Programmefundedbythe

EUROPEAN UNION

CONTRACTING AUTHORITY
Romanian Ministry of Regional Development and Tourism

Joint Operational Programme

Romania-Ukraine-Republic of Moldova
2007-2013

GRANT APPLICATION FORM

Reference: 2nd call for proposals,
Restricted call for proposals
Deadline for submission of Concept Notes 30th of January 2012 (first step)

For economical and ecological reasons, we strongly recommend that you submit your files on paper-based
materials (no plastic folder or divider).
We also suggest you use double-sided print-outs as much as possible .

Title of the action:

Number and title of the Priority 3 “People-to People cooperation”

priority

[Please choose and delete those which are not applicable:]

Number and title of the 3.1 Local and regional governance, support to civil society and local
measure communities
3.2 Educational, social and cultural exchanges

[specify country(ies), county(ies)/oblast, district(s), town(s)/locality(ies)

Location(s) of the action: that will benefit from the Action]

Name of the applicant [in English and in the national language]

Nationality of the
applicant1

Dossier No

(for official use only)

1
The statutes must make it possible to ascertain that the organisation was set up by an act governed by the national law of
the country concerned. In this respect, any legal entity whose statutes have been established in another country cannot be
considered an eligible local organisation. The international organisations does not have to fulfil the nationality requirements
(see also sections 2.1.2.1. and 2.1.2.2 of the Guidelines for applicants)

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Ongoing contract / Legal

Entity file number
(if available)2
Legal status3
Partner(s)4 [Name – in English and in the national language, Legal status, Nationality]

CONTACT DETAILS OF THE APPLICANT FOR THE PURPOSE OF THIS ACTION:

Postal address:

Telephone number:
(fix and mobile)
[Country code + city code +
number]
Fax number:
[Country code + city code +
number]
Contact person for this
action:
Contact person’s email
address:
Website of the organization

Any changes in the addresses, phone numbers, fax numbers and in particular e-mail, must be
notified in writing to the Joint Technical Secretariat.

The Contracting Authority or the Joint Technical Secretariat will not be held responsible in case
it cannot contact the applicant.

2
If an applicant has already signed a contract with the European Commission and/or has been informed of the Legal Entity
file number; if neither of this apply, indicate N/A
3
Check carefully Section 2.1.1 Eligibility of applicants: who may apply? of the Guidelines for grant applicants. E.g. non
profit making, governmental body, public institution, public administration, public bodies, international organisation
4
Add as many rows as partners
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TABLE OF CONTENTS

PART A. CONCEPT NOTE......................................................................................4

1. INSTRUCTIONS FOR DRAFTING OF THE CONCEPT NOTE 4

1.1 SUMMARY OF THE ACTION (MAX. 1 PAGE)................................................................4
1.2 RELEVANCE AND THE CROSS BORDER IMPACT OF THE ACTION (MAX. 3 PAGES).....................4
DESCRIPTION OF THE ACTION (MAX. 1 PAGE)..................................................................5

2. CHECKLIST FOR CONCEPT NOTE 6

3. DECLARATION BY THE APPLICANT FOR CONCEPT NOTE 8

4. ASSESSMENT GRID FOR THE CONCEPT NOTE 10

PART B. FULL APPLICATION FORM.......................................................................10

1. GENERAL INFORMATION 11

2. THE ACTION 11
2.1 BUDGET OF THE ACTION, AMOUNT REQUESTED FROM THE CONTRACTING AUTHORITY AND
OTHER EXPECTED SOURCES OF FUNDING....................................................................11
2.2 DESCRIPTION OF THE ACTION..........................................................................12
2.3 OTHER FUNDS ADDRESSED WITH THIS PROJECT..................................................19

3. THE APPLICANT 20
3.1 IDENTITY................................................................................................... 20
3.2 PROFILE.................................................................................................... 21
3.3 CAPACITY TO MANAGE AND IMPLEMENT ACTIONS...................................................21
3.4 LIST OF THE MANAGEMENT BOARD / COMMITTEE OF YOUR ORGANIZATION.....................24
3.5 JUSTIFICATION OF THE ELIGIBILITY....................................................................24

4. PARTNERS OF THE APPLICANT PARTICIPATING IN THE ACTION 25

4.1 IDENTITY................................................................................................... 25
4.2 CAPACITY TO MANAGE AND IMPLEMENT ACTIONS (1 PAGE PER ACTION, FOR ALL THE PROJECT
PARTNERS)......................................................................................................... 26
4.3 JUSTIFICATION OF THE ELIGIBILITY....................................................................27
4.4 PARTNERSHIP STATEMENT..............................................................................27

5. ASSOCIATES OF THE APPLICANT PARTICIPATING IN THE ACTION 30

6. CHECKLIST FOR THE FULL APPLICATION FORM 31

7. DECLARATION BY THE APPLICANT 33

8. ASSESSMENT GRID OF THE FULL APPLICATION FORM 35

9. INDICATORS 36

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2008 Page 4 of 37
511342329.doc
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PART A. CONCEPT NOTE

1. INSTRUCTIONS FOR DRAFTING OF THE CONCEPT NOTE

There is no specific template for the Concept Note but the applicant has to ensure that the text of
its concept note:
 Does not exceed 10 full pages (A4 size) of Arial 10 characters with 2 cm margins;

 Responds, in the same sequence, to the headings listed below. It is expected that the size
of each section will reflect the relative importance of each heading (ref max scores in the
Evaluation Grid and in the Guidelines). The evaluation will be carried out in accordance
with the evaluation grid and it will be based solely on the information provided by the
applicant in the concept note.

 Is drafted as clearly as possible to facilitate its assessment.

Please note that, when assessing the Concept Note, the Evaluation Committee will only consider the
first 10 pages. Moreover, all the information requested by the published instructions for drafting of the
Concept Note must be provided.
Consequently, the non-observance of the maximum number of pages requirement may conduct to the
rejection of the application.

1.1 SUMMARY OF THE ACTION (max. 1 page)

Please complete the table below, which should not exceed 1 page.

Title of the action

Aim of the priority To promote greater interaction between people and communities living
addressed by the action in the border areas
Location(s) of the action [country(ies), county(ies)/oblast(s), district(s)/locality(ies) that will benefit
from the action]
Total duration of the [… ] months
action
Amount of requested EU […] EUR
contribution
Objectives of the action Overall objective(s):

Specific objective(s):

Target group(s)5
Final beneficiaries6
Estimated results7

5
“Target groups” are the groups/entities who will be directly positively affected by the project at the Project Purpose
level.
6
“Final beneficiaries” are those who will benefit from the project in the long term at the level of the society or sector at
large.
7
Results are the tangible products/ services delivered as a consequence of implementing a project.

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Mactivities

1.2 RELEVANCE AND THE CROSS BORDER IMPACT OF THE ACTION (max. 5 pages)

1.2.1 Relevance to the objectives/sectors/themes/priority of the call for proposals

Please provide all the following information:

a) Describe the relevance of the action to the objective(s) and priority (ies) of the Call for
proposals.
b) Describe the relevance of the action to the specific themes/sectors/areas and any other
specific requirements indicated in the guidelines of the call, such as cross border
partnership, local ownership, cross border impact etc.
c) Describe which particular expected results mentioned in the guidelines of the call (Annex L
Priority indicators) will be addressed.
d) Indicate how the project pursues to create basis for effective cross border cooperation by
putting into practice at least two of the following cross border cooperation criteria: joint
project development, joint project implementation, joint staffing, and joint financing.
e) Please explain what are the benefits foreseen at the level of the cross border area, what
changes they will support and how they will contribute to the project’s specific
objective(s).
In exceptional cases when an organisation located outside the Programme area is involved
as a partner in the project , please justify the necessity of including it in the project
1.2.2 Relevance to the particular needs and constraints of the target
country/countries, region(s) and/or relevant sectors (including synergy with other EU
initiatives and avoidance of duplication)

Please provide all the following information:

a) Identify clearly the specific pre-project situation in the target country/countries, region(s)
and/or sectors (include quantified data analysis where possible and make reference to
official data).
b) Provide a detailed analysis of the problems to be addressed by the action and how they are
interrelated at all levels.
c) Where the action is a continuation of a previous action clearly indicate how the proposed
action is intended to build on the activities/results of this previous action; refer to main
conclusions and recommendations of evaluations that might have been carried out.
d) Where the action is part of a larger programme, clearly explain how it fits or is coordinated
with this programme or any other planned project. Specify the potential synergies with
other initiatives, in particular from the European Commission. I
e) In addressing the points above, refer to any significant strategies and action plans
undertaken at national, regional and/or local level relevant for the action and describe how
the action will relate to such plans. Provide reliable sources of information and if available,
provide web links where the documents may be consulted.
Where the project innovates and is not framed in a national/regional strategy or action plan,
indicate the added value of the project from the perspective of programme objectives and
complementarity with the national and regional strategies.
1.2.3 Describe and define the target groups and final beneficiaries, their needs and
constraints and how the action will address these needs

Please provide all the following information, indicating reliable sources:

a) Include a description of each target groups and final beneficiaries (quantify where possible),
including criteria for their selection.
b) Identify needs and constraints of each target groups and final beneficiaries.
c) Demonstrate the relevance of the proposal to the needs and constraints of the target groups
and final beneficiaries.

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d) Explain any participatory process ensuring participation of the target groups and final
beneficiaries.

1.2.4 Particular added-value elements

Indicate how the proposal contribute to promotion or consolidation of public/private partnerships,

innovation and best practices, or other cross-cutting issues such as environmental issues, promotion
of gender equality and equal opportunities, needs of disabled people, rights of minorities and rights
of indigenous people.

1.3 DESCRIPTION OF THE ACTION (max. 4 page)

Please provide all the following information:

a) Background to the preparation of the action.
b) Describe the objectives of the action. (Elaborate here on the objectives mentioned in the
table in section 1.1 above.)
c) Describe the key stakeholders groups, their attitudes towards the action and any
consultation undertaken with them.
d) Provide brief information on the type of activities foreseen and specify related outputs and
results, including a description of linkages/relationships between activity clusters.
e) Indicate a broad timeframe for the action and describe any specific factor that has been
taken into account.
f) In exceptional cases, when projects can take place partially in regions other than those
defined by the programme area, please explain why is this necessary for achieving projects’
objectives

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2. CHECKLIST FOR CONCEPT NOTE

Joint Operational Programme Romania-Ukraine-Republic of Moldova 2007-2013
Priority 3 –“People to people cooperation”
2nd Call for proposals

ADMINISTRATIVE DATA [To be filled in by the applicant]

Name of the applicant [in English and in the national language]

Country and date of registration

Legal Entity File number 8

Legal status 9

Partner 1 Name [in English and in the national language]:

Country of registration:
Legal status:
Partner 2 Name [in English and in the national language]:
Country of registration:
Legal status:
[Add as many rows as partners]

To be filled in
Before sending your Concept Note, please check that each of the following
by the
points is complete and respects the following criteria
applicant
Title of the Proposal: YES NO
PART 1 (ADMINISTRATIVE)
1. The instructions for concept note, published for this call for proposals,
have been followed: max. 10 full pages, (A4 size) of Arial 10 characters
with 2 cm margins?
2. The Declaration by the applicant has been filled in, signed, stamped, dated
and is enclosed?
3. The partnership statement(s) signed stamped and dated by each partner
is /are enclosed?
4. The proposal is typed and is in English?
5. One original and 4 copies are included?
6. An electronic version of the concept note (CD-ROM) is enclosed?
7. An electronic copy of the national/strategies, action plans, relevant for the
project is enclosed, or a web link was provided?
PART 2 (ELIGIBILITY)
8. The applicant and partner(s) organisations are located in the programme area,
or participation of a partner located outside the programme area is motivated in the
concept note?
8
If the applicant has already signed a contract with the European Commission
9
E.g. non profit making, governmental body, international organization, public body, etc.

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9. The entire action will be implemented in the eligible area of the

programme, or
When part of the action will take place in regions other than those defined
by the programme area, a duly justifications was provided by the applicant
in the concept note ?
10. The duration of the action is between 6 months (the minimum allowed by
this Call) and 18 months (the maximum allowed by this Call)?
11. The requested EU contribution is between 30,000 EUR (the minimum
allowed by this Call) and 150,000 EUR (the maximum) allowed by this
Call)?
12. The present Checklist and the Declaration by the applicant are filled in and
sent with the Concept Note?

3. DECLARATION BY THE APPLICANT FOR CONCEPT NOTE

The applicant, represented by the undersigned, being authorised signatory for the applicant, and in
the context of the present application, representing any partners in the proposed action, hereby
declares that

a) The applicant has the sources of financing and professional competence and qualifications
specified in section 2 of the Guidelines for Applicants;

b) The applicant undertakes to comply with the obligations foreseen in the partnership
statement of the grant application form and with the principles of good partnership
practice;

c) The applicant is directly responsible for the preparation, management and implementation
of the action with its partners, and is not acting as an intermediary;

d) The applicant and its partners are not in any of the situations excluding them from
participating in contracts which are listed in Section 2.3.3 of the Practical Guide to contract
procedures for EU external actions (available from the following Internet address)
http://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htm
Furthermore, it is recognized and accepted that if we participate in spite of being in any of
these situations, we may be excluded from other procedures in accordance with section
2.3.5 of the Practical Guide;

e) The applicant and each partner are in a position to deliver immediately, upon request, the
supporting documents stipulated under section 2.4 of the Guidelines for Applicants;

f) The applicant and each partner are eligible in accordance with the criteria set out under
sections 2.1.1 and 2.1.2 of the Guidelines for Applicants;

g) If recommended to be awarded a grant, the applicant accepts the contractual conditions as

laid down in the Standard Contract annexed to the Guidelines for applicants (annex II A);

h) The applicant and its partners are aware that, for the purpose of safeguarding the financial
interests of the European Union, their personal data may be transferred to internal audit
services, to the European Court of Auditors, to the Financial Irregularities Panel or to the
European Anti-Fraud Office.

Signed on behalf of the applicant

Name
Signature and stamp
Position

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Date

4. PARTNERSHIP STATEMENT 10

I hereby certify that the [insert the name of the organization that fills in the partnership
statement – in English and in national language] commits itself to the operation.

I confirm that no expenditure related to the activities foreseen to be implemented in the above
mentioned project by [insert the name of the organization that fills in the partnership statement -
in English and in national language] has been funded by any other EU programme.

I have read and approved the contents of the concept note submitted to the Joint Managing
Authority (the Ministry of Regional Development and Tourism from Romania).
I undertake to comply with the principles of good partnership practice.

Signed on behalf of the Partner [insert the name of the organization that fills in the partnership
statement – in English and in national language]:

11
Name :

Organisation:

Position:

Signature and stamp:

Date and place:

10
To be multiplied and filled in by each project partner. This parnership statement must only be filled in by
project partners.It is not necessary for the Applicant to sign a partnership statement.

11
Legal representative of the organization

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5. ASSESSMENT GRID FOR THE CONCEPT NOTE

(For the use of the Contracting Authority only)

YES NO
1. The submission deadline has been respected?
1. The Checklist has been duly completed?
The administrative verification has been conducted by:
Date:
DECISION 1:
The Committee has decided to evaluate the Concept Note after having
passed the Administrative Check.
The evaluation of the Concept Note has been conducted by:
Date:
DECISION 2:
The Committee has decided to recommend evaluating the full
application form.

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PART B. FULL APPLICATION FORM

Only to be completed by the applicants who receive an invitation to submit a

full application (at the time of the invitation)

For economical and ecological reasons, we strongly recommend that you submit your files on paper-based
materials (no plastic folder or divider).
We also suggest you use double-sided print-outs as much as possible.

1. GENERAL INFORMATION

Reference of the Call for Joint Operational Programme Romania-Ukraine-the Republic of

proposals Moldova 2007-2013

Title of the Call for proposals the 2nd Call for proposals

Name of the applicant [in English and in its national language]

N° of the proposal 12

13
Title of the action

Location of the action [country (ies) / region(s)/ localities that will benefit from the
action]

N° and title of the Priority Priority 3 “People-to-people cooperation”

N° and title of the Measure [Please choose and delete those which are not applicable:]
3.1 Local and regional governance, support to civil society and local
communities
3.2 Educational, social and cultural exchanges

2. THE ACTION 14

2.1 BUDGET OF THE ACTION, AMOUNT REQUESTED FROM THE CONTRACTING

AUTHORITY AND OTHER EXPECTED SOURCES OF FUNDING

12
The proposal number as allocated by the Contracting Authority and notified to the applicant at the time of the Concept Note
opening and administrative check.
13
As notified by the evaluation committee at the end of the 1st step.
14
The evaluation committee will refer to information already provided in the Concept Note as regards objectives and relevance
of the action.

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Fill in Annex B to the Guidelines for applicants to provide information on:

 The budget of the action (worksheet 1), for the total duration of the action and for its first
12 months, at project level and for each project partner, including the applicant AND,
 Justification on the budget (worksheet 2), for the total duration of the action AND,
 Amount requested from the Contracting Authority and other expected sources of funding for
the action for the total duration (worksheet 3).
For further information see the Guidelines for grant applicants (sections 1.4, 2.1.4 and 2.2.5).

Please note that the cost of the action and the contribution requested from the Contracting
Authority have to be expressed in EUR, using two decimals..

Please mention here the contributions in kind to be provided (please specify), if any (maximum 1
page). However, please note that contributions in kind are not considered actual expenditure and are
not eligible costs. Contributions in kind may not be treated as co-financing by the applicant.

The budget includes the budget lines for the whole actions well as the division of funds between the
partners. Please fill in Annex B (worksheets 1, 2 and 3) for the total duration of the action and for its
first 12 months.

2.2 DESCRIPTION OF THE ACTION

2.2.1 Description of the action and its effectiveness (max 14 pages)

Provide a description of the proposed action, including all the information requested below:

 Making reference to the overall objective(s) and specific objective(s), outputs and results
described in the concept note, elaborate on specific expected results indicating how the
action will improve the situation of the target groups and final beneficiaries as well as the
technical and management capacities of target groups and/or any local partners. Indicate in
particular foreseen publications.
 Making reference to the overall objective(s) and specific objective(s), outputs and results
described in the concept note, identify and describe in detail each work package to be
undertaken to produce results, justifying the choice of the activities and specifying the role
of each partner (and associates, or contractors) in the activities. In this respect, the
detailed description of activities must not repeat the action plan (to be provided in section
2.2.3 below) but demonstrate coherence and consistency in the project design.
In order to facilitate the management, Applicants are asked to divide the joint Action into
maximum 5 thematically diversified components, Groups of Activities. A Group of Activities
(GAs) is interlinked thematically in the project. Groups of activities should be broken down
into activities, in order to make them sufficiently simple to be organized and easy to
manage, but please make sure that you do not get into too much detail: the breakdown
should stop as soon as the planner has sufficient detail to estimate the time and resources
required, and the person responsible for actually doing the work has sufficient instructions
on what has to be done. Make sure that you do not omit essential activities and/or tasks,
like project management and communication/publicity activities.
 The description under GAs must be as precise as possible to deliver a clear picture of the
planned activities and their outputs and results, to allow for proper assessment of the
relevance and necessity of the Action, as well as its cost-effectiveness and cross-border
impact. The first GA must always contain information about the overall project
management, coordination and communication (internal and external communication) in the
context of the action, while a separate GA should deal with the visibility actions related to
the action. The remaining GAs (up to 3 thematic GAs) will be defined by the Action.
 First, the Action must define the titles of the GAs, describe their aim and purpose
(justification), and then provide the description of the GAs as defined below in the GA
tables.

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GROUP OF ACTIVITIES 1: Project management, coordination and communication

Aim and purpose of the GA (general To ensure proper project implementation
15
description of the GA)
To ensure that the project will achieve the expected results and objectives, while complying with the contract
provisions and the requirements of the programme.
Activity 1.1 Organisation of project team meetings
Total duration of the activity months 1-18
Aim(s) and short description of the To ensure proper communication and coordination between the members of the project implementation team and
activity between project partners
…….
Responsible partner applicant
Involved partners partner 1 and 2
Evolution per quarter Target group(s) Outputs Results
months 1-4 NA 2 PT meetings a well managed project
months 5-8 NA 1 PT meeting a well managed project
months 9-12 NA 2 PT meetings a well managed project
months 13-16 NA 1 PT meeting a well managed project
months 17-18 NA 2 PT meeting a well managed project
Activity 1.2
Total duration of the activity
Aim(s) and short description of the
activity
Responsible partner
Involved partners
Evolution per quarter Target group(s) Outputs Results

15
Please note that the texts highlighted in gray colour are provided only as examples and remember to delete them in the final version of the Grant Application Form. The information must be consistent
with the contents of the Logical Framework and of the Budget

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months 1-4
months 5-8
months 9-12
months 13 - 16
months 17 - 18

16
GROUP OF ACTIVITIES 2
Activity 2.1
Total duration of the activity
Aim(s) and short description of the
activity
Responsible partner
Involved partners
Evolution per quarter Target group(s) Outputs Results
months 1-4
months 5-8
months 9-12
months 13 - 16
months 17 - 18
Activity 2.2
Total duration of the activity
Aim(s) and short description of the
activity

16
To be multiplied for the necessary number of Group of activities

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Responsible partner
Involved partners
Evolution per quarter Target group(s) Outputs Results
months 1-4
months 5-8
months 9-12
months 13 - 16
months 17 - 18

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2.2.2 Methodology (max 4 pages)

Describe in detail:
a) the methods of implementation and reasons for the proposed methodology (including a
justification for the project duration);

b) where the action is the prolongation of a previous action, explain how the action is intended
to build on the results of this previous action. Give the main conclusions and
recommendations of evaluations that might have been carried out;

c) where the action is part of a larger programme, explain how it fits or is coordinated with
this programme or any other possibly planned project. Please specify the potential synergies
with other initiatives, in particular from the European Union;

d) the procedures for follow up and internal/external evaluation;

e) the role and participation in the action of the various actors and stakeholders (partner(s),
target groups, local authorities, etc.), and the reasons for which their roles for the project;

f) the organisational structure of the team proposed for the implementation of the action ( by
function: there is no need to include the names of individuals)

Please fill in the table below and give information about the structure of the project team (e.g.
project coordinator, financial manager etc.) and indicate the degree of involvement of each
partner.

Project team17

Function Full time Part time Partner

Project manager x Applicant
Financial manager 1 x Applicant
Project coordinator x Partner 1
Financial manager 2 x Partner 1

If the case may be, please describe other relevant human resources that might also contribute to
implementation of the project (e.g. volunteers, associated organizations, networks)

g) the main means proposed for the implementation of the action by the applicant and its
partners
Please give details on:
q offices, equipment, materials and supplies to be provided by the applicant and its
partners from their own resources
E.g. Applicant – office room (20 sqm) fully operational, 1 PC with internet connection to be used by
the project team, 1 copy machine, 1 car to be used for the project
Partner 1 – office room (50 sqm), 2 PCs to be used by the project team
Partner 2 – 2 photo cameras to be used for the project

q offices, equipment, materials and supplies to be purchased or rented for the

project, during its implementation
E.g. Applicant – 1 location to be rented for training activities (GA 2), 2 PCs, 2 copy machines
17
Please note that the texts highlighted in gray color are provided only as examples and remember to delete them in the final version of the
Grant Application Form. The information must be consistent with the contents of the Logical Framework and of the Budget

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Partner 1 – 1 car to be rented for the project (documentary activities)

Partner 2 – office room (15 sqm) to be rented for the project, 3 PCs

h) the attitudes of all stakeholders towards the action in general and the project activities in
particular
i) the justification for developing part of the activities of the project outside the programme area
(if the case)

j) the planned activities in order to ensure the visibility of the action and the EU funding.

2.2.3 Duration and indicative action plan for implementing the action (max 4 pages)

The duration of the action will be [X] months.

Applicants should not indicate a specific startup date for the implementation of the action but
simply show "month 1", "month 2", etc.

Applicants are recommended to base the estimated duration for each activity and total period on
the most probable duration and not on the shortest possible duration by taking into consideration
all relevant factors that may affect the implementation timetable.

The activities stated in the action plan should correspond to the activities described in section
2.2.1. The implementing body shall be either the applicant or any of the partners, associates or
subcontractors. Any months or interim periods without activities must be included in the action plan
and count toward the calculation of the total estimated duration of the action.

The action plan for the first 12 months of implementation should be sufficiently detailed to give an
overview of the preparation and implementation of each activity. The action plan for each of the
subsequent years may be more general and should only list the main activities foreseen for those
years. To this end, it shall be divided into six-month interim periods (NB: A more detailed action
plan for each subsequent year will have to be submitted before receipt of new pre-financing
payments, pursuant to Article 2.1 of the General Conditions of the grant contract).

The action plan will be drawn up using the following format:

YEAR 1

Semester 1 Semester 2 Implementing

body

Activity/Mon 1 2 3 4 5 6 7 8 9 10 11 12
th

GA 1
18
example

Preparation
Activity 1.1
(title)

Execution
Activity 1.1
(title)

18
Please note that the cells highlighted in gray color are provided only as examples and remember to delete them in the final version of the Grant
Application Form. The information must be consistent with the contents of the Logical Framework and of the Budget

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YEAR 1

Semester 1 Semester 2 Implementing

body

Activity/Mon 1 2 3 4 5 6 7 8 9 10 11 12
th

Preparation
Activity 1.2
(title)

Etc.

YEAR 2

Semester 1 Semester 2 Implementing

body

Activity/Mon 1 2 3 4 5 6 7 8 9 10 11 12
ths

GA 1

GA 2

GA 3

Etc.

2.2.4 Sustainability (max 3 pages)

Provide all the information requested below:

a) Describe the expected impact, especially the cross border impact of the action
with quantified data where possible, at technical, economic, social and policy
levels (will it lead to improved legislation, codes of conduct, methods, etc.?).

b) Describe a dissemination plan and the possibilities for replication and extension of
the action outcomes (multiplier effects), clearly indicating any foreseen
dissemination channel.

c) Provide a detailed risk analysis and contingency plan.

This should include at least a list of risks associated with each group of activity proposed,
accompanied by relevant mitigation measures. A good risk analysis would include a range of risk
types including physical, environmental, political, economic and social risks.

d) Describe the main preconditions and assumptions during and after the
implementation phase.

e) Explain how sustainability will be secured after completion of the action.

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This may include aspects of necessary follow-up activities, built-in strategies, ownership,
communication plan etc.
In doing so, please make a distinction between the following dimensions of sustainability:
 Financial sustainability (financing of follow-up activities, sources of revenue for covering
all future operating and maintenance costs, etc.);
 Institutional sustainability (including structures that would allow the results to continue to
be in place after the end of the action, capacity building, agreements and "ownership" of
action outcomes);
 Policy level sustainability, where applicable (including what structural impact of the action
have - e.g. will it lead to improved legislation, codes of conduct, methods, etc.);
 Environmental sustainability (what impact will the action have on the environment – have
conditions put in place to avoid negative effects on natural resources on which the action
depends and on the broader natural environment).

2.2.5 Logical framework

Please fill in Annex C to the Guidelines for applicants, if the requested grant is over EUR 100,000).
For further explanations about how to fill in the Logical Framework, you can consult Project Cycle
Management available at

http://ec.europa.eu/europeaid/multimedia/publications/publications/manuals-tools/t101 _en.htm

2.3 OTHER FUNDS ADDRESSED WITH THIS PROJECT

Has the project applied to other funds for support to all or some of NO
the activities proposed under this call (e.g. national funds, EU
funds: Phare CBC, other ENPI programmes, Structural Funds)?
If YES, please specify within which programme and provide details of YES
its scope and of its timeframe.

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6. THE APPLICANT

Name of the organisation [in English and in the national language]

3.1 IDENTITY

The applicant’s contact details for the

purpose of this action

19
Legal Entity File number

Abbreviation

Registration number (or equivalent)

Date of Registration

Place of Registration

Official address of Registration

Country of Registration

County (Oblast)

District

Town/ Village/ Commune

E-mail address of the organisation

Telephone number:
[Country code + city code + number]

Fax number:
[Country code + city code + number]

Website of the organisation

Information under this point need only be given in cases where there have been modifications or
additions as compared to the information given in the Concept Note form.

Any changes in the addresses, phone numbers, fax numbers and in particular e-mail, must be
notified in writing to the Joint Technical Secretariat.
The Contracting Authority or the Joint Technical Secretariat will not be held responsible in case
it cannot contact the applicant.

19
If the applicant has already signed a contract with the European Commission
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3.2 PROFILE

Legal status

Profit-Making □ Yes
□ No

NGO □ Yes
□ No

Value based20 □ Political

□ Religious
□ Humanistic
□ Neutral

Is your organisation □ Yes, parent entity:

linked with another (please specify its EuropeAid ID:…………………………)
entity?
□ Yes, controlled entity(ies)
□ Yes, family organization / network entity21
□ No, independent

3.2.1. Category

Category22
□ Public Administration
□ International Organisation
□ Local Authority
□ Implementation Agency
□ University/Education
□ Research Institute
□ Foundation
□ Association
□ Media
□ Network/Federation
□ Professional and/or Industrial
Organisation
□ Trade Union
□ Cultural Organisation
□ Other (please specify)

3.2.2 Sector (s)

Please specify the Sector to which your organisation belongs, as defined in its statutes (or
equivalent document).

20
Please choose only one set of values.
21
E.g. confederation / federation /alliance

22
Please specify the Category to which your organisation belongs (ONE CHOICE ONLY);
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3.2.3.Target group(s)

□ All
□ Children (less than 18 years old)
□ Young people
□ Community Based Organisation(s)
□ Consumers
□ Disabled
□ Drug consumers
□ Educational organisations (school, universities)
□ Elderly people
□ Illness affected people
□ Local authorities
□ Migrants
□ Non-Governmental Organisations
□ Professional category
□ Research organisations/Researchers
□ SME
□ Students
□ Victims of catastrophes
□ Women
□ Other (please specify): ……………………………..

3.3 CAPACITY TO MANAGE AND IMPLEMENT ACTIONS

3.3.1 Experience in donor funded projects in the same or similar sector(s)

Please provide a detailed description of actions managed by your organization over the past seven
years and indicate the role of your organization (maximum 1 page per action).
This information will be used to assess whether you have sufficient experience of managing actions
of a comparable scale to the one for which the present grant is being requested.

23
Project title:
Sector:
Location of the Cost of the Please indicate Amount Duration
action Action the role of your contributed (from dd/mm/yyyy
(EUR) organization in [EUR] and to dd/mm/yyyy)
the project: donor24
Lead partner or
partner
… … … … …
Objectives and …
results of the action

3.3.2 Financial and human resources of the applicant’s organization

23
Please insert as many tables as necessary: one for each project.
24
If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.
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3.3.2.1 Financial data

Please provide the following information, if applicable, on the basis of the profit and loss
account and balance sheet of your organisation, amounts in thousands Euro 25 .

Total
Net Shareholder Medium and Short-term
Turnover or balance
Year earnings or s’ equity or long-term debt
equivalent sheet or
equivalent equivalent debt (< 1 year)
budget
N26

N-1

N-2

3.3.2.2 Financing Source(s)

Please tick the source(s) of the revenues of your organisation and specify the additional information
requested.

Percentage (total for a given Number of fee-paying members (only

Year Source
year must be equal to 100%) for source = Member's fees)
□ EU Commission
N N/A
□ Member States Public
N N/A
Bodies
□ Third Countries Public
N N/A
Bodies
□ United Nations
N N/A
□ Other international
N N/A
Organisation(s)
□ Private Sector
N N/A
□ Member’s fees
N N/A
□ Other (please specify)
N N/A
Total
N 100% N/A
□ EU Commission
N-1 N/A
□ Member States Public
N-1 N/A
Bodies
□ Third Countries Public
N-1 N/A
Bodies
□ United Nations
N-1 N/A
□ Other international
N-1 N/A
Organization(s)
□ Private Sector
N-1 N/A
□ Member’s fees
N-1 N/A

25
If your project will be selected, these financial data will be checked and they should correspond to the amounts indicated
here.
26
N = previous financial year
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Percentage (total for a given Number of fee-paying members (only

Year Source
year must be equal to 100%) for source = Member's fees)
□ Other (please specify)
N-1 N/A
Total
N-1 100% N/A
□ EU Commission
N-2 N/A
□ Member States Public
N-2 N/A
Bodies
□ Third Countries Public
N-2 N/A
Bodies
□ United Nations
N-2 N/A
□ Other international
N-2 N/A
Organization(s)
□ Private Sector
N-2 N/A
□ Member’s fees
N-2 N/A
□ Other (please specify)
N-2 N/A
Total
N-2 100% N/A

3.3.2.3 Number of staff

Please tick one option for each type of staff.

Type of staff Number of staff

Full time □ < 10
□ > 10 and < 50
□ > 50 and < 100
□ > 100
□ N/A
Part time □ < 10
□ > 10 and < 50
□ > 50 and < 100
□ > 100
□ N/A

3.4 LIST OF THE MANAGEMENT BOARD / COMMITTEE OF YOUR ORGANIZATION

Country of On the board

Name Profession Function
Nationality since

Mr

Ms

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4. PARTNERS 27
OF THE APPLICANT PARTICIPATING IN
THE ACTION
This section must be multiplied and completed for each partner organisation within the meaning of
section 2.1.2 of the Guidelines for Applicants. Any associates as defined in the same section need not
to be mentioned. You must make as many copies of these tables as necessary to create entries for all
the project partners.

4.1 IDENTITY

Partner x

Full legal name [in English and in the national language]

Date of Registration

Place of Registration

Legal status28

Official address of
29
Registration

Country of Registration

Region

County/ Oblast

District

Town/Village/Commune

Contact person

Telephone number:
[country code + city code +
number]

Fax number:
[country code + city code +
number]

27
This section must be multiplied for each partner.
28
E.g. non profit making, governmental body, international organisation
29
If not in one of the countries listed in section 2.1.1 of the Guidelines, please justify its location
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E-mail address

Number of employees

Other relevant resources

Experience of similar
actions, in relation to the
role in the implementation
of the proposed action

History of cooperation with

the applicant

Role and involvement in

preparing the proposed
action

Role and involvement in

implementing the proposed
action

Financial Data: Please provide the following information, if applicable, on the basis of the
profit and loss account and balance sheet of your organisation, amounts in thousand Euros 30

Total
Net Shareholder Medium and Short-term
Turnover or balance
Year earnings or s’ equity or long-term debt
equivalent sheet or
equivalent equivalent debt (< 1 year)
budget

N31

N-1

N-2

4.2 CAPACITY TO MANAGE AND IMPLEMENT ACTIONS (1 page per action, for all the
project partners)

4.2.1 Experience in donor funded actions, in the same or similar sector(s) (max.1 page
per action)

Please provide a detailed description of the actions managed by your partners’ over the past three
years.
This information will be used to assess whether the partnership has sufficient experience of
managing actions of a comparable scale to the one for which the present grant is being requested.

30
If your project will be selected, these financial data will be checked and they should correspond to the amounts indicated
here.
31
N = previous financial year
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Project title:
Sector:
Location of the Cost of the Please indicate Amount Dates
action Action the role of your contributed (from dd/mm/yyyy
(EUR) organization in [EUR] and to dd/mm/yyyy)
the project: Lead donor
32
partner or
partner
… … … … …
Objectives and
results of the action

4.3 JUSTIFICATION OF THE ELIGIBILITY OF PARTNERS LOCATED OUTSIDE THE

PROGRAMME AREA

For partners located outside the programme area (core area and adjoining regions) please fill
in the table below with the required information:
Explain why the project objectives cannot be achieved without this partner participation
OR
Demonstrate by making reference to legal acts that this partner:
a) either is a central/national public sector body who has exclusive competence in the field
covered by the Action and/or in the geographical area and its legal competences extends to
the programme area; b) or is an international organisation

Explain how the proposed Action will be made for the full benefit of the programme area

IMPORTANT: This application form must be accompanied by a signed and dated partnership
statement from each partner, in accordance with the model provided in section 4.4.

32
If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU
Member State.

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Grant Application Form for Priority 3 “People to people cooperation”

4.4 PARTNERSHIP STATEMENT33

A partnership is a relationship of substance between two or more organisations involving shared

responsibilities in undertaking the action funded by the Contracting Authority (the Romanian
Ministry of Regional Development and Tourism). To ensure that the action runs smoothly, the
Contracting Authority requires all partners to acknowledge this by agreeing to the principles of good
partnership practice set out below.

a) Our organization has read the application form and understood what our role in the action
will be before the application is submitted to the Contracting Authority.

b) Our organization got acquainted with the Joint Operational Programme Romania-Ukraine-
Republic of Moldova 2007-2013, read the Guidelines for Grant Applicants and the standard
grant contract and understood what our respective obligations under the contract will be if
the grant is awarded. We authorize the applicant to sign the contract with the Contracting
Authority and represent us in all dealings with the Contracting Authority in the context of
the action's implementation.

c) Our organisation has sufficient human, financial and administrative capacity to implement
the share of the Action as described in the Grant Application Form. Our organisation will be
able to maintain sufficient financial liquidity to sustain implementation of the Action.

d) The activities that our organisation will carry out in the Action are in line with the
Community and national legislation and policies and with the rules of the Programme, in
particular, on requirements for public procurement, environmental impact and sustainable
development, equal opportunities, and non-discrimination.

e) We are aware of the applicant’s obligation to consult our organisation and other partners
regularly and keep us fully informed of the progress of the Action.

f) We have agreed with the applicant that he is obliged to send us copies of the reports -
narrative and financial - made to the Contracting Authority.

g) We are aware that proposals for substantial changes to the action (e.g. activities, partners,
etc.) should be agreed by the partners before being submitted to the Contracting Authority.
Where no such agreement can be reached, the applicant must indicate this when submitting
changes for approval to the Contracting Authority.

h) We are aware that where the Beneficiary does not have its headquarters in the country
where the action is implemented, the partners must agree before the end of the action, on
an equitable distribution of equipment, vehicles and supplies for the action purchased with
the EU grant among local partners or the final beneficiaries of the action.

i) We are aware of our obligation to sign a Partnership Agreement specifying the partners’
tasks and obligations in the project, before the Applicant is signing the Grant Contract with
the Contracting Authority.

j) Our organisation will keep available all documents related to the Action in accordance with
the programme requirements on the availability of documents.

k) Our organization will assume responsibility in the event of any irregularity in its own
declared expenditures, and will repay the beneficiary the amounts unduly received/paid.

l) Our organisation will inform the public about Community assistance received from the
Programme to implement the Action in compliance with the visibility rules of the Joint
Operational Programme Romania-Ukraine-republic of Moldova 2007-2013.
33
Please remember to multiply and fill in by each project partner

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Please choose one of the following and delete those which are not applicable:

q Our organisation is not entitled to recover any paid VAT (Value Added Tax) by whatever
means, and therefore all Action related expenditure to be reported will include VAT.

q Our organisation is entitled to recover any paid VAT (Value Added Tax), and therefore all
Action related expenditure to be reported will not include VAT.

q Our organisation is entitled to partially recover the paid VAT (Value Added Tax), and
therefore the respective Action related expenditure to be reported will not include VAT. For
the partially non-recoverable paid VAT (Value Added Tax) by whatever means, the
respective Action related expenditure to be reported will include VAT.

I hereby certify that the [insert the name of the organization that fills in the partnership
statement – in English and in national language] commits itself to the operation and intends to
provide and spend EUR [insert amount] as (national) co-financing to the project during its
implementation, as well as any ineligible expenditure or any other costs related to the project
implementation. This commitment is backed by the decision of the empowered bodies, available at
request.

I confirm that no expenditure related to the activities foreseen to be implemented in the above
mentioned project by [insert the name of the organization that fills in the partnership statement -
in English and in national language] has been or will be funded by any other EU programme.

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

Signed on behalf of the Partner [insert the name of the organization that fills in the partnership
statement – in English and in national language]:

34
Name :

Organisation:

Position:

Signature and stamp:

Date and place:

34
Legal representative of the organization
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5. ASSOCIATES OF THE APPLICANT

PARTICIPATING IN THE ACTION
This section must be completed for each associated organisation within the meaning of section 2.1.2
of the Guidelines for Applicants. You must make as many copies of this table as necessary to create
entries for more associates.

Associate 1

Full legal name

Country of Registration

Legal status35

Official address

Contact person

Telephone number:
[country code + city code + number]

Fax number:
[country code + city code + number]

E-mail address

Number of employees

Other relevant resources

Experience of similar actions,

in relation to role in the
implementation of the
proposed action

History of cooperation with the

applicant

Role and involvement in

preparing the proposed action

Role and involvement in

implementing the proposed
action

Relevance and added value of

the associates

35
E.g. non profit making, governmental body, international organisation
Page 31 of 37
 6. CHECKLIST FOR THE FULL APPLICATION FORM

Joint Operational Programme Romania-Ukraine-Republic of Moldova 2007-2013

Priority 3 –“People to people cooperation”
2nd Call for proposals

ADMINISTRATIVE DATA To be filled in by the applicant

Name of the Applicant

Country and date of

registration
36
Legal Entity File number

Legal status37

Partner 1 Name:
Country of registration:
Legal status:

Partner 2 Name:
Country of registration:
NB: Add as many rows as Legal status:
partners

Before sending your proposal, please make sure that each of the following items is checked “yes”.
Discrepancies between the Checklist that you have filled in and the content of the Grant
Application Form may lead to the rejection of your application.

36
If the applicant has already signed a contract with the European Commission
37
E.g. non profit making, governmental body, international organisation
2011 Page 32 of 37
Grant application form for Priorities 1 and 2
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Grant Application Form for Priority 3 “People to people cooperation”

BEFORE SENDING YOUR PROPOSAL, PLEASE CHECK THAT EACH OF THE FOLLOWING POINTS IS COMPLETE To be filled in by
AND RESPECTS THE FOLLOWING CRITERIA: the applicant
Title of the Proposal: [indicate the title] Yes No

PART 1 (ADMINISTRATIVE)
1. The correct grant application form, published for this call for proposals, has been
used and filled in?
2. The Declaration by the applicant has been filled in, signed, stamped and included in
original?
3. Each partner has completed and signed a partnership statement and the statements
are included in original?
4. The proposal is typed and is in English?

5. One original and four copies are included?

6. An electronic version of the project (CD-Rom) is enclosed and the CD- Rom includes
the Full application form, Annex B Budget of the action and, if the case, Annex C
Logical framework (if the requested grant is over EUR 100,000)?
7. The budget is using the template published for this call for proposals, is expressed in
EUR with 2 decimals and is enclosed?
8. If necessary, the logical framework has been completed and is enclosed?

9. Environmental information (Annex F) has been completed and is enclosed?

10. Job descriptions for the key permanent staff are enclosed ?

11. Legalized mandates of delegation from the legal representatives of the applicant and
partners are attached in original, if the case may be?
PART 2 (ELIGIBILITY VERIFICATION)
12. The duration of the action is between 6 months (the minimum allowed by the call)
and 18 months (the maximum allowed by the call)?
13. There is at least one partner from Romania and one partner from Ukraine or Republic
of Moldova?
14. The applicant and partner(s) organisations are located in the programme area or
participation of a partner located outside the programme area is fully justified in the full
application form, in section 4.3?
15. The requested contribution is between 30,000 EUR (the minimum allowed by the call)
and 150,000 EUR (the maximum allowed by the call)?
16. The EC requested contribution has not been modified by more than 20% of the total
eligible costs as provided in the Concept Note (the maximum percentage allowed)?
17. The EC requested contribution is equal to or lower than 90% of the total eligible costs
of the action?

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7. DECLARATION BY THE APPLICANT

The applicant, represented by the undersigned, being the authorised signatory of the applicant, in
the context of the present call for proposals, representing any partners in the proposed action,
hereby declares that:
a) the applicant has the sources of financing and professional competence and
qualifications specified in section 2 of the Guidelines for Applicants;
b) the applicant undertakes to comply with the obligations foreseen in the partnership
statement of the grant application form and with the principles of good partnership
practice;
c) the applicant is directly responsible for the preparation, management and
implementation of the action with its partners, and is not acting as an intermediary;
d) the applicant and its partners are not in any of the situations excluding them from
participating in contracts which are listed in Section 2.3.3 of the Practical Guide to contract
procedures for EC external actions (available from the following Internet address:
http://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htm.
Furthermore, it is recognised and accepted that if we participate in spite of being in any of
these situations, we may be excluded from other procedures in accordance with section
2.3.5 of the Practical Guide;
e) the applicant and each partner are in a position to deliver immediately, upon
request, the supporting documents stipulated under section 2.4 of the Guidelines for
Applicants.;
f) the applicant and each partner are eligible in accordance with the criteria set out
under sections 2.1.1 and 2.1.2 of the Guidelines for Applicants;
g) if recommended to be awarded a grant, the applicant accepts the contractual
conditions as laid down in the Standard Contract annexed to the Guidelines for Applicants
(annex IIA);
h) the applicant and its partners are aware that, for the purposes of safeguarding the
financial interests of the EU, their personal data may be transferred to internal audit
services, to the European Court of Auditors, to the Financial Irregularities Panel or to the
European Anti-Fraud Office.
The following grant applications have been submitted (or are about to be submitted) to the
European Institutions, the European Development Fund and the EU Member States in the last 12
months:
 [list only actions in the same field as this proposal]
The applicant is fully aware of the obligation to inform without delay the Contracting Authority to
which this application is submitted if the same application for funding made to other European
Commission departments or European Union institutions has been approved by them after the
submission of this grant application.

The applicant is aware that the partnership is a relationship of substance between two or more
organisations involving shared responsibilities in undertaking the action funded by the Contracting
Authority (the Ministry of Regional Development and Tourism). In this respect, the principles of good
partnership practice set out below are acknowledged and agreed.

a) The applicant understood what his role in the action will be before the application is
submitted to the Contracting Authority.

b) The applicant read the standard grant contract and understood what his respective
obligations under the contract will be if the grant is awarded. He is authorized by the
project partners to sign the contract with the Contracting Authority and to represent them
in all dealings with the Contracting Authority in the context of the action's implementation.

c) The applicant shall consult with its partners regularly and keep them fully informed of the
progress of the action.

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d) The applicant will forward copies of the reports - narrative and financial - made to the
Contracting Authority to his project partners.

e) Proposals for substantial changes to the action (e.g. activities, partners, etc.) will be
previously agreed with all the project partners before being submitted to the Contracting
Authority. Where no such agreement can be reached, the applicant must indicate this when
submitting changes for approval to the Contracting Authority.

f) Where the Beneficiary does not have its headquarters in the country where the action is
implemented, the partners must agree before the end of the action, on an equitable
distribution of equipment, vehicles and supplies for the action purchased with the EU grant
among local partners or the final beneficiaries of the action.

g) The applicant is aware of his obligation to sign the Partnership Agreement stating the tasks
and obligations in the project, before the signature of the Grant Contract with the
Contracting Authority.

It is hereby certified that the [insert the name of the organization] commits itself to the operation
and intends to provide and spend EUR [insert amount] as (national) co-financing to the project
during its implementation, as well as any ineligible expenditure or any other cost related to the
project implementation. This commitment is backed by the decision of the empowered bodies,
available at request.

Signed on behalf of the applicant

Name
Signature and stamp
Position
Date

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8. INDICATORS

The project will contribute to the achievement of the following programme indicator(s).

Please, indicate by number the indicators that your project is contributing to (results and outputs).
Indicate “1” each time your project is addressing a Result indicator.

PRIORITY 3 Number

RESULT 1: Number of projects supporting common planning initiatives, exchange of

experience, cooperation networks

OUTPUT 1: Number of bodies involved in cooperation initiatives

RESULT 2: Number of projects creating permanent social and cultural exchanges

OUTPUT 2: Number of joint cultural events/networks promoting regional CBC

identity, including awareness campaigns for environmental protection in the area

RESULT 3: Number of projects fighting against organised crime, people trafficking

in the border area

OUTPUT 3: Number of trainings/meetings for professionals

OUTPUT 4: Number of information campaigns for citizens and rehabilitation courses

for victims of people trafficking

RESULT 4: Number of projects creating activities for young population in the area

OUTPUT 5: Number of exchanges and joint events for young people

OUTPUT 6: Number of trainings/meetings for professionals

9. ASSESSMENT GRID OF THE FULL APPLICATION FORM

(To be used by the Contracting Authority or the Evaluation Committee)

YES NO
OPENING AND ADMINISTRATIVE CHECK
1. The submission deadline has been respected
2. The application form satisfied all the criteria specified in part 1 of the Checklist of the
application form (Section 6 of Part B of the Grant application form).
DECISION 1:
The evaluation committee decided to evaluate full application after having passed the
administrative check.
The administrative verification has been conducted by:
Date:
EVALUATION OF THE FULL APPLICATION FORM
DECISION 2:

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A. The Committee has recommended the proposal for Eligibility verification after
having been provisionally selected within top ranked second proposals within the
available financial envelope
B. The Committee has recommended the proposal for Eligibility verification after
having been put on the reserve list according to the top ranked scored proposals
The evaluation of the proposal has been conducted by:
Date:
ELIGIBILITY VERIFICATION
1. The application form satisfied all the criteria specified in part 2 of the Checklist of the
application form (Section 6 of Part B of the Grant application form).
2. The supporting documents listed hereunder, submitted according to the Guidelines
(Section 3.3.1), satisfy all the eligibility criteria of the applicant and its partner(s):
a. The statutes or articles of association of applicant and all partners
b. Certificates of Fiscal registration/ Certificate of tax payer registration for the applicant and
all partners
c. Certificate proving the fulfilment of the obligations relating to the payment of debts to the
consolidated state budget
d. Certificate proving the fulfilment of the obligations relating to the payment of debts to the
local budget or, when not available, the self-declaration signed by the legal representative-for
applicant and all partners
e. The Legal Entity Sheet (see annex D of the Guidelines for Applicants) is duly completed
and (for international organisations only) is accompanied by the letter of accreditation or a
bilateral agreement -for the applicant
f. The self-declaration, stating that documents proving ownership/ concession/ rent over the
facilities are available and may be provided before signing the grant contract for the applicant
and/or partner(s), as the case may be
g. The declaration on compliance with state aid regulations (only for Romanian applicants
and partners)
The assessment of the eligibility has been conducted by:
Date:
DECISION 3:
The Evaluation Committee has selected the proposal for funding after having verified its
eligibility according to the criteria stipulated in the Guidelines for applicants.

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