3 Annex a Appl-Form Progres-cfp1 Radna Verzija Prevedeno Gotovo Uz Cenkove Dodatke

8/13/2019 3 Annex a Appl-Form Progres-cfp1 Radna Verzija Prevedeno Gotovo Uz Cenkove Dodatke

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EUROPEAN PARTNERSHIP WITH MUNICIPALITIESPROGRAMME (PROGRES)

1st Call for Proposals for mun ! pal nfrastru!tur" pro#"!ts

Grant Appl !at on $orm

Budget line: ________

Publication Reference: __________

Deadline for submission of concept notes and applications: ___________________

Title of the action: Reconstruction and expansion of water treatment plant in Lebane Building of filter fields

Number and title of lot 2155/1 KO Grguro ce

Location(s) of theaction:

!erbia" #ablanica district" $unicipalit% of Lebane

Name of the applicant$unicipalit% of Lebane

Nationality of theapplicant 1

!erbia

Dossier No(for official use only)

The statutes must ma!e it possible to ascertain that the organisation "as set up by an act go#erned by thenational la" of the country concerned$ %n this respect& any legal entity "hose statutes ha#e been established inanother country cannot be considered an eligible local organisation$

%&&' Page of '*+,-. $doc


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/urope0id %D % R!&2'1'&()*&'+'2+,,+-5

Legal status !tate aut.orit% Local go ernment

Partner(s) #K /public utilit% compan%/ 0odo od Lebane" !erbia

Total "l * +l" !ost of t,"a!t on (A)

Amount r"-u"st". from t,"Contra!t n* Aut,or t/ (0)

of total "l * +l" !ost ofa!t on (02A31&&)

1/2R3 11- ''' 1/2R3 ++ , "-2 4 3,

Total duration of theaction:

+ mont.s

5ontact details for the purpose of this action:

Postal a..r"ss4 1 24' Lebane" ara (usana street" no 11

T"l"p,on" num+"r4 5ountrycode 6 city code 6 number

64311 3,4'2-

$a3 num+"r4 5ountry code 6city code 6 number

64311 3,4'34

Conta!t p"rson for t, sa!t on4

7enad #o ano i8

Conta!t p"rson5s "ma la..r"ss4

nnn9o ano ic:gmail com

W"+s t" of t," Or*an sat on www lebane org rs

To be inserted if the organisation is registered in P0D7R$ This number is allocated to an organisation "hichregisters its data in P0D7R$ 8or more information and to register& please #isithttp:99ec$europa$eu9europeaid9onlineser#ices9pador

' /$g$ non profit ma!ing& go#ernmental body& international organisation- 0dd as many ro"s as partners%&1& Page of 'PR7 R/; 5fP
http://ec.europa.eu/europeaid/onlineservices/padorhttp://ec.europa.eu/europeaid/onlineservices/pador


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An/ !,an*" n t," a..r"ss"s6 p,on" num+"rs6 fa3 num+"rs an. n part !ular "7ma l6 must +"not f ". n 8r t n* to t," Contra!t n* Aut,or t/9 T," Contra!t n* Aut,or t/ 8 ll not +" ,"l.r"spons +l" n !as" t !annot !onta!t an appl !ant9

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NOTICE

0ll personal data (such as names& addresses& 5


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TA0LE O$ CONTENTS

PART A. CONCEPT NOTE..........................................................................................6

I9 INSTRUCTIONS $OR THE :RA$TING O$ THE CONCEPT NOTE9999999999999999999999999999999999999;

PART B. FULL APPLICATION FORM.........................................................................8$ D/;5R%PT%7N$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$ Title: Reconstruction and eApansion of "ater treatment plant in Lebane Building of filter fields$$$$$$$$.$ Location(s): ;erbia& @ablanica district& Cunicipality of Lebane& rguro#ce #illage$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$.

'$ 5ost of the action and amount re?uested from the 5ontracting 0uthority$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$.-$ ;ummary (maA page)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$=$ 7b ecti#es (maA page)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$,$ Rele#ance of the action (maA ' pages)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$+$ Description of the action and its effecti#eness (maA - pages)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

.$ Cethodology (maA - pages)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$*$ Duration and indicati#e action plan for implementing the action$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$ ;ustainability (maA ' pages)$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ Logical frame"or!$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$ B2D /T 87R TE/ 05T%7N$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$'$ /FP/5T/D ;72R5/; 78 82ND%N $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$-$ /FP/R%/N5/ 78 ;%C%L0R 05T%7N;$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$=$ %D/NT%T>$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$,$ D/;5R%PT%7N 78 TE/ P0RTN/R;$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$+$ P0RTN/R;E%P ;T0T/C/NT$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

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PART A9 CON CEPT N OTE

I9 INSTRUCTIONS $OR THE :RA$TING O$ THE CONCEPTNOTE

There is no specific template for the 5oncept Note but the applicant has to ensure that the teAt ofhis9her concept note:

;.e s%stem of water suppl% in t.e $unicipalit% of Lebane consists of t.e followinguman=a Ri er w.ere a small dam was built& !edimentation installations for remo al of silt and plants& ipeline from inta=e structure to water treatment plant& ?ater treatment plant& ;run= pipeline from t.e plant to water suppl% s%stem& ?ater suppl% s%stem in settlements;.e issue t.is pro9ect is dealing wit. is a water treatment plant ;.e plant is using @@(egremont@@tec.nolog% of flocculation and .as a s%stem for batc.ing" mixing" coagulation and filtration ;.e =e%part for capacit% e aluation i e t.e Auantit% of water w.ic. can reac. beneficiaries are CL;*R C*L(!in t.e water treatment plant ilter fields are t.ree pools in w.ic. raw water is being processed fromorganic impurities and turbidit% One of t.ese t.ree filter fields .as been crac=ed and it can completel%brea= at an% moment ;.e reconstruction of t.e filter filed is not possible since t.e pipes connected tot.e water suppl% s%stem go from t.is crac=ed field Cn order to carr% out t.e reconstruction it would benecessar% to s.ut down t.e water suppl% completel% for a period of at least two mont.s ;.is couldt.reaten t.e ecolog% and .uman .ealt. On t.e ot.er .and" if t.is filter field completel% crac=ed" t.ebeneficiaries would be left wit.out water e en longer t.an two mont.s

Building of two new filter fields would not onl% pre ent t.e immediate danger of brea=down but wouldalso create 25D increase of water treatment plant capacit% since instead of current t.ree fields t.erewould be four fields Cn t.is calculation we are not ta=ing into account t.e pool Efilter fieldF w.ic. iscurrentl% out of order Cn practical terms t.is means t.at t.e water treatment plant could deli er to

beneficiaries at least ,' litres of drin=ing water per second instead of 4' litres per second w.ic. itcurrentl% does Ct is important to emp.asi e t.at water flow of 4' litres per second was insufficient drin=ing watersuppl% to beneficiaries in t.e summer w.en t.e water consumption reac.es its pea= (uring t.e.ig.est temperature periods t.e upper parts of town .ad no water suppl% Obtaining treated water of ,'litres per second would pro ide enoug. water during t.e driest period and it would be possible toexpand water suppl% s%stem to new settlements as well

;.e second important issue t.e pro9ect is dealing wit. is irrational expenditure of drin=ing water andt.e attitude of beneficiaries t.at water comes in unlimited Auantities and t.at it s.ould be c.eep or e enfor free (uring t.e period of .ig. temperatures t.ere is no solidarit% and rational expenditure ;.eciti ens from geograp.icall% lower parts water t.eir gardens" was. t.eir cars and use water irrationall% Ht t.e same time" t.eir fellow&townsmen from t.e upper parts of t.e town" in t.e .ills" .a e no watersuppl% at all Ia ing in mind t.at existing filter fields are damaged and impossible to be fixed and due to longerterm water disconnection and inabilit% of t.e existing capacities to suppl% all beneficiaries wit. waterduring t.e summer" building of new filter fields represents t.e onl% solution of t.e problem

;.e pro9ect was prepared b% professional and competent team from J redu e8e a .idrote.ni=u odote.ni=a do o Beograd E @ ompan% for .%drotec.nics odote.ni=a d o o Beograd@@

Benefits for target groups and beneficiaries"n"ss (ma3 1 pa*"s)

Pro#ide a description of the proposed action including& "here rele#ant& bac!ground information that ledto the formulation of the action$ This should include:

/Apected results (maA = pages)$ %ndicate ho" the action "ill impro#e the situation of target

groups9beneficiaries as "ell as the technical and management capacities of target groups and9orany local partners "here applicable$ Be specific and ?uantify results as much as possible$ %ndicatenotably foreseen publications$ Describe the possibilities for replication and eAtension of the actionoutcomes (multiplier effects)$

Basic results"s an. r"sults of t," a!t on In!r"as". -uant t/ an. -ual t/ of ra8 8at"r r"!" >". at nta " stru!tur" an. s"nt to 8at"rtr"atm"nt plant9

Pro#"!t t tl"4Production and transport oa&ricu#tura# products accordin& tot/e EU standards

S"!tor (s"" s"!t on %9% of s"!t on II)4 11 7 a*r !ultur"

Lo!at on oft," a!t on

Cost of t," a!t on(EUR)

l"a. mana*"r orpartn"r

:onors to t,"a!t on (nam")

Amount !ontr +ut".(+/ .onor)

:at"s (from ..2mm2////to ..2mm2////)

$unicipalit% ofLebane

4 ''' Lead manager &applicant

*HR E*uropean Hgenc% forReconstructionF

5- ''' 2''-

O+#"!t >"s an. r"sults of t," a!t on Pro.u!ts +ran. n* n a*r !ultur" an. "3!,an*" of "3p"r "n!"s 8 t, t," partn"r from 0ul*ar a


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II9 THE APPLICANT

Europ"A . I: num+"r @ R'5 7375 9E5707 0440:;

Nam" of t," or*an sat on Cunicipality of Lebane

%nformation re?uested under this point need only be gi#en in cases "here there ha#e beenmodifications or additions as compared to the information gi#en in the 5oncept note form$

=9 I:ENTIT

L"*al Ent t/ $ l" num+"r 1&

A++r"> at on$unicipalit% of Lebane

R"* strat on Num+"r (or"-u >al"nt) ounded as state aut.orit% Local go ernment

:at" of R"* strat onounded as state aut.orit% Local go ernment

Pla!" of R"* strat on Lebane

Off ! al a..r"ss of R"* strat on ara (uPana street no 11 " 1 24' Lebane

Countr/ of R"* strat on 112 Nat onal t/ 1%

!erbia

E7ma l a..r"ss of t,"Or*an sat on

=abinet:lebane org rs

T"l"p,on" num+"r4 5ountry code

6 city code 6 number 64311 3,4'2-

$a3 num+"r4 5ountry code 6 citycode 6 number

64311 3,4'34

W"+s t" of t," Or*an sat on www lebane org rs

* This number is a#ailable to an organisation "hich registers its data in P0D7R$ 8or more information and toregister& please #isit http:99ec$europa$eu9europeaid9"or!9onlineser#ices9pador9indeA_en$htm%f the applicant has already signed a contract "ith the /uropean 5ommission

8or organisations$ %f not in one of the countries listed in section $ $ of the uidelines& please ustify its

location8or indi#iduals$ %f not in one of the countries listed in section $ $ of the uidelines& please ustify itslocation

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mailto:[email protected]:[email protected]


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Point & ' and - o section %% belo" must only be filled in by applicants "ho ha#e been grantedderogations from registration in P0D7R$0ll other applicants must encode this information under their P0D7R registration$

III9 PARTNERS O$ THE APPLICANTPARTICIPATING IN THE ACTION

;9 :ESCRIPTION O$ THE PARTNERS

This section must be completed for "a!, partn"r or*an sat on "ithin the meaning of section $ $ ofthe uidelines for 0pplicants$ 0ny associates as defined in the same section need not be mentioned$>ou must ma!e as many copies of this table as necessary to create entries for more partners$

Partner

Europ"A . I: num+"r '

$ull l"*al nam" #a no =omunalno predu e8e 0O(O0O( Lebane

artners t.at are registered in H(OR do not need to fill in t.e rest of t.is section w.ic. is "ar2edin &re*

ate o Re&istration 11 11 2''4

Pla!" of R"* strat on Lebane

L"*al status - #a no =omunalno predu e8e

Off ! al a..r"ss of R"* strat on =

lica 1+ H gust b b " 1 24' Lebane

Countr* o Re&istration , / Nationa#it* +

!rbi9a

Conta!t p"rson Hndri9a KraQi8" dire=tor

T"l"p,on" num+"r : countrycode 6 city code 6 number

64311 3,4+'+

' This number is a#ailable to an organisation "hich registers its data in P0D7R$ 8or more information and toregister& please #isit http:99ec$europa$eu9"or!9europeaid9onlineser#ices9pador9indeA_en$htm

- /$g$ non profit ma!ing& go#ernmental body& international organisation=

%f not in one of the countries listed in section $ $ of the uidelines& please ustify its location, 8or organisations+ 8or indi#iduals

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$a3 num+"r : country code 6city code 6 number

64311 3,4+'+

E7ma l a..r"ss odo odlebane:gmail com

Num+"r of "mplo/""s ,,

Ot,"r r"l">ant r"sour!"s Ro o=opaM LB/11'" =anal&9et" d e cisterne a odu" 2 pi= ap o ila"putniM=o o ilo opel e=tra

E3p"r "n!" of s m lara!t ons6 n r"lat on to t,"rol" n t," mpl"m"ntat onof t," propos". a!t on

& napreNen9e te.nologi9e prerade ode E ' ''' *uraF sufinansi9er7(

& C gradn9a taloQnica na odo a. atu E + ''' *uraF sufinansi9er$CR 2 rogram

& 7aba =a me.ani aci9e E2'' ''' *uraF sufinansi9er Kral9e ina7or eP=a C$G

H stor/ of !oop"rat on 8 t,t," appl !ant

0odo od 9e 9a no =omunalno predu e8e =o9e 9e osno ala Lo=alnasamoupra a i u e i sa delatnoP8u odosnabde an9a" tesnosarad9u9u

Rol" an. n>ol>"m"nt npr"par n* t," propos".a!t on

0odo od 9e u saradn9i sa nadleQnim i struMnim institutima i radio=ompletnu pro9e=tno te.niM=u do=umentaci9u" priba io s eneop.odne do ole i dao te.niM=o te.noloP=e smernice i drugeinformaci9e neop.odne a popun9a an9e apli=aci9e

Rol" an. n>ol>"m"nt nmpl"m"nt n* t," propos".

a!t on

loga 0odo oda 9e monitoring pro9e=tni. a=ti nlosti poMe odgraNe ins=i. rado a" pa do a rPet=a pro9e=ta ;a=oNe" i rada idistribuci9a an=etni. listi8a i promoti ni. broPura fla9era 0odo odima i oba e u da preu me na =oriP8en9e filters=a pol9a i da i.odrQa a 0odo od ima oba e u i da uMest u9e u pripremitenders=og pa=eta a 9a nu naba =u

Important4 T, s appl !at on form must +" a!!ompan ". +/ a s *n". an. .at". partn"rs, pstat"m"nt from "a!, partn"r6 n a!!or.an!" 8 t, t," mo."l pro> .".9

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?9 PARTNERSHIP STATEMENT

0 partnership is a relationship of substance bet"een t"o or more organisations in#ol#ing sharedresponsibilities in underta!ing the action funded by the Delegation of the /uropean 2nion to Republicof ;erbia (5ontracting 0uthority)$ To ensure that the action runs smoothly& the 5ontracting 0uthorityre?uires all partners to ac!no"ledge this by agreeing to the principles of good partnership practice setout belo"$

$ 0ll partners must ha#e read the application form and understood "hat their role in theaction "ill be before the application is submitted to the 5ontracting 0uthority$

$ 0ll partners must ha#e read the standard grant contract and understood "hat theirrespecti#e obligations under the contract "ill be if the grant is a"arded$ They authorisethe lead applicant to sign the contract "ith the 5ontracting 0uthority and represent themin all dealings "ith the 5ontracting 0uthority in the conteAt of the actionOsimplementation$

'$ The applicant must consult "ith its partners regularly and !eep them fully informed of the progress of the action$

-$ 0ll partners must recei#e copies of the reports G narrati#e and financial G made to the5ontracting 0uthority$

=$ Proposals for substantial changes to the action (e$g$ acti#ities& partners& etc$) should beagreed by the partners before being submitted to the 5ontracting 0uthority$ Hhere nosuch agreement can be reached& the applicant must indicate this "hen submitting changes

for appro#al to the 5ontracting 0uthority$,$ Hhere the Beneficiary does not ha#e its head?uarters in the country "here the action is

implemented& the partners must agree before the end of the action& on an e?uitabledistribution of e?uipment& #ehicles and supplies for the action purchased "ith the /2grant among local partners or the final beneficiaries of the action$

% ha#e read and appro#ed the contents of the proposal submitted to the 5ontracting 0uthority$ %underta!e to comply "ith the principles of good partnership practice$

Name: Hndri9a KraQi8

7rganisation: Public utility company


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ID9 ASSOCIATES O$ THE APPLICANTPARTICIPATING IN THE ACTION

This section must be completed for each associated organisation "ithin the meaning of section $ $ ofthe uidelines for 0pplicants$ >ou must ma!e as many copies of this table as necessary to createentries for more associates$

0ssociate

$ull l"*al nam"

Europ"A . I: num+"r .

Countr/ of R"* strat on

L"*al status *

Off ! al a..r"ss

Conta!t p"rson

T"l"p,on" num+"r4 country code 6 city code 6 number

$a3 num+"r : country code 6 city code 6 number

E7ma l a..r"ss

Num+"r of "mplo/""s

Ot,"r r"l">ant r"sour!"s

E3p"r "n!" of s m lar a!t ons6 n r"lat on to rol" n t,"mpl"m"ntat on of t," propos". a!t on

H stor/ of !oop"rat on 8 t, t," appl !ant

Rol" an. n>ol>"m"nt n pr"par n* t," propos". a!t on

Rol" an. n>ol>"m"nt n mpl"m"nt n* t," propos".a!t on

.This number is a#ailable to an organisation "hich registers its data in P0D7R$ 8or more information and toregister& please #isit http:99ec$europa$eu9europeaid9"or!9onlineser#ices9pador9indeA_en$htm

* /$g$ non profit ma!ing& go#ernmental body& international organisation%&1& Page + of 'PR7 R/; 5fP


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D9 CHEC LIST

P2BL%50T%7N R/8/R/N5/ _______________& /2R7P/0N P0RTN/R;E%P H%TE C2N%5%P0L%T%/; PR7 R0CC/ (PR7 R/;) ;T 58P& B2D /TL%N/ _____________

A:MINISTRATIDE :ATA To be filled in by the applicantNam" of t," Appl !ant Municipa#it* o Le$ane

Europ"A . I: num+"r R'5 7375 9E5707 0440:;

Nat onal t/ %&2Countr/ %1 an. .at" ofr"* strat on

;erbia

L"*al Ent t/ $ l" num+"r %%

L"*al status % 'tate aut/orit* % Loca# &o,ern"ent

Partn"r 1 Name 2/urope0id %D number: Public utility company


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%&1& Page * of 'PR7 R/; 5fP

0E$ORE SEN:ING OUR PROPOSAL6 PLEASE CHEC THAT EACH O$ THE $OLLOWINGCOMPONENTS IS COMPLETE AN: RESPECTS THE $OLLOWING CRITERIA4

To +" f ll". n +/t," appl !ant

T tl" of t," Proposal4 Reconstruction and expansion o !ater treat"ent p#ant in Le$ane % Bui#din& o i#ter ie#ds "s NoPART 1 (A:MINISTRATIDE)19 T," !orr"!t *rant appl !at on form6 pu+l s,". for t, s !all for proposals6 ,as +""n us".

A

%9 T," :"!larat on +/ t," appl !ant ,as +""n f ll". n an. ,as +""n s *n".9 T," proposal s t/p". an. s n En*l s, A

9 On" or * nal an. !op "s ar" n!lu.".

=9 An "l"!tron ! >"rs on of t," proposal (C:7Rom) s "n!los".

;9 Ea!, partn"r ,as !ompl"t". an. s *n". a partn"rs, p stat"m"nt an. t," stat"m"nts ar" n!lu.".9

?9 T," +u.*"t s pr"s"nt". n t," format r"-u"st".6 s "3pr"ss". n F an. s "n!los".

'9 T," lo* !al fram"8or ,as +""n !ompl"t". an. s "n!los".

@9 T," CD of pro#"!t mana*"r s "n!los".PART % (ELIGI0ILIT )1&9 T," .urat on of t," a!t on s "-ual to or lo8"r t,an 1% mont,s (t," ma3 mum allo8".)

A

119 T," r"-u"st". !ontr +ut on s "-ual to or , *,"r t,an 1'9&&& EURO A

1%9 T," r"-u"st". !ontr +ut on s "-ual to or lo8"r t,an 1&&9&&& EURO (t," ma3 mum allo8".) A

1 9 T," r"-u"st". !ontr +ut on s "-ual to or , *,"r t,an =& of t," total "l * +l" !osts (m n mum p"r!"nta*"r"-u r".)

A

1 9 T," r"-u"st". !ontr +ut on s "-ual to or lo8"r t,an @& of t," total "l * +l" !osts (ma3 mum p"r!"nta*"allo8".)

A

1=9 At l"ast on" partn"r s from pu+l ! s"!tor as ."s!r +". n t," po nt %91919 of t," Gu ."l n"s for Appl !ant A

PART (TECHNICAL PRECON:ITIONS)

1;9 Positi#e Decision on /n#ironment %mpact 0ssessment or a statement from the rele#ant public authority that the latter isnot needed for the specific acti#iti es 7R appro#ed by the rele#ant authorities /n#ironment %mpact 0ssessment

A

1?9 Proof of o"nership or long term lease ( years after the signature of the contract) of the land 9assetsA

1'9 Cain Technical DesignA

1@9%ndicati#e Priced Bill of Quantities calculated in /2R (part of Cain Technical Design)A

%&9Building permit& if re?uested for such type of "or!s$ %n case no building permit is re?uired a confirmation from rele#antauthorities must be submitted$

A

%19 Proof that pro ect is imbedded in Local De#elopment ;trategy (LD;)A

%%9Proof that pro ect is imbedded in ;L0P data baseA


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31/32

DI9 :ECLARATION 0 THE APPLICANT

The applicant& represented by the undersigned& being the authorised signatory of the applicant&in the conteAt of the present call for proposals& representing any partners in the proposedaction& hereby declares that

the applicant has the sources of financing and professional competence and ?ualificationsspecified in section of the uidelines for 0pplicantsK

the applicant underta!es to comply "ith the obligations foreseen in the partnershipstatement of the grant application form and "ith the principles of good partnership

practiceK

the applicant is directly responsible for the preparation& management and implementationof the action "ith its partners& if any& and is not acting as an intermediaryK

the applicant and its partners are not in any of the situations eAcluding them from participating in contracts "hich are listed in ;ection $'$' of the Practical uide to contract procedures for /5 eAternal actions (a#ailable from the follo"ing %nternet address:http:99ec$europa$eu9europeaid9"or!9procedures9implementation9indeA_en$htm $8urthermore& it is recognised and accepted that if "e participate in spite of being in any ofthese situations& "e may be eAcluded from other procedures in accordance "ith section

$'$= of the Practical uideK

the applicant and each partner (if any) is in a position to deli#er immediately& upon re?uest&the supporting documents stipulated under section $- of the uidelines for 0pplicants$K

the applicant and each partner (if any) are eligible in accordance "ith the criteria set outunder sections $ $ and $ $ of the uidelines for 0pplicantsK

if recommended to be a"arded a grant& the applicant accepts the contractual conditions as

laid do"n in the ;tandard 5ontract anneAed to the uidelines for 0pplicants (anneA 8)K

the applicant and its partners are a"are that& for the purposes of safeguarding the financialinterests of the 5ommunities& their personal data may be transferred to internal auditser#ices& to the /uropean 5ourt of 0uditors& to the 8inancial %rregularities Panel or to the/uropean 0ntiG8raud 7ffice $

The follo"ing grant applications ha#e been submitted (or are about to be submitted) to the/uropean %nstitutions& the /uropean De#elopment 8und and the /2 Cember ;tates in the last

months: list only actions in the same field as this proposalS

The applicant is fully a"are of the obligation to inform "ithout delay the 5ontracting0uthority to "hich this application is submitted if the same application for funding made toother /uropean 5ommission departments or /uropean 2nion institutions has been appro#ed

by them after the submission of this grant application$

;igned on behalf of the applicant

Nam" $unicipalit% of Lebane" president $C H !;H7KO0C

S *natur"

Pos t on resident

:at" 23 '2 2'11

http://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htmhttp://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htm


32/32

DII9ASSESSMENT GRI:(TO 0E USE: 0 THE C ONTRACTING A UTHORIT )

ES NO

STEP 14 OPENING SESSION AN: A:MINISTRATIDE CHEC $ The submission deadline has been respected$ The 0pplication form satisfied all the criteria specified in part of the 5hec!list (;ection

< of Part B of the rant application form)$The administrati#e #erification has been conducted by:Date::ECISION 14The 5ommittee has recommended the 5oncept Note for /#aluation after ha#ing passed the0dministrati#e chec!$STEP % 4 EDALUATION O$ THE CONCEPT NOTE:ECISION %4

The 5ommittee has appro#ed the 5oncept Note and decided to proceed "ith the e#aluationof the full proposal after ha#ing preGselected the best 5oncept Notes$The e#aluation of the 5oncept Note has been conducted by:Date:STEP 4 EDALUATION O$ THE $ULL APPLICATION $ORM:ECISION 4A9 The 5ommittee has recommended the proposal for /ligibility #erification after ha#ing

been pro#isionally selected "ithin the top ran!ed scored proposals "ithin the a#ailablefinancial en#elope$09 The 5ommittee has recommended the proposal for /ligibility #erification after ha#ing

been put on the reser#e list according to the top ran!ed scored proposalsThe #erification of the proposal has been conducted by:Date:STEP 4 ELIGI0ILIT DERI$ICATION

'$ The 0pplication form satisfied all the criteria specified in part of the 5hec!list (;ection< of Part B of the rant application form)$

-$ The supporting documents listed hereunder& submitted according to the uidelines(;ection $-)& satisfied all the eligibility criteria of the applicant and its partner(s) (if any)

a$ The applicantOs statutes

b$ The statutes or articles of association of all partners

c$ The applicantOs eAternal audit report (if applicable)

to be inserted "hen the 5ontracting 0uthority is the /uropean 5ommissionSd$ The Legal /ntity 8ile (see anneA D of the uidelines for 0pplicants ) is dulycompleted and signed by the applicant and is accompanied by the ustifying documentsre?uested$

to be inserted "hen the 5ontracting 0uthority is the /uropean 5ommissionSe$ 0 8inancial %dentification form (see anneA / of the uidelines for 0pplicants )$

f$ 5opy of the applicant s latest accounts$

The assessment of the eligibility has been conducted by:Date::ECISION 4

The 5ommittee has selected the proposal for funding after ha#ing #erified its eligibilityaccording to the criteria stipulated in the uidelines$

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3 Annex a Appl-Form Progres-cfp1 Radna Verzija Prevedeno Gotovo Uz Cenkove Dodatke

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