30/09/2014
APPLICATION FORM FOR COFINANCING REQUESTS
AND
EXPLANATORY NOTE
Traduction par l’ASTM du texte official du Ministère des Affaires Etrangères, Direction de la Coopération au Développement
ANNOTATED APPLICATION FORM FOR
CO-FINANCING REQUESTS
I. PROFILE OF THE LUXEMBOURG NGO
I.1. Name of organisation
I.2. Contact Details
I.3. Name(s) of individual(s) responsible for project preparation and management
I.4. Other northern NGOs involved in the project (in Luxembourg)
II. PROJECT DESCRIPTION
II.1. Project Title
II.2. Type of project
II.3. Project Reference number
II.4. Location of project
II.5. Duration of project
II.6. Context and past activities related to project
II.7. Needs assessment
II.8. Strategic orientations
II.9. Beneficiaries of the Project
II.10. Aid effectiveness
II.11. Local partner(s) and institutional set-up
II.12. Crosscutting themes
II.13. Monitoring and evaluation
II.14.Sustainability and risks
III. FINANCIAL PLAN
III.1. Outside the developing country
III.2. In the beneficiary country or other developing countries
III.3. Contingency Reserve
III.4. Monitoring and evaluation expenses
I.1. Name of organisation
Name of principal NGO
I.2. Contact Details
Mailing Address:
Telephone:
Fax:
E-mail:
Bank account number: Bank account number to be used by the Ministry for its financial contribution to the project
I.3. Name(s) of person(s) in charge of project preparation and management
I.4. Name(s) of other northern NGOs involved in the project
I.4.1. Name(s) of other northern NGOs (especially Luxembourg) involved in the project
I.4.2. Name(s) of the person(s) in charge of the project within these NGO(s)
II.1. Project title
Provide an accurate and concise indication of the project title
II.2. Type of project
Indicate the type of project (emergency aid, reconstruction/rehabilitation or prevention or reduction of risks, resilience) and the link to a specific crisis or catastrophe.
II.3. Project reference number within the NGO
II.4. Detailed project location
Indicate the exact location of the project (country, region, state, province, department, district, county, town, village, neighbourhood and GPS coordinates. If possible, please enclose an accurate map that clearly indicates the project site.
II.5. Duration of the project
Starting and completion date of the project
II.6. Context and antecedents
Describe the humanitarian situation and the problems to be addressed.
Describe the methodology (participative, simple request) used in the planning of the project and in particular the extent to which the stakeholders have been involved in this process.
Mention any earlier partnership relations with the local partner(s) or the participation of the NGO in similar projects, whether cofinanced or not by the Ministry. What lessons have been learned from these previous experiences?
II.7. Needs assessment
Assessment of the needs (needs assessment, food security assessment, nutrition assessment, etc.) conducted specifically by the NGO, national or coming from a different organisation, or any other source of information that served as a basis for the formulation of the project, including the extent to which the beneficiaries have been involved in the decision making process.
II.8. Strategic orientations
Describe the strategic orientations and main actions envisaged by the project in order to achieve the intended results in accordance with the Luxembourg Humanitarian Aid Strategy.
II.9. Beneficiaries
Qualitative elements: socio-economic and cultural categories and characteristics (women, children, ethnic groups, farmers, merchants)
What are in the criteria used to select the beneficiaries?
Quantitative elements: number of direct beneficiaries
II.10. Aid effectiveness
Participation of the NGO and its partner(s) in the national or local coordination mechanisms; state the other humanitarian actors active in the geographical zone targeted (cf. general conditions for humanitarian aid: “3. Rights and Obligations of the NGO”, p.5).
II.11. Local Partner(s) and institutional set-up
1) Local partner
Presentation of the partner institution and the person responsible at the local level (Please include the organisational chart of the partner if possible).
Is there a contractual relationship between the local partner and the Luxembourg NGO? Is there an intention to sign an agreement or another document defining the rights and obligations, as well as the division of responsibilities between the different actors? If this is the case, please include the signed document or the document template to be signed (in the latter case, the signed document is to be provided upon signature).
Does the partner have professional relations with other financing agencies (e.g. European Commission)?
Capacities of the partner(s): especially in terms of organisation, staff competence, and past experiences in relation to the mission of the organization.
Does the local partner have any needs in terms of capacity building?
2) Institutional structure
Sharing of responsibilities: how are the responsibilities shared, especially with regard to the main parties concerned? In particular, what are the respective roles of the beneficiaries and of the support organisation?
What are the decision-making mechanisms?
Does the project have a steering committee? If this is the case, how does it function?
II.12. Cross-cutting themes
To what extent does the project address issues related to gender, good governance/human rights and/or the environment?
Examples of issues:
Gender:
- Does the project take sufficient account of the relations between men and women?
- To what degree do women and men have access to the resources and control the resources and benefits of the project?
- Are women involved and consulted at each stage of the planning and implementation of the project (are women included on the project team and on the staff of the partner organisation, as well as amongst the beneficiary population)?
Good governance/human rights
- Does the project strengthen the legitimate local authorities and local good governance mechanisms?
- Does the project help to consolidate the participation of the local population in decision-making processes?
- Does the project take into account the (political, structural and cultural) causes for the failure to uphold human rights?
Environment
- What are the environmental impacts associated with the implementation of the project?
- Does the project contribute to improving the environmental conditions of the local population?
- Is the technology used appropriate?
II.13. Follow-up and evaluation
1) Follow-up (How will the follow-up process be implemented?)
- How and by whom will the follow-up be organised in the field (by the local partner and/or the regional office of the Luxembourg NGO)?
- How many visits have been scheduled over the course of the project’s duration? (One visit by a maximum of two people per year is eligible, unless explicitly agreed otherwise beforehand in the case of unforeseen issues or difficulties)
- Has any form of external follow-up been envisaged?
- What is the frequency for the submission of reports that has been agreed on with the partner?
2) Financial Audit
Do you envisage undertaking a financial audit? If this is the case, when will it be done?
3) Evaluation (what is the approach envisaged with regard to the evaluation of the project?)
- Self-evaluation? An evaluation carried out jointly by the Luxembourg NGO and the partner NGO?
- Peer evaluation (i.e. by other NGOs)?
- Will there be an independent internal evaluation either during (mid-term evaluation) or after completion of the project (ex post evaluation)?
- If the NGO proposes to conduct an evaluation of the project in question on its own initiative and if the evaluation is included in the budget presented to the MAE, the NGO must submit a copy of the final evaluation report to the Ministry.
II.14. Sustainability and risks
SUSTAINABILITY
Analyse the project’s sustainability with regard to its social and economic aspects, as well as the consideration given to an exit strategy.
Examples of questions to be addressed:
1) Social sustainability
Is there any evidence to show that the (political, religious, traditional, …) local authorities are genuinely supporting the project?
Does the project take the local socio-cultural environment into account?
Does the project make a long-term and lasting contribution to enhancing the capacity of the beneficiaries (capacity building)?
Does the project take account of the most vulnerable and/or discriminated communities against the backdrop of the social settings to which the project is supposed to provide a response, and could it reinforce existing social inequalities?
2) Economic sustainability
Does the project give rise to any recurring costs (maintenance/operating costs)? If this is the case, who will bear these costs?
Is there a financing strategy other than that of long-term support provided by the NGO (e.g.: certain parts of the project or the project in its entirety could be handed over to the local authorities, other donors may be sought, the project could be integrated into an existing programme)?
3) Exit strategy
Is there an exit strategy for the NGO and/or the partner?
RISKS
Are there any internal or external factors that could jeopardise the achievement of the project’s expected results?
For example:
- Political or socio-cultural opposition to the project
- Disruption caused by possible natural disasters, political and/or economic instability?
III... FINANCIAL SET-UP
The NGO is required to complete the budget (Option 1 or 2) and the financing plan. The first budget format provides for a distribution of costs according to the procurement of services or movable goods, the second one groups the costs according to subjects. NB: the second format may only be used for emergency aid projects. In the case of emergency aid projects cofinanced by ECHO, the budget formats of ECHO are also accepted by the Ministry.
The budget format should be broken down over the number of years for which the project is due to run and should include a final column entitled “TOTAL per heading”.
In the case of a project with a duration of more than12 months, the budget should be divided up over 2 or more years and it is therefore considered a multi-annual project.
Should foreign currencies be used, the corresponding values in Euro must be indicated in the budget format.
If the Development NGO is financing part of a project funded by other donors, the NGO may choose to either split the overall costs according to the percentage of co-financing provided by each donor into independent budgets, or to clearly indicate the costs to be covered by Luxembourg (NGO and Ministry) within the global budget.
Once the mode of financing has been chosen, the Development NGO must respect it throughout the course of the project.
It should be noted that the formats presented below are merely examples. In order to facilitate the analysis of the project finances, the Ministry requires the budget to be submitted in Excel or any other spreadsheet programme.
BUDGET FORMAT – OPTION 1
Budget heading
/Amount
(euro)
/ Total per heading (euro) /III.1. Outside the developing country
III.1.1. Procurement of Services
III.1.2. Staff costs
III.I.3. Purchase of equipment/movable items
III.2. In the beneficiary country or other developing country
III.2.1. Procurement of Services
Examples:
a) Banking services
b) Training fees
c) Installation of accounting programme
d) Office rent
e) Insurance costs
f) Other fixed costs (electricity, gas, water, heaters/air conditioners)
g) Communication costs (Telephone, fax, Internet)
h) Transportation costs
i) Etc.
III.2.2. Staff costs
Example:
a) Coordinator (xxxx euro/month x 36 months)
b) Etc.
III.2.3. Procurement of equipment/movable items
Examples:
a) Office materials (papers, notebooks, pens, etc.)
b) Office equipment (telephone, fax, computers)
c) Vehicles
III.2.4. Procurement of real estate
Examples:
1) Purchase of a building
2) Purchase of land
III.3. Contingency reserve (calculated only for III.2) both outside and within the developing country (DC)
III.3.1. Provision for unforeseen costs, inflation and exchange rate fluctuation (maximum: 5% of III.2)
III.4. M&E related costs outside and within the DC
III.4.1. Project Preparation Costs
III.4.2. Monitoring Costs
III.4.3. Audit Costs
III.4.4. Evaluation Cost
TOTAL
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BUDGET – OPTION 2 (only for use for emergency aid projects)
Budget heading / Units / Cost per unit / Total per heading (EUR) / %III.1. / Outside the developing country
III.1.1. / Procurement of services
III.1.2. / Staffing costs
III.1.3. / Purchase of equipment/movable items
III.2. / In the developing country
III.2.1. / Costs directly related to humanitarian aid activities
STAFF: Locally employed staff (psychosocial or medical activities, distribution, logistics etc.)
TRANSPORT: Transport of emergency relief articles (rental, fuel etc.), charges for depot facilities and customs clearance
According to the purpose of the emergency aid project:
NUTRITION: Purchase of food items, , distribution of cash/vouchers
WASH: distribution of hygiene kits, information activities etc.
CCCM: shelters, early recovery, non-food aid
PROTECTION: protection of groups or particularly vulnerable minorities
HEALTH: medical services, procurement of medication etc.
LOGISTICS: coordination, telecommunications
EDUCATION: educational activities in crisis situations
- Etc.
III.2.2. / Administrative costs
Costs related to banking services, insurance, office supplies and equipment, office rental, electricity, communication and IT costs.
Locally employed staff (administration)
III.2.3. / Visibility costs (≤ 1%)
III.2.4. / Investment costs (Purchase of vehicles or motorbikes)
III.3. / Contingency reserve (calculated only on III.2.) both outside and within the developing country
III.3.1. / Provision for unforeseen costs, inflation and exchange rate fluctuation (maximum: 5% of III.2)
III.4. / M&E related costs within and outside the developing country
III.4.1. / Project preparation costs
III.4.1. / Monitoring costs
III.4.1. / Audit costs
III.4.1. / Evaluation costs
/
TOTAL
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III.1. Outside the Developing Country
This section consists of all expenses related to the implementation of the project outside a developing country. With regard to the eligibility of costs, please consult chapter 6, page 12 of the “General Conditions applying to relations (with NGOs) in the context of humanitarian aid”.
III.1.1. Procurement of services
Procurement of services refers to the provision of ad hoc services provided in the context of the project by a person who has the professional skills specifically required for the successful implementation of the project.
Total expenses related to hiring professional services outside a developing country (consultants, architects or engineers and any other professional expertise), which are necessary for the implementation of the project but for which the necessary competence is not available within the NGO or in the developing country.