ANNEX 5

PROGRAMME BG04“ENERGY EFFICIENCY AND RENEWABLE ENERGY"

FINANCIAL MECHANISM OF THE EUROPEAN ECEONOMIC AREA 2009-2014

INTERIM TECHNICAL REPORT

• This report is prepared and signed by the Project Manager or the person authorized by him
• The undersigned certifies that all data included in the report are true, complete and comprehensive
• The information in the report should be subject to the financial information presented in the financial statements
• The report should be completed in Bulgarian and English

• The Programme Operator will not accept the report, if a field is not filled. In the event that a field is not applicable, mark it.

• The answers to all questions must relate to the reporting period referred to in item. 1.6 below
• Interim reports shall be submitted till 15th of the month following the reporting period as follows:

Reportingperiod / Deadline for report submission
01 Janyary – 30 April / 15 May
01 May – 31 August / 15 September
01 September - 31 December / 15 January

The report shall besubmitted in paperand in electronic formto the address of the Programme Operator:

Programme Operator

Programme BG 04“Energy Efficiency and Renewable Energy"

Financial Mechanismofthe European Economic Area2009-2014

Ministry of Energy

8 Traditza Street

Sofia 1000

The reportis drawn upintwooriginal copies inBulgarianand English- one forthe Project Promoter (stored in the Project file)and one for the Programme Operator.

  1. Description

1.1. Full nameregistrationof the Project Prormroter,according to the contract for grant:
1.2. Name, position, telephone and e-mailof the contact person:
1.3. Full name ofthe Project Partners:
1.4. Project Title:
1.5.Contract number:
1.6. Start and enddateofthe reporting period:
1.7. Target groups

  1. Evaluation of the implementation of project activities
    2.1. Activities and results
    Describe all activities in accordance with Annex A to the contracts executed during the reporting period.
    Number and title of the activity:
    Describe the results in the activity during the reporting period
    For the implementation of activities related to information and publicity, fill item. 4.
    Attach all supporting documents proving the work done.
    2.2. Indicators achieved during the reporting period
    Throughout the implementation of the project, you have to gather information on the indicators that are set in the project proposal and accumulate this information in the interim report to the Programme Operator.

Activity / Specific targets / Expected results / Indicators set / Indicators achieved

2.3. Describe any changes in the contract / order for awarding a grant (significant or insignificant change)
2.4. You have to describe the plan for the project implementation by including specific activities and dates for events (conferences, roundtables, seminars, trainings and other) up to two months ahead:

Activity / 1 semester / 2 semester / 3 semester / Responsible
Month 1 / Month 2 / Month 3 / Month 4 / Month 5 / Month 6 / Month 7 / Month 8 / Month 9 / Month 10 / Month11 / Month 12 / Month 13 / Month 14 / Month 15 / Month 16 / Month 17 / Month 18
Activity 1 (title)
Activity2 (title)
Activity3 (title)
Etc.

3. Partners and other forms of cooperation
3.1. Describe your relationship with other organizations involved in the project (if applicable):
• Partners
• Contracting partie/s (if any) - all contracts with entities, the applied procedure for the award (if such is held) and name of the contractor
• Describe all contracts with individuals awarded in the context of the implementation of the project during the reporting period, indicating for each contract the value
• Target groups:
3.2. If your organization has received other grants from EC, to what extent in the framework of this project they have been developed / completed, results from the previous project (s)?

4.Information and publicity
How do you ensure visibility and public awareness on the EU financial contribution to the implementation of the project?
Describe the activities providing information and publicity that are fulfilled during the reporting period.
Note: They must comply with the activities envisaged in the project proposal.
Attach all supporting documents proving the work done.

5. On-site checks
Describe all the checks you have made to the project site, as well as any irregularities discovered and corrective measures proposed (if applicable).
Note: Under the agreement with the Programme Operator you are required to make on-site checks on the contractors.
Describe all on-site checks which were made to you by the Programme Operator or other inspection organization / institution, as well as any irregularities detected and corrective measures proposed (if applicable).
6. Audit
Indicate all started and / or completed audits in the reporting period. Regarding completed audits, attach the audit report to this interim technical report.
7. Other
I declare that:
1. All data included in the report are true, complete and comprehensive.
2. Project Partner / partners are familiraized with this report.

Nameof the Project Manageroran authorized person: ......

Signature and seal: ……………

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