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					                  Ministry of International Co-operation
               ITALIAN COMMODITY AID PROGRAMME


                         APPLICATION FORM

The purpose of this form is to provide information on the applicant and his
project for the evaluation of the application.

  Three parts and two annexes compose this form:

Part A            General information
Part B            Project information
Part C            Documents to attach to the application
Annexes:          1. List and specifications of commodities requested
                  2. Preliminary Commitment




                  Name of the Company or Organization



Public Administration or State Company Private Company or Entrepreneur

  Type of commodities-goods: ______________________________________

  Estimated Total Cost: EUROS ____________________________________



  This Application Form must be presented to:

                  Ministry of International Co-operation
               ITALIAN COMMODITY AID PROGRAMME
                      8, Adly St. - 9th floor - CAIRO
                                                -




  10-Jun-11                                                               1
                    Ministry of International Co-operation
                 ITALIAN COMMODITY AID PROGRAMME
                           APPLICATION FORM

                                       PART A

          GENERAL INFORMATION ABOUT THE APPLICANT


       All items must be filled in order to permit full profile of the applicant;
                   when not applicable please indicate: N.A.

A.l Company/Organization: _____________________________________

Name of the applicant: _________________________________________

Position of the applicant: _______________________________________

Address: ____________________________________________________

Telephone: ________________________Fax:_______________________

Other Contact person: _______________________________________
Public Administration or State Company Private Company or Entrepreneur
A.2 Nature of establishment: _____________________________________
(social organization, sole ownership, limited liability, stockholding company,
public company etc.)

A.3 Established under law: _________ (commercial law 32, 43, 159, 230, etc.)
A.4 Date of establishment: _________

A.5 Tax card no: ___________________Commercial registry ___________

A.6 Paid-up Capital:_____________________________________________

A.7 Number of employees: Permanent ___________ Part time___________



  10-Jun-11                                                                         2
A.8 Bank(s) reference(s):
a)    _________________________________________________________
b)    _________________________________________________________
c)    _________________________________________________________


A.9 Main Activity of the Company/Organization is in the field of:
Production and/or manufacturing                        Services
A.10 Main Sector of activity:
 Agriculture       Livestock       Fishing
 Environment  Mechanical Industry  Chemical
Industry:
 Furniture Industry  Food Industry  Telecommunication
 Construction         Handicraft  Tourism  Education
 Health               Informatics
 Services: _____________________________________
 Other: _______________________________________
A.11 Describe your main products or services:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

A.12 Describe your main activities:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Date: ____________________


Signature: _________________________________________




  10-Jun-11                                                                3
                     Ministry of International Co-operation
                  ITALIAN COMMODITY AID PROGRAMME
                            APPLICATION FORM

                                          PART B

                            PROJECT INFORMATION

          [If there is not enough space to the answers, please attach supplementary pages]


  B.1 Your application aims at:

 Start new activity  Reinforce present activity  Expansion of activities
 Rehabilitation          Acquisition of spare parts
 Other: _____________________________________________________

B.2 Brief description of the project for which you request the goods:
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________

B.3 General description of goods requested (to be detailed in technical annex 1):
         ___________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________

B.4 General description of the services related to the goods requested, if any:
         ___________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________




  10-Jun-11                                                                                  4
B.5 Requested Commodities’ Cost Estimation (goods and services):
      Goods           EUR ___________________________
      Services        EUR ___________________________
      Total cost      EUR ___________________________


B.6 Total Investment Costs of the project (including costs other than in point
    B.5, if any):

                             EUR __________________________

B.7 Indicate the main expected impact on your company of the utilization of the
    required goods and services:
       increasing quantity of product          increasing quality of product
       increasing process efficiency           production of new product(s)
       increasing sales on local market        increasing exportation
       increasing employment generation  more local row material utilization
       better foreign currency in-flow         better work organization
       others :
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

B.8 Other useful comments, if any:
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________
       _____________________________________________________________________


          Date: ____________________


              Signature: _________________________________________




  10-Jun-11                                                                  5
                  Ministry of International Co-operation
               ITALIAN COMMODITY AID PROGRAMME
                         APPLICATION FORM

                                    PART C

            LIST OF ATTACHMENTS TO THE APPLICATION

Please attach photocopy of the following documents:

   Commercial registry of your company.
   Taxation card.
   Import license (unless legally exempted).
   Audited copies of balance sheet (last year).

Please attach also:

 A technical report: you can attach any technical and/or economical
  document related to your project investment.
 A detailed list with technical specifications of the commodities required, as
  per annex 1.
 The Preliminary Commitment signed by the Applicant in original, as per annex 2.

For more information please contact in Cairo the following persons:

Ministry of International Co-operation:
Ambassador Marawan Badr
Assistant Minister for the European Cooperation Sector
Tel. 23902645
Fax 23935301 – 23908159
Mr. Moustafa Abdo Eissa (Programme Support Unit Contact Person)
Tel. 23924763 - fax 2391.0344

Italian Embassy
Dr. Igor Marcialis
Italian Commodity Aid Programme Manager
1018, Corniche El Nile, Garden City (4th floor)
Tel: 2794.1841 Fax: 2792.0272
E-Mail: commodity.egitto@esteri.it


10-Jun-11                                                                 6
                   Ministry of International Co-operation
                ITALIAN COMMODITY AID PROGRAMME
                          APPLICATION FORM

                                   Annex 1
      LIST AND SPECIFICATIONS OF COMMODITIES REQUESTED

       Please list in detail the goods requested in a table like here below (You
       may attach any technical document helpful to exactly determinate the
       specification of the goods required):

  ITEM        QUANTITY                        DESCRIPTION




Please supply the following additional information
  Delivery:     Alexandria Port      Cairo Airport     Other _________

 Site of installation: ______________________________________________

  Services requested with to the goods:
   Installation
   Commissioning
   Start-up supervision
   Operators training
   Maintenance training
   Post sale technical assistance
  Other: _______________________________________________________


  Date: ____________________


  Signature: _________________________________________




  10-Jun-11                                                                    7
                   Ministry of International Co-operation
                ITALIAN COMMODITY AID PROGRAMME
                          APPLICATION FORM

                                    Annex 2


                     PRELIMINARY COMMITMENT



I, (Mr./Mrs./Eng./Dr./Prof./…): ____________________________________________

On behalf of the company/organization: _______________________________

With the position of (in the company/organization): _____________________

With reference to the application presented on _______________ to the Ministry
of International Cooperation to import commodities from Italy in the framework
of the ITALIAN COMMODITY AID PROGRAMME, the undersigned states
to accept the terms mentioned in the GENERAL CIRCULAR of the Commodity
Aid Programme and particularly the following conditions:

1) Language applied will be English.

2) Imported goods must be in accordance with the Egyptian IMP/EXP
   regulations in force.

3) To supply the requested goods a public tender shall be floated in Italy
   according to the Italian laws. The Person in Charge, in behalf of the Ministry
   of International Cooperation, as the sole responsible, will sanction the
   selection of the bidder and the importer will not interfere with the tender
   process unless not requested by the same Person in Charge.

4) The contract of supply will be signed between the Person in Charge and the
   supplier, with the witness signatures of the Italian Expert and the importer.

5) The applicant, within 15 days from the date of the approval of the
   application, will constitute a “Commitment Bond” in favour of the special

  10-Jun-11                                                                     8
   account of the Commodity Aid Programme in the National Bank of Egypt
   denominated “Italian Counterpart Fund”. The amount of the Commitment
   Bond should be the 2% (two per cent) of the estimated value of the
   commodities requested.

6) The Commitment Bond will not be released to the importer in case the tender
   should be cancelled due to his own responsibility.

7) At the signature of the contract with the awarded supplier the importer shall
   provide the Programme’s bank account with a down payment of 20%
   (twenty percent) of the contract value (the Commitment Bond will be
   included in this 20%).

8) The 80% (eighty percent) of the cost of the supply will be paid by the
   importer to the Programme’s bank account through a loan contract with the
   National Bank of Egypt in four years with an interest rate fixed at 4% (four
   percent) according to the clause of the same contract that will be signed
   within 15 days after the awarding. The currency of the amount of the loan
   shall be in Egyptian Pounds, corresponding to the equivalent amount in euros
   paid to import the commodities. The exchange rate will be calculated by the
   National Bank of Egypt.

9) Unless not differently specified by the Person in Charge, the forwarding and
   clearance of the goods at the Egyptian Custom shall be on account of the
   importer.

10) The goods received should not be resold nor their property should be
    transferred to other persons for a period of at least 4 (four) years, starting
    from the date of goods reception, and in any case not before final payment
    has been made.


      Date: ____________________


      Signature: _________________________________________




  10-Jun-11                                                                      9
  TO BE RELEASED BY THE BENEFICIARY ON ITS COMPANY PAPER



  TO EGYPTIAN - ITALIAN COOPERATION
  ITALIAN COMMODITY AID PROGRAMME




                               DECLARATION


In order to accomplish with Italian Commodity Aid Programme rules as well as
Italian Antimafia regulations, I, (Mr./Mrs./Eng./Dr./Prof./…) ...............……………..,
duly authorized representative of the following company ……………………..,
hereby DECLARE that in the above mentioned company NO Italian citizen and
/or Italian Companies are working or are shareholders or to have any kind of
ownership (or: is present the following Italian citizen / Company:
name,…………, surname…….., born on…………/established on………, direction
in Italy……, tel. n° in Italy………………, and within the Company has the charge
of / is a shareholder in reason of ……….. [state the position of the person inside
the Company or the percentage of ownership]) onto the Company I am
representing which is applying for the Italian Commodity Aid Programme loan.

Ultimately, taking fully responsibility of this declaration will be my own duty, to
prompt inform Italian Embassy in Cairo, Egypt, of any change occurring within
the Company during the project life-time span.


Cairo, …………….


                        ----------------------------------
     [Name, surname and charge within the Co. of the person releasing this
                                  declaration]




  10-Jun-11                                                                        10

				
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