Download a Word Version [548kb]

318 views
238 views

Published on

Published in: Economy & Finance, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
318
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
1
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Download a Word Version [548kb]

  1. 1. COMET Completion Questionnaire Commercialising Emerging Technologies (COMET) Completion Questionnaire for Grant Projects over $5,000 Privacy and Confidentiality The confidentiality of information provided to AusIndustry, a division of the Department of Innovation, Industry, Science and Research ('the Department'), is protected by the relevant provisions and penalties of the Industry Research and Development Act 1986, the Public Service Act 1999, the Public Service Regulations, the Privacy Act 1988, and the Crimes Act 1914 as well as the common law. Disclosure of some otherwise confidential information may occur as specified in the Customer Information Guide or, depending on when your grant was approved, the Business Assistance Agreement or the Grant Deed. Detailed information may be disclosed for audit purposes to contractors engaged by AusIndustry and to Commonwealth agencies for law enforcement purposes. Further, AusIndustry may release confidential information if it is required or permitted by law to do so. This could happen, for example, if AusIndustry is required to respond to a resolution of the Parliament, or the order of a court. AusIndustry staff may also disclose information where they obtain consent to do so. AusIndustry may substantiate any claims or statements made in the form in relation to commercialisation outcomes achieved under COMET. Components of the Completion Questionnaire In accordance with your agreement with the Commonwealth, AusIndustry now seeks details on the progress and completion of your COMET project. The Completion Questionnaire has four sections that need to be completed by the customer before it is returned to AusIndustry. Section 1. Customer Details Section 2. Outcomes and Project Evaluation Section 3. COMET Delivery Network Evaluation Section 4. Program Administration Evaluation How to complete the questionnaire? It is important to note that there is no right or wrong answer to any question contained within the Completion Questionnaire. Customers need to choose the appropriate response where a multiple choice is provided and answer each question accurately. Other questions require you to check a box where appropriate. Note: The report can be filled out using Microsoft word by tabbing from text box to text box. Most text boxes can be expanded to accommodate your needs. Text boxes requiring numbers will only accept numbers The table has been left unprotected to allow for the addition of lines to accommodate circumstances where you have a large number of service providers to enter. You have the option of:  printing the form, signing/dating (by hand) and sending through to the COMET National Office; or  completing these processes using an electronic signature and e-mailing the form to the COMET National Office at COMETNationalOffice@innovation.gov.au COMET TAC Completion Questionnaire Page 1 of 9 Version 5.0 March 2009 Final Version COMET Section
  2. 2. COMET Completion Questionnaire How will the information from the questionnaire be used? The information you provide will form part of the ongoing evaluation to assess the appropriateness, effectiveness and efficiency of the COMET program. When does the Completion Questionnaire need to be returned to AusIndustry? Customers need to complete the COMET Completion Questionnaire and return it to AusIndustry within 28 days of completion of COMET assistance. It is important to note that your final payment under COMET will be withheld until the COMET Program receives the Completion Questionnaire and that all Sections have been completed satisfactorily. Section 1: Customer details 1. Company name:       COMET application number COMET business adviser             Section 2: Outcomes and Project Evaluation This section collects information relating to the success of your project. Aggregated data will be used publicly to report on the impact COMET has had in assisting customers. This section will be made available to your Business Adviser and to the National Manager. Part A: Project Outcomes 2. As part of your final reporting to AusIndustry you will submit a final Assistance Plan Progress Report. You will be asked to provide cumulative totals of commercialisation outcomes by type and value. Please ensure these totals are replicated in columns (c) and (d) below. Your Business Adviser will be provided with this information and be requested to confirm that the information is correct. (Please refer to Attachment A for definitions of commercialisation outcomes) (a) (b) (c) (d) BA use ID Commercialisation Number Value of outcomes only number outcome of achieved during the Please (refer outcomes project check () if Attachme achieved agree nt A) during the project Capital Raising 1 Equity Injection       $      2 Initial Public Offering       $      3 Borrowing/Debt Financing       $      Other (please specify): 4       $            COMET TAC Completion Questionnaire Page 2 of 9 Version 5.0 March 2009 Final Version COMET Section
  3. 3. COMET Completion Questionnaire Did you source the capital? (please one box) Domestically Internationally Both COMET TAC Completion Questionnaire Page 3 of 9 Version 5.0 March 2009 Final Version COMET Section
  4. 4. COMET Completion Questionnaire COMET TAC Completion Questionnaire Page 4 of 9 Version 5.0 March 2009 Final Version COMET Section
  5. 5. COMET Completion Questionnaire CAPITAL RAISING CATEGORIES (Please refer to Attachment B for Please Definitions of sources of Capital) check () if appropriate Equity Injection (Outcome ID number 11) Non-public Equity Injection 1. Angel Finance. Please specify whether: syndicate - Choose Syndicate type OR individual - Choose Individual type 2.Corporate Investment 3.Innovation Investment Fund 4.Pre-Seed Fund 5.Pooled Development Fund 6 Other Australian, State or Local Government Equity Program (please specify):       7.Other Venture Capital or Private Equity Fund 8.Other (please specify):       Was the Equity Injection: a) Additional investment from existing shareholder b) Investment from a new shareholder Initial Public Offering (Outcome ID number 2) Public Equity 1.IPO 2.Reverse Listing 3.Other (please specify):       Borrowing/Debt Financing (Outcome ID number 3) Loan/Debt Finance 1.Financial Institution 2.Non-Financial Institution 3.Other (please specify):       Other form of Capital (please specify):       (Outcome ID number 4) COMET TAC Completion Questionnaire Page 5 of 9 Other Version 5.0 March 2009 Final Version COMET Section
  6. 6. COMET Completion Questionnaire (a) (b) (c) BA use only ID number Commercialisation Number of Please check (refer outcome outcomes () if agree Attachment achieved A) during the project       Alliances 5 Strategic Alliances 6 Joint Venture       Other (please specify): 7             Licence 8 Merchandising       Other (please specify): 9             Agreement 10 Distribution       11 Manufacturing       12 Product Market Release       13 Other (please specify):             Production 14 Manufacturing       Commenced 15 Product/Service       Launched Part B: Third Party Service Providers 3. COMET provides assistance for customers to engage third party service providers to undertake approved activities. Using the scale below, please rate your level of satisfaction provided by your service provider/s: Name of Service Provider Service Provided* Provide Rating** 1       Categories Rating 2       Categories Rating 3       Categories Rating 4       Categories Rating 5       Categories Rating 6       Categories Rating 7       Categories Rating 8       Categories Rating 9       Categories Rating 10       Categories Rating 11       Categories Rating 12       Categories Rating 13       Categories Rating 14       Categories Rating 15       Categories Rating COMET TAC Completion Questionnaire Page 6 of 9 Version 5.0 March 2009 Final Version COMET Section
  7. 7. COMET Completion Questionnaire 16       Categories Rating 17       Categories Rating 18       Categories Rating 19       Categories Rating 20       Categories Rating 21       Categories Rating 22       Categories Rating 23       Categories Rating 24       Categories Rating 25       Categories Rating 26       Categories Rating * Categories – Management Development (MD), Business Planning (BP), Market Research/Validity (MR), IP Strategy (IP), Proven Technology (PT) or Working Prototype (WP) ** Ratings – Very Satisfied, Satisfied, Neither Satisfied or Dissatisfied, Dissatisfied Part C: COMET program 4. Overall, how would you rate the usefulness of the COMET program as per the Commercialisation objective that you provided in your COMET Grant Deed. Your Commercialisation objective can be found in Schedule 1, at Item 7. Provide Rating* a Transferring management skills to your company Rating b Improving your opportunity to raise capital Rating c Enabling your company to form beneficial alliances/collaborations Rating d Enabling your company to enter new markets Rating e Adding value to your business Rating f Increasing the efficiency and effectiveness of your business Rating g Transferring commercialisation skills to your company Rating * Ratings – Strongly Agree, Agree, Neither Agree or Disagree, Disagree 5. Please rate the level of your agreement with the following statements regarding the COMET program: Provide Rating* a The COMET program has been important in helping me achieve my Rating original goals b COMET has accelerated the commercialisation of our innovation Rating c COMET has improved my commercialisation skills and knowledge. Rating d The reporting and administrative requirements of the COMET program Rating improved my financial and general management skills. * Ratings – Strongly Agree, Agree, Neither Agree or Disagree, Disagree 6. Would you recommend the COMET program to others? Yes or No COMET TAC Completion Questionnaire Page 7 of 9 Version 5.0 March 2009 Final Version COMET Section
  8. 8. COMET Completion Questionnaire Section 3: COMET Delivery Network Evaluation This section collects information relating to the service and assistance provided by the COMET National Manager and your Business Adviser. Before proceeding, please tick/check ( ) the appropriate box if you do or do not want your Business Adviser to receive your comments. I do not want my Business Adviser to receive my I want my Business Adviser to receive comments my comments Part D: Your COMET Business Adviser (BA) 7. Overall satisfaction with your COMET BA Provide Rating* Overall, how satisfied were you with the contribution of your COMET Rating BA to your business? * Ratings – Very Satisfied, Satisfied, Neither Satisfied or Dissatisfied, Dissatisfied 8. Please rate the level of your agreement with the following statements regarding your COMET Business Adviser (BA): (If you disagree, please provide comments below) Provide Rating* a My COMET BA was important to achieving the desired outcomes of Rating my project. b My COMET BA assisted in the selection of appropriate Service Rating Providers to undertake the COMET project. c My COMET BA provided adequate information on COMET Rating reporting and financial requirements. d My COMET BA assisted me when required. Rating * Ratings – Strongly Agree, Agree, Neither Agree or Disagree, Disagree 9. Comments:       Part E: The COMET National Manager 10. Was the role of the COMET National Manager clearly explained to you by either the National Manager or your Business Adviser? Yes or No 11. If you had contact, please rate your overall satisfaction with the COMET National Manager: Provide Rating Overall, how satisfied were you with the service you received from the Rating COMET National Manager? * Ratings – Very Satisfied, Satisfied, Neither Satisfied or Dissatisfied, Dissatisfied 12. Comments:       COMET TAC Completion Questionnaire Page 8 of 9 Version 5.0 March 2009 Final Version COMET Section
  9. 9. COMET Completion Questionnaire COMET TAC Completion Questionnaire Page 9 of 9 Version 5.0 March 2009 Final Version COMET Section
  10. 10. COMET Completion Questionnaire Section 4: Program Administration Evaluation 13. Overall satisfaction with COMET program administration procedures and processes Provide Rating* Overall, how satisfied were you with the program administrative processes? Rating * Ratings – Very Satisfied, Satisfied, Neither Satisfied or dissatisfied, dissatisfied 14: Comments:       15. OVERALL COMMENTS - Are there any other comments that you would like to make about the COMET program?       NAME OF RESPONDENT:      ........................................................................................... SIGNATURE: {Place electronic signature here} ................................................................................................................... Private Arrangement with your Business Adviser Please note: Business Advisers are not permitted to work with a grantee in a private capacity, or receive payment outside the success fee agreement for the three month period directly after the Agreed Completion Date for Assistance Plan activities. When complete, please forward a copy of the report to: COMET Program AusIndustry Department of Innovation, Industry, Science and Research GPO Box 9839 CANBERRA ACT 2601 Fax: 02 6276 1947 Email: COMETNationalOffice@innovation.gov.au COMET TAC Completion Questionnaire Page 10 of 9 Version 5.0 March 2009 Final Version COMET Section
  11. 11. COMET Completion Questionnaire Thank you for your time in completing this questionnaire COMET TAC Completion Questionnaire Page 11 of 9 Version 5.0 March 2009 Final Version COMET Section
  12. 12. COMET Completion Questionnaire ATTACHMENT A Definitions of commercialisation outcomes [Refer Section 2, Part A: Commercialisation Outcomes] Capital Raising 1. Non Public Equity Injection: any funding that has been committed through a binding agreement to the COMET Grantee to commence operations, or finance a growth strategy, in return for a share of the company eg venture capital, business angel finance or other investors. 2. Public Equity: Equity capital invested in a public company.. 3. Borrowing/Debt Financing: finance committed through a binding agreement to the COMET Grantee, and which needs to be repaid. Alliances 5. Strategic Alliances: when an agreement between the COMET Grantee and another entity is entered into, stating that the involved parties will put in place specified actions to achieve a common goal. 6. Joint Venture: when a contractual agreement between the COMET Grantee and another party is entered into for the purpose of executing a particular business undertaking. All parties agree to share in the profits and losses of the enterprise. The venture is for one specific project only, rather than for a continuing business relationship as in a Strategic Alliance. Licence 8. Merchandising: contract is signed by the COMET Grantee giving permission for another party to promote, buy and sell the product/service for which COMET funds were granted. Agreement 10. Distribution: a contract is signed by the COMET Grantee authorising another party to supply to retailers/buyers the product/service for which COMET funds were granted. 11. Manufacturing: a contract is signed by the COMET Grantee authorising another party to manufacture the product/service for which COMET funds were granted. 12. Product/Market Release: a product is placed on the market by the COMET Grantee, or a contract is signed by the COMET Grantee, authorising another party to undertake the steps necessary to have the product/service for which the Grantee received funding available for sale. Production 14. Manufacturing Commenced: COMET Grantee has commenced production of the product for which it received COMET funding, or a third party has commenced the manufacture of the product under licence to the COMET Grantee. 15. Product/Service Launched: COMET Grantee has introduced to the public the availability for purchase of the product/service for which it received COMET funding. COMET TAC Completion Questionnaire Page 12 of 9 Version 5.0 March 2009 Final Version COMET Section
  13. 13. COMET Completion Questionnaire ATTACHMENT B Definitions of Sources of Capital: Non-public Equity: any funding that has been committed through a binding agreement to the COMET Grantee to commence operations, or finance a growth strategy in return for a share of the company through private arrangements (as opposed to Public Equity). Angel Finance: Finance can be provided by high net worth individuals or a network (syndicate) who invests their own money in entrepreneurial firms, and can be either formal or informal in nature: o Syndicate: The grouping of angels into syndicates can be formal and have rules, a defined minimum commitment, and provide expert advice to start-ups, OR can be informal alliances which make equity investments on an ad-hoc basis. o Individual: Formal angels provide expertise to the company in return for equity, and informal angels act as silent partners. Corporate Investment: equity funding secured by COMET grantees from public or private companies. An initiative by a corporation to invest either in young firms outside the corporation or units formerly part of the corporation. Various Government Equity Programs: such as, Australian Government Programs such as the Innovation Investment Fund (IIF); Renewable Energy Equity Fund (REEF); Pre-Seed Fund (PSF); Pooled Development Fund (PDF); and others etc: State Government Programs (to be specified) and/or Local Government Programs (to be specified). Venture Capital Fund: Independently managed, dedicated pools of capital that focus on early stage equity or equity-linked investments in privately held, high-growth companies. Many venture capital funds, however, occasionally make other types of private equity investments. Outside the United States, this phrase is often used as a synonym for private equity. Private Equity Fund: organisations devoted to leveraged buyouts, consolidations, mezzanine and distressed debt investments, and a variety of hybrids such as venture leasing and venture factoring. Public Equity: Equity capital invested in a public company. IPO: "Initial Public Offering", "flotation", "float", "going public", "listing" are just some of the terms used when a company obtains a quotation on a stock market. Reverse Listing (or Reverse Take Over/Reverse acquisition): When a company buys out a larger company, but could also occasionally refer to a private company taking over a publicly listed company. This can be either by financial buy-out or replacing the management team. Typically, a public company that is taken over by a private company will remain listed, and the private company will use the acquisition as means of gaining a listing. Borrowing/Debt Finance: Finance committed through a binding agreement, and which needs to be repaid. This is an amount owed to a person or organization (financial or non-financial institutions) for funds borrowed. Debt can be represented by a loan note, bond, mortgage or other form stating repayment terms and, if applicable, interest requirements. Other form of Capital: Any other form of capital not covered under other outcomes. Financial Institution: Bank, Credit Union or Building Society. COMET TAC Completion Questionnaire Page 13 of 9 Version 5.0 March 2009 Final Version COMET Section

×