Attachment 3 To The Rules Of Procedure Of The

attachment 3 to the rules of procedure of the open call for proposals project proposal no. ( complete project proposal

Attachment 3 to the Rules of Procedure of the open call for proposals
Project proposal no.
(
Complete Project Proposal
“Local Development” Programme
under the European Economic Area Financial Mechanism and the Norwegian
Financial Mechanism 2014-2021
the call organized by
the Ministry of Development Funds and Regional Policy
the Departament for Assistance Programmes
Submission date
( to be filled in by MDFRP )
I.
Applicant’s data
1.
Full name of the Applicant
2.
Applicant’s address for correspondence
Street
Number of house/flat
Postal code
Town/city
Voivodeship
Phone number
Fax
3.
Contact person
Name and surname
Function
Phone number
e-mail
II.
Concept of the project
1.
Project title
2.
DD/MM/YYYY
DD/MM/YYYY
The duration of the project: from to
3.
Accessibility dimension 1
Please indicate how under activities for accessibility referred to in
point 8.4.b) of the Rules of Procedure of the open call for proposals,
accessibility standards referred to in point 8 of the Rules of
Procedure of the open call for proposals and the Accessibility
Programme Plus 2018-2025 (https://www.miir.gov.pl/strony/zadania/dlaczego-dostepnosc/)
will be considered. An analysis of the situation in the city should
also be carried out in order to show that the above-mentioned
activities are justified and rational from the point of view of the
needs of specific groups of inhabitants / city users. It should not
raise any doubts as to whether the product (s) of these activities
will be available to persons with disabilities, providing them with
actual usefulness. Please indicate the cost of the proposed actions in
this area (not exceeding the value of up to PLN 100,000).
Aspect of accessibility in the project activities referred to in point
8.4. a) of the Rules of Procedure of the open call for proposals
should be taken into account, discussed and justified in the
Development Plan and the Action Plan.
(limit: no more than 2,500 characters including spaces)
4.
Information and promotion activities
It should be demonstrated how the information and promotion activities
will be carried out for the project. These activities must be in line
with the beneficiary's obligations specified in the Information and
Communication Requirements for Information and Communication of the
EEA Financial Mechanism and the Norwegian Financial Mechanism for
2014-2021 (http://www.eog.gov.pl/media/49605/Wymogi_dotyczace_Informacji_i_Promocji_1.pdf)
(limit: no more than 3,000 characters including spaces)
5.
Project management
Project management in the context of the implementation of the
Development Plan / Project activities and objectives.
Describe the organizational structure of the project team, the scope
of responsibilities of its members, the experience of the project team
in the implementation of similar projects, the way information flows.
A description of the decision path in the project should be included,
as well as a description of the activities that will be performed as
part of the management activities. It should also be indicated how
effective cooperation will be guaranteed with the pre-defined project
expert and the supervisor from the Ministry of Investment and Economic
Development.
(limit: no more than 2,000 characters including spaces).
6.
National partnership
Please indicate whether a project is implemented in national
partnership (i.e. assuming the participation of Polish entities). If
so, please determine a planned composition of a partnership,
responsibilities of all partners and justify it by benefits for the
implementation of the Development Plan.
(limit: no more than 3,000 characters including spaces)
7.
Planned effects and the project durability
The most important results/ outcomes of the project should be
presented, specifying the chances for their use in the future and
contributing to solving problems arising in the project. At the same
time, sources of financing for further activities based on the
above-mentioned effects should be indicated.
(limit: no more than 3,500 characters including spaces)
II.8 Dissemination of best practices
The information concerning manners and tools for dissemination of own
experience and sharing the knowledge gained during the project
implementation with self-governments/non-governmental sector/other
relevant stakeholders/inhabitants must be presented. To this aim the
proposed educational activities and their external target groups,
together with a short justification of their selection should be
briefly presented.
(limit: no more than 3,500 characters including spaces)
II.9 Horizontal issues
The Applicant should briefly demonstrate compliance of planned project
activities with general principles stipulated in Article 7 and 8 of
the Regulation (EU) of the European Parliament and the Council no.
1303/20132 concerning the equality between men and women,
non-discrimination based on sex, racial or ethnic origin, religion or
belief, disability, age or sexual orientation, as well as sustainable
development in particular positive impact on the implementation of 4R
principle (defined in the formal evaluation grid for the project
outline).
(limit: no more than 1,000 characters including spaces)
III.1. Project budget
Financing source
amount 3
%
Requested funding
EUR
PLN
Own contribution4
EUR
PLN
Total project value
EUR
PLN
100 %
III.2. Justification of the rationality of the project budget
A reliable way to estimate expenditure in the project budget should be
presented, showing the rationality of individual budget items
indicated in the Detailed budget of the project (Annex No. 3 to the
application form). It will be insufficient to refer to similar
expenses without providing specific examples and calculations. In the
case of management costs, the amount of remuneration should be
consistent with the level of remuneration in a given institution and
proportional to the specificity of planned content-related activities.
(limit: no more than 2,000 characters including spaces).
IV. Involvement of consultants
Please indicate whether any consultant was involved in the preparation
of the complete project proposal. If so, please indicate names of all
consultants involved.
Annexes:
1.
Development Plan
2.
Action Plan
3.
Detailed budget of the project
4.
Letter of intent - in case of national partnership
5.
Expectations to potential Donor Country (Norway, Iceland,
Lichtenstein) partner
Applicant’s declaration
I, the undersigned, being a person authorised to represent the
Applicant, hereby declare that:
1.
the proposed concept in full falls within the scope of the
Applicant’s activity,
2.
all given information is compatible with the current legal and
actual status.
Name and surname
Position
Signature
Signatures of persons authorised to represent the Applicant
..........................................................................................
(Place, Date)
1To be completed only if a negative assessment for this aspect is
obtained at the stage of project outline or modification/ update of
the proposed accessibility measures (up to PLN 100,000) against the
information provided in the project outline.
2Regulation of the European Parliament and of the Council of 17
December 2013 laying down common provisions on the European Regional
Development Fund, the European Social Fund, the Cohesion Fund, the
European Agricultural Fund for Rural Development and the European
Maritime and Fisheries Fund and laying down general provisions on the
European Regional Development Fund, the European Social Fund, the
Cohesion Fund and the European Maritime and Fisheries Fund and
repealing Council Regulation (EC) No 1083/2006.
3Currency conversions from PLN to EUR should be made using the average
NBP exchange rate as of the day of submitting to the applicants a
written information about qualifying for the 2nd stage of the call.
4 If applicable.
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