Shuraako Concept Note
<Business Name>
<Date>
DIRECTIONS: Completing and submitting the Concept Note is a mandatory first step in Shuraako’s application process. Ensure
that all questions are answered according to the guidelines stated throughout this form. The submission must be in English.
Once completed, submit the Concept Note (and accompanying documentation) to the appropriate regional representative: Mr.
Abdikarim Gole ([email protected]) responsible for Somaliland, or Mr. Mahad Awale ([email protected]) responsible for
Puntland and South Central Somalia. If you have not received acknowledgement of submission within 10 business days, email
Shuraako immediately. If you have any questions pertaining to the Concept Note contact your regional representative. Once
received, Shuraako will review and identify candidates that are most appropriate for investment.
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1. Business/Project Details
Business Project Name
Investment Request ($)
*Owner Cash Contribution ($)
*A cash contribution of at least 30% of total project cost is recommended
2. Applicant & Authorized Representative
Name of Applicant/Lead Applicant
Gender (Check the appropriate box)
☐ Male
☐ Female
Telephone
Telephone
Email
Email
Name of Authorized Representative
Telephone
Telephone
Email
3. Business/Project Description
3.1 Location
Check the appropriate box.
☐South Central
☐Puntland
☐Somaliland
3.2 Business Growth Stage
Check the appropriate box.
☐Startup: A new business created from scratch (or one that has not previously existed).
☐Existing Business: A business already in existence, but seeking investment for expansion.
☐New Project within an Existing Business: A new enterprise/project that is launching from an
already existing business.
☐Other: Explain,
3.3 Business Registration / License
Please provide the registration information, for the existing business, below. If a start-up, your
enterprise must be registered. Copies of registration documentation should be submitted along with
the Concept Note.
Registration / License
Date issued /
Registration / License
Authority
expected
Number
License
Registration
2
4. Business/Project
4.1 Goods/Services
Describe the goods and/or service your business provides, including the price of those
goods/services. How does it solve the problem or address the needs of your target customers?
This field should not exceed 1,000 words
4.2 Production
Describe the activities that occur in the production and delivery of goods and/or services. For
example, explain the production steps, how the goods are packaged and stored, how the goods are
transported to market, etc.
This field should not exceed 1,000 words
4.3 Operation
What kinds of facilities does the business have, including land, offices, factories, stores, etc.? How has
the business grown since it started?
This field should not exceed 1,000 words
5. Investment
5.1 Investment Request
Describe why you are seeking an investment, what you plan to do with the funds, and how the assets
purchased with the investment will increase revenue and/or profit.
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5.2 Assets Needed
Specify the equipment / items you will purchase with the investment and with the owner cash
contribution (add rows if necessary).
No
1
2
3
4
5
Item
Cost / Amount (USD)
5.3 Contributed Assets
Describe all of the assets you intend to contribute to the project (add rows if necessary). Note that a
contributed asset is different from assets to be purchased with the owner cash contribution.
No
1
2
3
4
5
6
Item
Cost / Value (USD)
6. Employment
6.1 Current Employees
Please use the definitions below the table to determine how many individuals you currently employ.
Staff type
Number
Total number of permanent employees
Number of total permanent employees that are female
Number of total permanent employees that are youth
Total number of temporary employees
Number of total temporary employees that are female
Number of total temporary employees that are youth
Employment Definitions:
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Permanent employees: employees who work for you 6 months or more in a year
Temporary employees: employees who work for you less than 6 months in a year
Permanent female employees: female employees who work for you 6 months or more in a year
Permanent youth employees: employees between the ages of 15-35 employees who work for you 6
months or more in a year
Temporary female employees: female employees who work for you less than 6 months a year
Temporary youth employees: employees between the ages of 15-35 who work for you less than 6
months a year
6.2 Job Creation
Please explain what types of jobs will be created by this project (ex: sales people, fishermen):
After investment, when do you plan to start hiring new employees (month/year)?
Enter the number of jobs you believe you will create in the two years following the investment period.
Please use the definitions under the table to determine what types of jobs you may create.
After Investment
Year 1 After
Investment
(first 12 months)
Year 2 After
Investment
(second 12 months)
Total number of permanent jobs
Number of permanent jobs for females
Number of permanent jobs for youths
Total number of temporary jobs
Number of temporary jobs for females
Number of temporary jobs for youths
Employment Definitions:
Permanent employees: employees who work for you 6 months or more in a year
Temporary employees: employees who work for you less than 6 months in a year
Permanent female employees: female employees who work for you 6 months or more in a year
Permanent youth employees: employees between the ages of 15-35 employees who work for you 6
months or more in a year
Temporary female employees: female employees who work for you less than 6 months a year
Temporary youth employees: employees between the ages of 15-35 who work for you less than 6
months a year
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6.4 Management Team
List the names, positions and contact information (email and telephone) of key members responsible
for implementing the project or running the business. If CV/Resumes of bios can be provided, please
submit those along with the Concept Note.
Name
Position
Email
Telephone
6.5 Ownership
List all those who have an ownership stake in the business.
Name
# of shares / % of shares or
ownership
Email
Telephone
7. Financials
Please provide the following historical financial data for the last 2-3 years (if you are an existing
business) and projected data for 2-3 years after investment. Update the year for the corresponding data
and submit exact figures (if exact figures are not available, use best estimates). All financials should be
verifiable by accounts or other official documentation.
20__
Historical Financials
20__
20__
Revenue (USD)
Profit/Loss (USD)
Projected Financials (After Investment)
20__
20__
20__
Revenue (USD)
Profit/Loss (USD)
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8. Production/Sales Data
Enter each type of product/service that you currently offer. Please enter only one product/service per
line. Then, enter the unit which you measure production for each product/service. For instance, fishing
measures their sales in kilograms (kg) and manufacturers measure their sales in units. (add rows if
necessary)
Product
Unit of production
Enter the amount of product you sold each quarter for the last year. First, enter the months
corresponding to each quarter on which you are reporting on in the column header. Then, add your
corresponding quarterly production figures. (add rows if necessary)
Product
Quarter 1
[enter months]
Quarter 2
[enter months]
Quarter 3
[enter months]
Quarter 4
[enter months]
9. Collateral
List assets you or the business own that can be pledged as collateral, not currently pledged to another
financial commitment (add rows if necessary).
No
1
2
3
4
5
6
Item
Value (USD)
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9. References & Guarantees
List at least three references and their contact information:
Name
Business /
Organization
Relationship
Reference 1
Contact
Phone:
Email:
Phone:
Email:
Phone:
Email:
Reference 2
Reference 3
In addition, list one person outside of your Company who might guarantee repayment to the investor:
Name
Business / Organization
Relationship
Contact
Phone:
Email:
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