This format is temporary. It will be digitalised during the spring of 2017. Always check the www.cisu.dk/derf
for the newest available information on how to apply.
THE DANISH EMERGENCY RELIEF FUND
QUALIFICATION of the ORGANISATIONAL
CAPACITY
Annex A: Organisational facts – Danish
partner
This annex must be completed and submitted when applying for an assessment of organisational
capacity to be qualified for funding through the Danish Emergency Relief Fund (DERF). This annex
shall be used both when applying for pre-qualification – prior to an actual crisis and in cases where
the organisation has not been pre-qualified. In the case where the organisation has not been prequalified the annex should be submitted in connection with an application for an actual
humanitarian intervention when the fund has opened a call for proposal.
This annex entails basic information about the organisation. The information is used to assess the
capacity of the organisation to administer grants and manage humanitarian interventions promoting
implementation of the nine principals of the CHS. The information is also used in the DERF
monitoring, learning and evaluation system. Information provided here shall not be repeated in the
organisational capacity application text or in (future) application to the DERF for funding of
humanitarian interventions.
Name of the organisation as it appears in your constitution or set of rules
Abbreviation or acronym for your organisation
Date
Signature of chairperson of the board or if a board does not exist, the
head of the management of the organisation
Name and position (block letters)
1
A. Basics about your organisation
A1. Contact details of the organisation
Street/Road:
City/Village:
District:
Region:
Postal Address/ PO Box:
Country:
Phone number (landline):
E-mail address:
Mobile number:
Website address (if any):
A2. Registration
Legal status
Tick
off
below
Date of registration
Registration number (if
applicable)
Civil Society or Non
Governmental
Organisation (CSO, NGO
etc. )
Non-profit organisation
and/or companies (E.g.
cooperatives, corporations,
etc.)
Limited (Liability) Company
(Ltd or LLC)
Unions and associations
OTHER (e.g. Community
Based Organisations, no
legal status or registration
etc.)
A3. Cooperation and affiliations
List of names of organisations you are affiliated
with or networks and alliances you are a part of:
A4. Sustainable Development Goals
Please tick off the Sustainable Development Goals your organisation is working with
Please tick
No
Goal
Keywords
2
off below
1
No Poverty
2
Zero Hunger
3
Good Health
and WellBeing
4
Quality
Education
5
Gender
Equality
6
Clean Water
and Sanitation
Affordable and
Clean Energy
Decent Work
and Economic
Growth
7
8
9
10
11
12
13
14
15
Industry,
Innovation and
Infrastructure
Reduced
Inequality
Ending of poverty in all forms everywhere – including
extreme poverty, hunger and malnutrition, social
discrimination and exclusion, lack of land rights, limited
access to social security and other basic services, and
resilience to climate disasters.
Achieve food security and improved nutrition and promote
sustainable agriculture, horticulture and forest
management.
Ensuring healthy lives and promoting the well-being for all,
promote sexual and reproductive health, clean water and
sanitation, malaria, tuberculosis, polio, HIV/AIDS and
alcohol abuse.
Ensure inclusive and quality education and lifelong
learning, promote qualified teaching, global citizenship
education (also in Denmark) and cultural exchange.
Equal access to education, health care, decent work and
wages, and representation in political and economic
decision-making processes.
Ensure access to water and sanitation for all which involves
a focus on clean and sustainable water supplies.
Ensure access to affordable, reliable, sustainable and
modern energy technology for all.
Promote inclusive and sustainable economic growth,
employment and decent work for all. Promote
entrepreneurship, income generating activities (like
Microfinance, VSLA groups), labor rights and unions and
combat child labor.
Resilient infrastructure, sustainable industrialization and
innovation. Access to modern IT and communication
technology.
Reduce inequality within and among countries. Develop
financial regulations, tax systems, policies on wage
regulations, secure immigration and increased development
assistance.
Make cities and communities inclusive, safe, resilient
towards climate disasters and sustainable in terms of
housing and transport.
Focus on food waste, fair trade, waste management and
Sustainable
Cities and
Communities
Responsible
recycling.
Consumption
and Production
Climate Action Combat climate change and its impacts. Promote sustainable
livelihood, resilience, and general robustness toward
climate change.
Life below
Conserve and sustainably use the oceans, seas and marine
Water
resources. Promote sustainable fishery and reduce the
pollution of the oceans and costs.
Life on Land
Promote sustainable forest management, combat
3
16
Peace, Justice
and Strong
Institutions
17
Partnerships
for the Goals
desertification, land degradation and biodiversity loss.
Access to decision making processes and information for
marginalized groups (fx civil society organisations’ work
with advocacy). Promote civil and political rights, good
governance and healthy institutions at all levels, conflict
resolutions, and fights against trafficking and corruption.
Partnerships for sustainable development including NorthSouth civil society based partnerships with focus on
organisational and capacity development. Partnerships
between civil society, the private sector and state
institutions.
B. Mission and Vision of the Organisation
B1. Establishment
Why was your organisation founded, when and by whom?
B2. Objectives
What are your organisation’s main objectives?
C. Governance and accountability
C.1 Board composition
(you may add more rows)
Position (president, member, etc.)
President of the board
Vice president of the board
Tresurer
Other members
Name
How often does the board meet?
C.2 General Assembly (if applicable)
When did you conduct your last general
assembly?
How many participated
C3. Organisation of development or humanitarian activities
Describe how you are organized in relation to activities related to development and/or humanitarian
work.
4
C.4 Persons affiliated with the organisation
If there are many people affiliated, list only those associated with development or humanitarian
work
Functions:
Contribution to the organisations
work in hours per week (if
applicable):
Members (sometimes called owners or patrons)
Board (sometimes called executive committee or
steering group)
Staff (sometimes called secretariat, management or
administration)
Volunteers (sometimes called unpaid staff)
Collective members (other organisations/associations)
C5. Financial Management
To be developed further in the spring 2017 to be adequate in relation to new Guidelines for the
DERF.
In order to obtain a grant from DERF, you must live up to CISU’s financial standards.
The standards are divided into three (3) levels depending on the size of the grant: 1) for a grant
less than 200,000 DKK, 2) for a grant more than 200,000 DKK, and 3) for a grant over 1 million
DKK. You have to live up to the financial standard which covers the largest grant you already hold
or you are applying for. The financial standards are available in English on CISU’s website.
If you meet all the requirements in the following four areas of finance, choose ‘yes’ "ALL ARE
MET" in each of the four boxes below. If there is a requirement which you do not meet, choose
‘no’, and you will have to describe how and when the adjustment will be made.
Financial Standards
<
200.000
Yes
No
>
200.000
Yes
> 1 mio.
No
Yes
No
Budgets
Accounting
Reporting
Internal controls
5
D. Financial Status
D.1. Turnover and funding
Please state last year’s turnover:
Total amount
Currency
Financial year
Please list main sources of last year’s income (you may add more rows)
Funding source
Period
Amount
Currency
D.2. Grants
If any, please list the last five years approved grants for humanitarian responses from entities
requiring the same level of reporting and audit as CISU, Danida, EU grant or the like. List the
recent 10 grants. (please insert the necessary rows below)
Type of grant
and jr.no
Titel
Country(ies)
Granted
amount
Periode
Please list the last five years approved grants from one of the funds managed by CISU, Danida
grants or EU grant. List the recent 10 grants. (please insert the necessary rows below)
Type of grant
and jr.no
Titel
Country(ies)
Granted
amount
Periode
Please also list the last five years approved public grants from other sources than the above
mentioned (e.g. tips- og lottomidler, Genbrug til Syd, Center for Kultur og Udvikling). List the recent
five grant. (please insert the necessary rows below)
Type of grant
and jr.no
Titel
Country(ies)
Granted
amount
Periode
6