Cooperation Fund for the Water Sector Pilot and Demonstration by lba17669


									                       Cooperation Fund for the Water Sector
                         Pilot and Demonstration Activity
                                  Request Form

Activity Title:
Request Date:
Country:                                      Region:
Activity Proposed Start Date:                 Activity Proposed Duration:
Cost Estimate:
Implementing Organization Contact:

1. Background and Rationale:

2. Objectives:

3. Scope and location of Work / Description of Activities:

4. Implementation Schedule, Institutional Management Arrangements, and Proponent

5. Expected Results (outputs/outcomes/effects/impacts):

6. Measurable Performance Indicators:

7. Stakeholders Participation:

8. Scope for Replication/Use in Other Countries:
9. Cost Estimate:

                       Inputs / Expenditure category                              Total Costs
                                                                                   (in US $)
1. Office Equipment and Supplies:
Summarize specifications, e.g. communications devices, audio-visual,
computing, and other office equipment.

2. Specialists/Consultants’ Services:
Summarize specifications, i.e. type of expertise to be engaged (e.g. irrigation
expert, water resources engineer, etc.), other consultants-related costs such
as travel, per diems, etc.

3. Training, workshops, conferences:
Summarize specifications, e.g. resource persons, costs of trainers and
facilitators, venue rental, travel, food and accommodation for participants.

4. Project Management:
Summarize specifications, i.e. rental of office space and associated costs.

5. Contingency (5% max)

Total PDA grant financed

To top