Project Change Request Form

ERDF-Forms-3-003

Project Change Request Form Annex AB / ERDF-Form-3-004
A Change to the Funding Agreement: Work Instruction / ERDF-WI-3-003

To request a Change to your project please complete this form. It is advisable to contact your Programme Delivery Team (PDT)[1] prior to completion and formal submission to the PDT.

There is no automatic right for a Change to be approved. A Change to a project must be approved by the PDT. A Change requested in the latter stages of project delivery is less likely to be approved.

Completed by ERDF Grant Recipient
Organisation name
Project name
ERDF project ref no
Contact name
Contact email address
Contact tel. number
Version no. of this form[2]
Date
Please confirm the key Change(s) proposed to the project:
change to the Ownership, Control and Nature of Business of the Grant Recipient
change to the nature or purpose of the project
change to the eligible expenditure
change to the expenditure profile
change to any of the key milestone dates
change to any of the targets (outputs and results)
other: please specify below (this could include a change to the ERDF grant value or sources/amounts of match funding or a change to the Contribution Rate)
·  Please describe the Change(s) and the reason(s) for the Change(s)
·  Please give details for each Change separately
·  If the Change involves a fundamental change to the way the project is being delivered please describe this in full
Please explain how the project retains a strategic fit with the ERDF Operational Programme:
Please give details of how the project will continue to deliver the objectives set out in the Full Application form; if the objectives have changed please give details:
Where a change to the project funding profile and/or outputs/results is sought, please complete the relevant Excel tables (Project Change Request Form Annex AB: ERDF Forms-3-004)
Name
Signature
(an electronic signature is permitted)
Date

Please return this form and the supporting Annex A&B tables (if applicable) by email to your PDT project contact.

The following sections are completed by the PDT:

Section 1: Completed by PDT project Lead
Name of project Lead
Date PCR form received by PDT
60-calendar days deadline date
In the box below, the project Lead should:
·  Consider the content of the request and give comment on whether the detail contained therein is correct and appropriate
·  Detail any performance issues (financial or otherwise)
·  Confirm whether or not they are content for the Change to be progressed
·  Confirm if the Change requires re-appraisal by the PDT Appraiser (Section 2 below)
·  List the value any identified potential corrections
Any correspondence should be held electronically on the local shared drive.
Name
Signature:
(an electronic signature is permitted)
Date
Section 2: Completed by the PDT ERDF Appraiser
In the box below, the appraiser should:
·  Consider the details of the proposed Change(s)
·  Consider the comments from the ERDF PDT project lead
·  Re-appraise all relevant aspects of the project in accordance with the Changes proposed – the re-appraisal must be commensurate with the size, scope and nature of the Change
·  Recommend any special conditions if appropriate
·  Consider if programme partners, including the LMC, should be consulted
Any correspondence should be held electronically on the local shared drive.
Name
Signature:
(an electronic signature is permitted)
Date
ERDF Head of PDT or senior officer with delegated authority for approving Changes to the Funding Agreement
The proposed changes are:
(please insert ‘x’) / Approved / Rejected
If approved, note any comments/recommendations:
If rejected, explain the reason(s):
Name
Signature
(an electronic signature is permitted)
Date

Annex A: Change request to project funding profile

Annex B: Change request to outputs and/or results

This is a request process and the Secretary of State is entitled to reject, accept in part of accept the whole request for a project change. For the avoidance of doubt, an acceptance of a change shall not act as a waiver of any project irregularity.

Project Change Request Form

ERDF-Form-3-003

Version Number 2

Date last published 11.12.12

Page 5 of 5

[1] PDT (Programme Delivery Team) refers to the GLA in London. References to the Secretary of State refer to the GLA.

[2] If there are several versions of this form, for the audit trail, please state the latest version number here (e.g. 1, 2 or 3 etc)