Please read the latest version (updated 31th July 2007) of TechnoFund Please read the Technofund Guidelines

carefully before Guidelines for Applicant carefully before you fill in this form. you fill in this form.

For office use only

All information required in the application form must Please submit 2 hard copies and 15 CDs (saved in be given. Date Received separate files) of project proposal, business plan and COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING PROJECT TITLE executive summary. Please submit the project proposal together with the plan (1 hard and 20 CDs) but save All business information required incopy the application form must bethe project proposalor inineligible a separate file. given. Incomplete application will not be entertained. Incomplete application and/or application received after the closing date of each cycle will be returned.
Reference No Project Officer

ALL INFORMATION PROVIDED IN THIS APPLICATION WILL BE TREATED AS CONFIDENTIAL PART 1: APPLICANT DETAILS
1.1 Particulars of Entity

Development and Procurement Division, Ministry of Science, Technology and Innovation (MOSTI) Level 3, Block C5, Complex C, FQ FEEDMILL SDN BHD Federal Government Administrative Centre, 62662 Putrajaya http://www.mosti.gov.my
Entity name: Company registration number (if applicable): 817754-V Tel: 03 - 8885 8810 / 8163 (Helpdesk) Date of Incorporation (if applicable):

Fax: 03 - 8888 9473 e-mail: technofund@mosti.gov.my

We are currently a (Please mark (X) in appropriate box): Start-Up Company Spin-Off Company

Small Company Medium / Large Company Public Listed Company Government Linked Company Institution of Higher Learning Government Research Institute

Authorised capital : RM 100,000.00 Paid up capital: RM 100,000.00 Structure of Shareholding: Malaysian: Bumiputra Non- Bumiputra Foreign: Total: 100.00

% 66.66 33.34

Core Business of Entity: 1. Manufacturing Animal Feed 2. Sales & Marketing Finished product 3.

Address: Lot 13G,Kawasan Perusahaan Bukit Angkat,43300 Kajang,Selangor

Company Directors (if applicable):

1.Hj Anuar bin Ibrahim 2.Dr.Iskandar Roshan bin Abdullah 3.Razis Shahrizan bin Zainal Principal Researcher / Leader: Hj Anuar bin Ibrahim Designation : Managing Director

Telephone no : 03-87336073 E-mail: admin@fqfeedmill.com

Fax no : 03-87336095

1.2

Have you or your business previously applied or been connected with an application, for other Government R&D, commercialisation or related funding? Please mark (X) in the appropriate box.

Yes

No

If yes, please give details:

1.3

Have you or any other partner, member or director of your business ever been disqualified from becoming a director? Please mark (X) in the appropriate box

Yes

No

If yes, please give details:

1.4

Have you or any other partner, member or director of your business ever been an owner, partner or director of a business which went into bankruptcy, liquidation or receivership? Please mark (X) in the appropriate box

Yes

No

If yes, please give details: How do you plan to fund your share of the project costs? Provide proposed source of funding (for start-up, spin-off and small company) or evidence of funding (e.g. bank statement, bank facility / over draft, etc)

1.5

PART 2: COLLABORATOR DETAILS

2.1 Particulars of Collaborator (mandatory for IHL/GRI Applicant): Company Name: Universiti Malaysia Sabah Company registration number: Universiti Malaysia Sabah Locked Bag 2073, 88999 Kota Kinabalu Sabah Malaysia

Address:

Date of Incorporation: 24 Nov 1994 Our collaborator is: Please mark (X) in appropriate box Start-Up Company Spin-Off Company Small Company Medium / Large Company Public Listed Company Government Linked Company Institution of Higher Learning Government Research Institute x

Company Directors: 1. 2. Contact Person: Prof. Dr. Rosnah Ismail Designation: Deputy Vice Chancellor (Research & Innovation) Telephone no : 088-320000 - 1407 Fax no : 088-448886 E-mail: isrosnah@ums.edu.my

Authorised Capital : Paid-up Capital:

Structure of Shareholding: Malaysian: Bumiputra Non-Bumiputra Foreign: Total:

Core Business of Collaborator: 1.Education 2. 3.

PART 3: PROJECT DETAILS

You are applying for (Please mark (X) in the appropriate box) Type A: Pre-Commercialisation B: IP Acquisition Total
Note: Applicants can apply for a combination of Types A and B or Type A only

Application

Proposed Project Cost (RM)

3,195,080.00

Technology Cluster (Please mark (X) in the appropriate box

Agriculture Biotechnology Information and Communication Technology Industry X

Sub cluster (please refer to the List of Sub Clusters at

http://ernd.mosti.gov.my/escience and indicate accordingly)

Sub cluster: 3.1

TYPE A: PRE-COMMERCIALISATION

3.1.1

Project Title COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING

3.1.2

Project Summary New fish feed formula that serve as a replacement fish-based feeds, using a mixture of poultry by-products and vegetable oils. The feed produced that was not only profitable for aquaculture farmers but one which would also contribute to the environment.

3.1.3

Proposed Project Duration (months) 24 months

3.1.4

Location of the Proposed Project Selangor

3.1.5 Technical Aspects (Refer Attachment) a. Previous Work Done (Laboratory Proof of Concept) b. Project Objectives c. Methodology d. Technology Benchmarking e. Project Deliverables f. Regulatory and Standards g. Patentable Output h. Project Risks i. Project Benefits j. Project milestones and activities (List the major milestones of the project (typically 5 to 8) in the table below. Outline the major activities of each milestone. A milestone typically consists of 8 to 12 activities. These activities should collectively cover the scope of the milestone. The activity costs should be equal to the total project cost.)
NO. MILESTONES ACTIVITIES DELIVERABLES COST COMPLETION DATES

1. 2. 3. 4. 5. 6. 7. 8. k. Project Gantt Chart (Please attach)

l. Project Costing (Please itemise and provide breakdown for expenses of each component and sub-component involved)
NO EXPENSES ITEMS COST (RM) TOTAL (RM)

1.

Pilot Plant & Equipment (if applicable)

2.

Clinical Trial / Field Trial (if applicable)

3.

Commercial Ready Prototype (if applicable)

4. 5. 6. 7.

IP Preparation and Registration (excluding maintenance) Market Testing of Commercial Ready Prototype Regulatory and Standards Compliance Contract Expenditure Expenditure of Services (market

8.

survey, consultancy and testing)

Total Proposed Project Cost

3.1.6

Project Team (Describe the technical and business capabilities, qualifications and experience of

project team members. Please attach CV of each team member.)

Refer CV

3.2

TYPE B - IP ACQUISITION 3.2.1 nil Title

3.2.2 Description (commercial potential, etc)

nil 3.2.3 nil 3.2.4 nil 3.2.5 nil 3.2.6 Cost of acquisition
COST (RM) TOTAL (RM)

IP Registration number and expiry date

Original Owner (Please attach IP Acquisition Agreement with owner)

Country of origin

NO 1. 2.

EXPENSES

ITEMS nil nil

Acquisition of IP (laboratory scale Training (technology transfer)

Total Cost of Acquisition

3.2.7 nil

Details of training provided

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3.2.8 nil 3.2.9 nil

Novelty of IP to be acquired

Proposed Acquisition Date

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PART 4: DECLARATION 4.1 Declaration

This form must be signed by someone with the legal authority to bind the applicant entity/institution (for example, an executive director of your entity) I / We certify that: a. I / We have read, understood and agreed to abide by the latest version of the TechnoFund Guidelines For Applicants; b. The information provided in this application, including attachments, is true and correct to the best of my knowledge; and c. The Entity/Institution is free from any litigation pertaining to the proposed project in Malaysia and overseas. Name: Designation: Signature:

Date:

For enquiries, please e-mail: technofund@mosti.gov.my Applicants must use the latest version of the Project Proposal Form for submitting applications and fill in the TechnoFund Application Checklist separately. MOSTI reserves the right to revoke application or withdraw approval based on false information submitted by applicants.

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TECHNOFUND APPLICATION CHECKLIST Reference No. Entity Name Project Title FQ FEEDMILL SDN BHD COST-EFFECTIVE FEEDS FOR MARINE FISH FARMING

No. Please mark ( ) in the appropriate box () Book 1 (2 hard copies) 1. 2. 3. 4. 5. 6. 7. Executive Summary (maximum 2 pages) Project Proposal Curriculum Vitae of project team Form 9 (Company Act,1965) Form 24 (Company Act,1965) Form 49 (Company Act,1965) Recent EPF statement of all employees / work permit of foreign workers (Company Applicants and IHL/GRI Main Collaborator) MOU between IHL/GRI and Collaborator (to finance the portion of project cost not funded by TechnoFund and to commercialise project output) (IHL/GRI applicants only) IP Acquisition Agreement (for Type B only) Itemised costing Book 2 (2 hard copies) 11. 12. Business Plan Latest audited Financial Report (annual turnover, profit and loss statement, balance sheet, cash flow, etc) (Company applicants and IHL/GRI Collaborator) CD (15 copies) Project Proposal + Business Plan + Executive Summary (in separate files)
(For Official Use)

8. 9. 10.

13.

13

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(For Official Use Only) Status: Complete Incomplete & Returned Ineligible & Returned Remarks: Name of Desk Officer : Signature: Date: Status: Complete Incomplete & Returned Incomplete & Returned Remarks: Name of AD: Signature: Date:

Ministry Chop:

Acknowledgement by Applicant: Name : Signature: Date:

Updated: 31 th July 2007

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