Proposal Submission Forms

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A1
Proposal Nr.
Multi-Annual Programme 2007-2013
Annual Programme
General Information on the Proposal
Title of the proposed action
Priority/Horizontal project / ▼ / Section (only for PP) / ▼
Transport mode / ▼
Start date of the Action / End date of the Action
Summary (up to 2000 characters)
Proposal field

Please enter the proposal field:

Proposal field:
Proposal type

Please ‘tick’ the box with the proposal type:

Study
Work

For ERTMS proposals only:

Trackside infrastructure
On board equipment
Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A2.1
Proposal Nr. / Applicant Nr
Information on Organisations
Organisation legal name
Administrative data
Legal address
Street name / Number
Town / City
Postal Code / Cedex
Country
Legal status of the applicant

Please ‘tick’ the box with the legal status of the applicant.

MemberState
Public Undertaking or Body
Private Undertaking or Body
International Organisation(*)
Joint Undertaking(*)

(*)Please attach the letter(s) containing the approval of the MemberState(s) concerned.

For multi-beneficiary proposals only.

Coordinating applicant

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A2.2
Proposal Nr. / Applicant Nr
Contact points
Contact person
Family Name / First name(s)
Function
Is the address different from the legal address? / YES/NO
Street name / Number
Town / City
Postal code / Cedex
Country
Phone
Fax
E-mail
Authorised representative to sign this application
Family Name / First name(s)
Function
Is the address different from the legal address? / YES/NO
Street name / Number
Town / City
Postal code / Cedex
Country
Phone
Fax
E-mail
Date
Stamp (*) and signature

(*) As foreseen by the ministry concerned.

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A2.3
Proposal Nr. / Applicant Nr
Financial identification
Account holder
Family name (1) / First name(s)
Street name / Number
Town / City
Postal code / Cedex
Country
Contact person
Family name / First name(s)
Phone
Fax
E-mail
Bank
Bank Name
Branch address
Street name / Number
Town / City
Postal code / Cedex
Country
Account number
IBAN (2)
REMARKS:
BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE
(Both Obligatory)(3) / DATE + SIGNATURE ACCOUNT HOLDER :
(Obligatory)
Date:

(1) The name or title under which the account has been opened and not the name of the authorized agent.

(2) If the IBAN Code (International Bank account number) is applied in the country where your bank is situated.

(3) It is preferable to attach a copy of recent bank statement, in which event the stamp of the bank and the signature of the bank's representative are not required. The signature of the account-holder is obligatory in all cases.

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A2.4
Proposal Nr. / Applicant Nr
If your organisation is a MemberState, introduce below the
Public or private undertaking or body(ies) which will implement the Action
Organisation legal name
Administrative data
Legal address
Street name / Number
Town / City
Postal code / Cedex
Country

(*) If there are more than one implementing body, please introduce them all.

If your organisation is a Public or Private undertaking or body, introduce below the
MemberState approving this application
Ministry legal name
Administrative data
Legal address
Street name / Number
Town / City
Postal code / Cedex
Country
Authorised representative to sign this application
Family name / First name(s)
Function
Is the address different from the legal address? / YES/NO
Street name / Number
Town / City
Postal code / Cedex
Country
Phone
Fax
E-mail
Date
Stamp (*) and signature

(*) As foreseen by the ministry concerned.

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A3.1
Proposal Nr.
Location of the Action
MemberState(s) / ▼ / ▼ / ▼ / ▼ / ▼
Region(s) (1) / ▼ / ▼ / ▼ / ▼ / ▼

(1) Regions will be given following NUTS 2 nomenclature.

Geographical co-ordinates
Long (X) (2) / Lat (Y) (2)
Start point
Interim point 1
Interim point 2
…
Interim point n
End point

(2) Long & lat must be given in a seven digit number (+ or - sign followed by three digits and by four decimals).

Activities of the Action
Activity number / ISIC code (3) / Activity name / Start date / End date / Verifying milestone
▼
▼
▼
▼

(3) For complete description and other codes, see:

Milestones of the Action
Milestone number / Milestone name
(including milestones at start and end date of the Action) / Expected date / Means of verification
Contribution of the Action to the TEN-T policy objectives

If the Action is part of a Global Project previously supported under the TEN-T budget, please specify:

Decision number / Title

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A3.2
Proposal Nr.
Financial information
Global project
SOURCES OF FINANCING / Contribution
1. State budget (-s)
2. Regional/local budget
3. Project promoter (Public or Private)
4. EIB loan
5. Other loans
6. TEN financing
7. Other EU funds (ERDF, CF, FPR)
8. Other sources
Total

For multi-beneficiary projects, please give only the total amounts per category.

Proposed Action
SOURCES OF FINANCING / (*) Total proposed contribution / 2008 / 2009 / 2010 / 2011 / 2012 / 2013 / >2013
1. State budget(s)
2. Regional/local budget(s)
3. Action promoter
(Public or Private)
4. EIB loan
5. Other loans
6. TEN financing
7. Other EU funds
8. Other sources
Total

(*) Contribution to eligible costs only.

For multi-beneficiary actions, please split state and regional budgets by applicant.

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A3.3
Proposal Nr.
Indicative breakdown of estimated eligible costs of the Proposed Action by activities
Activities / 2008 / 2009 / 2010 / 2011 / 2012 / 2013 / >2013 / Total eligible cost
1.DIRECT COST
1.1 Activity 1
1.2 Activity 2
1.3 Activity 3
1.4 Activity 4
1.5 Activity 5
1.6 Activity 6
….
1.N Activity N
SUBTOTAL DIRECT COST
2. INDIRECT COST
Flat rate funding up to 7% of total direct cost
TOTAL ELIGIBLE COST

Please give an indicative breakdown of estimated eligible costs of the proposed Action, i.e. the action for which a financial contribution from the TEN-T Programme is requested in this application, by activities (Activities from section A3.1) and year (all amounts are in EUR).

For multi-beneficiary actions, please fill in a table with the global breakdown of the costs and one table per applicant with respective costs per activity. This does not apply to multi-beneficiary actions which have a common financial structure.

Proposal Submission Forms
/ EUROPEAN COMMISSION / TRANS-EUROPEAN TRANSPORT NETWORK / A3.4
Proposal Nr.
Technical information
ProposedAction
Railways
Current / Target
Year / Value / Year / Value
Length of the section (km)
Number of tracks
Train length
Max speed (km/h)
Axle load
Inclination (deg)
Passenger capacity (persons)
Passenger traffic flow (pax per year)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Rail voltage (V)
Clearance or structure gauge
Voice system radio
Control and command system
Roads
Current / Target
Year / Value / Year / Value
Length of the section (km)
Number of lanes per direction
Max speed (km/h)
Longitudinal gradient (deg)
Vehicles capacity per direction (vehicles/day)
Annual average daily traffic per lane (vehicles/day)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Percentage of heavy good vehicles (%)
Road toll (euros/km)
Number of fatal accidents
Electronic management system (Y/N)
Airports
Current / Target
Year / Value / Year / Value
Number of runways
Max frequency (movements per hour)
Passenger capacity (persons)
Passenger traffic flow (pax per year)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Max size of aircraft
Electronic management system (which)
Air Traffic Management
Functional Airspace Blocks (FABs)
Current / Target
Year / Value / Year / Value
Number of FIRs in (proposed) FAB
Number ATM systems in use in (proposed) FAB
Number of ATCCs in (proposed) FAB
Number of Sectors in (proposed) FAB
Ports
Current / Target
Year / Value / Year / Value
Master plans (num ports)
Master plans (ha)
Master plans (t)
Breakwaters (km)
Breakwaters (m depth at entrance)
Dredged fairways and basins (m length)
Dredged fairways and basins (m wide)
Dredged fairways and basins (m of depth)
Maritime chamber lock (m wide x m long)
Waterway connection (UN class)
Waterway connection (t)
Rail connection (num tracks)
Rail connection (t)
Road connection (num lanes)
Road connection (t)
Port terminals (m draught)
Port terminals (m quays)
Port terminals (ha)
Combined terminals (num rail tracks)
Combined terminals (ha)
Passenger or cruise terminal (m2)
Passenger or cruise terminal (pass)
Freight capacity (t per year)
Port traffic (num vessels)
Electronic management system (which)
Inland Waterways
Current / Target
Year / Value / Year / Value
Master plans (km)
Master plans (UN class)
Master plans (t)
Section (km)
Section (reaches)
Section (UN class)
Navigation reliability (draught)
Navigation reliability (days)
Navigation reliability (%)
IWW locks (num)
IWW chamber lock (m wide)
IWW chamber lock (m long)
Local bottleneck solved (num bridge or others)
Ports, transhipment or storage facilities (num)
Ports, transhipment or storage facilities (tons)
Freight capacity (t per year)
Freight capacity (ton x km)
IWW traffic (vessels)
IWW traffic (vessels x km)
Electronic management system (which)
Motorways of the Sea
(Corresponding component parts relating to the other modes (road, ports, IWW, rail) should be also be filled out for MoS actions)
Current / Target
Year / Value / Year / Value
Distance of maritime part of link (nm)
Vessels (type: cont or ro/ro)
Vessels (type: number)
Vessels (capacity: TEU or lm)
Traffic volume (t per year)
Frequency of departure (e.g.: 1/day)
Average vessel turn around time (hours in ports per call)
Duration of action (number of years)
Total modal shift (ton/km)
Total CO2 emissions
Electronic management system (which)

Final Notes:

The following fields will provide a drop down list with values (see e-Application form - Part A - Annex for values):

–Priority/Horizontal Project

–Section

–Transport mode

–MemberState(s)

–Region(s)

–ISIC code