Project application form for the second stage of Norwegian Financial Mechanism open call
Open call project title
Norwegian Financial Mechanism 2009-2014 (programme number and title) / LV06"Green Industry Innovation"
Project applicant
Filled in by the Agency
Project number
Project submission date
Project selection type:
limited / open / X
PART 1. BASIC INFORMATION ON PROJECT APPLICANT

1.1.Project applicant:

1.1.1.Title:
1.1.2.Registration number:
1.1.3.Taxpayer's registration number:
1.1.4.Legal address: / Street, building No.
City, region
Country
Postal code
1.1.5.Actual address*: / Street, building No.
City, region
Country
Postal code
1.1.6.website address (if there is such) where information on the project in the case of its approval shall be placed
1.1.7.
Person in charge: / Name, surname
Position
Telephone
Fax
E-mail
Contact person*: / Name, surname
Position
Telephone
Fax
E-mail

*filled in if the actual address differs from the legal address or contact person differs from the person in charge

1.1.8.Enterprise category (mark the appropriate)

Enterprise, which complies with the status of a micro or small enterprise
Enterprise, which complies with the status of a medium sized enterprise
Enterprise, which complies with the status of a large sized enterprise

1.1.9.Associated persons of the project applicant (if the project applicant complies with the category of a micro, small or medium sized enterprise, this section must not be completed). Associated persons comply with the definition of enterprises defined in Annex1 of Commission Regulation (EC) No.651/2014 of 17June 2014 declaring certain categories of aid compatible with the internal market in application of Articles107 and 108 of the Treaty. Completed in case the project applicant is a large sized enterprise registered in the Republic of Latvia:

Autonomous enterprise;

Partner enterprises;

Registration No. / Last completed financial year whereof data have been submitted / Number of employees (average number of employees per year) / Annual turnover (euro) / Total sum of annual balance (euro)
1.Title
2....
3....
Total

Associated enterprises.

Registration No. / Last completed financial year whereof data have been submitted / Number of employees (average number of employees per year) / Annual turnover (euro) / Total sum of annual balance (euro)
1.Title
2....
3....
Total

1.1.10.Information on the activities of associated persons of the project applicant (please provide information on the field of specialisation of associated persons, product portfolio, main operational directions, etc.)— up to 1000words.

1.1.11.Type of project applicant (please mark the appropriate):

Code / Title
I-1 / Limited liability company
I-2 / Joint stock company
I-13 / Unlimited company

1.1.12.Field of basic activity of the project applicant pursuant to NACE Classification of Economic Activities Rev.2 (please enter the appropriate)

code / name

1.1.13.Shareholders of the project applicant (filled in if the project applicant is a joint stock company and shareholder investment constitutes at least 5% of the total investment in the enterprise)

No. / Name of shareholder / Share investment in % / Voting right
1.
2.
...
Total / 100% / 100%

1.2.Projects implemented and elaborated by the project applicant whereof state and/or European Union financing, other financing from public means within the scope of other foreign financial mechanism projects has been or is planned to be received(if there are no such projects, it is necessary to put "-" or to insert "none").

No. / Grant provider / Type of grant, project title and number / Volume of grant (euro) / Total costs of the project (euro) / Eligible costs / Project implementation period (mm/yyyy–mm/yyyy)
1.
2.
...

1.3.Projects implemented and elaborated by the associated persons of the project applicant whereof financing has been received or is planned to be received within the scope of the open call provided for in these regulations(if there are no such projects, it is necessary to put "-" or to insert "none").

No. / Grant provider / Type of grant, project title and number / Volume of grant (euro) / Total costs of the project (euro) / Eligible costs / Project implementation period (mm/yyyy–mm/yyyy)
1.
2.

1.4.Combination of project cost positions with aid mechanisms of another grant programme or individual grant project.

Please specify projects implemented and planned by the project applicant in which the received or planned state, municipal and/or European Union financing, financing planned within the scope of another foreign financial mechanism shall be combined with financing requested within the framework of this project, as well as specify planned or received financing within the scope of other state aid programmes or individual aid programmes, including deminimis, guarantees, loans or risk capital that shall be combined with the determined eligible costs of this project (if there are no such projects, it is necessary to put "-" or to insert "none").

Grant provider
Type of grant
Project title and number (if granted)
No. / Adjustable eligible costs position / Total eligible costs (euro) / Volume of granted/planned financing in another aid programme or individual aid programme (euro) / Intensity of the provided aid in %, which is constituted by state, municipal or European Union aid, aid from other foreign financial aid mechanisms (from total financing indicated in column4). Must not be specified if this is deminimis aid
1. / 2. / 3. / 4. / 5.

1.5.Information on project implementation in collaboration with a project partner(mark the appropriate)

The project is not being implemented in collaboration with a project partner
The project is being implemented in collaboration with donor project partner (in the Kingdom of Norway)
The project is being implemented in collaboration with a partner representing the Republic of Estonia, Republic of Bulgaria, Republic of Cyprus, Czech Republic, Republic of Croatia, Republic of Hungary, Republic of Latvia, Republic of Lithuania, Republic of Malta, Republic of Poland, Republic of Romania, Republic of Slovakia, Republic of Slovenia, Republic of Belarus or Russian Federation

1.5.1.Information on project partner

Please fill in the information on project partner in compliance with Paragraphs 1.1-1.4.

1.6.Role of the project partner in the implementation of the open call project. Resources at the disposal of the project partner (characterising experience of the project partner, resources thereof and its involvement in the implementation of activities planned within the scope of the project), as well as planned collaboration between the project applicant and project partner after the implementation of the open call project(if applicable) up to 2000words:

PART2. PROJECT DESCRIPTION

2.1.Summary on activities to be conducted within the scope of the open call project(pursuant to the procedure and in the extent prescribed in the Freedom of Information Law, the referred to information shall be available after the decision on the approval of the open call project application has come into force)(up to 500characters):

2.2.Objective and description of the project(up to 3000words). Detailed information must be provided in the business plan.

Please mark the appropriate:

  • Upon the implementation of the project, a new product with reduced impact on the environment shall be introduced;
  • Upon the implementation of the project, a new technology with reduced impact on the environment and by which a new product shall be advanced in production shall be introduced; or
  • Upon the implementation of the project, a new technology with reduced impact on the environment that will ensure significant changes in the production process shall be introduced.

Please specify what new product or significantly improved product shall be introduced as a result of the project implementation and specify the identified problems that are planned to be solved by using the product and its properties. Please specify types of product application, target clients and planned markets. If this is a significantly improved product, please provide a comparison with the existing product.
If a new technology is being introduced, please provide a description, specifying its properties and importance in the improvement of current production processes. If significant technological improvements are conducted, please provide a comparison with the principles of previously used technologies.
Please characterise the advantages of competitive capacity of the product or technology introduced as a result of the project implementation in respect of the current product/technology of the enterprise and similar products, services or technologies available in the market. Please indicate specific parameters (performance, materials, price, quality indicators, etc.) that characterise advantages, as well as provide comparison thereof with competitors.
Please characterise competitive capacity of the project applicant with productivity advantages in terms of labour force, materials, energy, capital resources and other factors, as well as characterise product and technology properties that will ensure sustainable competitive capacity advantages of the project applicant.
Please assess technological risks and possible alternative solutions to problems.
Please describe the strategy for the protection of intellectual property created as a result of the project.
Description specifying how maintenance of the results achieved within the scope of the project shall be ensured for a period of at least five years after the approval of the final report of the open call project.

2.3.Importance of the project in further development of the project applicant and its partners(up to 2000words). Please provide detailed information on economic indicators and financial justification of the project in the business plan.

Please characterise the impact of the project on the economic activity of the enterprise over a period of at least three years after project implementation and please provide information on the following economic indicators in the justification:
-discounted money value (NPV) during the project implementation (over a period of five years after project implementation);
-planned export volume and its increase (target states, target audience a.o. aspects);
-planned increase in the number of work places;
-profit indicators;
-turnover;
-etc.

2.4.If upon the implementation of the project a new technology, which will ensure significant changes in the production process, is introduced, please provide information on the depreciation of assets related to the change of production processes over a period of last three fiscal years (if applicable). If upon the implementation of the project a new product, which is related to diversification of economic activity, is introduced, please specify the accounting value of the used assets that has been registered in the previous fiscal year prior to the commencement of the open call project (if applicable).

2.5.Project implementation place (one project implementation place must be specified)

Please specify the following:

Address of the project implementation place (if it is possible to specify):
Municipality:
Planning region (mark the appropriate): / Kurzeme
Latgale
Zemgale
Vidzeme
Riga Region
City (please specify): / Riga City
Another city
Administrative unit (mark the appropriate): / Entire Latvia

2.6.Field of project implementation (one field of project implementation must be specified)

NACE Rev.2 class ______
Name ______

2.7.Potential impact on the environment

Eligibility of the project to the support fields of programme "Green Industry Innovation" (please mark the appropriate field)

No. / Field of project implementation / (X)
1. / Production of renewable energy
2. / Production of environment-friendly and energy efficient materials and products for buildings and structures
3. / Clean transportation
4. / Water management
5. / Waste management
6. / Ecodesign
7. / Any other improvements in products, technologies or processes in other fields, contributing to energy efficiency, lower emissions or lesser consumption of resources

Explanation about the environmental impact of the project(up to 2000words)

Please provide an explanation on how the technology, service or product elaborated within the scope of the project shall reduce the impact on the environment. Accurately measurable indicators*, characterising reduced impact on the environment and the expected extent of the impact over a period of five years after project implementation, must be indicated and substantiated in the explanation. The substantiation must include calculations on the impact on the environment and explanations of methods used in the calculations.
Please characterise the impact and provide an analysis also about the planned compliance of the impact with goals determined in environment planning documents (Sustainable Development Strategy of Latvia until 2030; Environmental Policy Guidelines for 2009-2015).

* Examples of impact substantiation indicators:

1.Reduction of air pollution (SO2, NO2, O3, CO, PM2,5, PM10, C6H6, NOx, non-methane volatile organic compounds, NH3) (kg per year per each polluting substance).

2.Water management:

• reduction of biogenic element emission in surface waters (Nkop and Pkop) (kg per year);

• reduction of oxygen-using organic substance input in surface waters (BSP5) (kg per year); and

• reduction of water loss (m3 per year).

3.Reduction of greenhouse gas (CO2, CH4, N2O, SF6, HFC, PFC) emissions (Gg CO2 equivalent per year).

4.Waste management:

• reduction of accumulated waste (domestic and hazardous waste) (t per year);

• reduction of buried domestic waste (t per year);

• accumulated domestic and hazardous waste (t per year); and

• processed domestic and hazardous waste (t per year).

5.Use of natural resources:

• volume of underground water extraction (thousand m3 per year);

• volume of surface water extraction (thousand m3 per year); and

• area of polluted territories subject to remediation, recultivation (ha).

6.Energy efficiency:

• reduction of energy resource consumption (%).

2.8.Substantiation for necessity of financing (filled in only by large sized enterprises):

a material increase in the total amount spent by the beneficiary on the project/activity due to the aid (Article 6(3)(b)(2) of Commission Regulation (EC) No.651/2014 of 17June 2014);
Explanation (up to 500words):
a material increase in the scope of the project/activity due to the aid (Article 6(3)(b)(1) of Commission Regulation (EC) No.651/2014 of 17June 2014);
Explanation (up to 500words):
a material increase in the speed of completion of the project/activity concerned (Article 6(3)(b)(3) of Commission Regulation (EC) No.651/2014 of 17June 2014);
Explanation (up to 500words):
PART3. PROJECT IMPLEMENTATION
3.1.Planned total project implementation length:
(in full months)

3.2.Time frame for the implementation of activities intended within the scope of the project.

Activity / Time frame of activities planned to be implemented within the scope of the project implementation (months)
1. / 2. / 3. / 4. / 5. / 6. / 7. / 8. / 9. / 10. / 11. / 12. / 13. / 14.
  1. activity
...
  1. activity
...
  1. activity
...
...

3.3.Description of eligible activities intended within the scope of the project

Please provide a brief explanation on the planned activities, planned results and indicative activity financing.

Eligible activities / Planned financing of eligible activities / Time frame for the implementation of eligible activities (from mm.yyyy to mm.yyyy) / Description of eligible activities / Planned result of eligible activities
  1. activity
...
  1. activity
...
...
PART4. PUBLICITY

4.1.Types of information and publicity events of the project that shall be implemented to meet the publicity requirements of the project(mark the number of the relevant measures):

Plate in the premises
Press releases
Spread of information in mass media
Informative stands
Informative plates
Information in the website on the Internet
Other (please specify)

4.2.Please characterise measures referred to in Section4.2 that shall be implemented during the project implementation to meet the requirements in respect of project publicity:

PART5.IMPACT OF THE OPEN TENDER PROJECT ON CROSS-CUTTING ISSUES

5.1.Impact of the project on cross-cutting issues— social sustainability and gender equality (please select one of the provided options) (up to 200words)

YES / Disadvantaged workers or workers with disabilities shall be employed in this project. Furthermore, these persons shall form at least 15% of the total number of persons employed in this project. "Disadvantaged workers" and "workers with disabilities" are persons who comply with the definitions included in Article2(3) and Article2(4) of Commission Regulation (EC) No.651/2014 of 17June 2014 declaring certain categories of aid compatible with the internal market in application of Articles107 and 108 of the Treaty (General block exemption Regulation).
NO
Explanation:
YES / Project applicant has studied the social portrait of the target group of the project, including division according to gender, age and disability.
NO
Explanation:
YES / The project provides for special measures, taking into account different needs of workers in respect of their gender, age group, and other possible risks of social exclusion.
NO
Explanation:
YES / At least 40% of project management shall consist of females.
NO
Explanation:
PART6. DETAILED BUDGET OF THE OPEN CALL PROJECT

Please fill in the tables with the required calculations of costs, as well as include detailed information on calculations and well-grounded assumptions in the business plan of the project.

6.1.Total project costs pursuant to eligible activities within the scope of the project
Title of eligible activity / Total eligible costs in euro (a) / Total ineligible costs in euro (b) / Total costs in euro (a+b) / Volume of requested financing (euro) / Requested grant rate (%)
1.Purchase of new equipment(purchase of equipment, installation and instruction of the personnel working with equipment)
2.Publicity events of the open call project.
3.Research activities(related to introduction of a new product, service or technology in production).
4.Knowledge transfer with project partner(necessary for the introduction of a new product, service or technology in production).
5.Costs of a credit institution guarantee.
Total: (1.+2.+3.+4.+5.)

6.2.Cost estimate of the project

Cost position of the project / Title of the unit / Units, quantity / Unit costs (euro) / Total costs (euro) / Eligible costs (euro) / Ineligible costs (euro) / Please specify in which six-month period project implementation costs have been included
VAT included / VAT excluded / VAT included / VAT excluded
  1. Costs related to purchase of new equipment. Costs related to delivery, installation of equipment and instruction of the personnel working with equipment can be included in costs related to purchase of equipment:

1.1....
1.2....
...
Total: (1.=1.1.+1.2.+…)
  1. Costs related to publicity events of the project provided for in the project publicity plan of the open call project beneficiary:

2.1....
2.2....
...
Total: (2.=2.1.+2.2.+…)
  1. Research activities related costs in respect of the introduction of a new product, service or technology in production:

3.1....
3.2....
...
Total: (3.=3.1.+3.2.+…)
  1. Costs for financing knowledge transfer with project partner, necessary for the introduction of a new product, service or technology in production:

4.1....
4.2....
...
Total: (4.=4.1.+4.2.+…)
  1. Costs of a credit institution guarantee:

...
Total: (1.+2.+3.+4.+5.)

6.3. Project financing sources* (cash flows)

Financing sources of the total costs of the project
during project implementation / Sum (euro) / %
1.Programme co-financing, including
1.1.the amount of advance payment
2.Own resources of the project applicant (free from entrepreneurial support)
3.Loan from a credit institution
4.Financial means received as entrepreneurial support (guarantees, loans or risk capital investment)
5.Other (please specify the source of financing)
Total (1.+2.+3+4.+5.) / 100%

*It is necessary to indicate the total sum of project financing sources that is not below the total project costs specified in Section6.1.

If a loan from a credit institution has been indicated as a source of financing, please specify from what bank it is planned to take the loan, as well as specify the contact person at the bank who can provide more detailed information on the loan.

Please specify from what bank it is planned to take the loan, as well as specify the contact person at the bank who can provide more detailed information on the loan:

6.4.Proof of expenditure(Please provide an explanation on costs included in the project and the mechanism used to determine and calculate the cost positions. Proof must be provided to all positions of eligible costs specified in Section6.2. At least the following information must be included in the proof: