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COMMUNITY INITIATIVE PROGRAMME INTERREG III B ARCHIMED FINAL PROJECT REPORT PART 1 ACTIVITY REPORT Submission Date: CO-FINANCED BY THE EUROPEAN REGIONAL DEVELOPMENT FUND
Transcript
Page 1: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

COMMUNITY INITIATIVE PROGRAMME

INTERREG III B ARCHIMED

FINAL PROJECT REPORT

PART 1

ACTIVITY REPORT

Submission Date:

CO-FINANCED BY THE EUROPEAN REGIONAL DEVELOPMENT FUND

Page 2: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

2

A. GENERAL PROJECT INFORMATION

LEAD PARTNER: (Name of the Institution)

COUNTRY OF LEAD PARTNER:

NAME:

POSITION:

ADDRESS:

TEL. No: FAX:

LEGAL REPRESENTATIVE

E-MAIL:

SIGNATURE & STAMP

Has the legal representative of the lead partner been replaced since the signature of the Subsidy Contract?

If yes, please state the mane of the legal representative that was replaced.

NAME

POSITION:

ADDRESS:

TEL. No: FAX:

PROJECT MANAGER

E-MAIL:

Has the project manager of the lead partner been replaced since the signature of the Subsidy Contract?

If yes, please write the mane of the project manager that was replaced.

PROGRAMME AND PROJECT INFO

COMMUNITY INITIATIVE: INTERREG III

OPERATIONAL PROGRAM: INTERREG III B ARCHIMED

PRIORITY AXIS: Axis Number and Title

MEASURE:

TITLE OF THE PROJECT:

ACRONYM OF THE PROJECT:

JOINT CONVENTION – DATE OF SIGNATURE:

SUBSIDY CONTRACT NUMBER - DATE OF SIGNATURE:

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3

LIST OF PROJECT PARTNERS

A. MEMBER STATES

PARTNER NAME OF THE INSTITUTION COUNTRY REGION

LEAD PARTNER (PP1)

PP2

PP3

PP4

PP5

PPn

B. NON-MEMBER STATES

PARTNER NAME OF INSTITUTION COUNTRY

PP..

Page 4: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

4

PROJECT BUDGET (€)

TOTAL BUDGET EU CONTRIBUTION

(ERDF) NATIONAL

CONTRIBUTION

Budget according to the Subsidy Contract

Budget according to the Application form in force (last approved modification)

PROJECT TIMETABLE

START (mm/yyyy) END (mm/yyyy) DURATION (in months)

Timetable according to the Subsidy Contract

Timetable according to the Application form in force (last approved modification)

PROJECT COST(€) PER PARTNER

PARTNER COUNTRY PAID OUT EXPENSES CERTIFIED EXPENSES*

TOTAL EU CONTRIBUTION

(ERDF)

TOTAL EU CONTRIBUTION (ERDF)

Lead Partner

PP1 PP2 … PPn

TOTAL

*Please, mention the total amount of certified expenses until the submission date of the final report.

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PROJECT MODIFICATIONS

Please list in chronological order all changes/modifications that have been approved by the Programme Authorities (Steering Committee/Managing Authority).

1st modification

Type of modification Specify the type of modifications (Budget, Timeframe, Partnership, Activities, Deliverables,

Outputs etc)

Date of approval Insert the reference number and date of Managing Authority’s correspondence

Description Give a short description of the reasons that lead to the modification of the project and how

these modification(s) affected the overall implementation for the project.

2nd modification

Type of modification

Date of approval

Description

n* modification

Type of modification

Date of approval

Description

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B. EXECUTIVE SUMMARY OF PROJECT IMPLEMENTATION

Project’s activities and objectives (max. 1000 words)

Please provide an overview of project’s objectives and the main activities carried out during its lifetime.

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Project’s achievements (max.750 words)

Please describe the project achievements with reference to the related work packages and actions in terms of:

1. Networks 2. Studies 3. Pilot Actions 4. Exchange of Know how 5. Information activities

Explain to what extent the objectives described above have been achieved and whether the project is fully operational.

Development of Transnational Partnership (max 450 words)

Please describe the development of the partnership throughout the project duration, especially the involvement of partners from several countries in its implementation. Highlight any problems that were arisen, their reasons and how the were solved. Refer to possible future co-operation of partners after project finalization.

Involvement of Non EU partners (max 300 words)

Please describe the involvement of non-EU partners to the implementation of the project, if applicable.

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Project management (max 300 words)

Please describe the system of project management. Present bodies, their composition, tasks and performance. Please refer to any challenges faced.

Changes and Problems (max. 300 words)

Please describe any major changes/problems encountered, their reasons, their solutions and their impact to the overall implementation of the project in terms of:

1. Project Coordination 2. Implementation of activities 3. Cooperation between partners 4. Financial management

Experience gained during the project implementation and the added-value of working transnationally (max 300 words)

Please present the experience gained from the project implementation in terms of:

1. Project Coordination 2. Implementation of activities 3. Cooperation between partners 4. Financial management

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Compliance with Programme, Priority Axis and Measure (max. 300 words)

Please explain how the project contributed to the objectives of the programme, priority axis and measure.

Contribution to EU Policies (max. 300 words)

Please review how the project has contributed to EU policies on equal opportunities, employment, spatial development and environment. How these policies were reflected in the project?

Follow up (max. 300 words)

Please answer the following questions:

1. What will happen to the partnership after the completion of the project? Will the partners continue to operate? 2. What will happen to the project’s results? Is there action plan for maintaining the results achieved? 3. Are there any follow-up projects planned? If yes, please give a short description.

Page 10: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

IMPLEMENTATION OF ACTIONS Please list all actions carried out as shown in the table below and fill in the expenses paid out until completion as well as the certified expenses until the submission date of the final report.

WP No

Action No

Start (mm/yy)

End (mm/yy)

Description of activities, components, means

Responsible Partner

No

Involved Partners

No Location

Achieved output/ deliverables

Paid out expenses

(€)

Certified expenses

(€)

1.1.

1.2.

WP1

1.n.

2.1.

2.2.

WP2

2.n.

3.1.

3.2.

WP3

3.n.

n.1.

n.2.

WPn

n.n.

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11

ATTENTION! ALL DELIVERABLES MUST BE SUBMITTED TO THE MANAGING AUTHORITY IN ELECTRONIC FORM AND/OR HARD COPY

DELIVERABLES PER PARTNER Please describe deliverables/outputs produced per partner as indicated in the table below and fill in the expenses paid out until completion as well as the certified

expenses until submission date.

Partner No Work-

package No

Action No

Deliverables / Outputs Start

(mm/yy) Concluded (mm/yy)

Paid out

expenses (€)

Certified expenses

(€)

PP1

(LEAD PARTNER) Total cost of deliverables cost of PP1

PP2

Total deliverables cost of PP2

PP3

Total deliverables cost of PP3

PP4

Total deliverables cost of PP4

PPn

Total deliverables cost of PPn

TOTAL

Total deliverables cost

Page 12: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

OUTPUTS/ RESULTS/ IMPACTS ACHIEVED BY THE PROJECT

ACHIEVED OUTPUTS (contributing to the aims of the Measure)

INDICATOR CODE*

INDICATOR** UNIT OF MEASUREMENT

TARGET VALUE

ACHIEVED VALUE

REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND

TARGET VALUES

* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.

ACHIEVED PROJECT RESULTS (contributing to the Priority Axis or Measure)

INDICATOR CODE*

INDICATOR**

UNIT OF MEASUREMENT

TARGET VALUE

ACHIEVED VALUE

REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND

TARGET VALUES

* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.

EXPECTED IMPACTS

INDICATOR CODE*

INDICATOR** UNIT OF MEASUREMENT

TARGET VALUE

ACHIEVED VALUE

REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND

TARGET VALUES

* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.

Page 13: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

ATTETINTION! SECTION C MUST BE FILLED SEPARATELY FOR EVERY PARTICIPATING PARTNER IN THE PROJECT

C. FINAL PROJECT REPORT PER PARTNER

FINAL REPORT OF LEAD PARTNER (PP1) - (name of Lead Partner)

DELIVERABLES PRODUCED AND THEIR AVAILABILITY

Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.

Deliverables foreseen in the Application Form

Deliverables produced by the Project

Work- package

No

Action No

Type of deliverable

Description / Title

Number Cost foreseen

Type of deliverable

Description / Title Number

Expense incurred

Location, responsibility and evidence

REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)

Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.

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ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER

Please present in detail the actions for publicity and dissemination that have been carried out by mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /

interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,

videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached

A. Kind of events organized

Type Topic Target groups

Number of participants /

persons reached

WP

B. Kind of instruments/tools used and/or developed

Type Topic Target groups

Number of participants /

persons reached

WP

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FINAL PROJECT REPORT PER PARTNER

FINAL REPORT OF PROJECT PARTNER 2 (PP2) - (name of Project Partner)

DELIVERABLES PRODUCED AND THEIR AVAILABILITY

Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.

Deliverables foreseen in the Application Form Deliverables produced by the Project

Work- package

No

Action No

Type of deliverable

Description / Title Number Type of

deliverable Description / Title Number

Location, responsibility and evidence

REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)

Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.

Page 16: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER

Please present in detail the actions for publicity and dissemination that have been carried out b mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /

interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,

videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached

A. Kind of events organized

Type Topic Target groups

Number of participants /

persons reached

WP

B. Kind of instruments/Tools used and/or developed

Type Topic Target groups

Number of participants /

persons reached

WP

Page 17: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

FINAL PROJECT REPORT PER PARTNER

FINAL REPORT OF PROJECT PARTNER … (PPn) - (name of Project Partner)

DELIVERABLES PRODUCED AND THEIR AVAILABILITY

Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.

Deliverables foreseen in the Application Form Deliverables produced by the Project

Work- package

No

Action No

Type of deliverable

Description / Title Number Type of

deliverable Description / Title Number

Location, responsibility and evidence

REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)

Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.

Page 18: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER

Please present in detail the actions for publicity and dissemination that have been carried out b mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /

interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,

videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached

A. Kind of events organized

Type Topic Target groups

Number of participants /

persons reached

WP

B. Kind of instruments/Tools used and/or developed

Type Topic Target groups

Number of participants /

persons reached

WP

Page 19: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

PLEASE ADD THE FINANCIAL TABLES FROM EXCEL FILE (PART 2a and 2b OF FINAL PROJECT REPORT)

Page 20: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

EU COMMUNITY INITIATIVEINTERREG III B ARCHIMED

FINAL PROJECT REPORT

FINAL FINANCIAL REPORT

CO-FINANCED BY THEEUROPEAN REGIONAL DEVELOPMENT FUND

Submittion Date:

PART 2a

Page 21: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

PROJECT TITLE:

PROJECT ACRONYM:

SUBSIDY CONTRACT

CODE NUMBER:

LEAD PARTNER

Please, indicate in the following tables all paid out and certified costs related to the project implementation. Fill in the “paid out” column all the costs that have occurred and been paid by the respective partner and in the “certified” column all the costs certified by the “Certifying Authorities” until submission date of the final report.

TABLES 1.1. TO 1.5. FINAL FINANCIAL INFORMATION CONCERNING THE ENTIRE PROJECT

IMPLEMENTATION

Page 22: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

approved budget paid out certified

approved budget paid out certified

approved budget paid out certified

approved budget paid out certified

Partner 1 (LP) 0,00 € 0,00 € 0,00 €

Partner 2 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 €

… 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 €%Total

approved budget paid out

approved budget paid out

approved budget paid out

approved budget paid out

certified (=4)

approved budget paid out certified

Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Partner 2 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

… 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €%Total

Project funding per partner and source (€) PAID OUT AND CERTIFIED

EU Member State (Y/N)

CountryTotal (7)= 5 + 6MEDA (5) National Funding (6)

TOTALNON EU MEMBERS

Total (4+7) % Total

National Funding (2)

EU MEMBERS ONLY

% Total

PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE

(4) = 1+ 2

EU Member State (Y/N)

Country ERDF (1) Total

Page 23: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

MEDA MEDA

paid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified paid out paid out certified paid out certified

Partner 1 (LP)

0,00 € 0,00 € 0,00 € 0,00 €

Partner 2 0,00 € 0,00 € 0,00 € 0,00 €

Partner 3 0,00 € 0,00 € 0,00 € 0,00 €

Partner 4 0,00 € 0,00 € 0,00 € 0,00 €

Partner 5 0,00 € 0,00 € 0,00 € 0,00 €

... 0,00 € 0,00 € 0,00 € 0,00 €

Partner n 0,00 € 0,00 € 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Percentage

MEDA MEDApaid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified paid out paid out certified paid out certified

Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 €

Partner 2 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 €

... 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Percentage

MEDApaid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified

Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 €

Partner 2 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 €

... 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Percentage

Project costs (€) per year and partner PAID OUT AND CERTIFIED

ERDF NC

2009

TOTAL %

TOTAL %

TOTAL %

2007 2008

Total

ERDF NC TOTAL % ERDF

%

NC

PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE

2005 2006ERDF NC TOTAL % ERDF NC

Page 24: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €

Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

TOTAL5.External Expertise and Audit6. Equipment, Materials

and Rents 7. Operational Costs 8. Other

Add rows if needed

Project costs (€) per item and partner PAID OUT AND CERTIFIED

PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE

Partner n

0. Costs for project preparation

1. PersonnelWork

Package

Partner 1

4. Promotion and publications3. Travels and

accommodations

Partner 4

Partner 2

Partner 3

2. Meetings, conferences, seminars

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Categories of Expenditurespaid out certified paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified

Costs for project preparation 0,00 € 0,00 €Personnel 0,00 € 0,00 €Meetings, Conferences, seminars 0,00 € 0,00 €

Travels and Accommodations 0,00 € 0,00 €Promotion and publications 0,00 € 0,00 €

External expertise and audit 0,00 € 0,00 €Equipment, materials and rents 0,00 € 0,00 €Operational Costs 0,00 € 0,00 €Other 0,00 € 0,00 €TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Work Package 5 Work Package 6 Total

Expenditures (€) by Work Package (WP) and Budget Lines (BL) PAID OUT AND CERTIFIED

Work Package 1 Work Package 2 Work Package 3 Work Package 4

PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE

Page 26: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified

Partner 1

Partner 2Partner 3Partner 4Partner 5

….

TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €

Expenditures (€) by Work Package (WP) and Project Partners (PP) PAID OUT AND CERTIFIED

Work Package 5 Work Package 6Work Package 1 Work Package 2 Work Package 3 Work Package 4 TOTAL

PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE

Page 27: FINAL REPORT - PART 1 REVISED - mit.gov.it filecommunity initiative programme interreg iii b archimed final project report part 1 activity report submission date: co-financed by the

INTERREG IIIB ARCHIMED 2000-2006

Project CodeProject AcronymFinal Beneficiary

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Identification of the accounting document0.Costs for project preparation

1.PersonnelIdentification of the accounting document

No of Action

3.Meetings, Conferences, seminarsIdentification of the accounting document

TOTAL LIST OF THE JUSTIFICATIONS OF THE EXPENDITURES ACTUALLY PAID OUT

1

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Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Identification of the accounting document6.External expertise and audit

4.Travels and Accommodations

7.Equipment, materials and rentsIdentification of the accounting document

Identification of the accounting document

5.Promotion and publicationsIdentification of the accounting document

2

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Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Type of accounting Document

Number Issuing dateAccounting Document Issued by

Description of expenditures

Date of payment

Amount paid out

Amount justified towards the project

Certified Expenses

e.x WP 1.1e.x WP 1.2e.x WP n

TOTAL 0

Place……………………… Date………………………………… NameFunctionSignature (Legal representative of the LP or PP)Stamp

Identification of the accounting document

8.Operational CostsIdentification of the accounting document

9.Other

3

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CIP INTERREG III B ARCHIMED

PROJECT COMPLETION STATEMENT

SUBSIDY CONTRACT NO:

PROJECT ACRONYM:

PRIORITY AXIS:

MEASURE:

LEAD PARTNER:

I, the undersigned ………………………………………………………………………………………… (Name of the legal representative of Lead Partner and position) representing ………………………………………………………………………………………………….. (Name and address of the institution of the Lead Partner)

With regard to the Subsidy Contract of the project (title) signed between the Managing Authority and the Lead Partner on (date) With regard to the Joint Convention of the project (title) signed between the Lead Partner and the participating partners of the project on (date) With regard to the Application Form of the project (title) as approved by the Steering Committee of the CIP Interreg III B ARCHIMED

as amended and currently in force, Declare that:

1. The information contained in the Final Progress Report is true and correct. 2. The Project has been completed in terms of the planned activities,

deliverables and outputs according to the timetable and the financial plan and it is in full compliance with the Subsidy Contract, the Joint Convention and the Application Form as amended and currently in force.

3. The date of project completion regarding both its activities and payments is indicated in the table below.

PROJECT COMPLETION DATE

ACTIVITIES

PAYMENTS

4. The total expenditure incurred in connection with the completion of the project

amounts to € … 5. All the relevant documents of the project (legal, financial, administrative,

audit) as well as all deliverables produced are archived by the Lead partner

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and/or the project partners and will remain available for at least three years after the final payment from ERDF to the INTERREG III B ARCHIMED programme

. I, hereby, submit the following documents:

1. The Final Project Report (Word and Excel files). 2. The final Application Form duly signed and stamped in which a detailed

description of the project’s implementation until its completion is given. 3. All deliverables produced in the context of the project.

As the Lead partner of the project, I request the Managing Authority of the CIP INTERREG III B ARCHIMED programme to undertake all necessary actions in order to issue the Project Completion Certificate.

Date

Legal Representative,

(Signature and official stamp of the Lead Partner)


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