Annex Ii to Grant Application Form

ANNEX II TO GRANT APPLICATION FORM

This annex has to be filled in if the total amount in the Budget Heading 4 “Infrastructure and Long-Term Investments” equals or exceeds EUR 50000; delete this line after filling

Detailed Description and Justification of Equipment and Works

<The information in case of planned works should cover such aspects:

1) Location the infrastructure object (including photos, if applicable);

2) Ownership of investments/ buildings/ land or access to land;

3) Socio-economic analysis of situation, justifying the need for investments;

4) Detailed description of object/investments and the planned works related to construction, renovation, reconstruction, modernisation, installation of infrastructure, including technical parameters. Information on readiness for implementation (availability of technical documents, permissions, etc.). Explanation about commissioning into exploitation;

5) Estimated results and their quantification (i.e. increase in capacity, improved service by number, %) and impact on target groups;

6) Financing plan of investment activity (stages of works and payments);

7) Impact on environment.

NB: The budgeted cost of works shall be based on the most recent cost estimates in current prices. Only the cost of the works which can be finalised within the project and independently commissioned into exploitation (e.g. the whole construction project, separated stages or launching complexes) , if this is required by the legislation, by the end of the project shall be included into the budget.

NB: It is required that the Beneficiaries and Lead Beneficiary implementing construction works ensure sufficient reserves of financing from own sources outside of the Project budget to invest in case of unexpected works in order to have the works finalised and commissioned into exploitation if applicable.

In case of purchase or rent of equipment (new or used) specifically for the purpose of the project provide the detailed explanation about the planned equipment and justify their necessity for the Project.

The information in case of planned equipment should cover such aspects:

1) Location the equipment and ownership;

2) Detailed description of the equipment and its technical parameters and way of use;

3) Socio-economic analysis of situation, justifying the need for equipment;

4) Estimated results and their quantification (i.e. increase in capacity, improved service by number, %) and impact on target groups;

5) Financing plan of investment activity (stages of installation and payments).

NB: Costs of equipment (purchase or rent) shall correspond to current market prices. Purchase/rent of equipment and vehicles is subject to procurement rules described in the Guidelines for Grant Applicants. In addition, as indicated in the Guidelines for Grant Applicants, the Rules of origin and nationality shall be applied for procuring of the equipment and supplies. All such contracts have to strictly follow procurement procedures with origin and nationality rules described in the Guidelines for Grant Applicants. Delete these instructions after filling.>

Name and position of the signatory

Signature

Date

1