DECLARATION OF by sofiaie

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									 1 original Declaration to be sent, duly completed and signed, to the Executive Agency for Competitiveness and
Innovation (EACI) within six (6) months following the date of entry into force of the Agreement as specified in its
                                                    Article I.2.1.
                                       * Please erase this instruction for use*

                                  DECLARATION OF
         ESTABLISHMENT AND ACTUAL START-UP OF AN ENERGY MANAGEMENT AGENCY


I the undersigned, [Mr/Ms] [insert first name + SURNAME] [position], representing the energy
management agency:
[Insert the full official name of the energy management agency] [Acronym]



HEREBY DECLARE THAT:

        the energy management agency [insert the full official name of the energy management agency ]
        [Acronym],
         the registered office of which is in [insert the full official address],
         was legally established on [insert date] , under the legal form of [specify private company, public
         entity, registration number or equivalent] in accordance with [make reference to the legal
         decision, i.e. law, decree, order […], number, date], and its actual start-up under the terms of
         Article I.3 of the agreement took place on [insert date];

       the energy management agency has been established in the framework of Grant agreement No
        IEE/07/AGENCIES/[…];

       in accordance with Article I.3.5 of the said agreement, after acceptance of this Declaration by the
        EACI, the energy management agency [insert acronym of the energy management agency] shall
        be considered as coordinator of this agreement and assume the related rights and obligations, as
        from the signature of the addendum to the agreement referred to in Article I.3.5; nevertheless, the
        eligibility of the costs presented by the energy management agency [insert acronym of the energy
        management agency] will run from the date of legal establishment referred to above, provided that
        the addendum to the agreement referred to in Article I.3.5 is duly signed.

       the members of the Management Committee are:
        - [Mr/Ms] [Insert first name + SURNAME] [Insert full name of the organisation represented] ,
        - [Mr/Ms] [Insert first name + SURNAME] [Insert full name of the organisation represented]
        - [Mr/Ms] [Insert first name + SURNAME] [Insert full name of the organisation represented]
        Add extra row for each member
        Please identify the President of the Management Committee


       the first staff member recruited is [Mr/Ms] [insert first name + SURNAME]
        Function: [complete]

       co-funding is guaranteed and comprises:

           Full name of organisation providing funding             Organisation type     Amount of co-
                                                                   (Public or Private)   funding (€)
    1
    2
    3
    4
    5


                                                                       Total
Insert extra rows into the table if necessary
Attach confirmation from the beneficiary and from each third party providing co-funding



Version December 2008                                                                         Page 1 of 2
 1 original Declaration to be sent, duly completed and signed, to the Executive Agency for Competitiveness and
Innovation (EACI) within six (6) months following the date of entry into force of the Agreement as specified in its
                                                    Article I.2.1.
                                       * Please erase this instruction for use*



      the own premises and energy agency’s address are:
       [insert full official address + Tel., fax, e-mail]




      own bank account N° of the energy management agency:

       Name of bank: […]

       Address of branch: […]


       Precise denomination of the account holder: […]

       Full account number (including bank codes): […]
       IBAN account code: […] (BIC code for countries where the IBAN code does not apply)

                                     1                              2
Done in ……………………………… , on …………………………..

Signature ……………………………..

Name [insert first name + SURNAME] [position]




1
    Insert place
2
    Insert date



Version December 2008                                                                         Page 2 of 2

								
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