1. Natural Gas Innovation Fund Investment Intake Template Project Title Submitted By *Note: This template is intended as a guide on content; you may use your own template with the checklist on S2 as a guide

2. Checklist Page Title 3 Corporate Profile 4 Funds Raised to Date 5
Problem – Solution 6
Environmental Benefits 7
Innovation 1 – Key Innovation 8
Innovation 2 – Detailed Description 9
Innovation 3 – History of Technology Development, Key Performance Metrics 10
Innovation 4 – Visual Aids 11
Innovation 5 – Intellectual Property 12
Innovation 6 – Technical Risks to Overcome Commercialization 13
Market 17
Management/Project Team 18
Project Partners 19
Project Summary 20
Project Work Plan 21
Project Budget 22
Project Funding 23
Summary 24
Next Steps 25
Contact Information

3. Corporate Profile (maximum 1 slide)
Applicant Name
Designated Contact
Project Title
Title
Applicant Address
Telephone
Telephone - Primary
Mobile
Website
Legal Status
Date of Incorporation
Ownership
Owner / Major Shareholder(s) / Partners
In Business Since
Full – Time Employees - Number
Annual Revenues
Main Product / Service

4. Funds Raised to Date (maximum 1 slide)
Prior private or public funding raised to date in the development of your innovation is required.
Please complete the table below:
*Maximum of 150 characters, including spaces, per item above; 16pt font.
Organization Funding Source
Date of Agreement
Funding Amount
Funding
Private / Public
Grant / Loan / Equity / In-Kind
Scope / Activity for Funding

5. Problem – Solution (maximum 1 slide)
Define the problem that your technology will solve for natural gas
X (maximum of 600 characters, including spaces, 16pt font)
Briefly, how will your technology solve this problem?

6. Environmental Benefits (maximum 1 slide)
How does the use of the technology result in emission, water, soil, and/ or social benefits (provide absolute and relative estimates of emissions benefits)?
What would happen in the absence of the proposed technology?
What sources of energy use are displaced?
What emissions sources are displaced?
List any relevant key assumptions to validate the claimed benefits.
*Maximum of 150 characters, including spaces, 16pt font, per item.

7. Innovation A – Key Innovation (maximum 1 slide)
What is the key innovation?
X (maximum of 600 characters, including spaces, 16pt font)
What are the competing technologies?

8. Innovation B (maximum 1 slide)
Detailed description of technology?
X (maximum of 600 characters, including spaces, 16pt font)
Technology readiness level (See Annex, slide 24)?
at the start of Project and End of Project

9. Innovation C (maximum 1 slide)
Provide a brief history of the technology development to date (maximum of 600 characters, including spaces, 16pt font).
List key performance indicators (metrics for costs, efficiencies, etc.) achieved to date relative to the competition (maximum of 150 characters, including spaces, 16pt font per entry).
Performance Indicator
Proposed Technology
Competitor #1
Competitor #2
Competitor #3
Competitor #4
Cost
Efficiency
Geography Implemented
Understanding Canadian Market

10. Innovation D – Visual Aids (maximum 2 slide)
Drawings
Photos
Renderings
Process Flow Diagrams

11. Innovation E – Intellectual Property (maximum 1 slide)
A breakdown of your patent applications to date is required.
Is the IP protected?
How?
Renderings
What is covered by the IP?
Who owns the IP?
*Maximum of 150 characters, including spaces, 16pt font, per above item.
IP Type
Filing Date
Country
Patent #
Status
Description
Patent

12. Innovation F – Technical Risks to Overcome Commercialization (maximum 1 slide)
Technical risks to overcome to commercialize:
Risk
High, Medium, Low
Mitigation

13. Natural Gas Market A (maximum 1 slide)
Quantify the Canadian and global market opportunity for the technology.
X (maximum of 600 characters, including spaces, 16pt font)
Quantify the potential market share and list assumptions to support that estimate.

14. Natural Gas Market B (maximum 1 slide)
What is your anticipated business model/path to market? X
Where is your initial target market?
What partnerships do you have or foresee to accelerate market roll-out?
*Maximum of 600 characters, including spaces, 16pt font, per item.

15. Natural Gas Market C (maximum 1 slide)
Who do you see as the end-user/customer for you technology solution?
What are the end-user and/or public benefits of your technology solution (see below for examples)?
Increased efficiency
Reduced equipment first cost
New high-efficiency, low emission to aid economic development
Enhanced safety
Enhanced system integrity
Reduced environmental impacts - emissions (CO2, CH4, NOx), water, soil
Reduced O&M costs
What are the key customer benefits related to the use of your technology, i.e., what is the value proposition for the customer?
What is the payback period or improvement to return for the customer and why?
*Maximum of 600 characters, including spaces, 16pt font per item.

16. Natural Gas Market D (maximum 1 slide)
List direct and indirect competitors and their key performance indicators strengths and weaknesses:
Competitor Name
Strengths
Weaknesses

17. Management / Project Team (maximum 1 slide)
Who will work actively on the project, who will advise, etc.?
Who, from the project partners, will advise on the project?
What relevant experience does the project team have? (technical expertise, business expertise, project management expertise, etc.)
Management Team
Full Name
Organization Role
Years of Experience
Responsibility
Previous Relevant Experience
Project Team
*Maximum of 150 characters, including spaces, 16pt font, per entry.

18. Project Partners (maximum 1 slide)
Letters of Intent are required from organizations that are participating in the project as partners. Letters should be addressed to NGIF, describe the organization participation, confirm objective and scope, and be signed by an officer of the company. X
Partner Organization
Role in Project
Status
(Target/Letter Of Intent/Contract)
*Maximum of 150 characters, including spaces, 16pt font, per entry.

19. Project Summary (maximum 1 slide)
Project Title:
Summary of Scope and Objectives (maximum of 150 characters, including spaces, 16pt font, per bullet): X
What needs to be achieved for a successful outcome (maximum of 150 characters, including spaces, 16pt font, per bullet)?

20. Project Work Plan (maximum 1 slide)
Start Date:
End Date:
Demonstration Site(s):
Overall Objective:
Key milestones, duration and key objectives to achieve during milestone:
Milestone Activity
Duration (months)
Key Objective to Achieve
*Maximum of 150 characters, including spaces, per item; two (2) slide maximum.

21. Project Budget Estimated total cost of the project: Item
Estimate ($k CAD)
Labour
Travel
Equipment / Materials
Subcontractors
Other
Total

22. Project Funding
Project funding sources: Include itemized partner contributions, other government funds etc., this may include in-kind contributions. Include estimate of funding request from NGIF (refer Guidelines Document for available NGIF’s funding)
Funding Source
Amount ($k CAD)
Status
Cash
In-kind
Target
Letter of Intent
Contract
Lead Organization (Applicant)
Partner #1
Partner #2
Partner #3
Total

23. Summary (maximum 1 slide)
Please give a brief summary of your project scope and objectives, focusing on how this project solves an industry problem.
Problem your technology solves
Project scope and objectives
How does a NGIF project advance the technology toward commercialization?
Size of market opportunity
Potential environmental benefits

24. Next Steps (maximum 1 slide)
*Maximum one (1) slide maximum.

25. Full Contact Information (maximum 1 slide)
Applicant Name
Applicant Title
Company
Address (# Street, Suite #)
City
Province / State
Postal / Zip Code
Phone (Area Code, Number)

26. Annex – Technology Readiness Level (TRL)
Description
Definition
1 - 3
Research and
Applied Research
At this stage of development, technology is at conceptual articulation, technology and applications described, and laboratory and studies analysis
4 - 5
Prototype Development
At this stage of development, the technological components have been integrated and the concept has been proven. Projects in this category include technology improvement, development of a prototype system, and prototype testing in a simulated operational environment 6
Prototype Testing in relevant environment
At this stage of development, the technology is tested in relevant environment. Projects in this category include testing a prototype, integrated with existing systems, if applicable, in a laboratory environment or in a simulated operational environment. Engineering feasibility demonstrated. 7
Field Pilot
At this stage of development, the technology is ready to be field tested in an operational environment. Projects in this category include scale up of prototypes to representative pilot scale demonstration and subsequent in-field demonstration testing of pilot units. 8
Deployment
At this stage of development, the technology is approaching the final commercial product and representative systems have been built. Projects in this category include demonstration of near or fully-commercial scale systems in an operational environment. 9
Commercial Implementation
At this stage, the technology is ready for commercial deployment. Projects in this category will involve design, construction, and operation of the technology in its final commercial form, with the intent to operate the technology for its full commercial life.