Before Completing This Form, Please Read Carefully the Call for Proposals 2016/C 401/11

/ EUROPEAN COMMISSION
DIRECTORATE-GENERAL FOR AGRICULTURE AND RURAL DEVELOPMENT
Directorate E. Economic analysis, perspectives and evaluation; communication
E.5. Internal and external communication

Application for a grant under call for proposals 2016/C 401/11concerning information measures relating to the common agricultural policy

Before completing this form, please read carefully the call for proposals 2016/C 401/11.

Please complete the enclosed forms in full. If a question does not apply to the proposed information measure, please write 'not applicable' or 'n/a'. Only applications submitted on these forms will be considered.

You will find below a specimen letter of application for a grant.

The maximum EU contribution shall be minimum EUR70.000 and maximum EUR500.000 (flat rate included).

Before sending your application to the Commission, please check that you have enclosed all the documents required (see the checklist at the end of this application form).

Your reply to the grant application will involves the recording and processing of personal data (such as your name, address and CV), which will be processed pursuant to Regulation (EC) No 45/2001 on the protection of individuals with regard to the processing of personal data by the EU institutions and bodies and on the free movement of such data. Unless indicated otherwise, your replies to the questions in this form and any personal data requested are required to assess your grant application in accordance with the specifications of the call for proposals and will be processed solely for that purpose by the relevant services in the European Commission. Details concerning the processing of your personal data are available on the privacy statement at:

Your personal data (name, given name if natural person, address, legal form, registration number and name and given name of the persons with powers of representation, decision-making or control, if legal person) may be registered in the Early Detection and Exclusion System (EDES) if you are in one of the situations mentioned in Article 106 of the Financial Regulation[2]. For more information, see the Privacy Statement on

You are informed that, to ensure that the Union’s financial interests are protected, your personal data may be communicated to internal audit services, the European Court of Auditors, the body specialising in financial irregularities or the European Anti-Fraud Office (OLAF).

The data of applicants in any of the situations referred to in Articles 106(1) and107(1) of the Financial Regulation may be included in a central exclusion database and communicated to designated persons in the Commission, the other institutions, agencies, authorities and bodies referred to in Article 108 of the Financial Regulation. This also applies to those with powers of representation, decision-making power or powers of control in respect of such applicants. Following a request to the Commission’s Accounting Officer, anyone registered in the database is entitled to be informed of the data recorded about them.

Specimen letter of application for a grant
(to be written on the applicant’s headed paper)

European Commission (date)
Unit AGRI. E5(place)
Call for proposals 2016/C401/11
Attn. Head of Unit AGRI. E5
L130 4/149
B-1049 Brussels

Application for a grant under call for proposals 2016/C401/11 concerning information measures relating to the common agricultural policy

Dear Sir/Madam,

I enclose the file concerning my application for a grant to finance the information measure entitled: [title of the information measure].

The estimated budget of the action is EUR [x],

The total amount of theEU contribution is EUR [x], which is composed of:

i) EUR [x] representing 60 % of the total eligible directcosts of the information measure;

and

ii) EUR[x] representing a flat rate amount of 7 % of the total eligible direct costs.

If my application for a grant is successful, I accept the reference conditions provided for in the grant agreement available on the Europa website

I also undertake to give immediate notice in writing of any change to the programme or to the budget of the action and of any change to the information provided in this application and its annexes.

Yours faithfully,

Signature
First name, surname and title of the legally
authorised person responsible within the applicant organisation

FORM1 - THE APPLICANT

1.IDENTITY OF THE APPLICANT

1.1.Business name (full legal title):

1.2.Short name (if any):

1.3.Legal status of applicant (association, commercial company, university, etc.):

1.4.Is the applicant a public or private body?

1.5.Legal personality Yes No
(if no, please indicate the representative with capacity to sign contracts)

1.6.Legal registration number:

1.7.Date and place of registration:

1.8.VAT number:

- Please state your VAT number:

- Are you entitled to recover the VAT for the costs that you have included in the expenditure table of the budget? Yes No

- If the answer is no, please specify the percentage of VAT applicable:
_____% and remember to enclose an official document confirming this information (see documentE in AnnexI).

1.9.Head office address:

Address:

City:

Postcode:

Country:

1.10.Tel.:

1.11.Fax:

1.12.Website:

1.13.Legally authorised person responsible within the applicant organisation:

Title: Mr Mrs

Surname:

First name:

Official capacity:

E-mail address:

1.14.Contact person responsible for the proposal

Title: Mr Mrs

Surname:

First name:

Official capacity:

E-mail address:
Tel:Mobile:

1.15.Person financially responsible:

Title: Mr Mrs

Surname:

First name:

Official capacity:

E-mail address:

1.16.In which language do you prefer the Commission to communicate with you?

EnglishFrenchGerman

Any change in the above mentioned information must be notified in writing to the authorising officer. The authorising officer will not be held responsible in the event s/he cannot contact an applicant.

2.INFORMATION CONCERNING THE APPLICANT

2.1.Summary of the aims and activities of the applicant (half-page maximum):

2.2.Structure of the organisation:

2.2.1.What are the member organisations of the applicant (if any)?

MemberState / Type of organisation, name, address, tel., fax, e-mail / Number of active members of the organisation

2.2.2.To what organisation(s) does the applicant belong (if any)?

MemberState / Type of organisation, name, address, tel., fax, e-mail / Number of active members of the organisation

2.3.Information on the governance of the applicant

2.3.1 APPLICANT'S STRUCTURE
List the organisations and/or natural persons holding capital or shares in the applicant, where appropriate specifying the proportion held (insert rows if necessary)
Organisation/Natural person / Proportion held
2.3.2 APPLICANT'S MANAGEMENT
List the members of the applicant's managing board or equivalent body, specifying their profession and position(insert rows if necessary)
Member / Profession/Position
2.3.3 OTHER AFFILIATED ENTITIES
List legal entities having a legal or capital link with the applicant (insert rows if necessary). Declare only information about affiliated entities that will participate in the action.

2.4.Technical and professional capacity of the applicant:

2.4.1.Applicant's average annual number of staff over the last three years:

2.4.2.Experience of the staff who will prepare, implement, follow up and evaluate the information measure to which this application relates, and description of the tasks assigned to each member of staff involved in the information measure (please enclose CVs):

(Please describe the tasks assigned to each member of staff within the framework of the information measure and enclose the relevant curricula vitae.)

2.4.3.Applicant’s professional experience over the last two years in the areas covered by the information measure proposed (give no more than five examples of experience):

(For each example of experience, please provide a short description of the information measure put into effect, including the title, the type of information measure, the programme for the measure [in the case of seminars and conferences] or the content [in the case of publications and audiovisual productions], specifying the particular subjects dealt with, the place in which the information measure was put into effect, the total cost of the information measure and the sources of funding.)

2.5.Other grants applied for from the European Union:

2.5.1.Have you received any grant from the European Unionin the last three years?

(If so, please state the amount, the institution and the programme concerned, the year of the grant and the reference number).

2.5.2.In 2014 and 2015, have you applied for a grant for any purpose to European Union institutionor do you intend to do so?

(If so, please state the institution and the details of the grant programme concerned, the amount and percentage of the grant applied for and the type of information measures concerned.)

2.5.3.Have the applicant or affiliated entities received or applied for any Union funding for the same action or part of the action or for its functioning during the action period?

(If so, please specify the institution and the details of the grant programme concerned, the amount and percentage of the grant applied for and the type of information measures concerned.)

2.5.4. Have the applicant or affiliated entities already received confirmation relating any external funding for the action or are awaiting such confirmation?

(If so, please specify)

FORM2

AFFILIATED ENTITIES (if any)

N.B: Please complete a separate form for each affiliated entity which will participate in the information measure

Affiliated entities are legal entities having a legal or capital link with applicants, which is neither limited to the action nor established for the sole purpose of its implementation.

The legal or the capital link shall not be established simply for the purpose of the action nor limited simply to the duration of the action in question (ad-hoc consortia are not eligible). On the contrary, the legal or the capital link shall, as a rule, be a “stable” link encompassing more than just the action in question. A transitional or provisional link would therefore hardly fulfil the conditions.

Similarly, a “soft” link, such as a non-binding link (for example a non-binding Memorandum of Understanding) or, in general, any link where the parties do not clearly imply a legal commitment or clearly intend to create a legally enforceable relationship between them, would very unlikely be considered as the legal link.

A legal link should in addition be appropriately set down in a document of stringent legal nature (see document C below).

A capital link shall be understood as any participation in the ownership of another entity: for this purpose, any document showing this participation should be submitted (see document C below).

For the above purpose, applicants shall identify such affiliated entities in this application form.

If affiliated entities take part in the action, the application shall:

-contain the written agreement of the affiliated entities (see at the end of this form 2);

-specifytheir role in the implementation of the action;

-provide all the relevant supporting documents allowing verification of their complying with the eligibility and non-exclusion criteria set out in this call for proposals.

1.Identity of the affiliated entity

1.1.Business name (full legal title):

1.2.Short name (if any):

1.3.Legal status of the affiliated entity(association, commercial company, university, etc.):

1.4.Is the affiliated entitya public or private body?

1.5.Legal registration number (if any):

1.6.Date and Place of Registration

1.7.VAT number:

- Please state your VAT number:

- Are you entitled to recover the VAT for the costs that you have included in the expenditure table of the budget? Yes No

- If the answer is no, please specify the percentage of VAT applicable:
_____% and remember to enclose an official document confirming this information (see documentE in AnnexI).

1.8.Head office address:

Address:

City:

Postcode:

Country:

E-mail address:

1.9.Website:

1.10.Legally authorised person responsible within the applicant organisation:

Title: Mr Mrs

Surname:

First name:

Official capacity:

E-mail address:

2.INFORMATION CONCERNING THE AFFILIATED ENTITY – TO BE FILLED IN BY EACH AFFILIATED ENTITY

2.1.Summary of the aims and activities of the affiliated entity(half-page maximum):

2.2.Structure of the organisation of the affiliated entity:

2.2.1.In which organisations is the affiliated entity a member(if any)?

MemberState / Type of organisation, name, address, tel., fax, e-mail / Number of active members of the organisation

2.3. Affiliation link (please specify)

Affiliated entity's Statement

I, the undersigned, hereby agree to participate in the information measure "Title" and to assume the responsibilities of an affiliated entity.

I acknowledge that:

1. I have read the call for proposals and application form and understood my role in the action before the application is submitted to the European Commission.
2. I have read the standard grant agreement and understood what my respective obligations under the agreement will be if the grant is awarded.
3. I authorise the entity to which I am affiliated to sign the agreement on my behalf with the European Commission and represent me in all dealings with it in the context of the action’s implementation.

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

Name:
Organisation:
Position:
Signature:
Date and place:

FORM3

DETAILED DESCRIPTION OF THE INFORMATION MEASURE

1. TITLE OF THE INFORMATION MEASURE
2. DETAILED DESCRIPTION OF THE INFORMATION MEASURE
A. Call for proposal point 9.1
The relevance of the measure: the ex-ante analysis of the needs and the specific, measurable, attainable and relevantobjectives and its innovative character. (25 points; minimum required 12,5 points)
Describe the ex-ante analysis of the needs in relation to the objectives of the call and how did you make the analysis (statistics, findings, experience, …) (maximum 3 pages)
B. Call for proposal point 9.2
The effectiveness of the measure: theme, messages and target public, detailed programme, timetable and ex-post evaluation methodology. (25 points; minimum required 12,5 points)
B.1 Describe the general and specific objectives that the information measures aims to achieve (maximum 6 pages).
The applicant should explain how the general and specific objectives of the information measures will contribute to the objectives of the Union grant programme concerned.
Please also explain if and in what way the action include innovative tools?
Where possible, specify related indicators to assess theproject's achievements and expected impacts.

• Specific objectives: Please link your activities proposed to the ex ante analysis and the objective of the call.
• Which are the target groups (Please only quote them)
• How many activities? Title of each activity?
• For each activity:

• How many people expected to be directly reached and what percentage of the target group they represent?
• How many people expected to be indirectly reached and what percentage of the target group they represent? Please justify the number of people expected to be reached, the number of regions/countries targeted? How will you calculate?

• How many outputs expected (brochures, seminars, conferences, radio spots, etc?)
• How many regions/countries targeted?

B.2Describe the information measures (on the basis of the main activities planned) and where it will be implemented. (maximum 10 pages)
Please describe the theme, messages and target public, detailed programme, timetable and ex-post evaluation methodology
The answer will be evaluated under the criteria n°2:The effectiveness of the measure: theme, messages and target public, detailed programme, timetable and ex-post evaluation methodology. (25 points; minimum required 12,5 points)
TIMETABLE FOR EACH STAGE OF THE INFORMATION MESURES SHOWING MAIN DATES AND EXPECTED RESULTS FOR EACH STAGE (table to be repeated as many times as necessary)
Semester 1 / Semester 2
Activity / Month 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
Preparation Activity 1 (title)
Implementation Activity 1 (title)
Preparation Activity 2 (title)
Etc.
Expected results at the end of the action (The expected results must be concrete, realistic and quantified as far as possible. The applicant should specify the benchmarks or deliverables which the applicant intends to employ to achieve the expected results and targets and how they will be used and disseminated. See annex "Report").
C.Call for proposal point 9.3
The efficiency of the measure: the cost-effectiveness in terms of the proposed resources(25 points; minimum required 12,5 points)
The efficiency of the measure (maximum 4 pages)

• How do you justify the costs of the measure compared to the outputs ?

• What part of the budget will be subcontracted to third parties

List here in detail all parts of the activities that will be subcontracted to third parties for implementation by clearly referring to the relevant budget lines and the indicative amount from each budget line that will be subcontracted. Sum up the total of the budget to be subcontracted to third parties. (Contracts must be awarded to the subcontractor offering best value for money, care being taken to avoid any conflict of interest.)
Budget Line / Amount to be subcontracted / Detailed description of activities
to be subcontracted / Reasons for recourse to subcontracting
Total budget to be subcontracted
D. Call for proposal point 9.4
The quality of the project management: the quality of the procedures and of the allocation of tasks in view of implementing the various activities of the proposed measure. (25 points; minimum required 12,5 points)
- The quality of the project management(maximum 2 pages)
- Expected constraints and risks (maximum 2 pages)
Describe possible constraints and risks involved in the action implementation, how they may affect the objectives, activities and outcomes of the project and how they will be mitigated.
3. PLANNED DURATION OF THEACTION
Planned duration of the action (in months):
Planned starting date:
LEGAL NOTICE
Applicants are informed that, under the Financial Regulation applicable to the general budget of theEuropean Union, no grants may be awarded retrospectively for actions already completed. Inthose exceptional cases accepted by the Commission where applicants demonstrate the need to start the action or work programme before the agreement is signed or the decision notified, expenditure eligible for financing may not have been incurred before the grant application was lodged before the start of the beneficiary's budgetary year.
4. BUDGET
Estimated Budget (Expenditure table and Income table)
Applications must include a detailed estimated budget in balance in which all costs are given in euros. Applicants from countries outside the euro zone may use either the conversion rates published in the Official Journal of the European Union, series C, during the month in which they are submitting the application, or themonthly rate published on the Commission's website at .
Summary (in €)
a) Eligible costs:
b) Total costs:
c) Requested Union Funding:
d) Rate of funding requested:

Document A