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Description
Confirmation Application Form document sample
Document Sample
Application ID
Project number
Date of approval:
dd mm yyyy
APPLICATION FORM
Central Baltic
INTERREG IV A Programme 2007-2013
The excel protection must not be removed
Damaged application forms will be deemed ineligible
5TH CALL FOR PROJECT APPLICATIONS
Application Form to be filled in and returned by email to:
application@centralbaltic.eu
Confirmation letter to be signed and mailed to:
Central Baltic INTERREG IV A Programme 2007-2013
Joint Technical Secretariat
Regional Council of Southwest Finland
P.O. Box 273, 20101 Turku, FINLAND
1. Project identification REFERENCE OF THE APPLICANT
1.1. Project title:
1.2. Project acronym
1.3. Duration of the project
Start: beginning of Closure: end of Duration months
1.4. Project budget
Project budget 0€
ERDF funding applied for 0€
Amount of eligible national funding 0€
1.5. (Sub)Programme and priority applied within
(Sub)Programme
Priority
Direction of Support
Project Acronym: 1/58 Application
1.6. Summary of the project and its work packages
Maximum amount of characters in these input fields is 3000.
Number of characters in input fields 1. 0 2. 0 3. 0
1.7. Previously submitted applications for funding in the Central Baltic Interreg IVA Programme
Has this application been previously submitted to the Central Baltic INTERREG IVA Programme and been rejected
If yes, please provide the acrony(m)s of the project(s) and specify the time(s) when the application(s) was/were submitted
Project Acronym: 2/58 Application
2. Origin of the project
2.1. Specific problem or development area to be addressed
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
2.2. Objectives of the project
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
Project Acronym: 3/58 Application
2.3. Expected results
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
2.4. Chosen methods
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 4/58 Application
2.5. Location of activities
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Does the project include activities that are targeted to the adjecent areas?
If yes please fill in the relevant parts in Annex3 "Budget"
Does the project include activities / actors outside the programme area (but within EU)?
If yes please fill in the relevant parts in Annex3 "Budget"
Does the project include activities / actors outside European Union?
If yes please fill in the relevant parts in Annex3 "Budget"
2.6. Work packages and Milestones
Please go to Annex 2 and fill in relevant sections
2.7 Indicators and Policy Objectives
Please go to the Annex4 Indicators and Policy objectives and fill in the section relevant to the chosen part of
the programme and priority
3. Overall programme objectives and links with other programmes
3.1. Cross-border added value
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
Project Acronym: 5/58 Application
3.2. Relevance of the project for the (sub)programme
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
3.3. Links with other programmes
3.3.1. Links with projects implemented under Interreg IIIA Southern Finland and Estonia programme, Interreg IIIA Skärgården
programme, Baltic Sea Region INTERREG IIIB Neighbourhood Programme 2000-2006 or Phare programmes
Does the project and its partnership follow on any of the projects implemented under Interreg IIIA Southern
Finland - Estonia, Interreg IIIA Skargarden, Baltic Sea Region INTERREG IIIB Neighbourhood Programme 2000-
2006 or Phare programmes?
If yes please describe what is the difference between the project implemented earlier and the current application.
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
3.3.2. Links to other relevant programmes (e.g. Baltic Sea Region Programme 2007-2013, South Baltic Cross-border Co-
operation Programme, Estonia – Latvia Programme 2007-2013, Structural Fund’s mainstream programmes or other relevant
programmes)
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
3.4. Relevance of the project for the EU Strategy for the Baltic Sea Region
Project Acronym: 6/58 Application
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 7/58 Application
4. Communication and publicity
4.1. Target groups of the communication activities
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
4.2. Communication and publicity
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
Project Acronym: 8/58 Application
5. Sustainability
5.1. Sustainability and follow-up actions
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
5.2. Institution implementing the results of the project
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
5.3. Sustainability of the project results through investments
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
Project Acronym: 9/58 Application
6. Project management
6.1. Project coordination
Institution
Legal status
Please mark the category that best matches the institution of the partner in the dropdown box below
Address
Postcode Town
Country Region
Contact person
Phone (office) Mobile
Fax
Email
Describe experience of the institution in management of cross-border EU-financed projects
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
6.2. Financial management
Institution
Legal status
Please mark the category that best matches the institution of the partner in the dropdown box below
Address
Postcode Town
Country Region
Financal Manager of the project:
Phone (office) Mobile
Fax
Email
Project Acronym: 10/58 Application
Describe experience of the institution in financial management of cross-border EU-financed projects
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
6.3. Overall co-ordination and management of the project
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 11/58 Application
6.4. Administrative and financial management of the project
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
7. Additional information
Please provide any other information that you find relevant for your application.
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 12/58 Application
8. Project budget
ERDF funding
ERDF Support rate %
National co-financing(total)
Central Baltic INTERREG IVA Project Budget
9. Lead Partner confirmation of the Application Form information
9.1. Confirmation of no complementary EU funding
9.1.1. By signing the confirmation letter the Lead partner hereby confirms that the project, neither in whole nor in part has or will
receive any complementary EU funding during the Central Baltic INTERREG IVA project period.
9.1.2. By signing the confirmation letter the Lead partner hereby confirms that none of the partners have received funding under
the Deminimis rule over 200 000€ including the amount applied for in the current application during the three year period before
the submission of this application .
9.2. Confirmation on the permits needed for the project implementation
9.2.1.By signing the confirmation letter the Lead partner confirms that all the partners are aware of the permits possibly needed by
legislation for the project implementation and the permits have been granted.
9.3. Confirmation on applying the Public Procurement regulations during the project implementation
9.3.1. By signing the confirmation letter the Lead partner confirms that during the project implementation the European and
national public procurement rules will be followed.
9.4. Confirmation of all partners' compliance with the rules regarding eligible partners
9.4.1. By signing the confirmatin letter the Lead partner confirms that all partners in the partnership comply with the rules on final
beneficiaries as defined in the Central Baltic INTERREG IV A Programme 2007-2013.
9.5. Confirmation of all partners' commitment to the project
9.5..1. By signing the confirmation letter the Lead partner confirms that all partners listed in Annex 1 of the application form are
commited to take part in the project's activities.
Date and place of signing the confirmation letter
dd mm yyyy Place
Person signing the confirmation letter
Position in the institution
Lead Partner institution
The Application Form is valid ONLY if it is accompanied by a signed confirmation letter.
Project Acronym: 13/58 Application
Annex1: Partnership
FOR FURTHER GUIDANCE PLEASE SEE THE PRACTICAL GUIDE FOR FILLING IN THE APPLICATION FORM
Institution Country Partner budget
Lead ERDF Nat. Public Nat. Private Total
Partner
Partner 2 ERDF Nat. Public Nat. Private Total
Total Project Budget 0 0 0 0
ERDF funding 0
ERDF Support rate
National co-financing(total) 0
Public National co-financing 0
Private National co-financing 0
Central Baltic INTERREG IVA Project budget 0
Project Acronym: 14/58 A1 Partnership
A1.1. Partnership composition
Maximum amount of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 15/58 A1 Partnership
A1.2. Partnership details
Partner no 1: Lead Partner
Institution
Name of the institution in the original language
Legal Status
Registry number of the insititution
Address
Postcode Town
Country Region
Contact person
Phone (office) Mobile
Fax
Email
Website
VAT is final cost for the partner
Bank information
Name of the bank
Address
Postcode Town
Country
Account No / IBAN
SWIFT code / BIC
National bank code
Internal reference (if needed)
Holder of the account
Please describe the specific role and tasks of the partner in the prepration of the application, implementation process and
management of the project.
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
Project Acronym: 16/58 A1 Partnership
Partner budget in EUR
ERDF funding
ERDF Support rate
National co-financing(total) 0
Public National co-financing
Private National co-financing
Central Baltic INTERREG IVA PARTNER BUDGET 0
Project Acronym: 17/58 A1 Partnership
Partner 2
Institution
Name of the institution in the original language
Legal Status
Registry number of the insititution
Address
Postcode Town
Country Region
Contact person
Phone (office) Mobile
Fax
Email
Website
VAT is final cost for the partner
Please describe the specific role and tasks of the partner in the prepration of the application, implementation process and
management of the project.
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
Partner budget in EUR
ERDF funding
ERDF Support rate
National co-financing(total) 0
Public National co-financing
Private National co-financing
Central Baltic INTERREG IVA PARTNER BUDGET 0
Project Acronym: 18/58 A1 Partnership
Additional partners
Name / Institution Address, ZIP, Town, Country Contact person and contact
information
Project Acronym: 19/58 A1 Partnership
Annex2: Work Packages
Table of contents
Work Package 1 Project management and coordination
Work Package 2
Work Package 3
Work Package 4
Work Package 5
Work Package 1
Title of WP1
Project management and coordination
Strategic focus of WP1
Planned results of the WP1
Overview of the work Package content
Responsible partner for WP1
Involved partners of the WP1
Budget of the WP1
0€
Please describe the major activities and main outputs of each milestone in four-month intervals.
WP1 Milestone 1 (Start -Aug 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 20/58 A2 Work Packages
WP1 Milestone 2 (Sep-Dec 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP1 Milestone 3 (Jan-Apr 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 21/58 A2 Work Packages
WP1 Milestone 4 (May-Aug 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP1 Milestone 5 (Sep-Dec 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 22/58 A2 Work Packages
WP1 Milestone 6 (Jan-Apr 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP1 Milestone 7 (May-Aug 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 23/58 A2 Work Packages
WP1 Milestone 8 (Sep-Dec 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 24/58 A2 Work Packages
Work Package 2
Title of WP2
Strategic focus of WP2
Planned results of the WP2
Overview of the work Package content
Responsible partner for WP2
Involved partners of the WP2
Budget of the WP2
0€
Please describe the major activities and main outputs of each milestone in four-month intervals.
WP2 Milestone 1 (Start -Aug 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 25/58 A2 Work Packages
WP2 Milestone 2 (Sep-Dec 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP2 Milestone 3 (Jan-Apr 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 26/58 A2 Work Packages
WP2 Milestone 4 (May-Aug 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP2 Milestone 5 (Sep-Dec 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 27/58 A2 Work Packages
WP2 Milestone 6 (Jan-Apr 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP2 Milestone 7 (May-Aug 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 28/58 A2 Work Packages
WP2 Milestone 8 (Sep-Dec 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 29/58 A2 Work Packages
Work Package 3
Title of WP3
Strategic focus of WP3
Planned results of the WP3
Overview of the work Package content
Responsible partner for WP3
Involved partners of the WP3
Budget of the WP3
0€
Please describe the major activities and main outputs of each milestone in four-month intervals.
WP3 Milestone 1 (Start -Aug 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 30/58 A2 Work Packages
WP3 Milestone 2 (Sep-Dec 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP3 Milestone 3 (Jan-Apr 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 31/58 A2 Work Packages
WP3 Milestone 4 (May-Aug 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP3 Milestone 5 (Sep-Dec 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 32/58 A2 Work Packages
WP3 Milestone 6 (Jan-Apr 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP3 Milestone 7 (May-Aug 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 33/58 A2 Work Packages
WP3 Milestone 8 (Sep-Dec 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 34/58 A2 Work Packages
Work Package 4
Title of WP4
Strategic focus of WP4
Planned results of the WP4
Overview of the work Package content
Responsible partner for WP4
Involved partners of the WP4
Budget of the WP4
0€
Please describe the major activities and main outputs of each milestone in four-month intervals.
WP4 Milestone 1 (Start -Aug 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 35/58 A2 Work Packages
WP4 Milestone 2 (Sep-Dec 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP4 Milestone 3 (Jan-Apr 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 36/58 A2 Work Packages
WP4 Milestone 4 (May-Aug 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP4 Milestone 5 (Sep-Dec 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 37/58 A2 Work Packages
WP4 Milestone 6 (Jan-Apr 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP4 Milestone 7 (May-Aug 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 38/58 A2 Work Packages
WP4 Milestone 8 (Sep-Dec 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 39/58 A2 Work Packages
Work Package 5
Title of WP5
Strategic focus of WP5
Planned results of the WP5
Overview of the work Package content
Responsible partner for WP5
Involved partners of the WP5
Budget of the WP5
0€
Please describe the major activities and main outputs of each milestone in four-month intervals.
WP5 Milestone 1 (Start -Aug 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 40/58 A2 Work Packages
WP5 Milestone 2 (Sep-Dec 2011)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP5 Milestone 3 (Jan-Apr 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 41/58 A2 Work Packages
WP5 Milestone 4 (May-Aug 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP5 Milestone 5 (Sep-Dec 2012)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 42/58 A2 Work Packages
WP5 Milestone 6 (Jan-Apr 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
WP5 Milestone 7 (May-Aug 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 43/58 A2 Work Packages
WP5 Milestone 8 (Sep-Dec 2013)
Activities
(Maximum 1000
characters)
Outputs
(Maximum 400
characters)
Indicative costs
for milestone EUR
Project Acronym: 44/58 A2 Work Packages
Annex3: Budget
Table of contents
A3.1.: Project budget by budgetlines
A3.2. Budget break down by workpackages
A3.3. Imbalances in the project financial set-up
A3.4. External support to the project - equipment and sub-contracting activities
A3.5. Activities in adjacent areas
A3.6. Activities outside the programme area (but within EU)
A3.7. Activities outside European Union
A3.8. Investments
A3.1.: Project budget by budgetlines Total Costs
All costs in EUR. per Budget
Budget line Specification 2011 2012 2013 Line
1 Office and Rent Costs 0
2 Personnel 0 0 0 0
Personnel employed by the project 0
Other partner personnel contributing to the project 0
Unpaid voluntary labour 0
3 Travel and accommodation 0 0 0 0
Travel costs in the programme area 0
Travel costs outside the programme area 0
4 External expertise 0 0 0 0
Expert services 0
Audit, First Level Control 0
Evaluations 0
5 Equipment 0
6 Investments 0
7 Other direct costs 0
8 In-kind contributions 0
9 Income 0
TOTAL COSTS PER YEAR 0 0 0 0
Total sum in work packages per year 0 0 0 0
A3.2. Budget break down by workpackages
Total Costs per
WP1 WP2 WP3 WP4 WP5 Milestone
Milestone 1 (Start -Aug 2011) 0 0 0 0 0 0
Milestone 2 (Sep-Dec 2011) 0 0 0 0 0 0
Milestone 3 (Jan-Apr 2012) 0 0 0 0 0 0
Milestone 4 (May-Aug 2012) 0 0 0 0 0 0
Milestone 5 (Sep-Dec 2012) 0 0 0 0 0 0
Milestone 6 (Jan-Apr 2013) 0 0 0 0 0 0
Milestone 7 (May-Aug 2013) 0 0 0 0 0 0
Milestone 8 (Sep-Dec 2013) 0 0 0 0 0 0
TOTAL COSTS PER WP 0 0 0 0 0 0
Project Acronym: 45/58 A3 Budget
A3.3. Imbalances in the project financial set-up
If relevant, please use the space provided to justify/explain any imbalances in the project financial setup.
The maximum number of characters in these input fields is 1100.
Number of characters in input fields 1. 0 2. 0
A3.4. External support to the project - equipment and sub-contracting activities
In case you plan to assign some activities to subcontractors or purchase equipment, please describe the nature of these and
the planned amount of the costs deriving from them.
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 46/58 A3 Budget
A3.5. Activities in adjacent areas
A3.5.1. Please clarify the content and amount of activities targeted to adjacent areas in workpackages.
The maximum number of characters in these input fields is 1500.
Number of characters in input fields 1. 0 2. 0
A3.5.2. Partners located in adjacent areas
Name of the partner
€
€
€
€
€
€
€
€
€
€
€
Total 0€
Project Acronym: 47/58 A3 Budget
A3.6. Activities outside the programme area (but within EU)
A3.6.1. Please describe the activities (incl. estimated cost of that activity) that will be carried out outside the programme area or
costs related to actors situated outside the programme area but within EU
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
A3.6.2. Please describe the specific objectives, target group and expexted results of these activities undertaken.
The maximum number of characters in these input fields is 1100.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 48/58 A3 Budget
A3.6.3. What added value do the actors / activities outside the programme area bring to the project?
The maximum number of characters in these input fields is 1100.
Number of characters in input fields 1. 0 2. 0
A3.7. Activities outside European Union
A3.7.1. Please describe the activities that will be carried out outside the European Union or costs related to actors situated
outside the European Union.
The maximum number of characters in these input fields is 2000
Number of characters in input fields 1. 0 2. 0
Project Acronym: 49/58 A3 Budget
A3.7.2. Please describe the specific objectives, target group and expexted results of these activities undertaken.
The maximum number of characters in these input fields is 1100.
Number of characters in input fields 1. 0 2. 0
A3.7.3. What added value do the actors / activities outside the European Union bring to the project?
The maximum number of characters in these input fields is 1100.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 50/58 A3 Budget
The activities outside European Union are included in the budget of following project partner(s)
€
€
Total 0€
Total Costs
All costs in EUR. per Budget
Budget line Specification 2011 2012 2013 Line
3 Travel and accommodation 0 0 0 0 0
Travel costs in the programme area 0
Travel costs outside the programme area 0
4 External expertise 0 0 0 0 0
Expert services 0
7 Other direct costs 0 0 0 0 0
0
0
0
0
0
Total 0
A3.8. Investments
A3.8.1. Specification of Budget Line 6 "Investments"
Specification of cost item Location Amount (EUR)
2011
Subtotal 0
2012
Subtotal 0
2013
Subtotal 0
Project Acronym: 51/58 A3 Budget
TOTAL 0
A3.8.2. Cross-border value of the investment
Maximum amount of characters in these input fields is 2000.
Number of characters in input fields 1. 0 2. 0
Project Acronym: 52/58 A3 Budget
Annex4: Indicators and policy objectives
Table of contents
A4.1.Project level targets
A4.2. Programme level targets
A4.3. Indicators for Sub-programmes and Directions of support
Indicators for direction of support
A4.4. Policy objectives
A4.4.1. Equality
A4.4.2. Environment
A4.4.3. Competitiveness and economic development
A4.4.4. Information society
A4.1.Project level targets
Quantitative targets (description of the quantitative targets defined for the project) Amount
Qualitative targets (description of the qualitative targets defined for the project)
A4.2. Programme level targets
Common indicators
Please select the relevant category for your project
Project involves universities / higher education institutions
Project promotes female entrepreneurship
Project involves technology institutes and SMEs
Project improves transport links across national borders
Project improves waste management services
Project targets to prevent risks (e.g. environmental risks….)
Project includes cooperation actions between rescue services.
Project encourages the development of cross-border trade
Project develops joint use of infrastructure
Project develops collaboration in the field of public services
Project reduces isolation through improved access to transport, ICT networks and services
Project encourages and improves the joint protection and management of environment
Number of people participating in joint education or training activities
Number of people getting employment on the other side of the border as a result of CBC
Project Acronym: 53/58 A4 Indicators and Policy object
A4.3. Indicators for Sub-programmes and Directions of support
Please select the relevant programme and direction of support from the dropdown below.
Select (Sub)Programme in 1.5 first
Select Priority in 1.5 first
Indicator Comment Target value
Output
indicators
fill Data in 1.5 first
Result
indicators
A4.4.Policy objectives
Target to be influenced Effect I Explanation
A4.4.1. Equality
Gender equality
Equality of different groups in the society (elderly, young, ethnic
minorities)
Preventing discrimination
A4.4.2. Environment
Air Quality
Flora, fauna, biodiversity
Soil
Water
Project Acronym: 54/58 A4 Indicators and Policy object
Climate, climate change
Cultural heritage and living environment
Natura 2000-network
Waste management (including amount of waste)
Sustainable use and protection of natural resources
Energy efficiency
New energy sources
Environmental awareness
A4.4.2.1. Sustainable developement
Maximum amount of characters in this input field is 1000
Number of characters in input fields 1. 0
A4.4.2.2.Other environmental impacts of the project
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Project Acronym: 55/58 A4 Indicators and Policy object
A4.4.3. Competitiveness and economic development
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A4.4.4. Information society
Describe how the project will contribute to the development of the Information Society
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Project Acronym: 56/58 A4 Indicators and Policy object
Annex5: Improvements
This annex is to be used only by as the reapplying projects that were previously rejected. Projects applying for the
first time do not need to attach this annex to the application form
In case of previously rejected projects please indicate what changes / modifications in the project set up (e.g. partnership,
budget, activities etc.) have been introduced in comparison to previously submitted application to improve your project.
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Project Acronym: 57/58 A5 Improvements
Checklist for submission
SUBMISSION OF APPLICATION FORM
One electronic version of the application form has been submitted between the opening and closure
of the call for proposals.
The confirmation letter has been signed and mailed in paper latest the day of the closure of the call
for proposals (post stamp) to the Joint Technical Secretariat in Turku/Finland.
The application has been filled in English and all mandatory fields have been filled in adequately.
PROJECT PARTNERSHIP
All project partners including the Lead Partner participating in the project are listed in Annex 1 of the
application form. Each project must involve partners from at least two of the participating countries
according to the geographical eligibility for the chosen (sub-)programme as defined in the
Programme Manual.
All project partners including the Lead Partner are eligible as defined in the Programme Manual (e.g.
legal status)
PROJECT BUDGET AND FINANCING
Annex6 “Partner budgets” is attached to the application form and budget information has been filled
in for all the project partners including the Lead Partner.
The co-financing statements for each project partner including the Lead Partner are attached to the
application and they correspond with Annex 1 and 6 of the application form and the indicated co-
financing is eligible partner co-financing as defined in the Programme Manual. The standard form of
the co-financing statement has been used and no changes to the standard form have been made.
SEPARATE ANNEXES TO THE APPLICATION FORM
All mandatory annexes have been sent with the application form/confirmation letter to the Joint
Technical Secretariat between the opening and closure of the call for proposals
VAT Declaration by each partner including the Lead Partner
Registration certificate of each project partner including the Lead Partner
Documantation by the Lead Partner on who has the authority to sign on behalf of the Lead
Partner organisation
For Estonian private enterprises in Southern Finland - Estonia sub-programme: declaration of
de minimis aid that the de minimis threshold has been observed
For projects containing investments: investment plan, long-term financial plan, action plan
including feasiblity study, other possible documents, e.g. different permits, SEA (Strategic
Environmental Assessment) if appropriate
For project containing in kind contibutions: documentation on the value of in kind contribution
Project Acronym: 58/58 Checklist for submission
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