USAID TL – ANNUAL PROGRAM STATEMENT (APS) – CD 17 de Abril de 2017


USAID’s Avansa Agrikultura Project

ANNUAL PROGRAM STATEMENT (APS)

Issuance Date:                                 April 18th, 2016

Closing Date/Time for Submission of Expressions of Interest:       April 17th, 2017

SUBJECT:             Annual Program Statement (APS) Number: AID-472-C-15_00001_APS-#001

1. Purpose

The purpose of this APS is to solicit Expressions of Interest (EOIs) and grant applications from qualified, legally registered Timorese non-profit, for-profit, and non-governmental organizations (NGOs) for funding innovative approaches for sustainable and inclusive economic growth accelerated in the horticulture sector. All awards issued under this APS will be to further advance the objectives of the USAID’s Avansa Agrikultura Project in Timor-Leste (“Project”).

The USAID’s Avansa Agrikultura Project in Timor-Leste is funded by the United States Agency for International Development (“USAID”) and is being implemented by Cardno Emerging Markets USA, Ltd. (“Cardno”). USAID’s Avansa Agrikultura Project is a horticulture value chain activity aimed at addressing the key challenges in rural poverty, natural resource degradation, food insecurity and undernutrition. The value chain approach will be applied in achieving increased productivity along key horticulture value chains that include vegetables, fruits, and legumes. Through the promotion of sustainable production practices, increased functionality of farmer groups and associations, improved market linkages, and increased availability and access to quality agricultural inputs and services, including access to finance, the project will aim to stimulate and support increased economic activity and growth in targeted rural communities and districts.

This solicitation is seeking EOIs and applications from eligible organizations that present creative technical approaches and methodologies for supporting the Project’s objectives as follows:

Sub-Purpose 1 – Increased Productivity of the Horticulture Value Chain

     1. Policy and Enabling Environment Maintained or Improved

     2. Climate Change Resilience Increased through Natural Resource Management

     3. Sustainable Production Practices Adopted at the Farm Level

     4. Capacity of Farmers’ Groups and Associations Strengthened

     5. Improved Market Linkages

     6. Availability of Quality Agricultural Inputs and Services Increased

 

Sub-Purpose 2 – Increased Ability of Timorese Citizens to Engage in Economic Activities

     7. Improved Nutrition and Sanitation Practices

     8. Improved Skills to Utilize Productive Assets for Economic Activity

 

Subject to the availability of funds, the Project intends to award grants to fund eligible applications that advance Project objectives and generate results in support of those objectives. Any awards resulting from this APS are expected to be in the range of $5,000 to $150,000 for a maximum implementation period of up to three years or the period of performance of the prime contract. However, in most cases it is envisioned that the grant implementation period will be less than one year.

2. Background, Project Objectives, Expected Results, and Indicators

USAID’s Avansa Agrikultura Project’s support is directed toward value chains within its focus sectors.  A value chain consists of all of the services and goods required to transform a product or service from the stage of its conception to its final buyer. For this APS, grant applicants should propose activities that benefit firms, farmers, and households within the project objectives described above. Illustrative activities can include:

§  Facilitate cooperatives, companies, farmers group, individuals (only on special cases with sufficient background and approval) in the USAID’s Avansa Agrikultura Project activities that support value chain actors to improve their products, services and manufacturing processes.

§  Strengthen existing and open new market connections, both domestic and export

§  Improve the legal and regulatory environment for doing business

§  Develop workforce skills and managerial competence and to support group development

§  Implement youth life skills and financial literacy activities

§  Support nutrition and WASH in rural households

§  Facilitate and support increased access to finance for farmers and agri-enterprises.

We are also seeking applications in relation to input supplies, extension and training and access to finance.

Applicants are encouraged to propose innovative yet sustainable approaches to addressing the issues stated above and producing results to meet the Project’s objectives. In developing the approach and concept for the grant activity, applicants should review the extent to which the proposed grant activity and approach will address the stated problems/issues, further the Project’s objectives described above, and produce verifiable results that contribute to the Project’s indicators.

3. Eligibility

This APS is open to:

·        Legally registered Timor-Leste Organizations

·        Non-profit/NGO, educational institutions, or commercial/for-profit organizations that understand that no profit will be paid under the grant agreement,

·        In some cases, Timor-Leste government entities may be eligible for grants. Grants to governmental organizations will be used to provide in-kind assistance only.

Eligible organizations must have the capacity to achieve the proposed grant activity and produce the desired results and have a satisfactory performance record and record of integrity and business ethics.

Eligible organizations must also adhere to the following requirements:

·        Demonstrate an ability to contribute to the objectives of the Project and perform the award in accordance with USAID’s and Cardno policies and practices;

·        Display sound financial, administrative, and technical management in the form of a system of controls that safeguards assets, protects against fraud and waste, and supports the achievement of the Project’s objectives;

·        Sign all mandatory certifications.

Ineligible organizations include:

·        Public International Organizations;

·        Entities that have misused USAID funds in the past;

·        Organizations that advocate, promote or espouse anti-democratic policies or illegal activities;

·        Political parties or institutions;

·        Organizations that intend to use the grant for religious objectives;

·        Organizations that are on the list of parties excluded from federal procurement and non-procurement programs or the United Nations Security Sanctions Committee.

Prior to the award of a grant under this APS, successful applicants will be required to sign a Certification Regarding Terrorist Financing certifying that the applicant’s organization does not provide and has never provided assistance to terrorists for terrorist activities. Successful applicants may also be required to sign other Certifications as applicable to the award. The Certification form is found in Appendix A.

Prior to the award of a grant under this APS, successful applicants will also be subject to a pre-award responsibility determination, which will be made by the Project. In making this determination, the Project will determine whether the applicant possesses the organizational capacity, financial capacity, internal controls, procurement systems (if required) and past performance record in order to successfully implement the grant activities. Only organizations that are determined to be responsible will be eligible for award.

4. Cost Sharing

Cost sharing refers to resources that a grantee contributes to the total cost of the grant agreement and becomes a condition of an award when it is part of the approved grant budget. Although cost sharing is not required under US Government regulations, cost sharing is highly-encouraged on grants under the Project and the amount of cost sharing proposed by grantees will be considered when evaluating the cost effectiveness of applications.

In determining the amount of cost sharing for each grant, the Project will consider whether it is appropriate depending on the grantees and the programmatic and technical needs of the activity. If cost sharing will be required or if it will be considered in the evaluation of applications, it will be stated in the solicitation documents.

Cost sharing must meet the following criteria:

·     Verifiable from the grantee’s records;

·     Not included as contributions for any other US Government project or program;

·     Necessary and reasonable for the accomplishment of grant objectives;

·     Allowable under the applicable cost principles;

·     Not paid by the Federal Government under another award;

·     Provided for in the approved budget.

Cost sharing may include:

·     Project costs financed with cash or in-kind contributions, either provided by the grantee or other donors;

·     Unrecovered indirect costs;

·     Volunteer services furnished by professional and technical personnel, consultants, and other skilled and unskilled labor if the services are a necessary part of the grant activity. Rates for volunteer services will be consistent with those paid for similar work in the grantee’s organization;

·     Donated supplies (such as expendable equipment, office supplies, etc.), non-expendable equipment, buildings, and land. Values for donated supplies, equipment, buildings and land will be reasonable and will not exceed their fair market value.

5. Expressions of Interest and Applications

This solicitation will involve a multi-tiered evaluation process.

Expressions of Interest

During the first phase, applicants are required to submit an Expression of Interest (EOI) summarizing the proposed grant activity, overall grant goal and objectives, illustrative activities, and expected results. The EOI should clearly and concisely explain the proposed grant activity’s purpose, relevance, activities and expected results in support of the objectives of the USAID’s Avansa Agrikulutra Project as set forth in Sections 1 and 2 of this solicitation. All EOIs must be submitted in the Expression of Interest Format included in Appendix B of this solicitation and must not exceed 5 pages.

EOIs may be submitted to the Project at any time within the closing date and time as specified in this solicitation. Applicants should submit written EOIsto: Celestina Lopes da Fonseca, Grants and Sub-contracts Manager, electronically, via email at cfonseca@avansaag.com and copyarahman@avansaag.com. The Closing Date for Submission of EOIs is April 4th, 2017 and the Closing Time for Submission of EOIs is 17:00 Hours Local Timor-Leste Time. EOIs submitted after this date and time will not be considered under this APS.

The Project will convene a Grants Selection Committee (GSC) that will evaluate EOIs submitted in response to this APS on a rolling basis. EOIs will be evaluated based on the criteria included in Section 6 below. Should an applicant’s EOI be accepted by the GSC, the applicant will be invited to submit a Full Grant Application as detailed below.

Full Grant Application

Upon evaluation of EOIs, the USAID’s Avansa Agrikultura Project will invite organizations that submitted successful EOIs to submit a full grant application based on the concept and technical approach proposed in the EOI. All applications must be submitted in the Full Grant Application Format included in Appendix C of this solicitation. The Full Grant Application Format requires applicants to expand in detail on the proposed grant activity, objectives and expected results, including a description of target beneficiaries and stakeholders, a proposed staffing structure, and a detailed grant budget. The Full Grant Application must not exceed 15 pages. Applications in excess of 15 pages may not be reviewed by the Project.

6. Evaluation and Selection

The Project will convene a Grants Selection Committee (GSC) that will review EOIs submitted in response to this APS on a rolling basis. The GSC will evaluate EOIs based on the following criteria:

1.      Relevance to the USAID’s Avansa Agrikultura Project Objectives: Are the proposed grant activity, goals and objectives in line with the objectives of the Project? Do the proposed grant activity, goals and objectives contribute to the achievement of Project goals and objectives as set forth in the APS?

2.      Understanding of the Key Issues: Does the applicant demonstrate a clear understanding of the problems/key issues that the proposed grant activity will address?

3.      Grant Activity Goals and Objectives: Is the overall goal of the proposed grant activity clearly stated and achievable? Does the applicant list specific objectives that will contribute to achieving the grant activity’s goal? Are objectives attainable and related to the overall goal? Is it clear how achieving the grant activity’s overall goal and specific objectives will contribute to solving the key issues?

4.      Proposed Tasks Activities: Does the applicant propose specific activities that are logical, realistic, and relevant to the grant activity’s goal? Will the proposed activities have a significant adverse effect on the environment?

5.      Gender and Youth Aspects: Are the majority of beneficiaries women? Are the majority of beneficiaries youth?

6.      Outcomes/Expected Results: Do the expected results of the proposed grant activities relate to the key issues and overall grant objective? Are anticipated results directly linked to a specific objective?

7.      Past Experience: Does the organization have relevant past experience implementing similar activities?

In all cases, preference will be given to grants that directly or indirectly benefit the largest number of micro, small and medium-sized enterprises (SMEs) and in the listed focus sectors, including farmers; benefit the most households; and/or those that promote women and youth as beneficiaries and /or participants.

If the GSC accepts the EOI based on the above criteria, the Project will notify the applicant in writing and will invite the organization to submit a full grant application. The deadline for the full grant application will be communicated to the successful applicant upon notification that the EOI has been accepted. The GSC will evaluate the full grant application based on the following evaluation criteria:

1.      Understanding of the Key Issues (20 points): Does the applicant demonstrate a clear understanding of the problems/key issues that the proposed grant activity will address?

2.      Grant Activity Goals and Objectives (10 points): Is the overall goal of the proposed grant activity clearly stated and achievable? Does the applicant list specific objectives that will contribute to achieving the grant’s goal?

3.      Outcomes / Expected Results (10 points): Do the expected results of the proposed grant activities relate to the key issues and overall grant objective? Are anticipated results directly linked to a specific objective? Are the results verifiable?

4.      Proposed Tasks and Activities (10 points): Does the applicant propose specific activities that are logical, realistic, and relevant to the grant activity’s goal?

5.      Staffing/Management Plan (10 points): Does the proposed staffing/management plan reflect the personnel/management needs of the grant activity? Does the applicant propose personnel with experience and skills necessary to successfully implement the proposed activities?

6.      Gender and Youth (10 points): Are the particular needs of women and youth addressed and considered in the approach? What is the proportion of women beneficiaries? What is the proportion of youth beneficiaries?

7.      Past Experience (10 points): Does the organization have relevant past experience successfully implementing similar activities?

8.      Cost Realism (20 points): Is the proposed budget realistic, well-thought out, and in-line with the proposed activities? Are the proposed costs reasonable, allowable and allocable to the grant? Is the grantee contributing cost-share?

All applications must also meet and adhere to project environmental compliance requirements, which will be considered as part of the evaluation of the proposal, and during implementation. Proposals that will risk and adverse impact on the environment will not be considered without mitigation plans, and must be done in accordance with USAID’s Avansa Agrikultura Environmental Monitoring and Mitigation Plans.

The Project reserves the right to fund any or none of the applications submitted. Issuance of this APS does not constitute an award commitment on the part of the Project, nor does it commit the Project to pay for costs incurred in the preparation and submission of an EOI or application. Further, the Project reserves the right to reject any or all applications received if such action is considered to be in the best interest of the US Government. Applications are submitted at the risk of the applicant; should circumstances prevent making an award, all preparation and submission costs are at the applicant’s expense.

7. Award Administration

Pursuant to 22 CFR 226.81, it is USAID policy not to award profit under assistance instruments. However, all reasonable, allocable and allowable expenses, both direct and indirect which are related to the grant activity and are in accordance with applicable cost standards (22 CFR 226, OMB Circular A-122 for non-profit organizations, the Federal Acquisition Regulation (FAR) Part 31 for for-profit organizations, and OMB Circular A-21 for educational institutions), may be paid under the grant.

USAID’s Avansa Agrikultura Project will pursue in-kind grants, where appropriate, under all grant formats. Goods and services over $500 will be procured directly by the Project while working closely with the grantee, and then delivered to the grantee or to the grant activity. All procurement done on the grantees’ behalf by USAID’s Avansa Agrikultura Project will be done in compliance with USAID’s and Cardno’s procurement regulations.

Any resultant award will be subject to the terms and conditions of the Prime Contract for the USAID’s Avansa Agrikultura Project, Standard Provisions for Non-U.S. Non-governmental Recipients.

8.      Appendices

A.     Certifications, Assurances and Other Statements of Offerors

B.     Expression of Interest Format

C.     Full Grant Application Format

A.           CERTIFICATIONS, ASSURANCES AND OTHER STATEMENTS OF OFFERORS

This attachment contains all of the certifications that applicants may be required to sign under the USAID’s Avansa Agrikultura Project during the negotiation for a potential grant agreement. A description of the certifications is listed below, along with instructions regarding the applicability of each certification to the grant award. The Grants and Subcontracts Manager will ensure that all required certifications are signed by the applicant.

 

Name of Certification

Applicability to NGOs

Applicability to Host Government Organizations

Description

Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs

Required for all US grantees and non-US organizations if any part of the program will be undertaken in the United States

Only if any part of the program will be undertaken in the United States.

Assures that no person in the US will be discriminated against any activity funded by USAID

Restrictions on Lobbying

Required for grants over USD100,000

Required for grants over USD100,000

Certifies that no Federal funds have been paid or will be paid by or on behalf of the grantee to any person for the purposes of influencing or attempting to influence an officer or employee of any agency, an officer, employee, or Member of Congress in connection with awarding the grant

Certification Regarding Terrorist Funding

Always required

Not required

Provides USAID with assurances that it is not entering into an assistance agreement with an organization that provides or has provided assistance to terrorists for terrorist activity

Survey on Ensuring Equal Opportunity for Applicants

Included in all RFAs and grantees’ completion of the survey is voluntary

Not required

Note: Survey not included in this Attachment but will be included in each RFA

Data Universal Numbering System (DUNS)

Required for US grantees only

Not required

Other Statements of Recipients

Required, though some sections may only apply to US grantees

Required, though some sections may only apply to US grantees

Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs

Note: This certification applies if any part of the program will be undertaken in the United States.

 

(a) The recipient hereby assures that no person in the United States shall, on the bases set forth below, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program or activity receiving financial assistance from USAID, and that with respect to the Cooperative Agreement for which application is being made, it will comply with the requirements of:

(1) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which prohibits discrimination on the basis of race, color or national origin, in programs and activities receiving Federal financial assistance;

(2) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance;

(3) The Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits discrimination based on age in the delivery of services and benefits supported with Federal funds;

(4) Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving Federal financial assistance (whether or not the programs or activities are offered or sponsored by an educational institution); and

(5) USAID regulations implementing the above nondiscrimination laws, set forth in Chapter II of Title 22 of the Code of Federal Regulations.

(b) If the recipient is an institution of higher education, the Assurances given herein extend to admission practices and to all other practices relating to the treatment of students or clients of the institution, or relating to the opportunity to participate in the provision of services or other benefits to such individuals, and shall be applicable to the entire institution unless the recipient establishes to the satisfaction of the USAID Administrator that the institution’s practices in designated parts or programs of the institution will in no way affect its practices in the program of the institution for which financial assistance is sought, or the beneficiaries of, or participants in, such programs.

(c) This assurance is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts, or other Federal financial assistance extended after the date hereof to the recipient by the Agency, including installment payments after such date on account of applications for Federal financial assistance which was approved before such date. The recipient recognizes and agrees that such Federal financial assistance will be extended in reliance on the representations and agreements made in this Assurance, and that the United States shall have the right to seek judicial enforcement of this Assurance. This Assurance is binding on the recipient, its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this Assurance on behalf of the recipient.

Certification of Recipient

By signing below the recipient provides certifications and assurances for the Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs above.

RFA/APS No. ________________________________

Application No. ______________________________

Date of Application ______________________________

Name of Recipient _______________________________

Typed Name and Title __________________________________

Signature and Date _____________________________________

Certification Regarding Lobbying

Note: Required for grants over USD100,000

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal Cooperative Agreement, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Statement for Loan Guarantees and Loan Insurance

“The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.”

Certification of Recipient

By signing below the recipient provides certifications and assurances for the Certification Regarding Lobbying above.

RFA/APS No. ________________________________

Application No. ______________________________

Date of Application ______________________________

Name of Recipient _______________________________

Typed Name and Title __________________________________

Signature _____________________________________

Date _______________

Certification Regarding Terrorist Financing, Implementing Executive Order 13224

By signing and submitting this application, the prospective recipient provides the certification set out below:

1. The Recipient, to the best of its current knowledge, did not provide, within the previous ten years, and will take all reasonable steps to ensure that it does not and will not knowingly provide, material support or resources to any individual or entity that commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in paragraph 3.

2. The following steps may enable the Recipient to comply with its obligations under paragraph 1:

a. Before providing any material support or resources to an individual or entity, the Recipient will verify that the individual or entity does not (i) appear on the master list of Specially Designated Nationals and Blocked Persons, which list is maintained by the U.S. Treasury’s Office of Foreign Assets Control (OFAC) and is available online at OFAC’s website :http://www.treas.gov/offices/eotffc/ofac/sdn/t11sdn.pdf, or (ii) is not included in any supplementary information concerning prohibited individuals or entities that may be provided by USAID to the Recipient.

b. Before providing any material support or resources to an individual or entity, the Recipient also will verify that the individual or entity has not been designated by the United Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999) (the “1267 Committee”) [individuals and entities linked to the Taliban, Usama bin Laden, or the Al Qaida Organization]. To determine whether there has been a published designation of an individual or entity by the 1267 Committee, the Recipient should refer to the consolidated list available online at the Committee’s website: http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm.

c. Before providing any material support or resources to an individual or entity, the Recipient will consider all information about that individual or entity of which it is aware and all public information that is reasonably available to it or of which it should be aware.

d. The Recipient also will implement reasonable monitoring and oversight

procedures to safeguard against assistance being diverted to support terrorist activity.

3. For purposes of this Certification-

a. “Material support and resources” means currency or monetary instruments or

financial securities, financial services, lodging, training, expert advice or assistance, safehouses, false documentation or identification,

communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.”

b. “Terrorist act” means-

(i) an act prohibited pursuant to one of the 12 United Nations Conventions and Protocols related to terrorism (see UN terrorism conventions Internet site: http://untreaty.un.org/English/Terrorism.asp); or

(ii) an act of premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents; or

(iii) any other act intended to cause death or serious bodily injury to a civilian, or to any other person not taking an active part in hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a government or an international organization to do or to abstain from doing any act.

c. “Entity” means a partnership, association, corporation, or other organization, group or subgroup.

d. References in this Certification to the provision of material support and resources shall not be deemed to include the furnishing of USAID funds or USAID-financed commodities to the ultimate beneficiaries of USAID assistance, such as recipients of food, medical care, micro-enterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

e. The Recipient’s obligations under paragraph 1 are not applicable to the

procurement of goods and/or services by the Recipient that are acquired in the ordinary course of business through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the Recipient has reason to believe that a vendor or supplier of such goods and services commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

This Certification is an express term and condition of any agreement issued as a result of this application, and any violation of it shall be grounds for unilateral termination of the agreement by USAID prior to the end of its term.

 

Certification of Recipient

By signing below the recipient provides certifications and assurances for the Certification Regarding Terrorist Financing Implementing Executive Order 13224 above.

RFA/APS No. ________________________________

Application No. ______________________________

Date of Application ______________________________

Name of Recipient _______________________________

Typed Name and Title __________________________________

Signature _____________________________________

Date _______________

Other Statements of Recipient

 

1. Authorized Individuals

The recipient represents that the following persons are authorized to negotiate on its behalf with the USAID’s Avansa Agrikultura Project and to bind the recipient in connection with this application or grant:

Name Title Telephone No. Facsimile No.

________________________________________________________________

________________________________________________________________

________________________________________________________________

2. Taxpayer Identification Number (TIN)

If the recipient is a U.S. organization, or a foreign organization which has income effectively connected with the conduct of activities in the U.S. or has an office or a place of business or a fiscal paying agent in the U.S., please indicate the recipient’s TIN:

TIN: ________________________________

 

3. Data Universal Numbering System (DUNS) Number

Applicability: This applies to US grantees only.

(a) In the space provided at the end of this provision, the recipient should supply the Data Universal Numbering System (DUNS) number applicable to that name and address. Recipients should take care to report the number that identifies the recipient’s name and address exactly as stated in the proposal.

(b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the recipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to the recipient. The recipient should be prepared to provide the following information:

(1) Recipient’s name.

(2) Recipient’s address.

(3) Recipient’s telephone number.

(4) Line of business.

(5) Chief executive officer/key manager.

(6) Date the organization was started.

(7) Number of people employed by the recipient.

(8) Company affiliation.

(c) Recipients located outside the United States may obtain the location and phone number of the local Dun and Bradstreet Information Services office from the Internet Home Page at http://www.dbisna.com/dbis/customer/custlist.htm. If an offeror is unable to locate a local service center, it may send an e-mail to Dun and Bradstreet at globalinfo@dbisma.com.

The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system.

DUNS: ________________________________________

 

4. Type of Organization

The recipient, by checking the applicable box, represents that –

(a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of the State of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a state or local governmental organization, [ ] a private college or university, [ ] a public college or university, [ ] an international organization, or [ ] a joint venture; or

(b) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of ___________________________ (country), [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a nongovernmental educational institution, [ ] a governmental organization, [ ] an international organization, or [ ] a joint venture

B.           EXPRESSION OF INTEREST FORMAT

Section 1: The Applicant

APS Number:

Full Legal Name of Applicant

(As per registration certificate, in Tetum)

Full Name of Applicant

(in English)

 

Address

 

Office Telephone Number(s)

 

Fax Number

 

E-mail Address

 

Web Address

 

Contact Person, Title

 

Contact Person, E-mail address

 

Contact Person, Phone number

 

Year organization was registered

 

Legal status of the organization

 

Registration Number

 

TAX ID Number

 

Organization’s mission statement/purpose and primary sectors of the organization’s operation

 

We/I hereby certify that the information contained herein and attached hereto is complete and accurate to the best of our/my knowledge.

________________________________   ______________________________   ___________________

Head of Organization/Institution                  Signature                                                        Date

Section 2 – Expression of Interest (EOI)

Submitting an Expression of Interest (EOI) is the first phase in the grant selection process. The EOI should clearly and concisely explain the proposed grant activity’s relevance, purpose, objectives, activities and expected results in support of the objectives of the USAID’s Avansa Agrikultura Project (Project) as set forth in the Annual Program Statement (APS). After evaluating EOIs, the Project will invite organizations that submitted successful EOIs to enter into a second phase of the competition by submitting a full grant application based on the concepts and technical approaches proposed in the EOI. EOIs must not exceed 5 pages and must be submitted in the following format:

1.      Proposed Grant Activity Details

Proposed Grant Activity Title:

Proposed Grant Duration (up to 36 months):

Estimated funds requested from the USAID’s Avansa Agrikultura (in USD):

Applicant’s proposed cost share (in USD) (if applicable):

Total cost of the proposed Grant Activity (in USD):

2.      Grant Activity Description and Problem Statement

Please describe the proposed grant activity and the main problems/issues that it will address.

3.      Relevance of the proposed Grant Activity to the Objectives of the USAID’s Avansa Agrikultura Project

Please explain how your proposed grant activity is in line with the objectives of the USAID’s Avansa Agrikultura Project as set forth in the APS.

4.      Grant Activity Goal and Objectives

Please state the overall goal of the proposed grant activity. List the specific objectives of the grant activity that must be met in order to achieve the overall goal. It should be made clear how achieving the grant activity’s goal and objectives will contribute to addressing the issues/problems listed in Section 2 above.

5.      Proposed Tasks and Activities

Please list and briefly describe the illustrative activities that your organization proposes to undertake to meet the objectives of the proposed grant activity.

6.      gender and youth aspects

Please describe how your activity will support women and youth, including describing whether they will be direct beneficiaries of the activity. Describe what the activity for women and youth will be, will it address households, MSMEs, support women farmers, or new employment.

7.      Expected Results

Please describe the expected results of the proposed grant activities and how they relate to the proposed grant activity goal and objectives. Please list anticipated and achievable results as measurable outcomes of the proposed grant activities. Each result should be directly linked to a specific objective.

8.      Past Experience

Please list your organization’s past experience implementing similar activities.

9.      Annexes

Please attach a copy of your organization’s Articles of Incorporation or other documentation which substantiates the legal character/registration of the organization.

C. FULL GRANT APPLICATION FORMAT

Section 1: The Applicant

APS/RFA Number:

Full Legal Name of Applicant

(As per registration certificate, in Tetum)

Full Name of Applicant

(in English)

 

Address

 

Office Telephone Number(s)

 

Fax Number

 

E-mail Address

 

Web Address

 

Contact Person, Title

 

Contact Person, E-mail address

 

Contact Person, Phone number

 

Year organization was registered

 

Legal status of the organization

 

Registration Number

 

TAX ID Number

 

Organization’s mission statement/purpose and primary sectors of the organization’s operation

 

We/I hereby certify that the information contained herein and attached hereto is complete and accurate to the best of our/my knowledge.

________________________________   ______________________________   ___________________

Head of Organization/Institution                  Signature                                                        Date

Section 2 – Grant Activity Proposal

1 Proposed Grant Activity Details

Proposed Grant Activity Title:

Proposed Grant Duration (up to 36 months):

Project Location:

2. Executive Summary

Please briefly describe the proposed grant activity including its relevance to the USAID’s Avansa Agrikultura Project, key issues/problems to be addressed, approach to address the identified issues/problems and expected results.

3. Justification and Background

Please provide background on the importance of the key issues/problems to be addressed by the proposed grant activity. Be specific in describing the key issues/problems that your activity will address. Identify major players associated with the key issues/problems and indicate the roles that they have in the problem solving process. Be specific in describing the way your organization intends to address the problem and the benefits and results it will achieve.

4. Grant Activity Goal and Objectives

Please state the overall goal of the proposed grant activity and several specific grant activity objectives contributing to the achievement of the goal. Each specific objective should be clearly stated, measurable and attainable during the proposed project timeline. Please list indicators for each specific objective.

5. Gender and Youth Aspects

Please describe how the activity will support women and/or youth. Explain how women and youth will be engaged to participate in the activity, how activities will be adjusted to meet their needs. Provide information on how many women and/or youth will be targeted directly and indirectly through the activity.

6. Expected Results

Please describe the expected results of the proposed grant activities and how they relate to the proposed grant activity goal and objectives. The results should be verifiable, practical and achievable. Please describe both qualitative and quantitative results.

7. Target Groups

Please describe the specific target groups of your grant activity and all relevant stakeholders. Explain which groups/individuals are your supporters, potential allies, and/or opponents and briefly define how your organization will interact with these groups throughout implementation of the grant activity.

8. Description of Grant Activities

Please elaborate on your action plan/strategy by listing and explaining all the proposed grant activities and how they help to achieve the goal and objectives of the grant. Please keep in mind that the activities should address the cause of the key issues/problems identified in Section 3, Justification and Background and should lead to the achievement of the specific goal and objectives listed in Section 4 above.

9. Logical Framework for the Grant Activity

Based on the information described above, please complete the Logical Framework for the Grant Activity included in Appendix A of the Full Grant Application Format.

10. Proposed Staffing Plan/Team

Please list the proposed staffing plan and team members for the implementation of the grant activity. Please list a management plan that outlines the roles and duties of each position ensuring that they correspond to activities listed in the previous sections. Please submit resumes for all proposed staff.

11. Budget Proposal and Budget Narrative

Please complete a detailed budget proposal in accordance with form included in Appendix B. Please also submit a corresponding budget narrative that explains in detail the proposed costs of the grant activity.

Section 3 – Institutional Capacity

1.      Brief description of the organization

Please describe your organization’s mission statement/purpose and the primary technical sectors of your organization’s operation. Briefly describe the level of cooperation with other sectors. Indicate the number of staff employed by your organization.

2.      Organization’s Experience

Please describe your organization’s experience, skills and knowledge in the technical area of the proposed grant activity. Clearly indicate your organization’s recent experience relevant to the proposed activities, defining specific successes achieved. Indicate partnerships and cooperation with other stakeholders that may have led to your success.

3.      References

Please list the names and contact information of at least three other donors/funding sources that have previously or currently support your organization through direct grants or contracts. Please indicate the project duration and year it was implemented.

Name of Funding Source

Contact Person, Name, Title, Email Address, Telephone Number

Name of Grant/Project

Brief Project Description

Project Period of Performance

 

4.      Annual Budget Review

Please indicate your organizations’ annual budget for the last three years.

YEAR

ANNUAL BUDGET (RSD or USD)

NUMBER OF GRANTS RECEIVED

Section 4 – Annexes

Please submit the following annexes with your application:

  • Logical Framework for the Grant Activity
  • Copy of your organization’s organizational chart
  • Copy of your organization’s personnel policies and procedures
  • Copies of financial reports for the previous 3‑year period (which have been audited by a CPA or other audit agency satisfactory to USAID, if available)

 

Section 5 – Budget

  1. Budget Format (Excel spreadsheet will be provided)
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