The application form for the EnDev promotion of solar lighting should be completed and submitted by a representative of the applicant company. The application should be submitted only electronically as an MS Word document (.doc or .docx) to UOB. The application will be signed together with the contract, no need to sign before.
1. Contact details
Company Name / [Insert company name here]Date of application / DD/MM/YYYY
Address in Rwanda / City / Town:
Street:
P.O. Box:
Website:
Contact person / Name:
Position within company:
Phone:
Email:
Bank details / Name of bank:
Account holder:
Account number:
2. Company information
Company description
Please describe your company and the products you currently sell or offer. What is the focus of your business? How are you organised? What was your turnover for 2015? (Max. 1 page)
Insert text here.
Full-time staff / Women:Men: / Part-time staff / Women:
Men:
If you were selling or installing solar systems before, please specify how many solar systems (solar lamps and solar home systems) you are selling or distributing per month on average? (If you sell more types, focus on top 3.)
Product model:Numbers sold last month:
Average price: / Product model:
Numbers sold last month:
Average price: / Product model:
Numbers sold last month:
Average price:
Support received from other organisations
Please describe past (up to one year ago) and current support received from other organisations, and participation in other programmes. This should include subsidies: purpose of subsidy, amount, funder, period covered, and product sold under this period.
Insert text here.
3. EnDev-supported products
Please fill out this section related only to products that should receive incentives. Please check the Application Information for the full set of products supported.
Products to be supported by EnDev
Please use the same name of a product as specified on the Lighting Global website: www.lightingglobal.org
Name of product / Warranty period for the end-customer / Annual customers/sales targets / Average price for end-customer / Source of importinsert product name
insert product name
insert product name
Optional: If the products for which you wish to receive incentives are in the process of being Lighting Global certified (i.e. they are not yet certified), please provide in Section 4. Annexes and supporting documents:
· Proof of submission of the products to Lighting Global for testing
· Results of Lighting Global “initial screen method” (ISM) 6-week test or preliminary tests for SHS or letter from Lighting Global confirming that your product will likely pass the certification.
Business model
Please describe your business model and how you plan to target rural customers with the EnDev-supported products.
· How are you reaching rural customers, e.g. directly through own retail network, by using a cooperative, SACCO, micro-finance institution?
· Please describe step-by-step how the product moves from you to the end-customers and who is doing what along the way. Please also include how the payments from the end-customer reach you.
· Please describe the relationship between your company and the ones selling to the end-customer. Are they your employees? Do they receive a commission per system sold? Are the employees of another organisation? Are they independent entrepreneurs?
· How are you training/instructing the people who will sell to end-customers? Will these people instruct end-customers in the use and maintenance of the solar system?
· Will the solar systems be owned by the customers or will they only benefit from the service?
· If customers do not buy the system up-front but over a longer period of time, when do they become the owner of the solar system? What happens when a customer stops paying the instalments? After what period do you decide to take back the system if a customer is not paying?
· If you are an NGO, please describe how you follow a commercial approach. If you are working with an NGO, how do you assure that the sales are commercial and not subsidised by the NGO?
Insert text here.
Warranty system
Please describe the warranty system for the EnDev-supported products. Please describe step-by-step how a faulty product moves from the end-customer to you, and potentially even back to the manufacturer. Who covers the costs of the warranty system? How do you make sure that a faulty product brought to you is actually one you sold before?
Insert text here.
Verification and data quality
How do you ensure that the data required for verification is collected correctly (name, location, phone number of customer, product type/model)? Do you give out any incentives for high data quality to the people collecting data? Do you collect data on paper or electronically? Do you analyse your own customer data? EnDev requires electronic customer data with each claim, how you will ensure that the data is submitted electronically to EnDev?
Insert text here.
EnDev incentives
What do you plan to do with the incentives you receive? What is the relevance of these incentives for your business? How do you plan to continue your business after the end of the programme and not receiving any more incentives (exit strategy)?
Insert text here.
4. Annexes and supporting documents
4.1. Certification of compliance
Once the application is accepted, it will become part of the contract and be signed by the company at contract signing. No need to sign it here, but please fill out the relevant sections.
I, [names], certify that I am the [title] of [name of the company]; that by signing this Application for and on behalf of [name of the company] I am certifying that all information contained herein is accurate and truthful and understand that any wilful misstatement described herein may lead to my disqualification or dismissal, if engaged.
I am committed to:
· Comply with the rules and obligations governing EnDev funds;
· Claim incentives only for the solar systems mentioned in this application, and sold to clients resident in Rwanda;
· Claim incentives only for solar systems that did not receive other grants;
· Provide all data related to the systems sold through the EnDev programme, accept checks, interviews and cross-check that could be conducted by the programme;
· Fund all activities before the reception of the incentive;
· Provide a working product warranty system for at least one year to all customers and warranty cards for each product sold.
I understand that any wilful disrespect herein may lead to the cancelation of this contract and disqualification or dismissal for receiving the incentive, if engaged.
______(Seal)
(Signature)
(Printed Name and Title of authorized representative of the company) (Date)
4.2. RDB Certificate of domestic company registration or RGB registration as an NGO
Attach the document either here or as an extra file. Please rename the file to:
4.2 RDB Certificate of domestic company registration or RGB registration as an NGO
4.3. RDB registration form showing shareholders, shares and manager of the company
Attach the document either here or as an extra file. Please rename the file to:
4.3 RDB registration form showing shareholders, shares and manager of the company
4.4. Valid RRA tax clearance certificate
Attach the document either here or as an extra file. Please rename the file to:
4.4. Valid RRA tax clearance certificate
4.5. Valid RRSB social security clearance certificate
Attach the document either here or as an extra file. Please rename the file to:
4.5. Valid RRSB social security clearance certificate
4.6. Optional: Proof of submission of the products to Lighting Global for testing
Attach the document either here or as an extra file. Please rename the file to:
4.6. Proof of submission of the products to Lighting Global for testing
4.7. Optional: Results of Lighting Global “initial screen method” (ISM) 6-week test or preliminary tests for SHS
Attach the document either here or as an extra file. Please rename the file to:
4.7. Results of Lighting Global “initial screen method” (ISM) 6-week test or preliminary tests for SHS