MATCHED SMALL GRANTS PROGRAm

application forms & guidelines

a WORLD BANK PROGRAM FOR THE ENVIRONMENT OF THE

CASPIAN REGION

MSGP/CEP

Baku, May 31, 2002

APPLICATION GUIDELINES

AND FORMS

ThIS DOCUMENT IS designed to assist applicants in preparing a full application for THE MATCHED SMALL GRANTS PROGRAM. a COMMITTEE OF REPRESENTATIVES FROM EACH cASPIAN LITTORAL STATE, THE CASPIAN ENVIRONMENT PROGRAMme coorDination unit, the european union/tacis programme AND THE WORLD BANK will select the best proposals.

DEADLINE FOR SUBMISSION OF APPLICATIONS IS August 09, 2002.

Only fully completed applications made according to this format will be considered for selection.

DESCRIPTION OF THE mATCHED SMALL GRANTS PROGRAM

The Matched Small Grants Program (MSGP)[1] is an element of the Caspian Environment Program (CEP), a regional initiative to promote the sustainable development and management of the Caspian environment, a major and unique ecosystem under threat from pollution and loss of biodiversity.

PURPOSE OF THE PROGRAM

The purpose of the MSGP is to advance small-scale investment or pilot projects to address urgent environmental problems in the Caspian region. With this program small-scale priority projects can be implemented quickly, in order to take curative or preventive actions; the MSGP also helps to develop capacity for further actions to improve the Caspian environment.

eligibility

The Matched Small Grants Program operates in the five Caspian littoral states: Azerbaijan, Iran, Kazakhstan, Russia and Turkmenistan. The Caspian region is defined as the sea, the coastal regions and 100 km inland from the shores of the sea, and the major tributaries up to the first major hydrotechnical construction. The following types of organizations are eligible to apply for the MSGP:

· Private sector: companies, businesses, and scientific institutions, both foreign and locally owned;

· Governmental sector: state-owned enterprises, local, provincial and national authorities, utilities, state scientific institutions and committees working on the regional level in the Caspian Sea region;

· Non-governmental sector: foreign NGOs, local NGOs, Community-based organizations (CBOs), local associations.

The Applicant organization must be legally registered in one of the Caspian countries. A copy of this registration must be attached in Annex IV as part of the application packet along with document confirming that the applicant is a legal entity that is authorized under national law to enter into international agreements. Partnerships between two countries and/or cooperation across different sectors is encouraged. However, one lead organization must be designated as fully responsible for the project implementation. The grant agreement must be written in the name of the lead organization, which will serve as the grant recipient for the Matched Small Grants Program with responsibility for all reporting.

Types of projects

Under the MSGP, small-scale investment or pilot projects will be financed that produce tangible, practical results. Projects eligible under the program may address the following areas:

· Decline in commercial fish stocks, including sturgeon

· Degradation of coastal landscapes and damage to coastal habitats

· Damage to coastal infrastructure and amenities

· Threats to biodiversity

· Overall decline in environmental quality

· Decline in human health

· Introduced species

· Contaminaton from offshore oil and gas activities

The Matched Small Grants Program focuses on investment projects and does NOT support the following projects and/or activities: research; monitoring; formal academic training; ongoing institutional core support; scholarships and fellowships; study programs; or individuals applying on their own behalf, including for travel or studies.

Matching and award amount

Grants may range from US$ 10,000 up to US$ 100,000. At least 100% matching of the grant amount is mandatory for grants up to $50,000; minimum of 200% matching is mandatory for grants over $50,000; total project budgets therefore range from US$ 20,000 to US$ 300,000 or more, if the applicant identifies additional resources.

Matching funds may come from the applicant or from a partner, whose name must be shown under the box “partner” of the cover sheet. If the funds come from the applicant organization, then appropriate proof should be provided in the form of bank statements, accounting reports or other financial documentation. If the funds come from a partner organization, then the lead organization must have written verification of authorization to disburse the funds. (Verification of matching funds must be attached in Annex VI of the application.)

Duration of the project

The Award Agreement must be signed and the project must begin within three months of the award notification. The project duration shall be no longer than 12 months. The project must be completed, including all reporting, by December 31, 2003.

Selection criteria

Applications will be evaluated based on the following criteria. Equal weight will be given to each criterion.

Impact

§ The project assists in solving one or more priority environmental problems of the Caspian region;

§ The results of the project are sustainable;

§ The project will generate tangible results, which can be verified with clearly set indicators;

§ The project has transboundary environmental impact, OR can be replicated on a larger scale or elsewhere in the Caspian region.

Budget (Annex II)

§ At least 100% matching of funds for grants up to $50,000 and minimum of 200% for grants over $50,000 is provided by the applicant (50% in-kind contribution of the applicant is allowed) and the ability of the applicant to make this contribution is clear from financial documentation attached to the application in Annex VI;

§ The budget is complete, reasonable and cost-effective. It is clearly explained, proposing realistic and cost-effective solutions and spending limited funds in the most efficient manner.

Planning and feasibility

§ The goals and objectives are feasible and relevant for the targeted environmental problem at the geographical location of the project;

§ The workplan (Annex III) clearly defines the key activities that are required to achieve the objectives as well as the planned timing of each of the key activities;

§ The applicant organization is capable of implementing and completing the project as proposed, both financially and organizationally.

Preference will be given to those projects that address transboundary environmental issues and make tangible environmental improvements, and/or create substantial innovation in solution of environmental problems in the Caspian region. Projects should help to address priority problems identified in the Transboundary Diagnostic Analysis (TDA) and National Caspian Action Plans (NCAPs). Information about these documents is available from the MSGP staff at the PCU, and on the CEP website.

conditions

Each grantee must attend a one-day Grantee Orientation, where the Award Agreement is signed, grantees introduce their projects to one another, and MSGP staff explain the procurement, financial management and reporting procedures. Cost of attending the Grantee Orientation (travel and lodging) should be included in the budget of the application. The Grantee Orientation will be held in Baku. Grantees should therefore budget an amount sufficient to cover the necessary travel and lodging for the participation of the project manager in the Grantee Orientation.

The Matched Small Grants Program does not fund activities undertaken prior to the date of the signed Award Agreement (except for travel costs to attend the Grantee Orientation).

The grantee is responsible for handling all taxes incurred by the project in accordance with the relevant policies and regulations in his/her country. MSGP will assist, where possible, in getting tax exemption status for grantee, but final responsibility lies with the grantee. The MSGP grant may not be used to cover taxes, though applicants may include taxes in their matching contribution

Any publications published by the grantee as a result of the grant, such as studies, manuals, newsletters, or brochures must acknowledge the support of the Matched Small Grants Program and the Caspian Environment Program.

Equipment acquired for execution of the project may remain with the grantee upon completion of the project.

The grantee owns all intellectual property created under a Matched Small Grants Award, however, the World Bank has the non-exclusive right to use and reproduce the intellectual property at no cost. The Matched Small Grants Program reserves the right to publish and distribute descriptive information and lessons learned from any of the projects implemented under the Program.

An organization currently working on a project funded partly by a Matched Small Grant cannot apply for another Matched Small Grant before the final report of the first project has been submitted and accepted by the Matched Small Grants Program.

Grant Payment and Reporting requirements

Matched Small Grants will be disbursed in USD to a legal bank account of the grantee that is established solely for the MSGP project. All budgets and financial reports should be made in USD, with conversion for costs in local currency.

All Matched Small Grant recipients shall prepare progress and final reports. All reports consist of narrative and financial sections. Reporting forms and procedures will be provided to the grantees at the Grantee Orientation. Grantees must maintain in their project records copies of all invoices and receipts for expenditures on salaries, equipment, travel, hotels, rent, service providers, printing and reproduction, as well as for any other expense exceeding USD25.

Matched Small Grants will be paid in a minimum of three installments, to include a maximum initial disbursement of 15% and a minimum final disbursement of 20%. For grants less than USD25K, three disbursements are usually adequate. For grants of USD25-49K, four disbursements or more will be made. For grants USD50K or more, at least 5 disbursements are required. Standard installments are as follows:

	Less than 25K	25K – 49K	50K or more
Disbursement 1	15%	15%	15%
Disbursement 2	65%	30%	20%
Disbursement 3	**	35%	20%
Disbursement 4	**	**	25%
Final Disbursement	20%	20%	20%

Applicants may request an alternative disbursement schedule if the nature of their project requires it. The MSGP Administrator will decide whether this is justified, and will approve only well substantiated requests for alternative disbursement.

The purchase of goods, works and services must follow the procurement guidelines described in the ”Manual for Conducting Very Small-Value Procurement Under World Bank/IDA Small Grants, Loans and Credits.” The Procurement Manual is available on request from the MSGP Administrator or the MSGP web page at http://www.caspianenvironment.org/msgp. Reporting according to the procurement guidelines is obligatory. If the guidelines are not followed, or reporting does not clearly reflect compliance with them, the expenditure in question will be disallowed.

The grantee may make budget changes of up to 20% to any line item, providing there is no change to the overall budget. For line item changes of over 20%, the grantee must request and receive MSGP Administrator’s permission prior to making the change.

The grantee must maintain full financial records, including all original receipts and invoices for at least three years following the completion of the project. Matched Small Grants Program staff and World Bank representatives (including consultants authorized by the World Bank) have the right to inspect the MSGP project records and monitor the project performance at any time.

the Matched small grants program application

A complete Matched Small Grants Program application consists of the following documents:

· Properly completed MSGP Cover Page;

· A narrative description of the proposed project following the guidelines below (maximum 5 pages);

· Annex I – the Procurement: Attachments 1 Assessment of Beneficiary’s Capacity to Conduct Procurement and 2 A. Procurement Plan and B. Operational Costs (forms attached);

· Annex II – the MSGP Budget: A. Budget Summary and B. Detailed Budget (forms attached);

· Annex III – the MSGP Work Plan (form attached);

· Annex IV – a copy of legal registration of the applicant organization and a document confirming that the applicant has the ability to enter into legal agreements with an international agency;

· Annex V – an organizational resume or other summary description of the organization’s objectives, history, staff, annual revenues, work products, etc.;

· Annex VI – all other necessary financial documentation including: verification of applicant’s matching funds, salary or fee rate verification of all those to be funded by the project, rental agreements, and any other documentation necessary for financial clarification of budget.

One hard copy original of the full application must be submitted to the Matched Small Grants Program staff by August 09, 2002. In addition, the applicant must send an electronic version of the application to the MSGP office at the email address provided below. The applicant is responsible for the timely delivery of the project proposal and may call or email or fax to confirm receipt. The hard copy of the application should be mailed or hand delivered to the address of the MSGP in Baku:

Matched Small Grants Program

Caspian Environmental Programme

Government House, Room #108, Entrance 3

40 Uzeir Hadjibeyov Street

Baku 370016, Azerbaijan

msgp@caspian.in-baku.com

The full application should be made in the format provided, following the sequence mentioned above. Please do NOT bind together the application, because the Matched Small Grant Program staff will need to make copies for the Evaluation Committee. Incomplete applications will not be considered. Additional materials not specified in the list above will be discarded, in order to ensure the comparability of the applications.

The full application must be prepared in English by all applicants. Applicants from Azerbaijan, Kazakhstan, Russia and Turkmenistan, should submit the application in English and Russian. Only the copies of legal registration and other official documents of the applicant may be submitted in the original language. Applicants are responsible for the quality of their translations. Poor quality translations may not receive proper consideration during evaluation.

guidelines for narrative description

In the narrative description the applicant explains why the project is important, how it will help to solve one or more environmental problems, where the project will take place, and who will undertake what actions. The narrative description needs to explain how the work will be organized to produce a successful project with concrete results.

The narrative part of the application should be no longer than 5 pages, with character size of 12 points and minimal line spacing of 1.5. The document must be clear and concise.

The narrative description includes the following seven main topics:

Title of the project – 2 sentences

Choose a short title specifying the type of project. A more explanatory sub-title may be added, for example specifying the geographical region where the project will be implemented.

Background and problem statement – 0.5 page

Explain the environmental problem the project addresses, where and how this problem occurs, what the consequences are and for whom. If necessary give the background of the problem, its history and/or the current developments surrounding it. Adequate data on the current situation will help the committee to understand the impact of the project.

Goal and objectives – 0.25 page

Define the overall goal of the project, then define the specific objectives. The goal gives the direction of the project, and the specific objectives to be reached as a result of a successful project.

Proposed project activities – 2 pages

This section gives all information on ‘who will do what, when and where’. In these two pages, specify the environmental problem(s) you are addressing and how you will address it. Describe thoroughly the different project phases, activities planned, equipment to be bought and tasks to be performed. The phases as described in this section should correspond directly to the phases shown in the work plan (Annex III of the application).

Expected results – 0.5 page

List the results that your organization would expect to see as the outcome of the proposed project. Make sure that the results follow logically from the activities you propose to implement. Describe the expected results in such a way that it is clear when you consider the project a success.

Deliverables and indicators for success – 0.75 page

Based upon your expected results, develop quantitative indicators to measure whether you reached that result or not. These indicators will ensure that the evaluations committee understands the project targets and their successful completion. Indicators will be used to measure project outcomes. Applicants are requested to develop relevant environmental indicators and to describe how the indicators will be measured. Deliverables may be various, for example: the number of square kilometers cleaned, hectares reclaimed from desertification, percentage increase in hatchery output, increase in waste water treatment capacity by x%, etc. This section should also identify any risks or constraints beyond the control of your organization that could prevent the successful implementation of the project.

Sustainability and/or follow up of the project – 0.75 page

An important criterion for the Matched Small Grants Program is the future sustainability of the project. Describe project follow up. Explain how you envision that the given environmental problem will improve for the long term. If you cannot foresee long-term improvement of the problem, then explain what actions will be taken to ensure that the impact of the project will not be lost. Develop a strategy for the replication of the project elsewhere, or on a larger scale, and specify how you propose that such a follow up could take place.

Refer to the Selection Criteria while preparing your application.

Matched Small Grants Program Cover Page

The cover page is the first page of your full application. It should be filled out clearly, so that the MSGP has complete contact information. Do not fill out the gray box marked: “To be filled out by MSGP staff.”

Matched Small Grants Program Budget Table and summary

The Matched Small Grants Program Budget Summary is designed to give a clear summary of the budget by showing the breakdown of the part financed by the Matched Small Grant, and the part financed by the applicant as in-kind and cash resources. If an additional, third (or fourth) funding source it to be used, these amounts should also be identified.

The budget for the Matched Small Grants Program must be filled in completely, showing all figures in USD. In the Budget Table list completely all expenses related to the proposed project. All activities must be broken down into costs matching the budget line items provided in the Budget Table. The subtotals for each section of the budget table correspond to each line of the Budget Summary. For your understanding, a sample Detailed Budget and a sample Budget Summary are attached. Applicants may adjust the blank Detailed Budget and Budget Summary Forms by adding lines and pages as necessary in the format provided.

In the budget, show the unit of measurement for each expected cost (for example a trip), how many of these units you need (for example one to Baku for the Grantee Orientation), the price per unit (for example 280 USD plane ticket) and the total (280*1 in this example). After the column for ‘Total’ you find columns specifying the source of funds for each line item.

Under the Matched Small Grants Program, a maximum of 50% of the total project budget for grants up to $50,000, and a maximum of 33.33% of the total project budget for the grants over $50,000 can be financed with a MSGP grant. The other 50% and 66.67% of the project must be financed by the grantee. A maximum of 25% (<$50K) and 33.33% (>$50K) of the total project costs can be supplied by in-kind donations. The remaining 25% and 33.33% of the total project cost must be provided in cash by the applicant organization(s). The matching funds and the in-kind contributions can be made to any line item in the budget. For each line item, show the source of funds (whether from the grant, matching funds, or in-kind contribution, or a combination of these sources). Additional funding from a third party may also be included, but is not required.

In-kind contributions are the applicant’s allocations of human and material resources, estimated in terms of their costs. In-kind contributions include work time (dedicated to the project), facilities, supplies, and other goods and services directly benefiting the project activities. Existing office equipment such as computers, printers, fax machines, cannot be included as in-kind contributions. For all in-kind contributions, specify their exact nature and estimate their worth in accordance with current market rates for rental or purchase of the items or services. The value of volunteer services can be estimated by the going market rates for that type of labor.

Competitive procurement of goods, works and services is required. The relevant procedures for competitive procurement are given in ‘Manual for Conducting Very Small-Value Procurement Under World Bank/IDA Small Grants, Loans and Credits’ that is available on the MSGP webpage (http://www.caspianenvironment.org/msgp) or by request from the MSGP office.

The Budget Summary and the Detailed Budget form Annex II of your application.

clarification OF budget line items

Goods

1. Equipment

Specify the type of equipment/technology that you intend to purchase and the estimated cost. Equipment or environmental technology includes any essential and tangible property that costs more than 100 USD and has a useful life of more than one year. (Software is “equipment” if it costs more than 100 USD). The equipment must be a separate and complete item to be used during project implementation and for project purposes. Please keep in mind that any equipment purchased for the project must follow the procurement rules, as described in the ‘Manual for Conducting Very Small-Value Procurement Under World Bank/IDA Small Grants, Loans and Credits’. The cost of shipping and customs duties for equipment should be included in this line item.

2. Supplies

Specify the type of supplies you plan to buy and the estimated costs. Provide breakdown by types of supplies, listing specific items necessary. Project supplies are consumables used during project implementation costing less than 100 USD a piece; these could be chemicals, spare parts, plastic waste bins, etc.

3. Printing and Reproduction

Specify all costs you intend to make for printing and reproduction at an outside copy-service, or instead indicate how much you will spend per month on an outside copy service. Specify all publications you intend to make and estimate their costs per copy.

Works (e.g., construction, site preparation)

Specify the labor costs, equipment rental, and supplies needed to carry out the works.

4. Labor

5. Rental Equipment

6. Supplies

Consultant Services

7. Services

Explain which services you intend to use during project implementation. These can be specialist professional, translation, computer, or other services. When using the item ‘other services’ please specify which services these will be. A standard unit for services is the workday, but if in your case it is a workweek or month, you can use that as well. Fill in the name of the company or person providing the service (if known) together with the type of service in the first column of the Detailed Budget Table.

Operating Costs

8. Employment Costs/Salaries

These are human labor costs from the applicant’s own organization used for implementation of the project. Also include cost of labor required for reporting. As a unit for calculation of salary cost, you may use a day, week or month. Estimate the amount of time required for each position. Specify the name of the person (if known) who will do the job and the position. Daily or monthly pay rates must be reasonable for the site of the project. Verification of average salary for the past year for each known person should be provided in Annex VI. Where it is still unknown who will be hired, specify a salary that is within the range of current market rates for such a position.

9. Travel

Include information on destination, means of transportation and the number of travelers. For every trip all items must be filled in. If per diem is included, indicate the number of days and the rates used. Standard units are provided in the Detailed Budget Table. The first item to be entered is the travel for the Grantee Orientation. Depending on your point of origin this means one plane ticket in the range of 100-400 USD, 1 or 2 nights lodging at 50 USD per night.

NOTE: Every applicant must include costs for attending the Grantee Orientation into the Budget Table.

10. Rent

The Matched Small Grants Program accepts rent of your office or project facility as an in-kind contribution, but the costs for rent given in the budget must be reasonable in relation to the size of the project and the time you and your staff spend on the project. For example, an office of 10 rooms would be excessive for a project that requires only 4 staff. To deal with this, the applicant can make an in-kind contribution of part of the rent, specifying the percentage of total monthly rent and attaching a copy of the rental agreement in Annex VI.

Rent for a meeting room or conference room must be specified under this budget line as well. Office rent should be calculated using the month as the standard unit. A meeting room should be calculated per day. If rent is an in-kind contribution, a copy of the rental agreement should be attached to the application.

11. Communication Costs

Specify the estimated monthly costs for telecommunication (phone and fax), postage and electronic communication.

12. Office Supplies and Maintenance

Specify the type of office supplies you plan to buy and the estimated costs. Provide breakdown by types of supplies and maintenance, listing specific items necessary. Office supplies include: paper, pencils, toner cartridges, floppy disks, etc. as well as any software costing less than 100 USD.

13. Transportation Charges

Specify the estimated expenses for ground transportation that may include cost of project staff local transportation, charges on equipment or supplies delivery, etc.

14. Other Costs

Specify any other direct costs you intend to make, which do not fit under any of the other budget line items mentioned above.

matched small grants program workplan format

Attached is a blank MSGP Work Plan, which you should adjust for your grant amount. The work plan specifies all key activities you are planning for your project, as well as when you plan to do that activity. The MSGP Work Plan Format provides a time frame of maximum 14 months. However, please keep in mind that all project activities, including final reporting should be completed by the end of December 2003.

In order to give a clear overview of all activities, divide your project into phases, for example a start-up phase in which you begin the project, implementation phase(s) in which the main work is being done and an evaluation phase in which you evaluate the outcomes of the project and prepare the final reports. It is important that your list of activities and/or tasks shows step-by-step what you are planning to do during all phases of your project. Phases should correspond to the deliverables and disbursement of grant funds, and should be adequately explained in the narrative section of the application.

The first activity for all grantees will be participation in the Grantee Orientation. The Grantee Orientation is planned for December 2002 and will be held in Baku. The exact date will be announced when grant recipients are notified.

Fill out the work plan by marking an ‘X’ where certain activities and/or tasks will be completed and specifying the name of the activity or task that you have described in the narrative portion of the application. The MSGP Work Plan is Annex III of your full application.

Matched small grants program procurement process

Please fill in attachment 1 (Assessment of Beneficiary’s Capacity to Conduct Procurement), so that the MSGP staff could determine the extent of help in procurement needed, and attachment 2 (A. Procurement Plan and B. Project Operational Costs) based on guidelines given in the ‘Manual for Conducting Very Small-Value Procurement Under World Bank/IDA Small Grants, Loans and Credits’. Attachments 1 and 2 form Annex I of your application.

Definitions:

Procurement for goods includes equipment, supplies, software, publication costs.

Procurement for works includes labor, rental equipment, supplies and other expenditures needed to carry out physical construction or other physical activity (e.g., site preparation, planting trees, digging canals, building structures).

Procurement for services includes consultants (individuals or firms) contracted to provide professional services under the project.

Operating Costs include labor from the recipient’s own organization, travel, rent, communication costs, etc. (see explanation under Budget line description, above).

Applicants may adjust the blank Procurement Plan Form by adding lines and pages as necessary in the format provided. For further information about the MSGP Procurement guidelines, please visit the MSGP webpage: http://www.caspianenvironment.org/msgp or request a copy from the MSGP office.

Assistance

For assistance please do not hesitate to contact the MSGP staff. Mr. Kamran Abdullayev and Ms. Ayada Iskandarova are available to assist you with your project application. You can email them at: Kabdullayev@caspian.in-baku.com and/or Aiskenderova@caspian.in-baku.com or phone/fax to the MSGP office in Baku: Phone: (99412) 97-17-85, 93-80-03/Fax: (99412) 97-17-86.

The applicant is also encouraged to contact the World Bank Local Lead Consultants (LLCs) for advice and information about the grant program and National Focal Points (NFPs) or MAGICAs for information about Caspian Environment Program (CEP):

National Focal Points and MAGICAs:

Azerbaijan Mr. Gouseyn Bagirov Minister of Ecology and Natural Resources 100a, Bahram Aliyev str., Baku, 370073 Azerbaijan Republic MAGICA: Mr. Rasim Sattarzadeh Tel: +99412-92 41 73, 38 84 24 Fax: +99412-92 59 07 E-mail: rsattarzade@azdata.net	Iran Mr. Hosseini Emami General Director of Marine Environment Research Bureau, Nejatollahi St, PO Box 15875-5181, Tehran Islamic Republic of Iran MAGICA: Ms. Parvin Farshchi Tel: +98-21-8808 776, +98-21-8901 096 Fax: +98-21-8907 223 Email: parvin@neda.net	Kazakhstan Mr. Andar Shukputov Ministry of Environment Protection and Natural Resources, Satpaev Street, 1 Kokshetau, 475000 Republic of Kazakhstan MAGICA (assistant) Ms. Anara Temirbekova Tel : +7 31622 54265; 54269; 55537 Fax: +7 31622 50620, 55428 Email: anarat@neapsd.kz
Russia Mr. Amirkhan M. Amirkhanov Head of Environment Department Ministry of Natural Resources 123812, Moscow GSP Gruzinskaya Street, 4/6 Russian Federation MAGICA: Ms. Tatyana Butylina Tel: +095 1256302, 165 63 81 Fax: +095 1256302, 165 08 90 E-mail: cip@id.ru	Turkmenistan Mr. Matkarim Radjapov Minister Ministry of Nature Protection of Turkmenistan, Kemine Street, 102 Ashgabad, 744000 Turkmenistan MAGICA: Ms. Gozel Orazdyrdiyeva Tel : +993-12 39 3737, 35 73 41 Fax: +993-12 51 1613, 35 37 16 E-mail: nfp-tm@online.tm

The World Bank Local Lead Consultants

Azerbaijan Mr. Azer Orudjev Caspian Environment Programme Government House, Room # 108 40 Uzeir Hadjibeyov Str., Entrance #3 Baku 370016, Azerbaijan Tel.: (99412) 97-17-85, 93-80-03 Fax: (99412) 97-17-86 E-mail: aorudjev@caspian.in-baku.com	IRan Mr. Fereidoun Rostami C/O Ozone office Department of Environment Tehran, Iran Tel.: (9821) 8261116 Fax: (9821) 8261117 Mobile: (0911) 2396587 E-mail: rostamif@yahoo.com	Kazakhstan Ms. Dinara Akhmetova Ministry of Environment Protection and Natural Resources, Satpaev Str. 1-223 Kokshetau 475000, Kazakhstan Tel/Fax.: (7 31622) 55428 Mobile: +7-300-325 1221 E-mail: dakhmetova@neapsd.kz
Russia Mr. Vassili Rodionov World Bank Residential Mission 3 Sadovaya-Kudrinskaya Str. Moscow 123242, Russia Tel.: (7 095) 7457000 ext # 2084 Fax: (7 095) 2548368 E-mail: vrodionov@worldbank.org	Turkmenistan Mr. Oleg Guchgeldiyev National Institute of Deserts, Flora & Fauna, 15 Bitarap, Turkmenistan Str. Ashgabat 744000, Turkmenistan Tel.: (99312) 357341 Fax: (99312) 353716 E-mail: pipp@online.tm oguchgeldiev@worldbank.org

msgp cover page
Matched Small Grants Program in the Caspian Region – 2^nd round
TO BE FILLED IN BY MSGP STAFF PROJECT CODE: DATE OF RECEIPT:	PROPOSAL COMPLETE: □ YES □ NO PROPOSAL IN SCOPE: □ YES □ NO COPIED FOR EVALUATION: □ YES □ NO
Cover Page (to be filled in and signed by the Project Manager)
Project Title:
Name of Lead Organization:	Role of Project Partner(s) (if applicable):
Name of Project Partner(s) (if applicable):
Type of organization (please check one): □ Private Sector (locally-owned) □ Private Sector (foreign-owned) □ Local Government □ State Company □ Local Non-Governmental Organization □ Foreign Non-Governmental Organization (locally registered) □ National Governmental Agency □ Scientific Institution □ Others (specify):
Registration Number: and/or Tax Identification Number:		E-mail:
		Phone:
Address:		Fax:
		Internet site (if available):
Project Manager (Name, Contact information Phone/Fax/E-mail):		Signature:
Total project budget (USD): Total Matched Small Grant (USD): Total matching funds: Duration of the project: Geographical location:

Project Summary (max. 8 lines):

Annex I of the Application

Procurement

Attachment 1: Assessment of Beneficiary’s Capacity to Conduct Procurement

1. Name of Beneficiary:

2. Legal Status:

3. Nature of Business Activity:

4. Description of Organization:

5. Number of Employees with brief description of their responsibilities:

6. Brief description of beneficiary’s experience with purchase goods, works, and services

7. Nature and value of purchases during the last fiscal year

8. Who is responsible for procurement and for contract signature?

9. Who provides technical and legal expertise for purchases?

10. A description of sources of supply:

11. Description of purchasing procedures and documents.

12. How are recurrent items, such as office supplies, spare parts, gas for cars, etc., purchased?

13. Does the Beneficiary have written procurement rules?

14. What kind of contract forms is used?

(For MSGP staff to determine the extent of help in procurement. The capacity of the PMU/PCU/PIU will be strengthened for this purpose).

Attachment 2 A

Form of Procurement Plan
Description of Contract Packages	Estimated Cost		Procurement Method	Contract Signature	Start	Finish	Remarks
	Currency	US$2
Goods
Works
Services
TOTAL

Attachment 2 B

Project Operational Costs
#	Item of expenditure	Costs (US$)
		From Grant Funds	From Matching Funds	Total
SALARIES
1.
2.
3.
TRAVEL COSTS
4.