Annexe A of the Guidelines for Calls for Proposals
GRANT APPLICATION FILE
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TABLE OF CONTENTS
1
PRESENTATION OF THE APPLICANT................................................................... 4
1.1 THE APPLICANT’S DATA SHEET .................................................................................................... 4
1.2 PROFILE OF APPLICANT ORGANISATION ...................................................................................... 5
1.3 PARTNERS AND ACTUAL STAKEHOLDERS .................................................................................... 7
1.3.1 DONORS 7
1.3.2 NGO
7
1.3.3 OTHER PARTNERS................................................................................................................................. 7
1.3.4 FINANCIAL INSTITUTIONS .................................................................................................................... 7
1.4 PREVIOUS EXPERIENCE ............................................................................................................ 8
1.5 FINANCIAL INFORMATION ............................................................................................................ 9
1.5.1 FINANCIAL DATA AND KEY FIGURES..................................................................................................... 9
1.5.2 SOURCE(S) OF FINANCING .................................................................................................................... 9
1.5.3 AUDITED ACCOUNTS ............................................................................................................................ 9
2
PROJECT’S PRESENTATION .................................................................................. 10
2.1 DATA SHEET OF THE PROJECT.................................................................................................... 10
2.2 METHODOLOGY .......................................................................................................................... 10
2.3 SUSTAINABILITY OF THE PROJECT ............................................................................................. 13
2.4 DURATION OF THE INDICATIVE ACTION PLAN FOR IMPLEMENTATION OF THE PROJECT ...... 14
2.5 BUDGET SHEET AND LOGICAL FRAMEWORK............................................................................. 14
2.6 THE APPLICANT’S DECLARATION ............................................................................................... 15
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Belgium
Contracting authority : Agence Belge de Développement
(CTB)
Call for Proposals for the intervention :
Trade for Development Centre
BEL1405411
Grant application file
Reference : BEL1405411/AP/009
Deadline for submission of Grant application file :
31/10/2016
File No.
(for internal use only)
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1 PRESENTATION OF THE APPLICANT
1.1 THE APPLICANT’S DATA SHEET
Name of the applicant
(organisation)
Nationality of the applicant1
Legal status
Please provide a copy of the articles and memorandum of
association. In the absence of these, the file will not be
considered as eligible.
Registration n°
Year of registration
Independent third-party sustainable
certification
(Fairtrade, UTZ, Rainforest Alliance,
Organic, etc.)
Fairtrade Certification, since : XX/XX/XXXX
Organic Certification, since : XX/XX/XXXX
Other certification, since : XX/XX/XXXX
member of a fair trade network, since : XX/XX/XXXX
Please provide a copy of the last issued certificate(s)
If you do not have a certificate yet, please provide evidence
that the organisation is in the process of obtaining certification.
In the absence of these, the file will not be considered as
eligible.
Mailing address :
Physical address :
Tel number (landline and mobile) :
country code + city code + number
Contact person(s) for this project :
E-mail address(es) of contact
person(s) :
Does the organisation have Internet access in its office ?
YES / NO
How frequently do you check your e-mails?
The organisation’s website :
1
The organisation’s articles of association must show that this latter was created in accordance with the national law of the
country concerned and that its registered office is situated in an eligible country. Any organisation established in a different
country may not be considered a local eligible organisation. See the footnotes of the Call for Proposals guidelines.
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1.2 PROFILE OF APPLICANT ORG ANIS ATION
Origin and evolution of
the organisation
Explain briefly the origin (response to a request/need) and evolution of the
organisation
General meeting
Number of members/beneficiaries2 :
At the start of the organisation
Total
men
women
Currently
Total
men
women
Decision-making process :
Explain how the members/beneficiaries are involved in the decision-making
process of the organisation (meetings, information sharing and transmission,
etc.)
What is the average participation rate ?
2
Member in the case of a non-profit producers’ co-operatives / Beneficiary in the case of a private society owned by a cooperative, or in the case of a support structure of producers (type NGO).
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Financial contribution of members/beneficiaries :
Explain how the members contribute financially (membership fee, annual
fee,…) and what is the amount for each financial contribution?
Services to members/beneficiaries :
Explain what services the organisation provides to its members (both businesslinked and other)
Impact
Does the company have an impact on the social development of its
members/beneficiaries (and their communities) ? Please explain.
Executive board (or
Board of Directors)
Number of board members :
Total
men
women
How is the board being elected ?
Who are the Board members? Producers? Elected or representatives of public
institutions? External persons? (explain globally without giving names)
How long are the terms ?
Business Plan
Has your developed organisation a business plan?
If yes, please add it as an annexe of your application. The presence of a
business plan will be positively assessed.
How were you informed
of the current call for
proposals?
Who is in charge of the
preparing the present
application? What is their
function within the
organisation?
Human resources
Numbers of employees (men/women)
Numbers of volunteers (men/women)
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1.3 P ARTNERS AND ACTUAL STAKEHOLDERS
1.3.1 Donors
Name
Donor
of
Contact
person
Period
Amount
received
Activities
funded
Country
1.3.2 NGO
Name
NGO
of
Contact
person
Period
Type of support
Country
Period
Partnership
Country
1.3.3 Other partners
Name of
partner
Contact
person
Highlight any specific partnership to market access and/or sustainable trade
1.3.4 Financial Institutions
Name of
institution
3
Contact
person
Period
Financing
received
Interest
rate
Destination3
Country
Working capital, investment, operational costs …
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1.4 PREVIOUS EXPERIENCE
Please give a detailed description of projects carried out in the same sector in the last five years (1
page maximum per project). The projects presented must have been managed and implemented by
your organisation. Only projects with an amount of minimum 50% of the grant requested are eligible
as reference.
This information will allow evaluate whether you have sufficient and solid enough experience in
managing projects in the same sector and on a scale comparable to the one for which a grant is being
requested. All references must be accompanied by a letter or attestation signed by the donor and
mentioning the amount you have directly implemented.
Project title:
Location
of project
Cost of
project
(EUR)
Donor of the
project (name)
Contact person
from the donor
…
…
…
…
Description of the project and activities carried
…
Project title:
Location
of project
Cost of
project
(EUR)
Donor of the
project (name)
Contact person
from the donor
…
…
…
…
Description of the project and activities carried
…
Project title:
Location
of project
Cost of
project
(EUR)
Donor of the
project (name)
Contact person
from the donor
…
…
…
…
Description of the project and activities carried
…
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Amount of the
contribution
(from the
donor)
…
Amount of the
contribution
(from the
donor)
…
Amount of the
contribution
(from the
donor)
…
Dates (from
mm/dd/yyyy to
mm/dd/yyyy)
…
Dates (from
mm/dd/yyyy to
mm/dd/yyyy)
…
Dates (from
mm/dd/yyyy to
mm/dd/yyyy)
…
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1.5 FINANCI AL INFORMATIO N
1.5.1 Financial data and key figures

Please provide the following information, when applicable, based on management accounts and
balance sheet of your organisation (amounts in thousands of euros)
Year
Turnover
(not
including
grants)
Income
statement
(profit or loss)
before tax
Balance
sheet
total
Equity capital
or equivalent
Medium and
long-term debt
(>1 year)
Short-term
debt (<1 year)
Quantity
produced
by
members
Quantity
bought by your
organisation
Total
quantity
sold
Quantity of
certified
production
sold
Total number
of clients
Total number
of clients
buying a
certified
production
N-14
N-2
N-3
Year
N-15
N-2
N-3
1.5.2 Source(s) of financing

Please indicate your organisation’s source(s) of financing for year N-1
Type of financing
Subsides
Loan (<12 months)
Loan (>12 months)
Membership fee
Subscribed capital
…
…
Sources (donor, financial institution, etc.)
Amount
1.5.3 Audited accounts
Please provide references of the external audit report drawn up by and an approved auditor, certifying
the applicant’s accounts for the last three years.
Year
N-1
N-2
N-3
Approved auditor name
Period of validity
From mm/dd/yyyy to mm/dd/yyyy
From mm/dd/yyyy to mm/dd/yyyy
From mm/dd/yyyy to mm/dd/yyyy
Please include with your application the mail conforming your annual account has been audited.
4
N-1 = previous financial year
5
Idem
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2 PROJECT’S PRESENTATION
2.1 DATA SHEET OF THE PROJECT
Sector / Value-chain
Project title
Total duration of the project (in month)
Total budget (€)
(details in Annex B)
CTB contribution (€) (90%)
Applicant contribution (€) (10%)
Specific objectives
Results
2.2 METHODOLOGY
The Logical Framework and the Budget Sheet of the project shall be provided in annexes.
 Please provide a narrative description of the project : What are challenges/difficulties/problems
the organisation is facing and how the project address will address them? Describe the
expected results and the proposed activities to achieve these according to your logical
framework (Annex C). Give a detailed description of all activities. Demonstrate the
links/relationships between activities groups and the overall project’s coherence.
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
Describe the actors involved in the sector, the relevant market and market opportunities. Back up
your words with simple, concrete financial data (volumes produced, bought, sold, number of
customers, cash income of members, etc.).

Has your organization already been assessed in the past? If so, how much will be covered by the
proposed project? To what extent will it consider the recommendations of the evaluation?

The principal means proposed for implementing the project (equipment, materials and supplies to
be acquired or rented)
 Human resources
Please list the staff members (or external) in charge of the implementation of the project by detailing
the roles and responsibilities of the persons and if they will be in charge of the implementation of the
project, activities or its supervision. If possible, to highlight on a general organization chart people (or
functions) who will be responsible of the implementation of the project.

Please refer to all policy, strategy or plan undertaken at national or regional level relevant and
useful to the submitted project. Describe also how will the project relate to these policy, strategy or
plan?
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
In the view of the general objective and calls for proposals’ priorities, explain how the project will
be contribute to the fair and sustainable trade themes:

Explain who are beneficiaries of the project (direct and indirect) and how many are they (womenmen). How are beneficiaries being selected? (10 lines maximum)

Describe how your organisation will ensure monitoring and evaluation of the project.
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 Project partners & stakeholders 6
Precise the different project partners and describe their role in the implementation of the project :
- Service providers (technical assistance, financial assistance,…)
- NGOs (national, international)
- Government (local, regional, national)
- Private sector
- …
Where the action is a part of a larger programme, clearly explain how it is integrated or how it is
coordinated with this programme or any other proposed project. Outline the possible synergies with
other initiatives.
 In case the applicant has received previous support from the TDC and/or BTC
Clearly indicate how the current demand will combine with activities and/or results of previous project;
refer to main conclusions and recommendations of potential evaluation
2.3 SUSTAINABILITY OF THE PROJECT

-
Explain how the project will become sustainable once successfully completed. This may involve
monitoring actions, internal strategy actions, ownership actions, communication plan actions, etc.
Please distinguish between the following four sustainability aspects :
financial sustainability: for example, the financing of monitoring activities and revenue sources to
cover all future operational and maintenance costs;
-
institutional level: for example, the structures that will allow the results of the project to remain in
place after the project ends, capacity building, agreements and local “ownership” of project results;
-
viability at the political level, for example, where applicable, the structural impact (improved
legislation, consistency with existing frameworks, codes of conduct or methods);
-
environmental viability (what impact will the project have on the environment?; mention the
conditions put in place to avoid negative effects on the natural resources on which the project
depends as well as on the natural environment in the broad sense).
6
A letter confirming the interest of identified partners will be considered as an asset at the time of the application evaluation
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2.4 DURATION
OF
THE
INDI CATIVE
IMPLEMENTATION OF THE P ROJECT
ACTION
PLAN
FOR
The duration of the project will be 12 months.
Applicants should not indicate a specific starting date for implementation of the project but simply
indicate “month 1”, “month 2”, etc..
It is recommended that applicants base the estimated duration of each activity and the total period on
the most likely duration and not on the shortest possible duration, taking into account all relevant
factors which could affect the implementation timetable.
The activities provided for in the action plan must correspond to those described in detail in point 2.2.
The organisation responsible for implementation must be either the applicants, the associates or the
sub-contractors. Any period without activities must be included in the project plan and in the evaluation
of the total estimated duration of the project.
The action plan for the first 12 months of implementation must be sufficiently detailed to give an idea
of the preparation and implementation of each activity.
The action plan will be drafted in accordance with the following template:
YEAR 1
Activities
Activity 1.1
Quarter 1
Month 1
2
3
Quarter 2
4
5
6
Quarter 3
7
8
Quarter 4
10
11
9
12
Activity 1.2
Activity 2.1
Etc.
Usual production or business calendar (peak season / low season if tourism)
YEAR
Month
First harvest…
Quarter 1
1
2
3
Quarter 2
4
5
6
Quarter 3
7
8
9
Quarter 4
10
11
12
Main harvest…
…
Etc.
2.5 BUDGET SHEET AND LOG ICAL FRAMEWORK
The logical framework and the budget sheet of the project should be completed in annexe B & C.
Please note that the project cost and the contribution requested from the contracting authority have to
be given in euros.
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2.6 THE APPLICANT’S DECL ARATION
The applicant, represented by the undersigned, the applicant’s authorised signatory for this Call for
Proposals, representing any co-applicant(s) in the proposed project, hereby declares that
o
the applicant has the sources of financing mentioned in point 2 of the guidelines for the
applicants;
o
the applicant has sufficient financial capacities for carrying out the proposed action or work
programme;
o
the applicant certifies both its legal status in accordance with this application;
o
the applicant have the professional skills and diplomas required in section 2 of the guidelines
for applicants.
o
the applicant shall be directly responsible for the preparation, management and
implementation of the project, and is not acting as an intermediary;
o
the applicant and, where applicable, each co-applicant shall be able to immediately provide,
on request, the supporting documents mentioned in point 2.4 of the guidelines for applicants;
o
the applicant and, where applicable, each co-applicant are eligible according to the criteria set
out in points 2.1.1 of the guidelines for applicants;
Signed in the name and on behalf of the applicant
Name
Signature
Function
Date
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