Kolarctic ENPI CBC Programme Grant Application Form Open Call for Proposals dd/mm/yyyy dd/mm/yyyy Application number Name of the lead partner: Location(s) of the action: Country(ies): Region(s): Name of the project: Priority: Project type: name of the priority name of project type Primary application/ Amendment application dd/mm/yyyy Dossier N o (for official use only) 2006
I THE ACTION 1. DESCRIPTION 1.1 Name of the project 1.2 Location(s) Country(ies), region(s) Finland Sweden Russia Norway Lapland Norrbotten Murmansk Finnmark Archangelsk Troms Nenets Nordland 1.3 Cost of the action (Requested financing) ( ) Please do NOT fill in these tables. The information comes automatically from table 4. Total EU eligible cost of the action Total eligible cost of the action (Norwegian equivalent financing and national cofinancing) Requested financing Requested EU financing Requested Russian national co-financing Requested Finnish national co-financing Requested Swedish national co-financing Requested financing Requested Norwegian equivalent financing Requested Norwegian national co-financing % of total EU eligible cost of the action % of total eligible cost of action 1
1.4 Summary Maximum 2 000 characters Duration of the action months (0, 1, 2,3,----) Objectives of the action Overall objective(s) Specific objective Partner(s)/ associate(s) Partner/ Associate (alasvetovalikk o : Partner 1, 2, 3... Associate 1, 2, 3...) Name of partner/ associate Country Region Partner 1 Partner 2 Associate 1 Target group(s) 1 Final beneficiaries 2 Estimated results Main activities 1 2 Target groups are the groups/entities who will be directly positively affected by the project at the Project Purpose level Final beneficiaries are those who will benefit from the project in the long term at the level of the society or sector at large 2
1.5 Objectives Maximum 2 000 characters. 1.5.1 Describe the overall objective(s) to which the action aims to contribute towards and the specific objective that the action aims to achieve. 1.5.2 Relevance of the action to the objectives and priorities of the programme 1.5.3 Identification of perceived needs and constraints in the target country. 1.6 Target group(s) and final beneficary/ ies Maximum 2 000 characters. Please provide the following information: 1.6.1 Description of the target group(s) and final beneficiaries 1.6.2 Reasons for the selection of the target group(s) and identification of their needs and constraints. How does the Action contribute to the needs of the target group(s) and final beneficiaries? How the action will improve the situation and capacities of target groups/beneficiaries 1.7 Detailed description of activities and methodology Maximum 8 000 characters. Include the title and a detailed description of each activity to be undertaken to produce the results, justifying the choice of the activities and specifying where applicable the role of each partner (or associates or subcontractors) in the activities. In this respect, the detailed description of activities must not repeat the action plan (see section 1.8). Notice also the following aspects of the action: - 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 - Where the action is part of a larger programme, explain how it fits or is coordinated with this programme. Please specify the potential synergies with other initiatives, in particular from the EC - Description of the role and participation in the action of the various actors (partners, target groups, local authorities, etc.), and the reasons for which these roles have been assigned to them. - The organisational structure and team proposed for implementation of the action (by function: there is no need to include the names of individuals). Give a description of the steering group of the project (structure of members and role in terms of implementation of the project). 1.7.1 Duration and action plan The duration of the project will be months. The action plan must be drawn up using the following format: 3
Year 1 Semester 1 Semester 2 Activity Month1 2 3 4 5 6 7 8 9 1 0 11 12 Implementing body activity 1 partner 1 activity 2 partner 1 activity 3 partner 2 For the following years: (one semester corresponds six months) Activity Semeste r 3 4 5 6 7 8 9 10 Implementing body activity 1 partner 1 activity 2 partner 2 activity 3 partner 1 1.8 Follow up of the project Maximum 1 000 characters. Detailed description of procedures for follow up and internal/ external evaluation of the project. 1.9 Environmental Impact assesment Maximum 1 000 characters. Fill in also annex x Effects on environment 2. EXPECTED RESULTS 2.1 Concrete outputs Maximum 1 500 characters. Be specific and quantify outputs as much as possible. Indicate notably foreseen publications, if any. 2.2 Multiplier effects Maximum 2 000 characters. Can the outcomes of the action be extended and utilised outside intended target group(s)? If yes, how? 2.3 Sustainability 4
Maximum 2 500 characters. Please distinguish between the following three dimensions of the sustainability: 2.3.1 The financial aspect (how will activities be financed when the grant ends?) 2.3.2 Institutional level (Will structures allowing the activities/ plans/ processes ect. to continue be in place at the end of the action? Will there be local "ownership" of action outcomes?) 2.3.3 Policy level where applicable (What structural impact will the action have - e.g. will it lead to improved legislation, codes of conduct, methods, etc?) 2.4 Indicators Programme level result indicators Sustainable development Number of operative cross-border networks on environmental issues to be planned Number of adopted environmental technical solutions to be planned Number of activities to be carried out to further adaptation to climate change Number of males/females < 29 yrs of age that will participate in activities Youth Males Equality Number of males/females that willl participate in Males activities Implementation of the programme Number of people that will participate in Males a) long-term activities Females Females Females b) conferences, seminars, education etc Males Females Priority 1: Economic and Social Development Number of cross-border networks that will operate between SMEs Number of cross-border business relations that will operate between SMEs Number of SMEs that will participate in network and business relation projects Number of SMEs/educational institutes that will participate in joint educational planning Number of males/females that will participate in joint educational programmes. Number of education and information events to be arranged Males Females Number of new communications methods to be developed to facilitate the movement of people and goods Number of solutions to be implemented in using renewable energy Number of commercial products to be developed between businesses and indigenous peoples Number of people from the Programme area that will commute to other countries within the Programme area Number of new services to be developed for inhabitants in cooperation between public and private services Number of municipalities that will participate in crossborder cooperation 5
Priority 2: Common challenges Number of plans, agreements or activities and operational models that will be actively executed Number of information activities about common challenges (seminars, brochures, internet-pages etc) Number of materials concerning environmental issues to be published Number of educational and information exchange activities between border authorities Number of border authorities that will participate in activities Priority 3: People-to-People Cooperation and Identity Building Number of new common cultural/sports events or common meeting places Number of people that will participate in common cultural/sports events and meeting places Number of media products that increase public knowledge about the Programme area to be published Number of networks to be created between institutions Number of educational organisations, NGOs and cultural institutions that will participate in cooperation Number of people that will participat in activities supporting cultural diversity Number of activities (seminars, festivals etc.) that support cultural diversity to be arranged 6
3. BUDGET FOR THE ACTION ( ) Fill in the budget information and annex x Budget for the action for the total duration of the action and for its first 12 months. For further information see the Guidelines for grant applicants (Section 2.1.4). Total eligible costs of the project by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 10.1 Costs directed to adjacent areas 11. Project revenues deducted 12. Net eligible costs, total EU eligible costs of the project by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 10.1 Costs directed to adjacent areas 11. Project revenues deducted 12. Net eligible costs, total Eligible costs in Finland by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 7
6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 10.1 Costs directed to adjacent areas 11. Project revenues deducted 12. Net eligible costs, total Eligible costs in Sweden by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 10.1 Costs directed to adjacent areas 11. Project revenues deducted 12. Net eligible costs, total Eligible costs in Russia by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 10.1 Costs directed to adjacent areas 11. Project revenues deducted 12. Net eligible costs, total Eligible costs in Norway by type Type of cost Year 1 Year 2 Year 3 Year 4 Sum 1. Human resources (without in kind) 1.1 Eligible in kind contribution 8
2. Travel 3. Equipment and supplies 4. Local office 5. Other costs, services 6. Other 7. Subtotal direct eligible costs of action (1-6) 8. Administrative costs (maximum 7% of 7, total direct eligible costs of the Action) 10. Total eligible costs (7+8) 11. Project revenues deducted 12. Net eligible costs, total 9
4. EXPECTED SOURCES OF FUNDING ( ) Fill in the following tables of the expected sources of funding for the action. Financing EU countries + Russia Financier % of total financing EU countries + Russia National cofinancing/ Sweden Year 1 Year 2 Year 3 Year 4 Sum National cofinancing/ Finland co- National financing/ Russia National cofinancing total EU financing Total national cofinancing + EU financing Private financing/ Sweden Private Finland financing/ Private Russia financing/ Total financing EU countries + Russia Financing Norway Financier Norwegian financing equivalent % of total financing Norway Year 1 Year 2 Year 3 Year 4 Sum Norwegian national cofinancing Total Norwegian 10
equivalent and national co-financing Private financing Total financing Norway Financing EU countries, Russia + Norway Year 1 Year 2 Year 3 Year 4 Sum Total Ineligible in kind contributions Please mention here below the contributions in kind brought by the applicants and his partners or any other sources (please specify), if any (maximum 2 000 characters) 11
II THE APPLICANT 1. IDENTITY Full legal name : Acronym : Organisation/ legal form: Is the applicant entitled to deduct value -added tax from project costs? Official address: 3 County council/ municipality Joint municipal board Other joint board Yes State authority/ state provincial office University/ higher educational institution/ research inst. Other educational institution Enterprise No Other Postal address: Telephone number: Country code + city code + number Fax number: Country code + city code + number E-mail of the Organisation: Website of the Organisation: Contact person for this action : Contact person s email address : Any change in the addresses, phone numbers, fax numbers and in particular e-mail, must be notified in writing to the Managing Authority. The Managing Authority will not be held responsible in case it cannot contact an applicant. 3 If not in the programme area, please justify its location. 12
2. BANK DETAILS Before the grant contract is signed, the applicants selected will have to supply a financial identification form using the model in Annex F to the Guidelines for applicants, certified by the bank where the payments are to be made. Bank name Address of bank Account number IBAN SWIFT 13
3. DESCRIPTION OF APPLICANT 3.1 When was your organisation founded and when did it start its activities? Maximum 500 characters 3.2 What are the main activities of your organisation at present? Maximum 1 000 characters 3.3 Experience of similar actions Maximum 2 000 characters. Please provide a short description of international actions managed by your organisation over the past years in the fields covered by this programme. 14
4. OTHER APPLICATIONS MADE TO EUROPEAN INSTITUTIONS, THE EUROPEAN DEVELOPMENT FUND (EDF) AND EU MEMBER STATES Grant applications submitted (or about to be submitted) to European Institutions, the EDF and EU Member States in the current year. The applicant may list only actions in the same field as this proposal Country intervention of EC budget line, EDF or EU Member States Amount requested (EUR) Nota Bene: The applicant is required to inform without delay the Managing Authority to which this application is submitted if the same application for funding made to other Commission departments or Community institutions has been approved by them AFTER submission of this grant application 15
III. PARTNERS OF THE APPLICANT PARTICIPATING IN THE ACTION 1. DESCRIPTION OF THE PARTNERS This section must be 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 be mentioned. You must make as many copies of this table as necessary to create entries for more partners. Full legal name (business name) Nationality Partner 1 Organisation/ Legal form Is the partner entitled to deduct value-added tax from project costs? County council/ municipality Joint municipal board Other joint board Yes State authority/ state provincial office University/ higher educational institution/ research inst. Other educational institution No Enterprise Other Official address Contact person Telephone number Fax number E-mail address 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 16
Important: This application form must be accompanied by a signed and dated partnership statement from every partner, in accordance with the ANNEX F 17
IV. ASSOCIATES OF THE APPLICANT PARTICIPATING IN THE ACTION 1. Description of the associates 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. Full legal name (business name) Nationality Associate 1 Organisation/ Legal form County council/ municipality Joint municipal board Other joint board State authority/ state provincial office University/ higher educational institution/ research inst. Other educational institution Enterprise Other Official address Contact person Telephone number Fax number E-mail address 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 18
V. CHECKLIST KOLARCTIC ENPI CBC PROGRAMME 2007 2013 OPEN CALL FOR PROPOSALS YYYY ADMINISTRATIVE DATA Name of the Applicant Number given to the application Nationality 4 /Country 5 and date of registration To be filled in by the applicant BEFORE SENDING YOUR PROPOSAL, PLEASE CHECK THAT EACH OF THE FOLLOWING COMPONENTS IS COMPLETE AND RESPECTS THE FOLLOWING CRITERIA : To be filled in by the applicant Title of the Proposal: Yes No 1. The correct grant application form, published for this call for proposals, has been used 2. The proposal is typed and is in English 3. One original and <X copy (ies)> are included 5. Each partner has completed and signed a partnership statement and the statements are included 6. The budget is presented in the format requested, is expressed in Euros ( ) and is enclosed 7. The logical framework has been completed and is enclosed. Milloin tarvitaan??? 8. The duration of the action is equal to or lower than <X months> (the maximum allowed) 4 For individuals 5 For organisations 2006 Page 28
9. The duration of the action is equal to or higher than <X months> (the minimum allowed) 10. The requested contribution is equal to or higher than <X EURO/other currency> (the minimum allowed) 11. The requested contribution is equal to or lower than <X EURO/other currency> (the maximum allowed) 12. The requested contribution is equal to or higher than <X %>of the total eligible costs (minimum percentage required) 13. The requested contribution is equal to or lower than <X %> of the total eligible costs (maximum percentage allowed) 14. The Declaration by the applicant has been filled in and has been signed Page 29
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VI. DECLARATION BY T HE APPLICANT The applicant, represented by the undersigned, being the authorised signatory of the applicant, including every partner, hereby declares that? the applicant has the sources of financing and professional competence and qualifications specified in section 2 of the Guidelines fo Applicants;? 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?the applicant is directly responsible for the preparation, management and implementation of the action with its partners and is not acting as an intermediary;?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 o the Practical Guide to contract procedures for EC external actions (available from the following Internet address http://ec.europa.eu/europeaid/work/procedures/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;?if selected, the applicant is in a position to deliver immediately, upon request, the supporting documents stipulated under section 2.4 of the Guidelines for Applicants.;?the applicant and each partner (if any) are eligible in accordance with the criteria set out under sections 2.1.1 and 2.1.2 of the Guidelines fo Applicants;?if recommended to be awarded a grant, the applicant accepts the contractual conditions as laid down in the Standard Contract annexed to th Guidelines for Applicants (annex F);?the applicant and its partners are aware that, for the purposes of safeguarding the financial interests of the Communities, their personal data may be transferred to internal audit services, to the European Court of Auditors, to the Financial Irregula rities Panel or to the European Anti Fraud Office. 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 Community institutions has been approved by them after the submission of this grant application. B. SIGNATURE: 31 Page
I, the undersigned and person responsible in the applicant organisation for the proposal, certify that the information given in this Declaration is correct. Date: Name: Position: Signature: 32 Page
VII PARTNERSHIP STATEMENT A partnership is a relationship of substance between two or more organisations involving shared responsibilities in undertaking the action funded by the Regional Council of Lapland (Contracting Authority). 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. 1. All partners must have read the application form and understood what their role in the action will be before the application is submitted to the Contracting Authority. 2. All partners must have read the standard grant contract and understood what their respective obligations under the contract will be if the grant is awarded. They authorise the lead applicant to sign the contract with the Contracting Authority and represent them in all dealings with the Contracting Authority in the context of the action's implementation. 3. The applicant must consult with his partners regularly and keep them fully informed of the progress of the action. 4. All partners must receive copies of the reports - narrative and financial - made to the Contracting Authority. 5. 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. 6. Where the Beneficiary does not have his 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 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. Name: Organisation: Position: Signature: Date and place: 33
VIII. ASSESSMENT GRID (to be used by the Contracting Authority) YES NO STEP 1: OPENING SESSION AND ADMINISTRATIVE CHECK 1. The Deadline has been respected 2. The Application form satisfied all the criteria mentioned in the Checklist (Section V of Part B of the Grant application form). The administrative verification has been conducted by: Date: DECISION 1: The Committee has recommended the Concept Note for Evaluation after having passed the Administrative check. STEP 2 : EVALUATION OF THE CONCEPT NOTE DECISION 2: The Committee has approved the Concept Note and decided to proceed with the evaluation of the full proposal after having pre-selected the best Concept Notes. The evaluation of the Concept Note has been conducted by: Date: STEP 3: EVALUATION OF THE FULL APPLICATION FORM DECISION 3: A. The Committee has recommended the proposal for Eligibility verification after having been provisionally selected within the top ranked scored 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 verification of the proposal has been conducted by: Date: STEP 4: ELIGIBILITY VERIFICATION 3. The supporting documents listed hereunder, submitted according to the Guidelines (Section 2.4), satisfied all the eligibility criteria of the applicant and its partner(s) (if any) a. The applicant's statutes b. The statutes or articles of association of all partners c. The applicant's external audit report (if applicable) <to be inserted when the Contracting Authority is the European Commission> d. The Legal Entity File (see annex D of the Guidelines for Applicants) is duly completed and signed by the applicant and is accompanied by the justifying documents requested. <to be inserted when the Contracting Authority is the European Commission> e. A Financial Identification form (see annex E of the Guidelines for Applicants). f. Copy of the applicant s latest accounts. The assessment of the eligibility has been conducted by: Date: DECISION 4: The Committee has selected the proposal for funding after having verified its eligibility according to the criteria stipulated in the Guidelines. 34