For Grants Signed On

Annex IV

(to the Grant Agreement)

Model Technical and Financial Report

GENERAL OVERVIEW

The final implementation reports consist of:

(1) a narrative (technical) part, describing the project activities, products and results; and

(2)a financial part, which must be presented according to the model used for the description of the envisaged budget (see tables in Annex V).

The final implementation reports must be presented to the Commission in two versions – one original and one electronic version (CD or USB) - signed and dated by the legal representative of the beneficiary of this agreement, within two months of the end of the project as specified in Article I.2.2 of the agreement.

Please note that original version of the presence list(s)* signed by participants as well as the participants evaluation questionnaires (see annex XI and XII) must be attached to the final technical report.

* one per day

THE FINANCIAL PART

The financial report has to be presented followingthis modeland accompanied by your correspondent final budget (annex III). The financial report has to respect the order of the headings and to be accompanied by a clear explanation of the means by which the amounts have been calculated

The beneficiary is also asked to submit proof of all expenditure (original invoices[1]).

Technical and financial implementation report

Grant agreement HT.XXXX/SI2.XXXXXX

Training of National Judges – Call for Proposals 2015

Title of the project

Promoter:

Start date and end:

Date and location of main event:

Table of Contents[2]

A) NARRATIVE TECHNICAL REPORT (max 15 pages)

Background on the project
Objectives at the moment of application
Expected results and impact at the moment of application
Partners at the moment of application
Work plan and time table at moment of application
Implementation of the project
Objectives achieved
Description of programme and speakers
Number and nationalities of participants
Description of milestones event/activity
Feedback from participants
Strategic implementation
Marketing
Methodology, tools and technology applied
Monitoring and evaluation arrangements
Partners
Feedback on the implementation of the project
Report any divergence from initial work plan
Report any difficulties encountered during the implementation
Provide recommendations to the Commission for future improvements
Products, results and their dissemination
Qualitative and quantitative description of the project results and/or products, and copies of any products produced
Elements of good practice identified and discoveries made
Dissemination measures undertaken
Intellectual property rights, copyright
Commercialisation strategy
Annexes for the technical report
Original attendance list signed by participants
Filled beneficiary questionnaire (annex IV.e)
Programme/brochure event, copy of documents distributed
Original evaluation questionnaires (PEQ) signed by participants
Products: publications (at any stage), print screens and links of online learning platforms, pictures etc.

B) FINANCIAL REPORT

Financial plan and final budget signed and dated (printed excel table)
Annexes to the financial report

Annexes:

IV.aTemplate request pre-financing

IV.bTemplate request final payment

IV.cCheck list of supporting documents for a complete financial report

IV.dTemplate cover page for annexes to the financial report

IV.eBeneficiary questionnaire

Annexes IV.a
Template request for pre-financing

XX/XX/201X

European Commission

DirectorateGeneral Competition

Directorate R

Unit R2 – Resources, Ethics and Security

MADO 13/028

1049, Brussels - Belgium

Reference number: HT.XXXX, SI2.XXXX

Subject: Request for pre-financing

I hereby request a pre-financing payment under the Grant Agreement mentioned above.

The amount requested is XX,XXX.XX € (representing 50% of the maximum EU Commission contribution as specified in Art. I.3.).

The payment should be made to the following bank account:

Bank name

Address

Account N°

Iban

Swift/BIC code

Yours faithfully

Name of representative

Signature of legal representative

Annexes IV.b
Template request of final payment

XX/XX/201X

European Commission

Directorate General Competition

Directorate R

Unit R2 – Resources, Ethics and Security

MADO 13/028

1049, Brussels - Belgium

Reference number: HT.XXXX, SI2.XXXX

Subject: Request for final payment

In accordance with Art I.4. of the above-mentioned Grant Agreement, I hereby request a final payment of the balance to be paid by the EU Commission.

The amount requested is XX,XXX.XX €.

The payment should be made to the following bank account:

Bank name

Address

Account N°

Iban

Swift/BIC code

Yours faithfully

Name of representative

Signature of legal representative

Annexes IV.c
Check list of supporting documents for a complete financial report

PART A –Expenditure/eligible costs

A.a) Cost of staff assigned to the operation

Copies of contracts with each staff member, clearing mentioning monthly salary
Table explaining calculation cost per day of staff (ex. 1 day=8 hours) and if necessary hours rates
Original (or certified) worksheet signed and dated by each staff allocated to the project, containing hours worked (on what) per month.

A.b) Travel and subsistence expenses for staff involved in the operation

Original proof of expenses for travels (invoice stating price paid, original tickets issued, original boarding passes, train tickets, taxi receipts etc.) and accommodation (hotel invoice clearing mentioning name of guest(s), number of nights spent, and the amount paid), ordered by staff name.
In addition to point 1., if costs are borne by staff, proof of reimbursement.
Unit costs for accommodation, meals and refreshments (Annex IX of your Grant Agreement)-headings A.b), A.c), A.d)- should be applied. The original attendance list signed by participants, the original hotel rooming list(s) will be sufficient as supporting documents.

A.c) Travel, subsistence expenses and other costs for participants

Original proof of expenses for travels (invoice stating price paid, original tickets issued, original boarding passes, train tickets, taxi receipts etc.) and accommodation (hotel invoice clearing mentioning name of guest(s), number of nights spent, and the amount paid), ordered by participant.
In addition to point 1., if costs are borne by participants, proof of reimbursement.
Unit costs for accommodation, meals and refreshments (Annex IX of your Grant Agreement)-headings A.b), A.c), A.d) - should be applied. The original attendance list signed by participants, the original hotel rooming list(s) will be sufficient as supporting documents.

A.c) Travel, subsistence expenses and other costs for speakers

Original proof of expenses for travels (invoice stating price paid, original tickets issued, original boarding passes, train tickets, taxi receipts etc.) and accommodation (hotel invoice clearing mentioning name of guest(s), number of nights spent, and the amount paid), ordered by speaker.
In addition to point 1., if costs are borne by speakers, proof of reimbursement.
Unit costs for accommodation, meals and refreshments (Annex IX of your Grant Agreement)-headings A.b), A.c), A.d) - should be applied. The original attendance list signed by participants, the original hotel rooming list(s) will be sufficient as supporting documents.

A.c) Travel, subsistence expenses and other costs for interpreters

Original proof of expenses for travels (invoice clearing stating price paid, original tickets issued, original boarding passes, original train tickets, original taxi receipts etc.) and accommodation (original hotel invoice clearing mentioning name of guest(s), number of nights spent, and the amount paid), ordered by interpreter.
In addition to point 1., if costs are borne by interpreters, proof of reimbursement.
Unit costs for accommodation, meals and refreshments (Annex IX of your Grant Agreement)-headings A.b), A.c), A.d) - should be applied. The original attendance list signed by participants, the original hotel rooming list(s) will be sufficient as supporting documents.

A.d) Cost of meals/refreshments

Unit costs for accommodation, meals and refreshments (Annex IX of your Grant Agreement)-headings A.b), A.c), A.d) - should be applied. The original attendance list signed by participants, the original hotel rooming list(s) will be sufficient as supporting documents.

A.e) Interpreters fees

Copy of the contract(s) clearly mentioning languages translated, hours worked, date(s) of service (+ proof of payment)
Invoice clearly mentioning languages translated, hours worked, date(s) of service, amount paid.

A.e) Speakers fees

Copy of the contract(s) clearly mentioning work performed, hours worked (or forfeit established), date(s) of service, fees expected (+ proof of payment)
Invoice clearly mentioning hours worked, date(s) of service, amount paid.

A.f) Cost of equipment, land and immovable property (rent purchase)

For cost of equipment (rent or purchase) please provide an original invoice and specify the usage rate and depreciation rule applied. You can only charge to the project the equipment's depreciated value. The direct link to the project implementation should also be presented.
Original invoice of rental costs, clearly mentioning the item rent, the price per unit and the duration of the rent (in months/days). The direct link to the project implementation should also be described.If costs of rental of equipment are part of a service (room rental, hotel invoice), the cost should be clearly detectable.

A.g) Cost of consumable and supplies

The costs of consumables and supplies are eligible, provided that they are identifiable and exclusively used for the purpose of the project.

General office supplies (pens, paper, folders, ink cartridges, electricity supply, telephone and postal services, Internet connection time, computer software, etc.) are considered as indirect costs (A.j).

A.h) Cost of publications and reports

Original invoices of printing jobs, clearly mentioning the name of the document printed, pages and number of items
Original invoices of editing or proof-reading or translations of texts, clearly mentioning the rate per page and the pages analysed.
Original invoice of publications costs, clearing mentioning the price per unit and the number of items published.

A.i) Any other direct costs

Original postage invoices, clearly linked to the project.
Proof of bank charges, clearly linked to the projects.
Accounting/audit invoices clearly linked to the projects, specifying the hours/days worked and the rate per hour/day.

A.j) General costs linked to the operations

A calculation of up to maximum 7% of the total eligible costs (if already present in the original budget – Annex III).

Annexes IV.d
Example cover page for annexes to the financial report
Heading / A.a
N° of item / 1
Title / Pay slip Mr Red
Description / Monthly pay slip of Mr Red
Heading / A.c / Participant
N° of item / 56
Title / Reimbursement travel Mr Smith
Description / Travel from London to Bratislava (A/R) for event 15/06/2011- Taxi+Flight
Annexes IV.e
Beneficiaries' Evaluation Questionnaire

Please note that this template is a standard document, thus,if a section is not applicable to your specific project please indicate with 'N/A'. Where space is provided for additional information ensure that the changes are reflected in the Participants' Evaluation Questionnaire (PEQ). Whenthe data required to answer these questions has to be gathered from the PEQ, the corresponding question in the PEQ is indicated (e.g. PEQ 1.a).

1. Awareness-raising

Please indicate the number of persons reached by activities/materials raising awareness of the project:

Whereas activities such as sending emails and brochures or the number of hits on a website are easily quantifiable (e.g. number of emails, number of visitors to a website), the number of persons viewing a poster, for example, is not. Thus, in that case, the number of posters sent or personally displayed should be indicated.

Awareness-raising activity/material / Number of persons
Number of brochures or invites sent by email
Number of brochures or invites sent by post
Information displayed on a website (number of visitors to the website)
Information disseminated on an online forum (number of enrolled users)
Presentation given in public (number of participants)
Posters displayed ((number of locations/number of posters sent or displayed) x50)
Number of persons contacted by telephone
Other (please specify)

2. Number and geographical scope of participants

Using the data gathered from the participant identity boxes in the PEQ:

a.(i) Please specify the number of judges who participated in the project:

Please specify their nationalities: