7.2: Will this project include the services of a current or former Federal public servant either as an employee or as a member of the Board of Directors or advisory committee?

Yes
No

Please describe their role and provide assurance that the public servant (or former public servant) is in compliance with the Values and Ethics Code for the Public Sector, and the Conflict of Interest Act (S.C. 2006, c.9) or the Parliament of Canada Act (R.S. 1985, c.P-1.01):

Q7.3: Will this project include the services of a lobbyist?

Yes
No

Please provide assurance that, where lobbyists are used, they are registered in accordance with the Lobbying Act (R.S.C., 1985, c44 (4th supp.)) and that no commissions or contingency fees have or will be paid directly or indirectly to any person for negotiating or securing this request for funding:

Q7.4: Will the project have an impact on Official Language Minority Communities (OLMCs) and does the project offer an opportunity to foster the full recognition and use of English and French in Canadian Society?

Yes
No

Describe how the needs of the official language group (anglophone/francophone) will be addressed. If there are none to be considered, provide a rationale as to why:

Section 7.2: Feedback

In this subsection, you are given the opportunity to provide any feedback on this application tool, our resources and processes. You are also provided with the opportunity to add any additional information which you feel may be necessary in regards to your application for funding.

Q7.6: Would you like to provide any feedback with regards to this application tool (i.e. understanding, technology, questions, length, user-friendliness etc.), other resources or the process?

Yes
No

Thank you for taking the time to provide feedback. Please provide your feedback below:

Q7.7: Is there anything else you would like to tell us about your project, your present circumstances, or have us consider as part of the assessment of your application?

Information provided in this question is supplementary and is not guaranteed to impact our decision on funding your project proposal.

Yes
No

Please provide additional information below:

Application Signature (SHMIS)

You previously indicated that your organization is applying on behalf of the applying organization (the intended recipient). Please ensure that the applying organization has reviewed this section and authorized the submission of this application on their behalf.

As a representative of the organization submitting on behalf of the applying organization named in Section 2 of this application, I declare that:

• The information in this application and the attached supplementary materials are complete and accurate;
• The application is made on behalf of the applying organization with their leadership and signing authority's full knowledge and consent;
• The applying organization agrees to respect and comply with all relevant municipal codes, by-laws and Provincial/Territorial laws and regulations; and,
• The applying organization will disclose any role of a departmental official participating on an advisory committee or board. Such involvement must not be seen to be exercising control on the committee or board or on the use of the funds.
• The applying organization agrees to respect and comply with the Lobbying Act (R.S.C., 1985, c44 (4th supp.)), the Values and Ethics Code for the Public Sector, the Policy on Conflict of Interest and Post-Employment, and the Conflict of Interest Act (S.C. 2006, c.9, s.2).

As a representative of the organization named below, I declare that:

• The information in this application and the attached supplementary materials are complete and accurate;
• The application is made on behalf of the organization with their leadership and signing authority's full knowledge and consent;
• The organization agrees to respect and comply with all relevant municipal codes, by-laws and Provincial/Territorial laws and regulations; and,
• The organization will disclose any role of a departmental official participating on an advisory committee or board. Such involvement must not be seen to be exercising control on the committee or board or on the use of the funds.
• The organization also agrees to respect and comply with the Lobbying Act (R.S.C., 1985, c44 (4th supp.)), the Values and Ethics Code for the Public Sector, the Policy on Conflict of Interest and Post-Employment, and the Conflict of Interest Act (S.C. 2006, c.9, s.2).

And understand that:

• Project proposals can be shared with other Federal Departments, Provincial and Territorial governments, and relevant stakeholders;
• The information provided in this application may be accessible under the Access to Information Act (R.S.C., 1985, c. A-1); and
• If this project is approved, and it is provided with funding, the recipient organization will be required to comply with the terms and conditions set out in an agreement.
• The applicant has not paid or agreed to pay, directly or indirectly, and agrees that in shall not pay, directly or indirectly, any contingency fees for the solicitation, negotiation or acquisition of funding for the purposes of this application.
• Should this funding request be approved, funding will be conditional upon the applicant signing a written agreement with Public Safety Canada.

Please contact Public Safety Canada for further information should you have any concerns.

Q8.1: Declaration:

By submitting this application, I agree to the above and confirm that the submitted information is intended to support my application for funding under the Communities at Risk: Security Infrastructure Program (SIP) and that the information contained in this application is true, accurate and complete to the best of my knowledge.

Q8.2: Application Submitted by:

Name:
Title:
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Date modified:

2023-07-12