Connecting Europe Facility 2014-2020 ENERGY CALL FOR PROPOSALS 2016 APPLICATION FORM PART D Technical and financial information Title of the proposed action TENtec number For INEA use only Received on: Number: 1. BACKGROUND INFORMATION ON THE PROJECT OF COMMON INTEREST (PCI) 1.1. General outline of the PCI(s) (maximum of 2 000 characters) 1.2. Current situation and main needs addressed by the PCI(s) (maximum of 2 000 characters) 1.3. Main objectives of the PCI(s) (maximum of 2 000 characters) 2. DESCRIPTION OF THE PROPOSED ACTION 2.1. Description of the proposed Action and of the related Activities (consistent with summary provided in the application form, Part A1) 2.2. Key physical characteristics of the infrastructure o Length (km) : o Route type: Onshore Offshore Both o Technical specifications: 2.3. Location of the proposed Action o Start point (geographical coordinates): o End point (geographical coordinates): Please also upload a map (e.g. JPEG or PDF format) representing the detailed location of the proposed Action AND the PCI(s) the proposed Action is located on. To ensure sufficient level of detail, both types of actions, works and studies, should be digitised at a scale of at least 1:100.000. GIS data of adequate quality should also be uploaded to the eSubmission module as one or more vector datasets (see detailed requirements in the Guide for Applicants). 2 2.4. Describe and justify the level of resources needed for implementing the Action 2.5. Contribution of the proposed Action to the PCI(s) 2.7. Revenues of the proposed Action 2.8. Planning overview of the Action (graphic representations) Please provide a planning detailing the critical path and including the milestones of the proposed Action and their interdependencies, by using graphic project management tools (e.g. Gantt, PERT, CPM) and attach them as a supporting document to the application form. 2.9. Control procedures and quality management during implementation of the proposed Action 2.10. Ex-post monitoring of the proposed Action 3 2.11. Risk Assessment Grid by activities Activity N° Risk Impact (High/Medium/Low) Likelihood (High/Medium/Low) Control (Under/Beyond) Preventive/Mitigating measure(s) 3. TECHNICAL EVALUATION [MATURITY] 3.1. Please explain why the proposed Action and the included activities are mature enough to be financed from this year's call 3.2. Explain which preceding steps have been/are being completed for this Action and their main findings/conclusions 3.3. PCI annual report (within the meaning of Article 5(4) of the TEN-E Regulation) Please attach the latest PCI annual report sent to ACER for the annual reporting on the PCI required by Article 5(4) as a supporting document to the application form. 3.4. Brief summary of the public consultation (only for works) 3.5. Building permits (only for works) Subject of building permit procedure 3.6. If relevant, foreseen date of award of building permit Foreseen start date of works Date of award If relevant, foreseen date of award Foreseen start date Procurements/Subcontracting Subject 3.7. Date of award of building permit Pending legal/administrative/technical issues, if any: [CROSS-BORDER DIMENSION OF THE ACTION, AREA OF IMPACT AND MEMBER STATES INVOLVED] 3.8. Which is the area of impact of your proposed Action and which Member States are impacted by the Action? How do Member States and relevant project promoters cooperate? If relevant, how is the cooperation with third countries ensured? 3.9. Which Member States/ companies from Member States do financially contribute to this Action and how? 3.10. If applicable, please summarise the cross-border cost allocation (CBCA) for the PCI and the main outcome of it (only for works) (not applicable for smart grids and electricity storage) [POSITIVE EXTERNALITIES, IMPACT ON SOLIDARITY] 3.11. Please identify the positive externalities which the PCI provides: (macro-regional) security of supply, solidarity or technological innovation, and which are translated in the Action. (Positive externalities are impacts of the Action which go beyond the Member States involved in the Action). Regarding solidarity, please consider the positive impact of the Action to non-involved Member State(s). (only for works) Please provide monetary or at least quantified values, if possible: [NEED TO OVERCOME FINANCIAL OBSTACLES] 3.12. Provide information on the commercial viability of the action based on the main features of the Business Plan and explain why the PCI is not commercially viable (only for works) 6 3.13. Please describe the financial obstacles and how public funding would help to overcome them 3.14. Please describe the general method used in calculating the tariffs in the Member State(s) involved (only for works) 3.15. What would be the impact on the tariffs, if there were no Union grants obtained? (only for works) [STIMULATING EFFECT OF THE CEF FINANCIAL ASSISTANCE ON THE COMPLETION OF THE ACTION] 3.16. How will the grant accelerate the implementation of the proposed Action. Is the PCI expected to leverage public and/ or private financing? 3.17. Please indicate the financial net present value (FNPV) for the PCI and the financial internal rate of the return (FIRR) if no Union financial assistance is granted, in line with what is provided in the Business Plan. (only for works) FNPV FIRR 3.18 Estimated revenues to be generated by the PCI (only for works) [PRIORITY AND URGENCY OF THE ACTION] 3.19. The proposed Action will contribute to: removing bottlenecks 7 ending energy isolation the implementation of the internal energy market other benefits Please describe how for each of your choices: 4. SUPPORTING DOCUMENTS All relevant information for assessing the proposal must be provided in the application form. The purpose of supporting documents is to provide additional information. At minimum, the following supporting documents shall be included in the application form: - Planning overview of the Action (graphic representations) Map of the location of the Action (JPEG or PDF; vector datasets) Latest PCI annual report (Article 5(4) of the TEN-E Regulation) In addition, if the application refers to any other documents to support the information provided in the forms (e.g. preparatory studies, TSO agreements, MoUs, etc.) you may provide such documents or their executive summaries as additional information. In particular, the following supporting documents should be provided if available; - For applications for studies, any supporting document justifying the claimed costs and resources For works, information about the expected use of the infrastructure: results from market tests and/or open season procedures (if carried out) 8
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