Incorporated Society. The seal of [insert name of Incorporated Society] was affixed in the presence of : Authorised Signatory Name Authorised Signatory Name
Incorporated Society. The seal of [insert name of Incorporated Society] was affixed in the presence of : Authorised Signatory Name Authorised Signatory Name SCHEDULE Land Copy exactly from the concession document – ensure it is a well explained description of the Land SCHEDULE 6 ANNUAL CONCESSION ACTIVITY FEE RETURN FORM [Concessionaire’s name] [Description of Activity / Location] Lease and Licence Concession Number: 38966-ACC YEAR: 01/07/ to 30/06/ Description Amount GROSS REVENUE derived from all rental (sub-letting) activities authorised under this Concession during the year 1 July to 30 June as defined in Item 6(a) of Schedule 1. $ x.x% of Gross Revenue $ Plus GST $ Total Concession Activity Fee to be paid: $ I certify that the above figures are a true and accurate copy of records held. Signed by: Date: / / Name: Title: for [Concessionaire name]
Incorporated Society b) Have IRD charitable status
Incorporated Society. The seal of [insert name of Incorporated Society] was affixed in the presence of : Authorised Signatory Name Authorised Signatory Name SCHEDULE 1 1. Land (clause 2) As marked on the attached plan or map in Schedule 4 being: Physical Description/Common Name: Land Status: Area: Legal Description: Map Reference: 2. Concession Activity (clause 2) Give a good summary of concession activity – and as more specifically set out in Schedule 3 3. Term (clause 4) years months commencing on ~&~PermissionTermStart^&^ 4. Renewal(s) (clause 4) List number of renewals and length of renewals 5. Final Expiry Date (clause 4) ~&~PermissionTermEnd^&^ 6. Concession Fee (clause 5) Activity Fee $xxx per annum plus GST (or as agreed) and Management Fee $xxx per annum plus GST 7. Environmental Monitoring Contribution (clause 10) $xxx per annum plus GST/ Not required 8. Community Services Contribution (clause 7) $xxx per annum plus GST / Not required 9. Total payment to be made per annum (clause 5) $xxx per annum plus GST 10. Total payment instalment(s) (clause 5) Amount to be paid for each instalment in Item 11 11. Concession Fee Payment Date(s) (clause 5) Insert concession anniversary date or named date(s) for fee payment(s) 12. Penalty Interest Rate (clause 5) Double the current Official Cash Rate (OCR). See Reserve Bank of New Zealand website 13. Concession Fee Review Date(s) (clause 6) Insert 3 year anniversary dates, or a specific date or dates 14. Insurance (To be obtained by Concessionaire) (clause 13) Types and amounts: Public Liability Insurance for: (a) General indemnity for an amount no less than $1,000,000.00; and (b) Forest and Rural Fires Act extension for an amount no less than $250,000.00; and Third party vehicle liability for an amount no less than $500,000.00. delete if no vehicle involved in activity Other insurances as necessary Subject to review on each Concession Fee Review Date 15. Health and Safety (clause 14) Audited Safety Plan: Required / Not required (Delete as appropriate) 16. Concessionaire Identification (clause 32) Required / Not required (Delete as appropriate) 17. Addresses for Notices (clause 25) The Grantor’s address is: NB: Use street address Permissions team email address XXX Permissions Team Office address The Concessionaire’s address in New Zealand is: NB: Use street address ~&~HolderTableStreetAddress^&^ Phone: ~&~HolderTableContactWorkPhone^&^ Fax: ~&~HolderTableContactFax^&^ Email: 18. Guarantee (clause 30) Required / Not required (Delete a...
Incorporated Society. The seal of [insert name of Incorporated Society] was affixed in the presence of : Authorised Signatory Name Authorised Signatory Name SCHEDULE Land Copy exactly from the concession document – ensure it is a well explained description of the Land SCHEDULE 6 ANNUAL ACTIVITY RETURN FORM PERIOD 01/07/…… to 30/06/…… Name of Concessionaire: Concession No: Supplying this information to the Department not only helps us to collect the fees for your activity, but more importantly, it helps us to understand the visitor use patterns and trends on public conservation lands. This information is important and assists us to manage the effects of all activities, including the cumulative impacts on conservation and recreation values. An electronic version of this document is available upon request. Date (or range of dates) Main Activity Location Duration of stay Number booked to stay $ Received EXAMPLE Bookabatch EXAMPLE Aramoana Cottage/Pilot House 3 e.g. 5 days SCHEDULE 6 (Continued) ANNUAL CONCESSION ACTIVITY FEE RETURN SUMMARY FORM [Concessionaire’s name] [Description of Activity / Location] Lease and Licence Concession Number: 38967-ACC YEAR: 01/07/ to 30/06/ Description Amount GROSS REVENUE derived from all rental (e.g. bookabatch) activities authorised under this Concession during the year 1 July to 30 June as defined in Item 6(a) of Schedule 1. $ x.x% of Gross Revenue $ Plus GST $ Total Concession Activity Fee to be paid: $ I certify that the above figures are a true and accurate copy of records held. Signed by: Date: / / Name: Title: for [Concessionaire name]
