Contracting Authority: Deutsche Gesellschaft für Internationale Internationale Zusammenarbeit (GIZ) GmbH
Eastern Partnership Pa rtnership Territorial Territorial Cooperation Programmes Cross Border Cooperation Progamme Moldova-Ukraine Grant Application orm Reference: 1st call for proposals Deadline for submission of concept notes and applications: applications: !"th o# $uly %&!' at 16:00 local time
o reduce e!pense and "aste# "e stron$l% recommend that %ou use onl% paper for %our file (no plastic folders or di&iders)' lease also use doublesided printin$ if possible
itle itle of the action: *ocation(s) of the action:
+ame of the applicant +ationalit% of the applicant! 1
An organisation’s statutes must show that it was established under the national law of the coun countr try y conc concer erne ned d and and that that the the head head oce oce is loca locate ted d in an elig eligib ible le coun country try. Any Any organisat organisation ion establish established ed in a dieren dierentt country country cannot cannot be consider considered ed an eligible eligible local local
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uropeid ID 2n$oin$ contract3*e$al ntit% 4ile +umber (if a&ailable) 5 *e$al status, oapplicant 7
+ame8 uropeid ID8 +ationalit% and date of establishment8 establishment8 *e$al status8 Relation "ith the applicant or coapplicant
ffiliated entit%6
+ame8 uropeid ID8 +ationalit% and date of establishment8 establishment8 *e$al status8 Relation "ith the applicant or coapplicant
pplicant9s contact details for the purpose of this action Postal address: Telephone num(er: (fi!ed and mobile) ountr% code cit% code number a) num(er: ountr% code cit% code number Contact person #or this action: Contact person*s email: Address: +e(site +e( site o# the ,rganisation:
Any change in the addresses phone num(ers #a) num(ers or e-mail must (e noti#ied in .riting to the Contracting Authority/ Authority/ The Contracting Authority .ill not (e held responsi(le in the event that it cannot contact an applicant/
organisation. See the footnotes footnotes to the Guidelines Guidelines for the call. -
To To be inserted if the organisation is registered registered in PADO !Potential !Potential A""licant Data On# $ine egistration%. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*euro"eaid*o htt")**ec.eur o"a.eu*euro"eaid*onlineser(ices*"ador nlineser(ices*"ador..
5
+f an a""licant has already signed a contract with the ,uro"ean -ommission and*or has been informed of the $egal ,ntity &ile number. number. +f not' write /*A’.
,
,.g. non#"ro0t' go(ernmental body' international organisation.
7
1se one row for each co#a""licant.
6
1se one row for each aliated entity..
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uropeid ID 2n$oin$ contract3*e$al ntit% 4ile +umber (if a&ailable) 5 *e$al status, oapplicant 7
+ame8 uropeid ID8 +ationalit% and date of establishment8 establishment8 *e$al status8 Relation "ith the applicant or coapplicant
ffiliated entit%6
+ame8 uropeid ID8 +ationalit% and date of establishment8 establishment8 *e$al status8 Relation "ith the applicant or coapplicant
pplicant9s contact details for the purpose of this action Postal address: Telephone num(er: (fi!ed and mobile) ountr% code cit% code number a) num(er: ountr% code cit% code number Contact person #or this action: Contact person*s email: Address: +e(site +e( site o# the ,rganisation:
Any change in the addresses phone num(ers #a) num(ers or e-mail must (e noti#ied in .riting to the Contracting Authority/ Authority/ The Contracting Authority .ill not (e held responsi(le in the event that it cannot contact an applicant/
organisation. See the footnotes footnotes to the Guidelines Guidelines for the call. -
To To be inserted if the organisation is registered registered in PADO !Potential !Potential A""licant Data On# $ine egistration%. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*euro"eaid*o htt")**ec.eur o"a.eu*euro"eaid*onlineser(ices*"ador nlineser(ices*"ador..
5
+f an a""licant has already signed a contract with the ,uro"ean -ommission and*or has been informed of the $egal ,ntity &ile number. number. +f not' write /*A’.
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,.g. non#"ro0t' go(ernmental body' international organisation.
7
1se one row for each co#a""licant.
6
1se one row for each aliated entity..
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ontents
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PA0T PA0T A/ C,1CEPT 1,TE 1 ,TE !
2nstructions 2nstructions #or dra#ting the concept note/////////////////////////////////////// note////////////////////////////////////////////////////////////// //////////////////////////////////////" ///////////////" 1'1' ;ummar% ;ummar% of the action''''''' action'''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''', ''''', 1'-' Description Description of the action (ma! 1 pa$e)''''''''' pa$e)'''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' '''''''''''''''7 ''''''''7 1'5' Rele&ance Rele&ance of the action (ma! 5 pa$es)'''''''''''''' pa$es)'''''''''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' '''''''''''''''''''''''''''''''7 '''''''''''''''''''''''7 6
PA0T PA0T B/ U33 APP32CAT2,1 APP32CAT2,1 ,0M !
General Gene ral in#ormatio in#ormation//// n///////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ///////////// //////////////////4 //////////4
%
The action//////////////////////////////////// action/////////////////////////////////////////////////////////// ////////////////////////////////////////////// ////////////////////////////////////////////// //////////////////////////////////////////// ////////////////////////4 ///4 -'1' Description Description of the ction''''' ction'''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''6 '''6 -'-' ffiliated ffiliated entit%(ies) entit%(ies) e!perience e!perience (if applicable)'' applicable)'''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''''''''''''''' '''''''''''''''''''''''''''1''''''''1-
5
The applicant/////////////////////////////// applicant////////////////////////////////////////////////////// ////////////////////////////////////////////// ////////////////////////////////////////////// /////////////////////////////////////////////!" //////////////////////!" 5'1' 5'-' 5'5' 5','
"
Identit%'''' Identit%''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''''''''''''''''''1, ''''''''''''''''''''''1, rofile'''''' rofile''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''''' ''''''''''''''' ''''''17 17 apacit% apacit% to mana$e mana$e and implement actions''''''''''' actions'''''''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''''''-'''''''''''-*ist of the mana$ement mana$ement board3committee board3committee of %our or$anisation''''' or$anisation'''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''''''''''''-7 ''''''''''''''''-7
The Co-applic Co-applicant6 ant6s7/// s7//////// ////////// ////////// ////////// ///////// ///////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// /////////////// ///////////////////%4 /////////%4 ,'1' apacit% apacit% to mana$e mana$e and implement actions''''''''''' actions'''''''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''''''-. '''''''''''-.
'
A232A A232ATE TE8 8 E1T2T2E96 E1T2T2E96ies7 ies7 participat participating ing in the action////// action/////////// ////////// ////////// ////////// ////////// /////////// /////////////// ///////////5& //5& 7'1' 7'-' 7'5' 7','
Description Description of the affiliated affiliated entit%(ies)'''''''' entit%(ies)'''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''''''''''''''''50 ''''''''''''''''''''50 apacit% apacit% to mana$e mana$e and implement actions''''''''''' actions'''''''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''''''51 '''''''''''51 !perience !perience b% sector''''''' sector'''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' ''''''''''''''' ''''''''''''''' '''''''''''''' '''''''''''''51 ''''''51 ffiliated ffiliated entit%(ies)
4
Associat Associates es o# the applicant applicant participat participating ing in the action///// action////////// ////////// ////////// ////////// ////////// ////////// ////////// ////////// /////////// //////////5" ////5"
Checklist #or the #ull application #orm////////////////////////////////////// #orm///////////////////////////////////////////////////////////// ///////////////////////////////////////////5' ////////////////////5'
;
8eclaration (y the applicant//////////////////////////////// applicant/////////////////////////////////////////////////////// ////////////////////////////////////////////// //////////////////////////////////////////5 ///////////////////5
<
Assessme Assessment nt grid ,0 the #ull applicati application on #orm//////// #orm///////////// ////////// ////////// ////////// ////////// ///////////// ///////////////// /////////////////// ///////////////5< /////5<
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PA0T PA0T A/ C,1C EPT 1 ,TE !/!/ INSTRUCTIONS FOR DRAFTING THE CONCEPT
NOTE lease note that if this is a restricted call# onl% the concept note should be submitted in the first sta$e (no full application)' If this is an open call# both the concept note and the full application shall be submitted at the same time' here is no specific template for the oncept +ote but the applicant must ensure that the t e!t: •
does not e!ceed 7 full pa$es (, si=e) of rial 10 characters "ith - cm mar$ins# sin$le line spacin$8
•
pro&ides the information re>uested under the headin$s belo"# in the order in "hich it is re>uested# and in proportion to its relati&e importance (see the rele&ant scores set out in the e&aluation $rid and in the Guidelines)8
•
pro&ides full information (as the e&aluation $rid "ill be applied solel % on the information in the concept note)8
•
is drafted as clearl% as possible to enable it to be e&aluated'
!/%/ !/%/ =u =umm mmar ary y o# o# the the acti action on lease complete the table belo"# "hich "hich should not e!ceed 1 pa$e' Title o# the action 3ocation o# the action
specify country(ies) region(s) - specify that will benefit from the action Total duration o# the action:
?@ monthsA
EU #inancing re>uested 6amount7
? EUR / currency of the Contracting Authority A
EU #inancing re>uested as a percentage o# total (udget (udget o# the Action 6indicative7
B
,(?ectives o# the action
?!erall ob"ecti!e(s)A ob"ecti!e(s)A ?#pecific ob"ecti!e(s)A ob"ecti!e(s)A
Target group6s7 C
.
-o(er "age as "er tem"late in "age 2 should be attached as well
C
ar$et $roupsE are the $roups3entities "ho "ill directl% benefit from the action at the action purpose le&el'
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inal (ene#iciaries/ Estimated results Main activities
!/5/ 8escription o# the action 6ma) ! page7 lease pro&ide all the follo"in$ information: Gi&e the bacF$round to the preparation of the action' !plain the obecti&es of the action $i&en in the table in ;ection 1'1' Describe the Fe% staFeholder $roups# their attitudes to"ards the action and an% consultations held "ith them' riefl% state the t%pe of acti&ities proposed and specif% related outputs and results# includin$ a description of linFa$es3relationships bet"een acti&it% clusters' ;tate the broad timeframe for the action and describe an% specific factor that has been taFen into account'
!/"/ 0elevance o# the action 6ma) 5 pages7 !/"/!/!/
0elevance to the o(?ectives@sectors@themes@speci#ic priorities o# the call #or proposals
lease pro&ide all the follo"in$ information: Describe the rele&ance of the action to the obecti&e(s) and priorit% (ies) of the call for proposals' Describe the rele&ance of the action to an% specific subthemes3sectors3areas and an% other specific re>uirements stated in the Guidelines for the call# e'$' local o"nership etc' Describe "hich particular e!pected results referred to in the Guidelines for the call "ill be addressed'
!/"/!/%/
0elevance to the particular needs and constraints o# the target country@countries region6s7 and@or relevant sectors 6including synergy .ith other EU initiatives and avoidance o# duplication7
lease pro&ide all the follo"in$ information: ;tate clearl% the specific preproect situation in the tar$et countr%3countries# re$ion(s) and3or sectors (include >uantified data anal%sis "here possible)' ro&ide a detailed anal%sis of the problems to be addressed b% the action and ho" the% are interrelated at all le&els' Refer to an% si$nificant plans undertaFen at national# re$ional and3or local le&el rele&ant to the action and describe ho" the action "ill relate to such plans' here the action is the continuation of a pre&ious action# clearl% indicate ho" it is intended to build on the acti&ities3results of this pre&ious action8 refer to the main conclusions and recommendations of an% e&aluations carried out' here the action is part of a lar$er pro$ramme# clearl% e!plain ho" it fits or is coordinated "ith that pro$ramme or an% other planned proect' ;pecif% the potential s%ner$ies "ith other initiati&es# in particular b% the uropean ommission' /
3&inal bene0ciaries4 are those who will bene0t from the action in the long term at the le(el of the society or sector at large.
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8escri(e and de#ine the target groups and #inal (ene#iciaries their needs and constraints and state ho. the action .ill address these needs
lease pro&ide all the follo"in$ information: Gi&e a description of each of the tar$et $roups and final beneficiaries (>uantified "here possible)# includin$ selection criteria' Identif% the needs and constraints of each of the tar$et $roups and final beneficiaries' Demonstrate the rele&ance of the proposal to the needs and constraints of the tar$et $roups and final beneficiaries' !plain an% participator% process ensurin$ participation b % the tar$et $roups and final beneficiaries'
!/"/!/"/
Cross-(order impact
Indicate ho" the proposal demonstrates the crossborder character b% describin$ ho" at least one of the follo"in$ criteria is applied in the action: oint de&elopment# oint staffin$# oint implementation and3or oint financin$'
PA0T B/ U33 APP32 CAT2,1 ,0M To (e su(mitted (y all applicants o reduce e!pense and "aste# "e stron$l% recommend that %ou use onl% paper for %our file (no plastic folders or di&iders)' lease also use doublesided printin$ if possible
1
GENERAL INFORMATION
0e#erence o# the Call #or Proposals
Enter EuropeAi$ reference for the Call for %roposals
Title o# the Call #or Proposals
Enter the title of the Call for %roposals
1ame o# the applicant 1um(er o# the proposal10
&umber/not applicable (open proce$ures)
Title o# the action 3ocation o# the action - specify country(ies) region(s) that will benefit from the action
!/!/ THE ACTION !!
10
&or restricted "rocedures only5 when the -ontracting Authority has e(aluated the -once"t /ote it informs the a""licant of the outcome and allocates a "ro"osal number.
11
The e(aluation committee will refer to information "ro(ided in the -once"t /ote as regards ob6ecti(es and the rele(ance of the action.
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!/%/ 8escription o# the Action !/%/!/!/
8escription 6ma) !5 pages7
ro&ide a description of the proposed action# includin$ all the information re>uested belo"# referrin$ to the o&erall obecti&e(s) and specific obecti&e(s)# outputs and results described in the concept note: •
•
•
!plain the specific results e!pected# statin$ ho" the action "ill i mpro&e the situation of the tar$et $roups and final beneficiaries and the technical and mana$ement capacities of tar$et $roups and3or an% local coapplicants and affiliated entit %(ies)' Identif% and describe in detail each acti&it% (or "orF pacFa$e) to be undertaFen to produce results# ustif%in$ the choice of acti&ities and specif%in$ the role of each coapplicant(s) and affiliated entit%(ies) (and associates or contractors or sub$rantees "here applicable) in the acti&ities' Do not repeat the action plan to be pro&ided in ;ection -'1'5# but demonstrate coherence and consistenc% of proect desi$n' In particular# list an% publications proposed' If financial support is allo"ed b% the Guidelines for pplicants# applicants "ishin$ to $i&e financial support to third parties must define# in line "ith the conditions set b% the Guidelines for pplicants the obecti&es and results to be obtained "ith financial support# the different t%pes of acti&ities eli$ible for financial support# on the basis of a fi!ed list# the t%pes of entit% eli$ible or cate$ories of persons "hich ma% recei&e financial support# the criteria for selectin$ these entities and $i&in$ the financial support# the criteria for determinin$ the e!act amount of financial support for each third entit%# and the ma!imum amount "hich ma% be $i&en'
!/%/!/%/
Methodology 6ma) ' pages7
Describe in detail: the methods of implementation and rationale for such methodolo$%8 "here the action continues a pre&ious action# describe ho" the action is intended to build on the results of the pre&ious action ($i&e the main conclusions and recommendations of an% e&aluations carried out)8 "here the action is part of a lar$er pro$ramme# e!plain ho" it fits or is coordinated "ith this pro$ramme or an% other possibl% planned proect (please specif% potential s%ner$ies "ith other initiati&es# in particular b% the uropean Jnion)8 the procedures for follo" up and internal3e!ternal e&aluation8 the role and participation in the action of the &arious actors and staFeholders (coapplicant(s)# affiliated entit%(ies)# tar$et $roups# local authorities# etc')# and the reasons "h% these roles ha&e been assi$ned to them8 the or$anisational structure and the team proposed for the implementation of the action (b% function: there is no need to include the names of indi&iduals)8 the main means proposed for the implementation of the action (e>uipment# materials# and supplies to be ac>uired or rented)8 the attitudes of all staFeholders to"ards the action in $eneral and the acti&ities in particular8 the planned acti&ities in order to ensure the &isibilit% of the action and t he J fundin$'
!/%/!/5/ action 6ma) " pages7
8uration and indicative action plan #or implementing the
he duration of the action "ill be ?KA months'
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pplicants should not $i&e a specific startup date for the implementation of the action but simpl% refer to Lmonth 19# Lmonth -9# etc' pplicants are recommended to base the estimated duration of each acti&it% and the total period on the most probable duration and not on the shortest possible duration# b% taFin$ into consideration all rele&ant factors that ma% affect the implementation timetable' he acti&ities stated in the action plan should match those described in detail in ;ection -'1'1' he implementin$ bod% must be either the applicants or an% of the affiliated entit%(ies)# associates or subcontractors' n% months or interim periods "ithout acti&ities must be included in the action plan and count to"ard the calculation of the total estimated duration of the action' he action plan for the first 1- months of implementation should be sufficientl% detailed to $i&e an o&er&ie" of the preparation and implementation of each acti&it%' he action plan for each of the subse>uent %ears ma% be more $eneral and should onl% list the main acti&ities proposed for those %ears' o this end# it must be di&ided into si!month periods (+: more detailed action plan for each subse>uent %ear must be submitted before an% ne" prefinancin$ pa%ments are recei&ed under rticle ,'1 of the ;pecial onditions of the $rant contract)' he action plan "ill be dra"n up usin$ the follo"in$ format: Mear 1 Half%ear 1 cti&it%
Nonth 1
!ample
e!ample
-
5
,
Half%ear 7
6
.
C
/
10
11
1-
Implementin$ bod% !ample
reparation cti&it% 1 (title)
coapplicant and3or affiliated entit%
!ecution cti&it% 1 (title)
coapplicant and3or affiliated entit%
reparation cti&it% (title)
coapplicant and3or affiliated entit%
tc'
4or the follo"in$ %ears: cti&it%
Half%ear , 5
!ample
!ample
7
6
.
C
/
10
Implementin$ bod% !ample
!ecution cti&it% 1 (title)
coapplicant and3or affiliated entit%
!ecution cti&it% (title)
coapplicant and3or affiliated entit%
reparation cti&it% 5 (title)
coapplicant and3or affiliated entit%
tc'
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!/%/!/"/
=ustaina(ility o# the action 6ma) 5 pages7
ro&ide all the information re>uested belo": •
Describe the e!pected impact of the action "ith >uantified data "here possible# at technical# economic# social# and polic% le&els ("ill it lead to impro&ed le$islation# codes of conduct# methods# etc'O)'
•
Describe a dissemination plan and the possibilities for replication and e!tension of the action outcomes (multiplier effects)# clearl% indicatin$ an% intended dissemination channel'
•
ro&ide a detailed risF anal%sis and contin$enc% plan' his should include a list of risFs associated "ith each proposed action# accompanied b% rele&ant miti$ation measures' $ood risF anal%sis "ill include a ran$e of risF t%pes includin$ ph%sical# en&ironmental# political# economic and social risFs'
•
Describe the main preconditions and assumptions durin$ and after the implementation phase'
•
!plain ho" the action "ill be made sustainable after completion' his ma% include necessar% follo"up acti&ities# builtin strate$ies# o"nership# communication plan# etc' Distin$uish bet"een four t%pes of sustainabilit%: a'
4inancial sustainabilit%: e'$' financin$ of follo"up acti&ities# sources of re&enue for co&erin$ all future operatin$ and maintenance costs'
b'
Institutional sustainabilit%: e'$' structures that "ould allo" the results of the action to continue to be in place after the end of the action# capacit% buildin$# a$reements and local Lo"nership9 of action outcomes'
c'
olic% le&el sustainabilit%: e'$'# "here applicable# structural impact (impro&ed le$islation# consistenc% "ith e!istin$ frame"orFs# codes of conduct# or methods)'
d'
n&ironmental sustainabilit%: "hat impact "ill the action ha&e on the en&ironment P ha&e conditions been put in place to a&oid ne$ati&e effects on the natural resources on "hich the action depends and on the broader natural en&ironmentO
!/%/!/'/
3ogical rame.ork
lease fill in nne! to the Guidelines for pplicants'
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!/%/!/4/ Budget amount re>uested #rom the Contracting Authority and other e)pected sources o# #unding 4ill in nne! to the Guidelines for pplicants to pro&ide information on: •
•
•
the bud$et of the action ("orFsheet 1)# for the total duration of the action and for its first ?1-3if more specif%A months8 ustification of the bud$et ("orFsheet -)# for the total duration of the action# and amount re>uested from the ontractin$ uthorit% and other e!pected sources of fundin$ for the action for the total duration ("orFsheet 5)'
4or further information# see the Guidelines for Grant pplicants' lease note that the cost of the action and the contribution re>uested from the ontractin$ uthorit% must be stated in JR2'
!/%/!//
Applicant*s e)perience
his information "ill be used to assess "hether %ou ha&e sufficient and stable e!perience of mana$in$ actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested' i) 4or similar actions' lease pro&ide a detailed description of actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action'
1ame o# the applicant: Pro?ect title: 3ocation o# the action
@
=ector 6see =ection 5/%/% o# =ection 57: Cost o# the action 6EU07
@
0ole in the action: Coordinator coapplicant a##iliated entity
@
8onors to the action 6name7 1-
@
Amount contri(ute d 6(y donor7
@
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy7
@
,(?ectives and results o# the action
ii) 2ther actions lease pro&ide a detailed description of other actions mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action and ma!imum 10 actions'
1-
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
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1ame o# the applicant: Pro?ect title: 3ocation o# the action
@
=ector 6see =ection 5/%/% o# =ection 57: Cost o# the action 6EU07
@
0ole in the action: Coordinator co-applicant a##iliated entity
@
8onors to the action 6name7 15
@
Amount contri(uted 6(y donor7
@
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy7
@
,(?ectives and results o# the action
!/%/!/;/
Co-applicant6s7s e)perience 6i# applica(le7
his information "ill be used to assess "hether %ou ha&e sufficient and stable e!perience of mana$in$ actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested' i) 4or similar actions' lease pro&ide a detailed description of actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action'
1ame o# the co-applicant: Pro?ect title: 3ocation o# the action
Cost o# the action 6EU07
@
@
=ector 6see =ection 5/%/% o# =ection 57: 0ole in the action: Coordinator co-applicant a##iliated entity
@
8onors to the action 6name7 1,
Amount contri(uted 6(y donor7
@
@
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy7
@
,(?ectives and results o# the action
15
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
1,
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
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a$e 11 of ,0
ii) 2ther actions lease pro&ide a detailed description of other actions mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action and ma!imum 10 actions'
1ame o# the co-applicant: Pro?ect title: 3ocation o# the action
@
=ector 6see =ection 5/%/% o# =ection 57: Cost o# the action 6EU07
0ole in the action: Coordinator coapplicant a##iliated entity
8onors to the action 6name7 17
@
@
@
Amount contri(uted 6(y donor7
@
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy7
@
,(?ectives and results o# the action
!/5/ A##iliated entity6ies7 e)perience 6i# applica(le7 his information "ill be used to assess "hether %ou ha&e sufficient and stable e!perience of mana$in$ actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested' i) 4or similar actions' lease pro&ide a detailed description of actions in the same sector and of a comparable scale to the one for "hich a $rant is bein$ re>uested mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action'
1ame o# the a##iliated entity: Pro?ect title:
=ector 6see =ection 5/%/% o# =ection 57:
3ocation o# Cost o# 0ole in the action: the action the action Coordinator co6EU07 applicant a##iliated entity
8onors to the action 6name716
Amount contri(ute d 6(y donor7
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy 7
@
@
@
@
@
@
,(?ectives and results o# the action
ii) 2ther actions 17
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
16
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
%&!" -.10///.0'doc
a$e 1- of ,0
lease pro&ide a detailed description of other actions mana$ed b% %our or$anisation in the past three %ears' Na!imum 1 pa$e per action and ma!imum 10 actions
1ame o# the a##iliated entity Pro?ect title: 3ocation o# the action
@
=ector 6see =ection 5/%/% o# =ection 57: Cost o# the action 6EU07
0ole in the action: Coordinator co-applicant a##iliated entity
@
@
8onors to the action 6name7 1.
@
Amount contri(uted 6(y donor7
@
8ates 6#rom dd@mm@yyyy to dd@mm@yyyy7
@
,(?ectives and results o# the action
1.
+f the donor is the ,uro"ean 1nion or an ,1 7ember State' "lease s"ecify the ,1 budget line' ,D& or ,1 7ember State.
%&!" -.10///.0'doc
a$e 15 of ,0
!/"/ THE APPLICANT EuropeAid 28 num(er 1C 1ame o# the organisation
!/'/ 2dentity
The applicant*s contact details #or the purpose o# this action 3egal Entity ile num(er 1/ A((reviation
0egistration num(er 6or e>uivalent7 8ate o# registration
Place o# registration
,##icial address o# registration
Country o# registration
+e(site and E-mail address o# the organisation Telephone num(er: ountr% code cit% code number a) num(er: ountr% code cit% code number The Contracting Authority must (e noti#ied o# any change in addresses phone num(ers #a) num(ers and e-mail in particular/ The Contracting Authority .ill not (e held responsi(le in the event that it cannot contact an applicant/
1C
1/
This number is a(ailable to an organisation which registers its data in PADO. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*euro"eaid*wor8*onlineser(ices*"ador*inde9:en.htm. This information is NOT obligatory for this call for "ro"osals' but is encouraged. +f the a""licant has already signed a contract with the ,uro"ean -ommission.
%&!" -.10///.0'doc
a$e 1, of ,0
!/4/ Pro#ile 3egal status Pro#it-Making 1G, alue (ased-0
2s your organisation linked .ith another entity
!/4/!/!/
Category
Category--
Pu(lic D ublic dministration D Decentralised representati&es of ;o&erei$n ;tates D International 2r$anisation D udicial Institution D *ocal uthorit% D Implementation $enc% D Jni&ersit%3ducation D Research Institute D hinF anF D 4oundation D ssociation D Nedia D +et"orF34ederation D rofessional and3or Industrial 2r$anisation D rade Jnion D ultural 2r$anisation D ommercial 2r$anisation
-0
Private
Implementation $enc% Jni&ersit%3ducation Research Institute hinF anF 4oundation ssociation Nedia +et"orF34ederation rofessional and3or Industrial 2r$anisation rade Jnion ultural 2r$anisation ommercial 2r$anisation 2ther +on;tate ctor
=ector6s7 %5
!/4/!/%/ Q Q
Q Mes Q +o Q Mes Q +o Q olitical Q Reli$ious Q Humanistic Q +eutral D Mes# parent entit%: (please specif% its uropeid ID:@@@@@@@@@@) D Mes# controlled entit%(ies) D Mes# famil% or$anisation 3 net"orF entit% -1 D +o# independent
11 111
ducation ducation# le&el unspecified
Please choose only one set of (alues.
-1
'$' confederation 3 federation 3 alliance'
--
Please s"ecify !2% the sector to which your organisation belongs' as de0ned in its statutes !or e;ui(alent document%) "ublic !established and*or funded by a "ublic body% O "ri(ate !established and*or funded by a "ri(ate entity%5 !<% in the a""ro"riate column' the category to which your organisation belongs !one choice only%.
-5
Please tic8 the bo9 for each sector your organisation has been acti(e in the "ast = years. The sectors come from the DA- list set u" by the O,-D.
%&!" -.10///.0'doc
a$e 17 of ,0
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
11110 111-0 11150 111C1111--0 11-50 11-,0 115 115-0 11550 11, 11,-0 11,50 11-1 1-110 1-1C1 1-1C1-1/1 1-1---0 1--50 1--,0 1--70 1--61 1--C1 15 150 15010 150-0 15050 150,0 150C1 1, 1,0 1,010 1,017 1,0-0 1,050 1,0,0 1,070 1,0C1 17
%&!" -.10///.0'doc
171 17110 171-0 17150 171,0 17170 17161 171617165
ducation olic% S dmin' Nana$ement ducation 4acilities nd rainin$ eacher rainin$ ducational Research asic education rimar% ducation asic life sFills for %outh and adults arl% childhood education ;econdar% education ;econdar% education Tocational rainin$ ostsecondar% education Hi$her ducation d&anced ech' S Nana$erial rainin$ Health Health# $eneral Health olic% S dmin' Nana$ement Nedical education3trainin$ Nedical Research Nedical ;er&ices asic health asic Health are asic Health Infrastructure asic +utrition Infectious Disease ontrol Health ducation Health ersonnel De&elopment opulation pro$rammes opulation polices3pro$rammes and reproducti&e health opulation olic% nd dmin' N$mt Reproducti&e Health are 4amil% plannin$ ;td ontrol Includin$ HIT3ids ersonnel de&elopment for population S reproducti&e health ater ;uppl% and ;anitation ater suppl% and sanitation ater Resources olic%3dmin' N$mt ater Resources rotection ater suppl% S sanitation P *ar$e s%stems asic drinFin$ "ater suppl% S basic sanitation Ri&er De&elopment aste Nana$ement3Disposal ducation S trainin$ in "ater suppl% and sanitation Go&ernment and i&il ;ociet% Go&ernment and ci&il societ%# $eneral conomic and de&elopment polic%3plannin$ ublic sector financial mana$ement *e$al and udicial de&elopment Go&ernment administration ;tren$thenin$ ci&il societ% lections Human Ri$hts 4ree 4lo" 2f Information a$e 16 of ,0
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
1716, 1717-10 17--0 17-50 17-,0 17-70 17-61 16 16010 160-0 16050 160,0 16070 16061 160616065 1606, -1 -10 -1010 -10-0 -1050 -10,0 -1070 -1061 -10C1 ---0 --010 --0-0 --050 --0,0 -5 -50 -5010 -50-0 -5050 -50,0 -5070 -5061 -506-5065 -506, -5067 -5066 -506. -506C -506/ -50.0 -50C1 -50C-,
%&!" -.10///.0'doc
omen9s e>ualit% or$anisations and institutions onflict pre&ention an resolution# peace and securit% ;ecurit% s%stem mana$ement and reform i&ilian peacebuildin$# conflict pre&ention and resolution ostconflict peacebuildin$ (J+) Reinte$ration and ;* control *and mine clearance hild soldiers (pre&ention and demobilisation) 2ther ;ocial Infrastructure and ;er&ice ;ocial3"elfare ser&ices mplo%ment polic% and admin' m$mt' Housin$ polic% and admin' mana$ement *o"cost housin$ Nultisector aid for basic social ser&ices ulture and recreation ;tatistical capacit% buildin$ +arcotics control ;ocial miti$ation of HIT3ID; ransport and ;tora$e ransport and stora$e ransport olic% S dmin' Nana$ement Road ransport Rail ransport ater ransport ir ransport ;tora$e ducation S rainin$ In ransport S ;tora$e ommunications ommunications ommunications olic% S dmin' N$mt elecommunications Radio3ele&ision3rint Nedia Information and communication technolo$% (I) ner$% ner$% $eneration and suppl% ner$% olic% nd dmin' Nana$ement o"er Generation3+onRene"able ;ources o"er Generation3Rene"able ;ources lectrical ransmission3Distribution Gas distribution 2il4ired o"er lants Gas4ired o"er lants oal4ired o"er lants +uclear o"er lants H%droelectric o"er lants Geothermal ener$% ;olar ener$% ind po"er 2cean po"er iomass ner$% education3trainin$ ner$% research anFin$ and 4inancial ;er&ices a$e 1. of ,0
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
-,0 -,010 -,0-0 -,050 -,0,0 -,0C1 -7 -70 -7010 -70-0 51 511 51110 511-0 51150 511,0 51170 51161 511651165 5116, 51167 51166 511C1 511C511/1 511/511/5 511/, 511/7 5151-10 51--0 51-61 51-C1 51-C51-/1 515 51510 515-0 515C1 515C515/1 5-
%&!" -.10///.0'doc
5-1 5-110 5-1-0 5-150 5-1,0 5-161 5-165-165 5-16,
anFin$ and financial ser&ices 4inancial olic% S dmin' Nana$ement Nonetar% institutions 4ormal ;ector 4inancial Institutions Informal3;emi4ormal 4inancial intermediaries ducation3trainin$ in banFin$ S fin' ser&ices usiness and 2ther ;er&ices usiness and other ser&ices usiness support ser&ices and institutions ri&atisation $riculture# 4orestr% and 4ishin$ $riculture $ricultural olic% nd dmin' N$mt $ricultural de&elopment $ricultural *and Resources $ricultural ater Resources $ricultural inputs 4ood rop roduction Industrial rops3!port rops *i&estocF $rarian reform $ricultural alternati&e de&elopment $ricultural e!tension $ricultural ducation3rainin$ $ricultural Research $ricultural ser&ices lant and posthar&est protection and pest control $ricultural financial ser&ices $ricultural cooperati&es *i&estocF3Teterinar% ;er&ices 4orestr% 4orestr% olic% S dmin' Nana$ement 4orestr% de&elopment 4uel "ood3charcoal 4orestr% education3trainin$ 4orestr% research 4orestr% ser&ices 4ishin$ 4ishin$ olic% nd dmin' Nana$ement 4isher% de&elopment 4isher% education3trainin$ 4isher% research 4isher% ser&ices Industr%# Ninin$ and onstruction Industr% Industrial olic% nd dmin' N$mt Industrial de&elopment ;mall and mediumsi=ed enterprises (;N) de&elopment otta$e industries and handicraft $roIndustries 4orest industries e!tiles P leather S substitutes hemicals a$e 1C of ,0
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
5-167 5-166 5-16. 5-16C 5-16/ 5-1.0 5-1.1 5-1.5-1C5-5--10 5---0 5--61 5--65--65 5--6, 5--67 5--66 5--6. 5--6C 5-5 5-510 55 551 55110 551-0 55150 551,0 551C1 5555-10 ,1 ,10 ,1010 ,10-0 ,1050 ,10,0 ,1070 ,10C1 ,10C,5 ,50 ,5010 ,5050 ,50,0 ,5070 ,50C1 ,50C71 710 71010 7-
%&!" -.10///.0'doc
7-0
4ertiliser plants ement3lime3plaster ner$% manufacturin$ harmaceutical production asic metal industries +onferrous metal industries n$ineerin$ ransport e>uipment industr% echnolo$ical research and de&elopment Nineral resources and minin$ Nineral3Ninin$ olic% S dmin' N$mt Nineral rospection nd !ploration oal 2il and $as 4errous metals +onferrous metals recious metals3materials Industrial minerals 4ertiliser minerals 2ffshore minerals onstruction onstruction olic% nd dmin' N$mt rade and ourism rade polic% and re$ulation rade olic% nd dmin' Nana$ement rade facilitation Re$ional trade a$reements (Rs) Nultilateral trade ne$otiation rade education S trainin$ ourism ourism olic% nd dmin' Nana$ement General n&ironment rotection General en&ironmental protection n&ironmental olic% nd dmin' N$mt iosphere protection iodi&ersit% ;ite reser&ation 4lood re&ention3ontrol n&ironmental e ducation3trainin$ n&ironmental research 2ther multisector 2ther multisector Nultisector id Jrban De&elopment nd Nana$ement Rural De&elopment +ona$ricultural alternati&e de&elopment Nultisector education3trainin$ Research3scientific i nstitutions General bud$et support General bud$et support General bud$et support De&elopment food aid3food securit% De&elopment food aid3food securit% assistance a$e 1/ of ,0
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
7-010 75 750 75050 750,0 60 600 60010 600-0 60050 600,0 60061 600660065 ..-0 .-010 .-0,0 .-070 .5 .50 .5010 ., .,0 .,010 /1 /10 /1010 //-0 /-010 /-0-0 /-050 /5 /50 /5010 //
%&!" -.10///.0'doc
//C //C10 //C-0
4ood id 3 4ood ;ecurit% ro$rammes 2ther commodit% assistance 2ther commodit% assistance Import support (capital $oods) Import support (commodities) ction relatin$ to debt ction relatin$ to debt ction relatin$ to debt Debt for$i&eness Relief of multilateral debt Reschedulin$ and refinancin$ Debt for de&elopment s"ap 2ther debt s"ap Debt bu%bacF mer$enc% and distress relief mer$enc% and distress relief Naterial relief assistance and ser&ices mer$enc% food aid Relief coordination8 protection and support ser&ices Reconstruction relief and rehabilitation Reconstruction relief and rehabilitation Reconstruction relief and rehabilitation Disaster pre&ention and preparedness Disaster pre&ention and preparedness Disaster pre&ention and preparedness dministrati&e costs of donors dministrati&e costs of donors dministrati&e osts ;upport to +G2 ;upport to +G2 ;upport to national +G2s ;upport to international +G2s ;upport to local and re$ional +G2s Refu$ees Refu$ees (in donor countries) Refu$ees (in donor countries) Jnallocated3unspecified Jnallocated3unspecified ;ectors +ot ;pecified romotion of De&elopment "areness
a$e -0 of ,0
!/4/!/5/
Target group6s7
Q ll Q hild soldiers Q hildren (less than 1C %ears old) Q ommunit% ased 2r$anisation(s) Q onsumers Q Disabled Q Dru$ consumers Q ducational or$anisations (school# uni&ersities) Q lderl% people Q Illness affected people (Nalaria# uberculosis# HIT3ID;) Q Indi$enous peoples Q *ocal authorities Q Ni$rants Q +on Go&ernmental 2r$anisations Q risoners Q rofessional cate$or% Q Refu$ees and displaced Q Research or$anisations3Researchers Q ;N3;NI Q ;tudents Q Jrban slum d"ellers Q Tictims of conflicts3disasters Q omen Q Moun$ people Q 2ther (please specif%): @@@@@@@@@@@''
%&!" -.10///.0'doc
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!// Capacity to manage and implement actions !//!/!/
E)perience (y sector
;ector
Mear(s) of !perience Q *ess than 1 Q 1 to 5 %ears Q , to . %ears
!perience in the past . %ears Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q . %ears
!//!/%/ By geographical area 6country or region7
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
stimated amount (in thousand euros) in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
E)perience (y geographical area
Mear(s) of e!perience
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
%&!" -.10///.0'doc
+umber of roects in the past . %ears Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
+umber of proects in this $eo$raphical area in the past . %ears Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
stimated amount (in thousand euros) in&ested in this $eo$raphical area in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
2ndicative list o# regions − −
− − −
Republic of Noldo&a JFraine: herni&ts%# 2dessa# Tinnitsa urope J urope nonJ astern urope
a$e -- of ,0
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
Cross-re#erence o# e)perience (y sector and (y geographical area:
;ector(s) (as selected in 5'-'-)
!//!/5/ •
Geo$raphical area(s) (countr% or re$ion# as identified pre&iousl%)
0esources inancial data
%lease pro!i$e the following information, if applicable, on the basis of the profit an$ loss account an$ balance sheet of your organisation, amounts in thousan$s euros
Mear
urno&er or e>ui&alent
+et earnin$s or e>ui&alent
otal balance sheet
;hareholders9 e>uit% or e>ui&alent
Nedium and lon$term debt
;hortterm debt (?1 %ear)
+-, +1 +-
-,
/ > "re(ious 0nancial year.
%&!" -.10///.0'doc
a$e -5 of ,0
•
inancing =ource6s7 %lease tic' the source(s) of the re!enues of your organisation an$ specify the a$$itional information reueste$
Mear
+ + + + + + + + +
;ource
Q J Q Nember ;tates9 ublic odies Q hird ountries9 ublic odies Q Jnited +ations Q 2ther International 2r$anisation(s) Q ri&ate ;ector Q Nembership fees Q 2ther (please specif%): @@@@@ otal Mear
+ P 1 + P 1 + P 1 + P 1 + P 1 + P 1 + P 1 + P 1 + P 1 + P + P + P + P + P + P + P + P + P -
;ource
Q J Q Nember ;tates9 ublic odies Q hird ountries9 ublic odies Q Jnited +ations Q 2ther International 2r$anisation(s) Q ri&ate ;ector Q Nembership fees Q 2ther (please specif%): @@@@ otal Q J Q Nember ;tates9 ublic odies Q hird ountries9 ublic odies Q Jnited +ations Q 2ther International 2r$anisation(s) Q ri&ate ;ector Q Nembership fees Q 2ther (please specif%): @@@@ otal
ercenta$e (total for a $i&en %ear must be e>ual to 100 B)
+umber of fee pa%in$ members (onl% for source U Nember9s fees) +3 +3 +3 +3 +3 +3 +3 +3
100 B ercenta$e (total for a $i&en %ear must be e>ual to 100 B)
+umber of feepa%in$ members (onl% for source U Nember9s fees) +3 +3 +3 +3 +3 +3
100 B
100 B
+3 +3 +3 +3 +3 +3 +3 +3 +3 +3
+ot mandator%# but encoura$ed to be filled in in case of a&ailabilit%' cop% of e!ternal audit report ma% be pro&ided instead of a cop% of the applicant9s latest accounts# if the accounts are in practice the same documents as the e!ternal audit report'
Mear
+ame of appro&ed auditor
eriod of &alidit%
+
4rom dd3mm3%%%% to dd3mm3%%%%
+ P 1
4rom dd3mm3%%%% to dd3mm3%%%%
+ P -
4rom dd3mm3%%%% to dd3mm3%%%%
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a$e -, of ,0
•
1um(er o# sta## 6#ull-time e>uivalent7 please tic' one option for each type of staff %pe of staff
aid
Jnpaid
HV ;taff: recruited and based in Head>uarters (located in De&eloped ountr%)
Q ? 10
Q ? 10
Q A 10 and ? 70
Q A 10 and ? 70
Q A 70 and ? 100
Q A 70 and ? 100
Q A 100
Q A 100
Q +3
Q +3
Q ? 10
Q ? 10
Q A 10 and ? 70
Q A 10 and ? 70
Q A 70 and ? 100
Q A 70 and ? 100
Q A 100
Q A 100
Q +3
Q +3
Q ? 10
Q ? 10
Q A 10 and ? 70
Q A 10 and ? 70
Q A 70 and ? 100
Q A 70 and ? 100
Q A 100
Q A 100
Q +3
Q +3
!pat ;taff: recruited in Head>uarters (located in De&eloped ountr%) and based in De&elopin$ ountr%
*ocal staff: recruited and based in De&elopin$ ountr%
!/;/ 3ist o# the management (oard@committee o# your organisation +ame
rofession
4unction
ountr% of +ationalit%
2n the board since
Nr Ns
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!/ THE CO-APPLICANT(S) his section must be completed for each coapplicant "ithin the meanin$ of ;ection -'1'1 of the Guidelines for pplicants' Mou must maFe as man% copies of this table as necessar% to create entries for each additional coapplicant' oapplicant no'1 EuropeAid 28 num(er %' 1ame o# the organisation The co-applicant*s contact details #or the purpose o# this action 3egal Entity ile num(er %4 A((reviation
0egistration num(er 6or e>uivalent7 8ate o# registration
Place o# registration ,##icial address o# registration
Country o# registration
+e(site and E-mail address o# the organisation Telephone num(er: ountr% code cit% code number a) num(er: ountr% code cit% code number 3egal status
Pro#it-Making D 9es D 1o/ 1G,
D 9es D 1o/
D 9es D 1o alue (ased
Q olitical
Q Reli$ious
Q Humanistic
Q +eutral
-7
This number is a(ailable to an organisation which registers its data in PADO. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*wor8*euro"eaid*onlineser(ices*"ador*inde9:en.htm. This information +s NOT obligatory for this call for "ro"osals' but is encouraged.
-6
+f the coa""licant has already signed a contract with the ,uro"ean -ommission.
%&!" -.10///.0'doc
a$e -6 of ,0
2s your organisation linked .ith another entity
D Mes# parent entit%: (please specif% its uropeid ID:@@@@@@@@@@) D Mes# controlled entit%(ies) D Mes# famil% or$anisation 3 net"orF entit% -. D +o# independent
istory o# cooperation .ith the applicant Category 60e#er to =ection 5/%/!7 =ector6s7 60e#er to =ection 5/%/%7
Target group6s7 60e#er to =ection 5/%/57
!/!&/ Capacity to manage and implement actions !/!&/!/!/
;ector
E)perience (y sector Mear(s) of !perience Q *ess than 1 Q 1 to 5 %ears Q , to . %ears
!perience in the past . %ears Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q . %ears
+umber of roects in the past . %ears Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
stimated amount (in thousand euros) in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
-.
%&!" -.10///.0'doc
a$e -. of ,0
E)perience (y geographical area By geographical area 6country or region7
Mear(s) of e!perience
+umber of proects in this $eo$raphical area in the past . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
stimated amount (in thousand euros) in&ested in this $eo$raphical area in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
2ndicative list o# regions − −
− − −
Republic of Noldo&a JFraine: herni&ts%# 2dessa# Tinnitsa urope J urope nonJ astern urope
Cross-re#erence o# e)perience (y sector and (y geographical area:
;ector(s) (as mentioned in table abo&e)
Geo$raphical area(s) (countr% or re$ion# as identified pre&iousl%)
2mportant: This application #orm must (e accompanied (y a signed and dated Mandate #rom each co-applicant in accordance .ith the template provided (elo./
%&!" -.10///.0'doc
a$e -C of ,0
Mandate 6#or co-applicant6s77 he coapplicant(s) authorise the pplicant ?indicate the name of the or$anisationA to submit on their behalf the present application form for applicant and to si$n the standard $rant contract (nne! G of the Guidelines for pplicants# W$rant contractW) "ith Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH (Wontractin$ uthorit%W)# as "ell as# to be represented b% the pplicant in all matters concernin$ this $rant contract' I ha&e read and appro&ed the contents of the proposal submitted to the ontractin$ uthorit%' I undertaFe to compl% "ith the principles of $ood partnership practice'
+ame: 2r$anisation: osition: ;i$nature: Date and place:
%&!" -.10///.0'doc
a$e -/ of ,0
AFFILIATED ENTITIE(IES) PARTICIPATING IN THE ACTION !/!!/
!/!%/ 8escription o# the a##iliated entity6ies7 his section must be completed for each affiliated entit% "ithin the meanin$ of ;ection -'1'- of the Guidelines for pplicants' Mou must maFe as man% copies of this table as necessar% to create entries for each affiliated entit%'
ffiliated entit% no'1 EuropeAid 28 num(er -C ull legal name 8ate o# 0egistration Place o# 0egistration 3egal status
Pro#it-Making D 9es D 1o/ 1G,
alue (ased
Q olitical
Q Reli$ious
Q Humanistic
D 9es D 1o
Q +eutral
2# #ul#illing the criteria and conditions to (e considered as a##iliated entity6ies7 %< peci#y to .hich entity you are a##iliated 6applicant@coapplicant7 detailingthe speci#ic nature o# the a##iliation6i/e/ parent entity #amily organisation @ net.ork entity etc7 and i# any its EuropeAid 28 ,##icial address o# 0egistration50 Country o# 0egistration Contact person Telephone num(er : countr% code cit% code number a) num(er: countr% code cit% code number E-mail address -C
This number is a(ailable to an organisation which registers its data in PADO. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*wor8*euro"eaid*onlineser(ices*"ador*inde9:en.htm. This information is NOT obligatory for this call for "ro"osals' but is encouraged.
-/
As described in "oint <.2.<. of the Guidelines.
50
+f not in one of the countries listed in Section <.2.2 of the Guidelines' "lease 6ustify its location.
%&!" -.10///.0'doc
a$e 50 of ,0
1um(er o# employees istory o# cooperation .ith the applicant@co-applicant Category 6re#er to =ection 5/%/!7 =ector6s7 6re#er to =ection 5/%/%7 Target group6s7 6re#er to =ection 5/%/5 57
!/!5/ Capacity to manage and implement actions !/!"/ E)perience (y sector ;ector
Mear(s) of !perience Q *ess than 1 Q 1 to 5 %ears Q , to . %ears
!perience in the past . %ears Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q . %ears
+umber of roects in the past . %ears Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 Q 1 to 5 %ears Q , to . %ears Q . %ears
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
stimated amount (in thousand euros) in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
E)perience (y geographical area By geographical area 6country or region7
%&!" -.10///.0'doc
Mear(s) of e!perience
+umber of proects in this $eo$raphical area in the past . %ears
stimated amount (in thousand euros) in&ested in this
2ndicative list o# regions − −
Republic of Noldo&a JFraine:
a$e 51 of ,0
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
Q *ess than 1 %ear Q 1 to 5 %ears Q , to . %ears Q . %ears
Q 1 to 7 Q 6 to 10 Q 11 to -0 Q -1 to 70 Q 71 to -00 Q -00 to 700 Q 700
$eo$raphical area in the past . %ears Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n Q *ess than 1 Q 1 to 7 Q 7 to -0 Q -0 to 70 Q 70 to 100 Q 100 to 500 Q 500 to 1'000 Q 1000 Q JnFno"n
− − −
herni&ts%# 2dessa# Tinnitsa urope J urope nonJ astern urope
Cross-re#erence o# e)perience (y sector and (y geographical area:
;ector(s) (as mentioned in table abo&e)
2mportant:
%&!" -.10///.0'doc
Geo$raphical area(s) (countr% or re$ion# as identified pre&iousl%)
This application #orm must (e accompanied (y a signed and dated a##iliated entities statement #rom each a##iliated entity in accordance .ith the model provided/
a$e 5- of ,0
!/!'/ A##iliated entity6ies7s =tatement o ensure that the action runs smoothl%# the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH (ontractin$ uthorit%) re>uires all affiliated entit%(ies) to acFno"led$e the principles of set out belo"' 1'
ll affiliated entit%(ies) must ha&e read the $uidelines for applicants and application form and understood their role in the action before the application is submitted to the ontractin$ uthorit%'
-'
ll affiliated entit%(ies) must ha&e read the standard $rant contract and understood "hat their respecti&e obli$ations under the contract "ill be if the $rant is a"arded' he% authorise the entit% to "hich the% are affiliated to si$n the contract on their behalf "ith the ontractin$ uthorit% and represent them in all dealin$s "ith the ontractin$ uthorit% in the conte!t of the action9s implementation'
5'
he affiliated entit%(ies) must consult re$ularl% "ith the entit% to "hich are affiliated "hom# in turn# should Feep them full% informed of the pro$ress of the action'
,'
ll affiliated entit%(ies) must recei&e copies of the reports P narrati&e and financial P made to the ontractin$ uthorit%'
7'
roposals for substantial chan$es to the action (e'$' acti&ities# affiliated entit%(ies)# etc') should be a$reed b% the affiliated entit%(ies) before bein$ submitted to the ontractin$ uthorit%' here no such a$reement can be reached# the applicant must indicate this "hen submittin$ chan$es for appro&al to the ontractin$ uthorit%'
I ha&e read and appro&ed the contents of the proposal submitted to the ontractin$ uthorit%' I undertaFe to compl% "ith the principles of $ood partnership practice'
+ame: 2r$anisation: osition: ;i$nature: Date and place:
%&!" -.10///.0'doc
a$e 55 of ,0
ASSOCIATES OF THE APPLIC ANT PARTICIPATING IN TH E A CTION !/!4/
his section must be completed for each associated or$anisation "ithin the meanin$ of ;ection -'1'5 of the Guidelines for pplicants' Mou must maFe as man% copies of this table as necessar% to create entries for more associates'
ssociate 1 ull legal name EuropeAid 28 num(er 51 Country o# 0egistration 3egal status5,##icial address Contact person Telephone num(er: countr% code cit% code number a) num(er: countr% code cit% code number E-mail address 1um(er o# employees ,ther relevant resources E)perience o# similar actions in relation to role in the implementation o# the proposed action istory o# cooperation .ith the applicants 0ole and involvement in preparing the proposed action 0ole and involvement in implementing the proposed action
51
5-
This number is a(ailable to an organisation which registers its data in PADO. &or more information and to register' "lease (isit htt")**ec.euro"a.eu*euro"eaid*wor8*onlineser(ices*"ador*inde9:en.htm. ,.g. non#"ro0t' go(ernmental body' or international organisation.
%&!" -.10///.0'doc
a$e 5, of ,0
CHEC!LIST FOR THE FULL APPLICATION
!/!/
FORM FPUB32CAT2,1 0EE0E1CE T2T3E , TE CA33 BU8GET 321EH
A8M212=T0AT2E 8ATA
o be filled in b% the applicant
1ame o# the Applicant EuropeAid 28 num(er Country and date o# registration 3egal Entity ile num(er 55 3egal status5, Co-applicant 5' 1ame o# the co-applicant EuropeAid 28 num(er 1ationality@Country and date o# registration 3egal Entity ile num(er 3egal status A##iliated entity 54 1ame o# the A##iliated-Entity EuropeAid 28 num(er Country and date o# registration 3egal status: =peci#y to .hich entity you are a##iliated 6applicant and@or the co-applicant7/ =peci#y the kind o# a##iliation you have .ith that entity/
55
+f the a""licant has already signed a contract with the ,uro"ean -ommission.
5,
,.g. non#"ro0t' go(ernmental body' or international organisation.
57 56
Add as many rows as co#a""licant!s% Add as many rows as aliated entities
%&!" -.10///.0'doc
a$e 57 of ,0
BE,0E =E1821G 9,U0 P0,P,=A3 P3EA=E CECI TAT EAC , TE ,33,+21G C02TE02A AE BEE1 MET 21 U33 A18 T2CI TEM , Title o# the Proposal: F in$icate the title>
Tick the items o## (elo. 9es
1o
PA0T ! 6A8M212=T0AT2E7 !/ The correct grant application #orm has (een used/ %/ The 8eclaration (y the Applicant has (een #illed in and signed/ 5/
The proposal is typed and is in English/
"/
,ne original and % copies are included
'/
An electronic version o# the proposal 6C8-0om7 is enclosed
4/
Each co-applicant has completed and signed the mandate and the mandate is included/ Each a##iliated entity6ies7 has completed and signed a a##iliated entity6ies7 s statement and the statements are included/ Please .rite J1ot applica(le* 61A7 i# you have no a##iliated entity6ies7/
/
;/
The (udget is enclosed presented in the #ormat re>uested and stated in EU0/
The logical #rame.ork has (een completed and is enclosed/
PA0T % 6E32G2B232T97 !&/ The duration o# the action is (et.een FK monthsH and FK monthsH 6the minimum and ma)imum allo.ed7/ !!/ The re>uested contri(ution is (et.een FK EU0,@other currencyH and FK EU0,@other currencyH 6the minimum and ma)imum allo.ed7/ !%/ The re>uested contri(ution is (et.een FK LH and FK LH o# the estimated total eligi(le costs 6minimum and ma)imum percentage allo.ed7/
%&!" -.10///.0'doc
a$e 56 of ,0
!/!;/
DECLARATION " THE APPLICANT
he applicant# represented b% the undersi$ned# bein$ the authorised si$nator% of the applicant# in the conte!t of the present call for proposals# representin$ an% coapplicant(s)# affiliated entit%(ies) in the proposed action# hereb% declares that −
the applicant "ill ha&e the sources of financin$ specified in ;ection - of the Guidelines for pplicants8
−
the applicant "ill ha&e sufficient financial capacit% to carr% out the proposed action or "orF pro$ramme8
−
the applicant certifies the le$al statues of the applicant# of the coapplicant(s) and of the affiliated entit%(ies) as reported in part 5# ,# and 7 of this application8
−
the applicant# the coapplicant(s) and the affiliated entit%(ies) ha&e the professional competences and >ualifications specified in ;ection - of the Guidelines for pplicants8
−
the applicant undertaFes to compl% "ith the obli$ations foreseen in the affiliated entit%(ies)
−
the applicant is directl% responsible for the preparation# mana$ement and implementation of the action "ith the coapplicant(s) and affiliated entit%(ies)# if an%# and is not actin$ as an intermediar%8
−
the applicant and the coapplicant(s) and the affiliated entit%(ies) are not in an% of the situations e!cludin$ them from participatin$ in contracts "hich are listed in ;ection -'5'5 of the ractical Guide to contract procedures for J e!ternal actions (a&ailable from the follo"in$ Internet address: http:33ec'europa'eu3europeaid3"orF3procedures3implementation3inde!Xen'htm' 4urthermore# it is reco$nised and accepted that if "e participate in spite of bein$ in an% of these situations# "e ma% be e!cluded from other procedures in accordance "ith ;ection -'5', of the ractical Guide8
−
the applicant and each coapplicant and affiliated entit% (if an%) is in a position to deli&er immediatel%# upon re>uest# the supportin$ documents stipulated under ;ection -', of the Guidelines for pplicants'
−
the applicant and each coapplicant and affiliated entit% (if an%) are eli$ible in accordance "ith the criteria set out under ;ections -'1'1 and -'1'- of the Guidelines for pplicants8
−
if recommended to be a"arded a $rant# the applicant accepts the contractual conditions as laid do"n in the ;tandard ontract anne!ed to the Guidelines for pplicants (anne! G)8
−
the applicant# the coapplicant(s) and the affiliated entit%(ies) are a"are that# for the purposes of safe$uardin$ the financial interests of the J# their personal data ma% be transferred to internal audit ser&ices# to the uropean ourt of uditors# to the 4inancial Irre$ularities anel or to the uropean nti4raud 2ffice'
hese are the sources and amounts of Jnion fundin$ recei&ed or applied for the action or part of the action or for its functionin$ durin$ the same financial %ear as "ell as an% other fundin$ recei&ed or applied for the same action ?list source and amount and indicate status (i'e' applied for or a"arded)A he applicant is full% a"are of the obli$ation to inform "ithout dela% the ontractin$ uthorit% to "hich this application is submitted if the same application for fundin$ made to other uropean ommission departments or uropean Jnion institutions has been appro&ed b% them after the submission of this $rant application' The applicant ackno.ledges that according to Article !5! 6'7 o# the inancial 0egulation o# %' ,cto(er %&!% on the #inancial rules applica(le to the general (udget o# the Union 6,##icial $ournal 3 %<; o# %4/!&/%&!% p/ !7 and Article !"' o# its 0ules o# Application 6,##icial $ournal 3 54% 5!/!%/%&!% p/!7 applicants #ound guilty o# misrepresentation may (e su(?ect to administrative and #inancial penalties under certain conditions/
;i$ned on behalf of the applicant %&!" -.10///.0'doc
a$e 5. of ,0
1ame =ignature Position 8ate
%&!" -.10///.0'doc
a$e 5C of ,0
ASSESSMENT GRID FOR THE FULL APPLICATION FORM !/!
( *E U#E+ * -E C&RAC.& AU-R. ) 9E= ,PE121G A8M212=T0AT2E CECI A18 C,1CEPT 1,TE EA3UAT2,1
1' he submission deadline has been met' -' he checFlist for the application form has been dul% completed' dministrati&e compliance has been checFed b%: Date: 8EC2=2,1: A/ he ommittee has decided to e&aluate the oncept +ote# "hich passed the administrati&e checFs' B/ he ommittee has decided to recommend e&aluation of the full application form' he oncept +ote has been e&aluated b%: Date: EA3UAT2,1 , TE U33 APP32CAT2,1 ,0M 8EC2=2,1 :
A/ he proposal has been pro&isionall% selected as one of the top ranFed proposals "ithin the a&ailable financial en&elope and t he ommittee has recommended eli$ibilit% checFin$' B/ he proposal has been put on the reser&e list as one of the top ranFed proposals and the ommittee has recommended eli$ibilit% checFin$
he proposal has been e&aluated b%: Date: E32G2B232T9 E022CAT2,1
5' he checFlist for the application form has been dul% completed' ,' he applicant satisfies the eli$ibilit% criteria in section -'1'1 7' he coapplicant(s)# if an%# satisf% the eli$ibilit% criteria in section -'1'1' 6' he affiliated entit%(ies)# if an%# satisf% the eli$ibilit% criteria in section -'1'-' .' he supportin$ documents listed belo" "ere submitted in accordance "ith the Guidelines (;ection -',) a' he applicants statutes b' he statutes or articles of association of the coapplicants and the affiliated entit%(ies) c' he applicant9s e!ternal audit report (if applicable) d' he *e$al ntit% 4ile (see nne! D to the Guidelines for pplicants) has been dul% completed and si$ned b% the applicants and the supportin$ documents re>uested ha&e been enclosed' e' op% of the applicant9s and coapplicants latest accounts' (an be substituted b% e!ternal audit report for the last financial %ear) f' he recent cop% of compan% re$istration certificate or an% e>ui&alent document h' document from the lead applicant9s mana$in$ bod% confirmin$ the name of the %&!" -.10///.0'doc
a$e 5/ of ,0
1,