Application for participation to the call “Pépinière d’entreprise ” The call is targeted at both already established companies and companies yet to be established. You are: Established company Unestablished company • Project name/company name …………………………………………………………………………………………………… • Overview of the company/project and of its innovative characteristics (max 2,500 characters) • Company/project website ……………..…………………………………………………………………………………………………… • Possible synergies with companies/individuals in Aosta Valley …………………………………….......................... ……………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………………… Your project
If selected for the incubationprogram,we commit ourselves to continuously use the spaces of theincubator;
If selected for the incubation program, we commit ourselves to participate to the events (evenpromotionevents)offeredbythePépinières;
If selected for the incubationprogram,wewill start implementingour activitieswithin twomonthsfromthegrantreceipt;
If selected for the incubation program, wewill consent to publicly advertising our project and ourincubation at the Pépinières. The related rules will be previously agreed with the management of thePépinières;
If selected for the incubation program, the contractor commits to give visibility to the logo of thePépinièresaswellastothebrandofAostaValleyRegionforthewholeincubationperiod.Thisdispositionhastobeapplied inallcasesofpublicoccurrences(papers,conferences…) includingeveryformofdigitalcommunication (i.e.: thewebsiteof the companyor theproject, social network, blog, forum, etc.). Thecontractor undertakes to obligatorily include in all material, information and advertising tools on theapplicationofart.115ofreg.(EU)1303/2013andreg.(EU)821/2014,theemblemsoftheEuropeanUnion,oftheStateandoftheautonomousRegionValled’Aosta,theindicationoftherelevantFund,namelytheERDF– European Regional Development Fund, the indication of the Program, namely “Investment forgrowthandoccupation2014/20”(ERDF)accordingtowhatisstatedbythespecific“Guidetotheutilizationof emblems and logos of the Regional Development Policy 2014/20” and the related Valle d’AostaprogramsapprovedbytheContractingAuthoritywithdeliberationn.1905,18December2015.
a) Micro,smallormediumcompanyasdefinedbyRegulation(EC)No800/2008oftheEuropeanCommission;
b) RegistrationintheItalianChamberofCommerceRegistry;c) Start-up(establishedfornomorethan5yearsfromthedateofpublicationofthisnotice);d) Be in regular activity as defined by the Community guidelines of the State (OJ C 244 of 1
October 2004) and, in particular, not being in a state of bankruptcy, liquidation (includingvoluntary),oranyotherequivalentsituationundercurrentlaw;
e) Have fulfilled theirobligationsandbecompliantwith the regulationsonhealthandsafetyatworkplacesasdefinedbyD.lgs.n.81/2008andsubsequentamendmentsandadditions;
h) Thecandidatecommitstoformalizingtheestablishmentoftheenterprisewithin2monthsofnotification of selection for the incubation program and subsequent registration at theChamberofCommerce.
Participationrequirementsandselfcertification
Howdidyougettoknowaboutthiscall?
o Communicationchannel(i.e.:website,Facebookpage,Twitter…)…………………………………………………………………………………………..
o From which information source? (i.e.: Aosta Valley Region, Giacomo Brodolini Foundation,LattanzioGroup…)
UndertheprovisionsofArt.13ofLegislativeDecreeno.196/2003themanagementofthePépinièrestatesthat the data provided by the proposers will be processed solely and exclusively in those procedures,automatedorpaperwork,strictlynecessaryforthecompletionoftheactivitiesnecessaryforadmissiontothelistofthisinvitation,includingdisseminationandpublication.ThedatacontrollerisAlbertoMerolla.Tobeawareofthedata,thedatamaybeusedbythestaffoftheholderwhoisresponsiblefororinchargeofthetreatmentandcommunicatedtothirdpartieswhotakepartinthebusinessprocessortocomplywithspecificlegalobligations.Theprocessingofsuchdatawillbebasedontheprinciplesoffairness,lawfulnessand transparency and in compliance with the security rules. The proposer will be able to contact thePépinièremanagementbysendingane-mailtoinfo@pepinieresvda.eutoclaimhisrightsasprovidedforinart.8oftheabove-mentionedLegislativeDecree.
AUTHORIZATIONFORTHEPUBLICATIONOFIMAGES
Bysigningthisform,themanagementofPépinièreorthepersoninchargeofit,isauthorizedtopublicizeyourimagestakenduringpubliceventswithpromotionalintentandaccordingtoallthepopularchannelsconsidered functional (Internet publication, in printed press, television). It’s forbidden to use data orinformationincontextswhichdon’trespectthedignityofthehumanbeing.Theproponentscanuseandpublishtheimages(logos)forfree.
Optionalinformation
DECLARATIONACCORDINGTODPR445/2000
Theundersigned,________________________________informedofcriminalresponsibilityandofrelatedpenalsanctionsaccordingtoarticle76ofD.P.R.445/2000,aswellasoftheadministrativeconsequencesofrevocationfromthebenefitseventuallyachievedtothismeasureissued,accordingtoD.P.R.28.12.2000n.445,declares thatall the informationprovided in thepresentapplicationand in theannex,andgiven inaccordancewitharticle46ofD.P.R.445/2000,iscorrect.
Following registration you will receive an e-mail of confirmation and you will be invited to send thefollowingsdocuments:
o résuméofeachteammember(maximum2pagesperrésumé)o thelastapprovedbalancesheetincludingthefinancialstatementso an overview of financial projections of the company/project for the next 3 years and a
