SUEZ Initiatives - Institut De Franceaward

SUEZ initiatives - Institut de FranceAward

5th edition

2015 - 2016

APPLICATION FORM

I.REMINDER

II.PROJECT EVALUATION

III. PROJECT PRESENTATION

IV. Additional information

2015-2016SUEZ initiatives-Institut de France Award

Application Form

I.REMINDER

Deadline for applications: January 15th2016

By email:

And a copy to:

orby post:

SUEZ initiativesAward

Institut de France

23 quai de Conti

75006 PARIS, France

Your application form must include:

The synthesis form(maximum one double-sided page – as for the format provided)

The applicationcompleted according to the following format:

Appendices:

PowerPoint project presentation (maximum 10 slides);

Presentation of the applicant organisation,

Presentation of the project manager(s)with their CV,

For applicants for the Access to Essential Services Award, a letter of recommendation from a public organisation supporting the project (local authority, devolved government department, etc.),

Project budget and calendar: timing and duration of actions, planned and achieved,

Bank details of the applicant organisation,

Any guarantee concerning publication and intellectual property (cf. article 7of the competition rules),

Any further documentation that the applicant deems useful.

Incomplete forms will not be examined

The organisers may ask the applicant for further documentation that they deem useful.

IMPORTANT: read the competition rules.

(to be downloaded from the SUEZ initiatives Award website:

To complete your application:

-Tick the boxes or write your answer in the spaces provided (grey boxes)

-Please use Arial typeface, size 10, with single line spacing throughout the document.

2015-2016SUEZinitiatives-Institut de France Award

Application Form

II.PROJECT EVALUATION

The SUEZ initiatives - Institut de France Award rewards projects and innovations that contribute to the development of water services, sanitation and waste management in developing countries. These projects and innovations must have proved their usefulness, feasibility and sustainability over time.

The aim of such an Award is to promote the rewardedprojects and innovations so that they can serve the greatest number of people and be applied by interested stakeholders in other contexts.

The selection jury for the SUEZ initiatives - Institut de France Award will examine and choose the applicants according to the following points:

Applicants must meet the selection criteria described in article 4 of the Award Competition Rules(to be downloaded from the Award’s website).

When choosing the winners, the Jury will pay great attention to:

-The replicable nature of the project,

-The results achieved by the project,

-The project’s technical and financial feasibility as well as factors guaranteeing the sustainabilityof the results achieved,

-The involvement of the stakeholders in the project.

Without excluding other applications, the jury will give priority to projects:

-designed for appropriation by local stakeholders and the project’s beneficiaries (populations, local authorities, etc.)

-enabling the integration or participation of at-risk populations,

-applicable to urban and peri-urban environments.

For the Access to Essential Services Award, the SUEZ initiatives - Institut de France Award is not aiming at financing a “traditional” development project for which the Fonds SUEZ initiatives and the Institut de France alreadyhave other means of providing support (grants, patronage, etc.). The jury will be looking for projects with an innovative nature (from a technical, organisational, social, etc. standpoint).

III.PROJECT PRESENTATION

1.Project title

The title must be explicit, precise and concise (1500 signs maximum).

2.Presentation of the organisation running the project

Name of the organisation:

Legal status:

Date of creation:

Website:

Head office address:

Name and email address of the legal representative:

Main expertise/intervention domains:

(Water/sanitation/waste management, rural/urban area, geographical zone…)

Year -1 / Year -2 / Year -3
Budget review [in €]
Number of ongoing projects
Average budget for the projects [in €]
Number of employees
Number of volunteers
Main constant partners
Amount of private subsidies received
Amount of public subsidiesreceived

3.Project relevance

Context

Describe:

-The origin of the project;

-The challenges and needs the project plans to meet;

-The place and context where the project was developed and tested.

Objectives

Present, concretely, the project’s objective(s)

4.Description of your project

Location: where has your project been implemented?

Describe your project.

The solution that you present can be technical, financial, political, organisational, etc.

5.Project implementation through one or several pilot phases

Duration and action plan

Describe factually and in detail the project calendar, the different activities launched, etc.

If the project is part of a broader programme, describe how the project fits in with this programme and benefits from its results.

6.Project resources

Human resources of the applicant organisation

Briefly present the team involved in the project (composition, organisation).

Illustrate how your experience (and that of your team) provides credibility to your project (references, expertise in water services, sanitation or waste management in developing countries, experience in the geographic area of the project, etc.).

If necessary, describe any subcontractedactionsor actions entrusted to other organisations, companies, associations, etc.

Material and technical resources

Describe the main material and technical resources (in-house and outsourced by the applicant) used during the project (equipment, materials, etc.).

Financial resources

Provide details of the project’s budget and financing.

7.Stakeholders involvement

Which local stakeholders, public or private, were associated with the project (experts, associations, local businessmen, public authorities, etc.)?

For each person and stakeholder involved in the project, explain clearly and in detail their degree of involvement and role in the project.

For applicants for the Access to Essential Services Award, highlight how the public authorities areinvolved in this project.

8.Results

Describe factually the results already achieved throughout the implementation of your project and the forecast results.

In particular, describe and quantify, as far as possible, how your project contributes to the improvement of:

-Water services, sanitation or waste management or access to these services;

-The situation of the project’s beneficiaries/targets;

-The cost and financial accessibilityof the water, sanitation or waste management services.

9.Project sustainability

What are the factors necessary to ensure your project’s viability and sustainability (from a technical, institutional, organisational, etc. standpoint)? Does your project include some or all of these factors?

10.Follow-up/evaluationand use of the Award

Describe the in-house and/or external resources, implemented or planned, to ensure the follow-up and evaluation of the project’s results.

If you win the Award, how will your organisation use it?

11.Innovative nature

Explain clearly and concisely why your project is innovative.

We believe an innovative project to be a project that:

presents original and new solutions to water service, sanitation and waste management issues;

concerns an intervention, technique or service presenting a change or providing a contribution in comparison with existing practices.

12.Project promotion

Describe the methods you are using (or planning to use) to promote the project’s activities and the results achieved.

13.Project replication and scale-up

In this section, describe the framing elements to be communicated if another organisation wanted to appropriate and implement your project/innovation.

Methodology

Explain how your innovation could be generalised (location, context and local resources, geographical area, potential beneficiaries), and the possible limits to its generalisation.

Describe the global method required for the project’s implementation.

Estimate the time-frame required to obtain significant results.

Present:

The key factors for success

The key difficulties and constraints

The particularities to be respected (geographical, institutional, context, etc.)

The prerequisites and necessary resources (human resources in terms of numbers and expertise, financial resources, etc.).

Economic feasibility

Provide any economic information to help explain the feasibility and significance of the innovation (investments, maintenance costs, impact on costs of the service, etc.).

Presentthe necessary and/or potential financing sources.

Technical feasibility

Provide any information enabling the replication of your innovation (technical details, instructions, etc.).

Intellectual property

If all or part of the project/innovation is protected as intellectual property:

Clearly indicate it: titles of ownership cost of use, etc.

Demonstrate how this would not hinder the scale-up and broader use of the project/innovation by others.

2015-2016SUEZinitiatives-Institut de France Award

Application Form

IV.Additional information

Miscellaneous

Have you won other awards or are you competing for other awards? If so, which one(s)?

How did you hear about the SUEZ initiatives – Institut de France Award?

Bank details

In order to anticipate the granting of the amount of the awards to the winning organisations, please enter the bank details of the applicant organisation:

Bank name :
Bank address:
Account number :
Bank or routing code:
SWIFT code :
Account name:
Applicant organisation address :

I attest to have read the competition rules and certify the information in this application and the appendices as accurate and sincere. I pledge to provide any additional information required.

Date

Nameand signature of the person authorised to apply for the applicant organisation.

2015-2016SUEZinitiatives-Institut de France Award

Application form