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Ministry of European Integration

Cross Border Cooperation Directorate

( Romania)

and

Ministry of Regional Development and Public Works

(Bulgaria)

 

Ministry of Development and Prognosis Romania

 

Grant Application Form

Applicable to

Joint Small Projects Fund

RO0103.05 - BG0107.04

And

RO2002/000-625-04 – BG2002/000-623-04

 

 

Name of the applicant:

  

Dossier No

(for internal use only)
  1. THE PROJECT

1. Description

1.1 Title

 

1.2 Location

Country or countries, region, city

 

1.3 Phare Amount requested from the Ministry of European Integration (Romania) and matching contribution

 

Amount requested from Phare

  

EUR

  

% of total project cost

Amount provided by the applicant(s) as matching contribution)

EUR

% of total project cost

Total project cost:

  

EUR

No resources, which have been assisted by Phare or other EU support, may be taken into account as own contribution.

 

1.4 Summary

Maximum 10 lines (include information on (a) the aim of the project, (b) the target groups and (c) the main activities).

 

1.5 Objectives

Maximum 1 page. Describe the objectives of the project.

Please indicate which immediate objective your proposal aims from the list:

 

1.6 Justification (in terms of cross-border co-operation)

Maximum 3 pages. Provide the following information:

 

  1. identification of perceived needs and constraints in the target regions
  2. list of target groups with an estimate of the anticipated number of direct and indirect beneficiaries
  3. reasons for the selection of the target groups and activities
  4. relevance of the project to the target groups
  5. relevance of the project to the objectives of the programme
  6. relevance of the project to the priorities of the programme

 

1.7 Detailed description of activities

Maximum 5 pages. Include the title and a detailed description of each activity. In this respect, the detailed description of activities must not be confused with the plan of action (see 1.9).

 

1.8 Methodology (CBC impact and criteria to be included when relevant)

Maximum 4 pages. Detailed description of:

  1. methods of implementation

  2. reasons for the proposed methodology

  3. how the project intends to build on a previous project or previous activities (where applicable)

  4. procedures for internal evaluation

  5. level of involvement and activity of other organisations (partners or others) in the project

  6. reasons for the role of each partner (Indicate if one of the partners on the other side of the border is applying for the similar Joint Small Projects Fund in order to get financing for the purpose of the complementary project).

  7. team proposed for implementation of the project (by function: there is no need to include the names of individuals here)

  8. promotion of the project and its results

 

1.9 Duration and plan of action

Note: The indicative plan of action should not mention actual dates, but should start with "month 1", month 2", etc. Applicants are advised to foresee a security margin in the proposed plan of action. The plan of action should not contain detailed descriptions of activities, but only their titles (please ensure that these match the titles listed in section 1.7).

The plan of action for the first year of implementation must be sufficiently detailed to provide insight into the preparation and implementation of each activity. The plan of action must be provided in accordance with the following model:

Year

Activity

Location (city)

Implementing body
 

(example)

  

(example)
       

Month 1

Preparation of Activity 1

  

Leader
 

Preparation of Activity 2

  

Partner 1

Month 2

Implementation of Activity 1

    
 

Preparation of Activity 3

    
       

 

2. Expected results

2.1 Estimated impact on target groups

Maximum 2 pages. Include information on:

  1. how the project will improve the situation of the target groups

  2. how the project will improve the managerial and technical capacities of the target groups or the partners (where applicable)

  3. how the project will improve the cross-border co-operation

 

2.2 Publications and other outputs

Maximum 1 page. Be specific and quantify outputs as much as possible.

 

2.3 Multiplier effects

Maximum 1 page. Describe the possibilities for replication and extension of project outcomes.

 

2.4 Sustainability

Maximum 3 pages. Distinguish between the following aspects of sustainability:

  1. financial sustainability (How will the activities be financed after the EC funding ends?)

  2. institutional sustainability (Will structures allowing the activities to continue be in place at the end of the present project? Will there be local "ownership" of project outcomes?)

  3. sustainability at the policy level (where applicable) (What will be the structural impact of the project – e.g. will it lead to improved legislation, codes of conduct, methods, etc?)

  4. describe eventual risks in the implementation

 

3. Budget for the project

Provide a budget for the total duration of the project. See Guidelines for Applicants, section 2.5 (payments) for further information.

Note: The budget must be provided in accordance with Annex B (Excel file). The budget format is contained in Worksheet 1 (3. Budget).

Every item in the budget should be shortly described on an additional sheet (max. 5 lines per item).

 

4. Expected sources of funding

Provide information on the expected sources of funding for the project.

Note: this information must be provided in accordance with Annex B (Excel file). The format is contained in Worksheet 2 (4. Sources of Funding).

To switch between Excel Worksheets, click the tab at the bottom of the screen.

  1. THE APPLICANT

1. Identity

Full legal name

(business name):

  

Acronym (where applicable):

  

Legal status:

  

VAT registration number

(where applicable):

  

Official address:

  

Postal address:

  

Contracting Person:

  

Project Manager / Contact Person:

  

Telephone n°:

  

Fax n°:

  

E-mail address:

  

Website:

  

 

2. Bank details

The bank must be in the country in which the applicant is registered.

Account name:

  

Bank account no:

  

Bank code:

  

SWIFT code:

  

Bank name:

  

Bank address:

  

Name(s) of signatory (ies):

  

Position(s) of signatory(ies):

  

 

Corresponding bank (where applicable)

Account name:

  

Bank account no:

  

Bank code:

  

SWIFT code:

  

Bank name:

  

Bank address:

  

Routing information:

  

 

 

3. Description of the applicant (maximum 3 pages)

3.1 When was your organisation founded and when did it start its activities?

 

3.2. What are the main activities of your organisation at present?

 

3.3. List of the management board / committee of your organisation.

Name

Profession

Function

Years on the board
       
       

 

3.4. List of the project team members (national and foreign):

Position in the project

Name

Present position

Years of experience

Specialised areas of knowledge

Signature

Project Manager

          
           
           

 

4. Capacity to manage and implement projects

4.1. Experience with similar projects

Maximum 1 page per project. Detailed description of projects managed by your organisation over the past five years in the fields covered by this programme, identifying for each project:

  1. the object and location of each project
  2. the results of the project
  3. your organisation’s role (leader, partner) and level of involvement in the project
  4. the project cost
  5. the donors of the project (name, address and e-mail, telephone number, amount contributed)

 

4.2 Resources

Maximum 3 pages. Detailed description of the various resources at the disposal of your organisation including:

  1. the annual income over the past three years, mentioning where applicable for each year the names of the main financial contributors and the proportions of annual income contributed by them

  2. the number of full-time and part-time staff by category (e.g. number of project managers, accountants, etc).

  3. equipment and offices

  4. other relevant resources

 

5. Other applications submitted to European Institutions or EU Member States

 

5.1 Grants, contracts or loans obtained during the last three years from European Institutions or EU Member States

Title of operation

EC budget line or other source

Amount (EUR)

Date of award
       
       
       
       
       

 

5.2 Grant applications submitted (or due to be submitted) to European Institutions or EU Member States in the current year:

Title of project

EC budget line or other source

Amount (EUR)
     
     
     
     
     

  1. partners of the applicant participating in the project

1. Description of the partners:

This section must be completed for each partner organisation. You may duplicate this table as necessary to create entries for more partners.

 

Partner 1 (from the other side of the border)

Partner 2

Full legal name

(business name)

    

Nationality

    

Legal status

    

Official address

    

Contact person

    

Telephone n°

    

Fax n°

    

E-mail address

    

Number of staff (permanent and non-permanent)

    

History of co-operation with the applicant

    

Role and involvement in preparing the proposed project

    

Role and involvement in implementing the proposed project

    

Title of complementary project on the other side of the border (if applicable)

    

 

Important: This application form must be accompanied by a signed and dated partnership statement from the main applicant and every partner in accordance with the model provided on the next page.

Please indicate in the table if your partner on the other side of the border is also applying for the JSPF for financing a complementary project (a project, in which complementary actions are foreseen with your organisation being the 1. Partner from this side of the border). The same activities can not receive funding from both complementary projects (neither from EC funding, nor from own contribution).

 

2. Partnership statement

Partnership

A partnership is a relationship of substance between two or more organisations involving shared responsibilities in undertaking the project funded by the Contracting Authority. In order to assist the smooth operation of the project, the Contracting Authority requires all partners (including the main applicant which signs the contract) to acknowledge this by agreeing to the principles of good partnership practice set out below.

 

Principles of Good Partnership Practice

  1. All partners should have read the application form and understood what their role in the project will be.

  2. The applicant should consult regularly with its partners and should keep them fully informed of the progress of the project.

  3. All partners should receive copies of the reports - narrative and financial - made to the Contracting Authority.

  4. Substantial changes proposed to the project (eg activities, partners etc) should be agreed by the partners before submitting the proposals to the Contracting Authority. Where no such agreement can be reached, the applicant must indicate this when changes are submitted for approval to the Contracting Authority.

 

Statement of partnership

We have read and approved the contents of the project submitted to the Contracting Authority. We undertake to comply with the principles of good partnership practice.

 

Name:

  

Organisation:

  

Position:

  

Activities contributing to the success of the project implementation

(referring to point I/1.7 "Detailed description of activities")

  

Signature:

  

Date and Place:

  

  1. Declaration by the applicant

 

I, the undersigned, being the person responsible in the applicant organisation for the project, certify that:

  1. the information given in this application is correct; and

  2. the applicant organisation and the partner organisation(s) (where applicable) are eligible in accordance with section 2.1.1. of the Guidelines for Applicants

  3. the own contribution will be provided by the applicant organisation, as follows:

in cash …… EUR

total own contribution …… EUR

 

Name:

  

Position:

  

Signature:

  

Date and Place:

  

 

  1. SUMMARY/PROJECT description in english

1. Title and area of activity to be covered

2. Location

Country (or countries), region, city

3. Amount requested from the Ministry of European Integration (Romania)

Amount requested from Phare

  

EUR

  

% of total project cost

Amount provided by the applicant(s) as matching contribution)

EUR

% of total project cost

Total project cost:

  

EUR

 

4. Summary

Please use the space below and on the next page and include information on (a) the aim of the project, (b) the target groups, (c) the main activities and (d) the justification for the project). Please describe the above in the framework of your cross-border co-operation. Please indicate whether your partner organisation of the other side of the border intends to apply for an equivalent JSPF in order to complementary finance your common project.

The project budget should be submitted both in the English language (here below) and in the Romanian language for Romania and in Bulgarian language for Bulgaria as Annex B to this Application Form!

 

Checklist

Before sending your proposal, please check that your application is complete as regards:

The application form

the proposal is complete and filled out in accordance with the application form

one original and five (5) copies of all documents

the proposal is typed and is in Romanian language with the summary in English

the Partnership statement is signed by the applicant and all partners. All Applicants and all partners are eligible according Guidelines.

the budget and the expected sources of funding are presented in the format of the application form (Annex B) and is presented also in English in the English summary section

in the budget the Contracting Authority’s contribution is identified and is maximum 90% of total eligible project costs.

in the budget the administration costs are 7% or less of total direct eligible costs

in the budget the contingencies are no more than 5% of total eligible project costs

the declaration by the applicant (Section IV) is signed

Annexes

Annex B

Budget

Note: This document is in Microsoft Excel format and is contained in a separate file.

 

Annex C

Logical Framework

Note: This document is in Microsoft Excel format and is contained in a separate file

 

Annex D

Daily allowance rates (per diems) as of July 31,2001

Notes: Per diems include all costs: hotels, food and transport within the city.

The latest per diem can be found on http://europa.eu.int/comm/scr/perdiem.

 

Annex E

Standard contract