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Spin-off 2020Funding application

Deadline for submission: 17 January 2020, 12.00am

Please note: the 'Interface' of the research institution coordinates the submission of projects to Innoviris. Applications must therefore be submitted to this department before the deadline. Please contact this department as soon as possible to find out the internal deadline of each institution.

Submission of the projects: Paper version: send 2 copies on both sides to Innoviris' address. Send an electronic version to [email protected] and to

[email protected], with the name of the action and the abbreviation of the project in the subject field:This version must consist of:

o a consolidated Word version (the form and annexes must be merged);o PDF version with signatures;o budget in Excel format

Research institution of the applicant

Project title

Abbreviation

Start date of the project DD/MM/YYYY

Duration of the project XX months

Total budget amount € XXXX

http://www.innoviris.brussels/

This form is addressed to promoters from a research institution that meets the definition of point 15 ee of the Guidelines for state aid for research and innovation 2014/C 198/01 (universities, higher education institution, De Groote centres, etc.) and that has at least one operating office in the territory of the Brussels-Capital Region.

It allows to apply to Innoviris for funding for a SPIN-OFF project.

Before completing this form, we ask that you read the SPIN-OFF 2020 rules carefully. You can download these from www.innoviris.brussels on the page for this programme.

Innoviris will send you a receipt no later than 5 days after submitting your application. After that, you will receive a letter within one month related to the administrative admissibility of your application.

For each admissible project, Innoviris will organize an ad hoc jury for the evaluation of the project. This jury will be made up of independent scientific experts, an expert with a business profile and scientific advisors of Innoviris. Each expert will sign a confidentiality agreement before receiving a copy of the project for prior reading. The jury will evaluate the project on the basis of the grant application and an interview. The information provided in the application therefore forms the basis for the juries' assessment.. Please complete this document with due care.

Please do not delete the instructions in this form, so that the jury members can assess the information according to the expectations of Innoviris.

Do you need more information? Please contact:

Aline Grosfils

[email protected]

+32 2 600 50 66

Spin-off 2020 Application form / 25

http://www.innoviris.brussels/

Table of contents1 Overview...................................................................................................................................................4

1.1 BENEFICIARY...........................................................................................................................41.2 PROJECT PROMOTER..............................................................................................................41.3 RESEARCHER-ENTREPRENEUR...........................................................................................51.4 MANAGER OF THE INTERFACE...........................................................................................51.5 SPONSORS.................................................................................................................................51.6 PROJECT TITLE.........................................................................................................................61.7 SECTOR......................................................................................................................................61.8 START DATE AND DURATION..............................................................................................71.9 BUDGET FOR THE IMPLEMENTATION OF THE PROJECT..............................................71.10 SUMMARY OF THE PROJECT..............................................................................................71.11 EXPERTISE..............................................................................................................................71.12 EQUAL OPPORTUNITIES......................................................................................................7

2 Presentation of the applicant and the team................................................................................................82.1 PROFILE OF THE HOST INSTITUTION.................................................................................82.2 PROFILE OF THE PROMOTER AND HIS RESEARCH ENTITY.........................................9

2.2.1 Research activities.................................................................................................................92.2.2 Experience in the field of research........................................................................................92.2.3 Justifying reasons of the promoter........................................................................................9

2.3 PROFILE OF THE CANDIDATE..............................................................................................92.3.1 Competencies in the field of research....................................................................................92.3.2 Entrepreneurial competencies................................................................................................9

2.4 PROFILE OF THE ALTER EGO (IF THIS IS ALREADY KNOWN).....................................92.5 PROFILE OF THE SPONSORS...............................................................................................10

3 Presentation of the project.......................................................................................................................103.1 CONTEXT.................................................................................................................................10

3.1.1 Background to the funding application...............................................................................103.1.2 Market demand....................................................................................................................10

3.2 STATE OF THE ART AND ACQUIRED RESEARCH RESULTS........................................113.3 OBJECTIVE: PRODUCT/PROCESS/SERVICE.....................................................................113.4 CHALLENGES IN THE AREA OF EXPERIMENTAL DEVELOPMENT...........................113.5 PROJECT PROGRAMME........................................................................................................113.6 TRAINING PLAN.....................................................................................................................12

4 Valorisation.............................................................................................................................................124.1 VALORISATION POTENTIAL...............................................................................................12

4.1.1 Market..................................................................................................................................124.1.2 Positioning and differentiation factors................................................................................12

4.2 VALORISATION STRATEGY................................................................................................124.3 MEASURES REGARDING INTELLECTUAL PROPERTY.................................................13

4.3.1 Current state, patents and rights to be acquired...................................................................134.3.2 Nature of the knowledge that needs to be protected and the approach that will be taken...134.3.3 Transfer of rights to the future spin-off...............................................................................13

4.4 . SUMMARY TABLE...............................................................................................................135 Budget.....................................................................................................................................................14

5.1 BUDGET FOR ... MONTHS: Period of ... / ... / 20 ... to ... / ... / 20 ........................................156 Summary of the attachments to be appended..........................................................................................167 Signatures................................................................................................................................................17

7.1 SIGNATURE AND DECLARATION OF THE CANDIDATE...............................................177.2 SIGNATURE AND DECLARATION OF THE PROMOTER................................................177.3 SIGNATURE AND DECLARATION OF THE AUTHORITIES OF THE PROMOTER......17

Annex 1.d: Declaration of the qualification of the applicant as a research institution..............................18Annex 9: Cooperation agreement on sponsorship......................................................................................25


1 Overview

This section contains the basic information of the application.

1.1 BENEFICIARY

Name of the research institution:

Legal form:

Company number:

Registered offices: Street: Number/Bus:

Postcode: Location:

Ppertaing office where the project will be executed:

Street: Number/Bus:

Postcode: Location:

Telephone E-mail:

Bank account number: (Add an overview of the bank details in attachment.)

IBAN:

Person legally authorised to commit the entity

Full name ................................................ Function ..................................................

Tel. .............................................................. Email ....................................................................

Administrative manager of the project

Full name ................................................ Function ..................................................

Tel. .............................................................. Email ....................................................................

1.2 PROJECT PROMOTER

Full name:

Function:

Department:

Address: Street: Number/Bus:

Postcode: Location:

Telephone:

Email:

Areas of research:


1.3 RESEARCHER-ENTREPRENEUR

Full name:

Nationality:

Place and date of birth:

Gender:


Postcode: Location:

Telephone:

Email:

University degree(s):

Current function:

1.4 MANAGER OF THE INTERFACE

If applicable, contact the "Interface" department (Knowledge Transfer Office/Interface-KTO/KTI) of the research institution. The advisor of the interface helps to prepare the project, and coordinates the submission of the application.

Full name:

Function:

Telephone:

Email:

1.5 SPONSORS

As a reminder: the sponsors come from the economic or financial world and will assist the researcher-entrepreneur in the economic valorisation of the project within the framework of the steering committee (see the rules § 2.4/3).

Sponsor 1:

Full name:

Function:

Employment (Undertaking/Institution/...) Company number:


Postcode: Location:

Telephone:

E-mail:


Sponsor 2:

Full name:

Function:

Employment (Undertaking/Institution/...) Company number:


Postcode: Location:

Telephone:

E-mail:

1.6 PROJECT TITLE

Provide the title of the project and an abbreviation.

Project title:

Abbreviation:

1.7 SECTOR

Please indicate an application sector in the list of eight proposed sectors (only one sector can be chosen)

ICT/Telecoms Chemicals/Materials Environment/Energy/Transport & Mobility Health & Biology

Construction/Urban planning Industry/Robotics Economy/Management/Law Art, education and society

Below you will find examples of subsectors for each application sector.

Sectors Examples of relevant subsectors

ICT/Telecoms Software, Hardware, Data, Networks, Security

Chemicals/MaterialsChemicals, Additive manufacturing, Advanced materials

Environment/Energy/Transport & Mobility

Mobility, Logistics, Networks and energy storage

Health & Biology Biotechnology, Pharma, Medicine, e-health, Medical devices

Construction/Urban planning Urban planning & Social Geography, Eco-construction, Architecture

Industry/Robotics Industrial Security, Industry 4.0

Economy/Management/Law Economy & Management, Social Economy, Law & Policy, HR, Finance/insurance, Consulting

Art, education and societyPsychology, Communication & Education, Philosophy, Arts & Literature, Cultural and creative industries, Sustainable food, Public administration and policy, Social sciences


1.8 START DATE AND DURATION

Indicate the start date and duration of the project.

Start date (Between 01/10/2019 and 01/01/2020, see regulations § 6):

Duration (in months):

1.9 BUDGET FOR THE IMPLEMENTATION OF THE PROJECT

Fill in the amount of the subsidy for the first two years of the project.

Total amount in €:

1.10 SUMMARY OF THE PROJECT

Provide a non-confidential summary of the project (0.5 - 1 page) which must include the following elements:

the context of the project; the research results that will be valorised during the project; the product/process/service that will be bring to the market within the framework of the project; the R&D challenges in the context of the project; the socio-economic finality of the spin-off to be set up.

!! Except for an explicit justification by the beneficiary that justifies the confidentiality of the information, the information in this summary shall be considered to be non-confidential. The beneficiary gives Innoviris the permission to use the information for a publication or other form of communication with the public.

Summary of the project (non-confidential)

1.11 EXPERTISE

Provide the most relevant keywords for your project. On this basis, we will determine which experts will assess your application.

Key words:

Please indicate any potential conflicts of interest that may arise between your laboratory and experts in the sector who are active in Belgium or in neighbouring countries.

Conflict of interest:

Full name, University, Department, Laboratory

1.12 EQUAL OPPORTUNITIES

Do you think that the themes and/or activities of the project could lead to discrimination against persons directly or indirectly impacted, on the basis of gender, ethnic and cultural background, sexual orientation, gender identity and expression, or origin and social situation?

If so:

1. What kind of discrimination might there be in the project? 2. What would be the amplitude of this impact? 3. How did you take this into account when setting up your project?4. How are you going to monitor these aspects during the project?


2 Presentation of the applicant and the team

The information requested below is used to describe the profile of the host institution, the promoter and the candidate researcher-entrepreneur. 2.1 PROFILE OF THE HOST INSTITUTION

!!! Only to be filled in if the applicant is not a university or higher education institution.

Provide a description of the activities (production, services and R&D) of the research institution Explain the distribution of the activities (if there are multiple activities) Describe the evolution of the research institution by means of important events. Describe the evolution of staff, turnover, the R&D budget of the research institute and fill in the

table below.

Year N (Last closed financial year)

N-1 N-2

Total staff (in FTE)

Employees (in FTE) [Social code 105]

Self-employed (in FTE)

Staff in BCR (in FTE)

R&D staff in BCR (in FTE)

Turnover

R&D budget

R&D budget in BCR

State aid for R&D in BCR

Describe the links with and dependence on other organisations. If the research institution is part of a group, all the activities of this group must be included. Provide the name, location and main activity of all national and international operating offices of the group.

Describe the profile and experience of the key people (CEO, CTO, CFO and any other director) of the research institution.

Indicate whether the research institution currently has debts with banks, suppliers or government in-stitutions (NSSO, VAT professional withholding tax). If necessary, clarify any arrears and the agreed repayment plan.

Attachments to be appended The CVs of the key persons of the research institution An organisational chartA bank extractDeclaration of the qualification of the applicant as a research institution (see Annex 1.d.)


2.2 PROFILE OF THE PROMOTER AND HIS RESEARCH ENTITY

2.2.1 Research activities

Describe the research areas of your entity.

2.2.2 Experience in the field of research

Draw up a list of current or previous research projects related to the current spin-off project . For each project, indicate the source of funding (European Union, Federal, Community and/or Regional level), the duration, the amount and why the results form the basis of the current project.

2.2.3 Justifying reasons of the promoter

Give the promoter's motivation for setting up a spin-off in the Brussels-Capital Region and describe how he/she sees his/her possible involvement in the spin-off.

Attachments to be appended

CV of the promoter

A list of recent and important publications relating to the current proposal

2.3 PROFILE OF THE CANDIDATE

2.3.1 Competencies in the field of research

Describe and explain why the researcher-entrepreneur is suitable to undertake the technological programme of the project.

If the researcher-entrepreneur does not hold at least a Master's degree, explain why he/she has acquired similar competencies through his/her experience.

2.3.2 Entrepreneurial competencies

Describe and explain why the researcher-entrepreneur has the necessary entrepreneurial spirit to undertake the aspects of the programme associated with the creation of a spin-off (management, autonomy, versatility, etc.).

Attachments to be appended:

CV of the candidate researcher-entrepreneur

Cover letter of the candidate researcher-entrepreneur

2.4 PROFILE OF THE ALTER EGO (IF THIS IS ALREADY KNOWN)

Describe and explain why the proposed alter ego is competent in business development (economic aspects, financial plan, financial and communication strategy, organisation, etc.).

Explain how the alter ego complements the profile of the researcher-entrepreneur and why they can form a techno-economic tandem.

Attachments to be appended:

CV of the alter ego

Cover letter of the proposed alter ego


2.5 PROFILE OF THE SPONSORS

2.5.1 Sponsor 1

2.5.1.1 Description of the activities and competencies of the sponsor

Explain the goal and the activities of the company or organization in which the sponsor carries out his/her role.

Describe the role of the sponsor within this organization and his/her competencies related to the goal of the present project.

2.5.1.2 Terms of guidance

Explain the terms of guidance of the sponsor in the project.

2.5.1.3 Sponsor's motivation

Explain the sponsor's motivation to guide the researcher-entrepreneur in his/her work for creating the spin-off.

2.5.2 Sponsor 2

2.5.2.1 Description of the activities and competencies of the sponsor

Explain the goal and the activities of the company or organization in which the sponsor carries out his/her role.

Describe the role of the sponsor within this organization and his/her competencies related to the goal of the present project.

2.5.2.2 Terms of guidance

Explain the terms of guidance of the sponsor in the project.

2.5.2.3 Sponsor's motivation

Explain the sponsor's motivations to guide the researcher-entrepreneur in his/her work for creating the spin-off.

Attachments to be appended CV of the sponsors Cooperation agreements with the sponsors

3 Presentation of the project

The aim of this section is to describe the framework of the project, the needs of the sector addressed by the project and present the product, process or service to be developed. 3.1 CONTEXT

3.1.1 Background to the funding application

Describe the background which led to the submission of the current application.

3.1.2 Market demand

Describe the demand expressed by the target sector of the future spin-off and how the project tries to meet it. Please also explain why no solution currently fully meets market demand.


3.2 STATE OF THE ART AND ACQUIRED RESEARCH RESULTS

3.2.1 State of the art

Briefly describe the state of the art in the domain of the project.

3.2.2 Acquired research results

Describe the acquired research results of the host institution with respect to the state of the art. Clearly state which research results will be transferred to the spin-off. The scientific added value and the innovative nature of the results with regard to the state of the art must be clearly defined.

3.2.3 Proof of concept

Explain in what sense you already have a proof of concept1 of the product/process/service that you plan to valorise.

3.2.4 Freedom to operate

Describe, if applicable, which steps will be taken to analyse the freedom to operate.

3.3 OBJECTIVE: PRODUCT/PROCESS/SERVICE

Within the context of your project, describe the product, process or service that you plan to develop and that will be commercialised by the spin-off.

Describe why the product, process or service can provide a possible solution to current problems.

3.4 CHALLENGES IN THE AREA OF EXPERIMENTAL DEVELOPMENT

Indicate whether there are still experimental development challenges with regard to the state of the art. Describe them.

As a reminder: the project should not only focus on tasks related to the industrialisation of the product/process/service (e.g.: GUI, ergonomics, etc.).

The description of the programme must allow an evaluation of the relevance of the approach, the feasibility of the project within the set time frame and the match between the resources and the tasks.3.5 PROJECT PROGRAMME

The programme must describe both the tasks involved in the development of the product, process or service and in the creation of the spin-off.

The programme must be subdivided into work packages that contain the following information:

WP X:FTE Duration

Objectives and criteria:

Give a short description of the aim of the work package.

1 "Proof of Concept": objective demonstration of the feasibility and reliability of a technology, method or idea through the short, incomplete or small-scale implementation of the technology, method or idea.


Tasks and methodology

Give a detailed description of the actions, methods and techniques. Give a brief explanation of how the task will be performed, and to what extent existing and/or to be developed methods/tools/techniques/software, will be used.

Explain when and to what extent subcontracting services would be required.

Risk analysis

What are the specific risks associated with carrying out the tasks of this workpackage and how will they be managed? For major risks, mention the plan B that would be considered. Results

Describe the tangible results expected at the end of the workpackage.

Monitoring indicators:

Describe the quantitative or qualitative criteria for the assessing the achievement of the workpackage.

Documents to be appended:

A Gantt diagram describing the planning of all workpackages and providing an estimate of the time the staff time allocated to each work package;.

3.6 TRAINING PLAN

Describe the programme of training that the researcher-entrepreneur will follow to acquire basic competences in business management and entrepreneurship.

If the researcher-entrepreneur has already followed this training, provide the certifying documents in order to obtain an exemption from this training.

4 Valorisation

This information must enable to assess the economic valorisation potential of the project in the Brussels-Capital Region. 4.1 VALORISATION POTENTIAL

4.1.1 Market

Explain the market structure and potential competitors and alternatives to the product, process or service. What is the size of the relevant market? Is it still a growing market? Are there environmental factors (legal, regulatory, political, etc.) that can influence the valorisation (positively or negatively)?

4.1.2 Positioning and differentiation factors

What is the position with respect to competitors and existing alternatives (competitive advantage, etc.)? Emphasise the niche market that you wish to occupy in relation to the above market.

4.2 VALORISATION STRATEGY

Describe the valorisation strategy. Explain how the creation of a new company is the best way to valorise your product/process/service.

What business model do you have in mind?


4.3 MEASURES REGARDING INTELLECTUAL PROPERTY

4.3.1 Current state, patents and rights to be acquired

What is the current situation in terms of intellectual property rights?

Draw up a list of the patents related to the project that have already been filed and are already held by the organisation and provide the following information:

◦ The date of filing of the application

◦ The filing number of the application

◦ The title of the invention

◦ The applicable countries

◦ Where applicable, the date of issue of the patent

Explain what rights, if any, need to be acquired from third parties.

4.3.2 Nature of the knowledge that needs to be protected and the approach that will be taken

What kind of knowledge needs to be protected or disseminated?

Describe the method that will be used to protect intellectual property.

4.3.3 Transfer of rights to the future spin-off

Explain which strategy will be applied when transferring the intellectual property rights.

4.4. SUMMARY TABLE

Fill in this summary table concisely. If your project is funded, this table will be used to monitor your project.

1 Who are the main stakeholders (end users, partners, regulators)?

2 Which needs are met by the product/process/service?

3 Who is the end user? paying customer?

4 How would you describe the competition?5 What is your Unique Selling Proposition? 6 What is your situation at IP level?


5 BudgetStaff costsThese are all costs related to the staff (the researcher, the alter ego on the payroll and the part-time technical support staff).

Costs related to the execution of the technical objective

1. Costs of tools and equipment: These costs correspond to the depreciation of instruments and equipment used for the project. If instruments and equipment are not used for the project for their entire lifetime, only the depreciation costs which correspond to the duration of the project are authorised, calculated on the basis of generally applicable accounting principles.

The depreciation is calculated in proportion to the duration of the project and the percentage of use of the equipment. The whole is reduced to a period of three years for IT equipment and a period of five years for scientific and technical equipment.

Calculation:• IT equipment: (Quantity * Unit cost * Number of months of use during the project * percentage of use) /

36• Other equipment: (Quantity * Unit cost * Number of months of use during the project * percentage of

use) / 60

2. Other operating costs These costs cover the current expenditure relating to:

• IT costs (a laptop or fixed computer per person on the budget, software licences for the period of the project, calculation costs)

• Minor scientific and technical equipment• Consummables (chemical products, materials)• Books and documentation• Missions expensesin Belgium or abroad (seminars, conferences, one-off technical training, travel,

rental of a car used in the context of technical approval). • Miscellaneous (costs of scientific or commercial meetings with external persons of the beneficiary or of

the team, photocopies done outside of the institution, student jobs, etc.)Clarify all budgetary sub-items (unit cost * quantity).

3. The costs of contractual research, knowledge and patents purchased or licensed from external sources under the condition of full competition as well as the costs of consultancy and similar services used solely for the purposes of the project.

General costs: This is a lump sum to cover the additional costs directly linked to the implementation of the project (secretariat, accounting, telecommunications). It is a lump sum of maximum 10% of the sum of the other operating costs (2) and the staff costs for employees (1).

Training costs: (max €4,000/2 years)These costs cover the registration costs of the researcher-entrepreneur for a training course in business management and entrepreneuship (e.g. Solvay Business School, ICHEC, Louvain School of Management, etc.). Any other type of training is not allowed in this section.

Valorisation costs:The valorisation budget covers the costs

1. For legal, marketing (logo, website, brochures, business cards), financial and economic advice associated with the creation of the spin-off, including the income of the alter ego, if applicable.

2. For economic demonstrations (trade fairs, customer acquisition, certification, etc.) 3. Patenting (costs associated with acquiring, approving and defending the patent linked to the project).


5.1 BUDGET FOR ... MONTHS: Period of ... / ... / 20 ... to ... / ... / 20 ...

Clarify each item of the operating costs and the valorisation costs in order to justify the amounts requested. The costs shown in the table are given as examples.


6 Summary of the attachments to be appended

1. If the applicant is not a university or college: a) The CVs of the key persons of the research institutionb) An organisational chartc) A bank extract d) A declaration of the competence of the applicant as a research institution

2. CV of the promoter3. A list of recent and important publications linked to the current proposal4. CV of the candidate researcher-entrepreneur5. Cover letter of the candidate researcher-entrepreneur6. CV of the candidate alter ego (if known)7. Cover letter of the alter ego8. CV of the sponsors9. Cooperation agreements with the sponsors 10. GANTT diagram11. If the project had already been submitted to a previous call of the programme, but was not selec -

ted: a document showing that the new version of the project has addressed the shortcomings identified during the evaluation.


7 Signatures

7.1 SIGNATURE AND DECLARATION OF THE CANDIDATE

The researcher-entrepreneur in charge of the project:

declares to have read the rules of the SPIN-OFF programme and agrees to respect them undertakes to make every effort to ensure the good execution of the programme

declares all information in this form to be complete and correct undertakes to do its utmost to create and maintain a new company in the Brussels-Capital Region

Name : .......................................................... Date : ...................................................Signature :

7.2 SIGNATURE AND DECLARATION OF THE PROMOTER

The project promoter:

declares to have read the rules of the SPIN-OFF programme and agrees to respect them undertakes to provide the researcher-entrepreneur with the relevant environment for the good

execution of the programme declares all information in this form to be complete and correct

Name : .......................................................... Date : ...................................................

Signature :

7.3 SIGNATURE AND DECLARATION OF THE AUTHORITIES OF THE PROMOTER

…………………………………………(Name, Surname, function)

(Person legally authorised to commit the institution)

declares to have read the rules of the SPIN-OFF programme and agrees to respect them undertakes to provide the researcher-entrepreneur with the relevant environment for the good

execution of the programme declares all information in this form to be complete and correct

undertakes to promote the creation of the new company in the Brussels-Capital Region

Name : .......................................................... Date : ...................................................

Signature:


Annex 1.d: Declaration of the qualification of the applicant as a research institution The purpose of this form is to make it easier for entities to qualify as research institutions, non-profit organisations or undertakings within the meaning of European law. On this basis, it is verified whether state aid is possible and what percentages of state aid are permitted.

Reminder of definitions

Article 1.3 of the Guidelines for State aid for research, development and innovation (2014/C 198/01) defines the term research organisation as follows: "an entity (such as universities or research institutes, technology transfer agencies, innovation intermediaries or entities for virtual or real research-oriented cooperation), irrespective of their legal status (public or private) or their method of funding, which is principally concerned with the completely independent performance of basic research, industrial research or experimental development or with the wide dissemination of the results of these activities by means of teaching, publication or transfer of knowledge. When this type of entity also engages in economic activities, separate accounts shall be maintained for the financing of, costs of, and revenues from those economic activities. Companies which can exercise decisive influence over this type of entity in their capacity as, for example, shareholder or member of the organisation, shall not enjoy preferential access to the research results obtained by this entity."

Activities considered by the European Commission to be non-economic (non-exhaustive list):

- training for more and better qualified human resources. Public education funded by the State, either mainly or wholly, and subject to State control within the national education system;

- independent R&D activities;; - cooperative R&D activities; - wide dissemination of research results on a non-exclusive and non-discriminatory basis; - knowledge transfer activities, where all profits from such activities are reinvested in the primary activities of

the research organisation.

Company: any entity, regardless of its legal form and even non-profit making, when it regularly carries out an economic activity. Any offer of goods or services which corresponds to a market and which may compete with the offers of other economic players may be defined as an economic activity. It is of little importance whether activities/services are exercised/delivered, with or without consideration, by the State itself or by a non-profit organisation. Each activity should be analysed separately to determine whether it should be considered as an economic activity, by checking whether other companies offer the same service and whether competition has developed in the sector concerned. Thus, several non-profit organisations offering parascolar activities for children in need may compete with each other and thus be considered as a company within the meaning of European law.

In concrete terms, an entity which simultaneously carries out economic and non-economic activities will not be classified as a company if

- the economic activities use exactly the same means of production (such as materials, equipment, employees, intangible assets, etc.) as the non-economic activities

AND

- the capacity allocated annually to the economic activities does not exceed 20% of the total annual capacity of the entity concerned.

A non-profit organisation is an entity, other than a research organisation, that does not carry out economic activities, or that carries out economic activities of a purely subordinate nature and is not dependent on an undertaking. In other words, your entity is a non-profit organisation if it is neither a research organisation nor a company.


Please fill in all the fields below.

Name and legal form of the applicant:

Address of the registered office:

Company number / VAT number:

Name and title of the main managers:

1. Autonomy and independence

a) My entity is controlled for more than 25% by one or more other entities.

NO YES and this entity or entities is (are) a research organisation(s). YES and this entity or entities is (are) a company(ies) within the meaning of the above

definition.

b) The intellectual property rights generated outside the research collaborations are a priori reserved - through contractual, statutory or regulatory provisions - to one or more entities.

NO YES and this entity or entities is (are) a research organisation(s). YES and this entity or entities is (are) a company(ies) within the meaning of the above definition.

c) Entities that can exercise decisive influence over my entity (shareholders or associates, etc.) may have preferential access to the research results obtained.

YES NO

My entity has:

Legal personality? Yes No

Decision-making autonomy? Yes No

Management autonomy? Yes No

Its own budget? Yes No

Its own bookkeeping? Yes No

Is it controlled by another entity (majority of voting rights / right to appoint or remove from office the majority of the members of the governing body / contractual or statutory right to exercise a determining influence)

Yes No

Are the materials and personnel used by my entity shared with one or more other entities?

Yes No

Are the research programmes themselves determined by my own entity?

Yes No


Is your entity independent on the basis of the information entered in this section?

YES NO

If your entity is not independent, the remainder of the form should be completed with the consolidated data of the whole group formed by your entity and its associated entity(ies).

If your entity is independent, the remainder of the form should be completed on the basis of its own data.

2. Main activities

a) My entity is mainly engaged in the independent conduct of fundamental research, industrial research or experimental development.

YES NO

b) My entity is mainly engaged in the broad dissemination of the results of those activities through education, publications or the transfer of knowledge?

YES NO

3. Existence of economic activities

a) Does my entity carry out a supply activity / is it engaged in the production of goods or the performance of services?

YES NO

b) Is there a market (other operators that want, and are able, to deliver this good or want, or are able, to deliver this service)?

YES NO


A laboratory, a research centre or a department that has an organisational structure, capital, equipment and personnel that enable it to carry on its activities alone and autonomously is considered an autonomous entity, whether or not it has a legal personality other than a university or college.

4. Separate accounts for the economic and non-economic activities related to the primary purpose of the research organisation

a) If my entity also carries out economic activities, they are purely ancillary activities, namely: they correspond to an activity directly related and necessary to the operation of that activity, or they are intrinsically linked to the entity's primary non-economic use and are limited in size.

YES NO

b) When my entity also engages in economic activities, the funding of these economic activities shall be accounted for separately from non-economic activities.

YES NO

c) When my entity also engages in economic activities, the costs of those economic activities are accounted for separately from the costs of the non-economic activities. YES

NO

d) When my entity also engages in economic activities, the income of those economic activities is accounted for separately from the income of the non-economic activities.

YES NO

e) when the economic activities of my entity generate revenues or profits, they are reinvested in the non-economic core activities of my entity, i.e. independent research, the wide dissemination of research results or education.

YES NO


5. Total funding of the entity

Reference periodFunding methods Last closed financial year

(N)Previous financial year N-1

Subsidies / allocations (€) (€)Members' contributions (€) (€)Gifts and legacies (€) (€)Turnover (sales / services / receipts) (€) (€)Other (please specify) (€) (€)Total (€) (€)

6. Allocation of funds Reference period

Application Last closed financial year (N)

Previous financial year N-1

Intangible fixed assets (patents, ...) (€) (€)Tangible fixed assets (machinery, land, buildings, etc.)

(€) (€)

Cost of the employees (volunteers, employees, self-employed, ...)

(€) (€)

Total (€) (€)

7. Global list of activities Please indicate the different types of activities you carry out. The activities in the table are given as examples.

Reference periodLast closed financial year (N) Previous financial year N-1

Education and training activities Awareness raising activitiesTrade fair ColloquiumExhibition ...

Research activities ...Lecture ...

Exposition...


8. Allocation of financial resources to the activitiesFor each type of activity mentioned in point 3, please complete the following table.

Means used to carry out the activities in (%) of in (€)2

Activities Intangible fixed assets (patents, ...)

(%) or (€)

Tangible fixed assets (machinery,

land, buildings, etc.)

(%) or (€)

Cost of the employees (volunteers,

employees, self-employed, ...)

(%) or (€)

...

Fina

ncia

l

Education and training activities

Trade fairExpositionLecture

Fina

ncia

l yea

r ColloquiumResearch activitiesExhibition .........

Analysis of the tables Considering the information given in the tables above:

a) Does my entity use the same resources (materials, equipment, employees) to carry out its economic and non-economic activities?

YES NO

b) Does the pursuit of the economic activities of my entity require more than 20% of the above resources to be made available?

YES NO

2 Data may be expressed as a percentage or in euros.


Conclusion:In light of the above information, I, the undersigned, ... (name, title) declare that the entity for which I am responsible is considered to be:

a research organisation a business a non-profit organisation

Drawn up in Brussels on ................Signature (With my signature I confirm that these data are complete, sincere and true.)

Contact person for checking the information provided in this document: Name:Tel.:

For questions relating to the completion of this document, please contact Catherine Moné, cmone @innoviris.brussels , +32 2 600 50 69


Innoviris draws your attention to the fact that an incorrect qualification of the beneficiary entity may result in the latter being obliged to repay the amounts unduly received, plus interest calculated in accordance with the applicable European regulations.

Annex 9: Cooperation agreement on sponsorship

The signature of all the sponsors of the project is required.

The entity of the sponsor (corporate name):

Registered office:

No. CBE:

represented by:

.......................................................... (full name and title of the person legally authorised to commit the organisation)

and by ……………………………………………………. (full name and title of the project sponsor)

Declares to have read the rules of the SPIN-OFF programme and agrees to re-spect them.

Undertakes to create the context necessary for the good execution of the pro-ject.

Undertakes to comply with the commitments set out in this document. Confirms that all information provided in this form is complete and true. Declares that there is no conflict of interest between the activities of the organ-

isation and the current project. Declares that, where appropriate, the cooperation agreement between the be-

neficiary(ies) and the sponsor(s) will be respected.

Name : .......................................................... Date : ...................................................

Signature:

Name : ..........................................................

Signature:
