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Capacity to manage and implement actions

Experience by sector

Sector Year(s) of Experience Experience in the past 7 years Number of Projects in the past 7 years Estimated amount (in thousand euros) in the past 7 years
  □ Less than 1 □ 1 to 3 years □ 4 to 7 years   □ 7 years + □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years +     □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown
  □ Less than 1 □ 1 to 3 years □ 4 to 7 years □ 7 years + □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years +     □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown
  □ Less than 1 □ 1 to 3 years □ 4 to 7 years □ 7 years + □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years +     □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown

 

Experience by geographical area

By geographical area (country or region) Year(s) of experience Number of projects in this geographical area in the past 7 years Estimated amount (in thousand euros) invested in this geographical area in the past 7 years Indicative list of regions - Europe EU - Europe non-EU - Eastern Europe - Central America - South America - South-East Asia - North-East Asia - South Asia - Central Asia - Mediterranean - Gulf Countries - Eastern Africa - Central Africa - Western Africa - Southern Africa - Indian Ocean - Caribbean - Pacific
  □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years + □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown
  □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years + □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown
  □ Less than 1 year □ 1 to 3 years □ 4 to 7 years □ 7 years + □ 1 to 5 □ 6 to 10 □ 11 to 20 □ 21 to 50 □ 51 to 200 □ 200 to 500 □ 500+ □ Less than 1 □ 1 to 5 □ 5 to 20 □ 20 to 50 □ 50 to 100 □ 100 to 300 □ 300 to 1.000 □ 1000+ □ Unknown  

 



Cross-reference of experience by sector and by geographical area:

Sector(s) (as selected in 3.2.2) Geographical area(s) (country or region, as identified previously)
   
   
   
   
   
   

 

Resources

· Financial data

Please provide the following information, if applicable, on the basis of the profit and loss account and balance sheet of your organisation, amounts in thousands euros

Year Turnover or equivalent Net earnings or equivalent Total balance sheet Shareholders’ equity or equivalent Medium and long-term debt Short‑term debt (<1 year)
N[24]            
N-1            
N-2            

· Financing Source(s)

Please tick the source(s) of the revenues of your organisation and specify the additional information requested

Year Source Percentage (total for a given year must be equal to 100 %) Number of fee-paying members (only for source = Member’s fees)
N □ EU   N/A
N □ Member States’ Public Bodies   N/A
N □ Third Countries’ Public Bodies   N/A
N □ United Nations   N/A
N □ Other International Organisation(s)   N/A
N □ Private Sector   N/A
N □ Membership fees    
N □ Other (please specify): ……………   N/A
N Total 100 % N/A
Year Source Percentage (total for a given year must be equal to 100 %) Number of fee-paying members (only for source = Member’s fees)
N — 1 □ EU   N/A
N — 1 □ Member States’ Public Bodies   N/A
N — 1 □ Third Countries’ Public Bodies   N/A
N — 1 □ United Nations   N/A
N — 1 □ Other International Organisation(s)   N/A
N — 1 □ Private Sector   N/A
N — 1 □ Membership fees    
N — 1 □ Other (please specify): …………   N/A
N — 1 Total 100 % N/A
N — 2 □ EU   N/A
N — 2 □ Member States’ Public Bodies   N/A
N — 2 □ Third Countries’ Public Bodies   N/A
N — 2 □ United Nations   N/A
N — 2 □ Other International Organisation(s)   N/A
N — 2 □ Private Sector   N/A
N — 2 □ Membership fees    
N — 2 □ Other (please specify): …………   N/A
N — 2 Total 100 % N/A

 

[Please provide the references of the external audit report produced by an approved auditor, certifying: the Applicant's accounts for the last financial year available where the total amount of the grant exceeds EUR 750 000 (EUR 100 000 for an operating grant).. This obligation does not apply to international organisations nor to public bodies.]

 

Year Name of approved auditor Period of validity
N   From dd/mm/yyyy to dd/mm/yyyy
N — 1   From dd/mm/yyyy to dd/mm/yyyy
N — 2   From dd/mm/yyyy to dd/mm/yyyy

· Number of staff (full-time equivalent)

please tick one option for each type of staff

Type of staff Paid Unpaid
HQ Staff: recruited and based in Headquarters (located in Developed Country) □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A
Expat Staff: recruited in Headquarters (located in Developed Country) and based in Developing Country □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A
Local staff: recruited and based in Developing Country □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A □ < 10 □ > 10 and < 50 □ > 50 and < 100 □ > 100 □ N/A

3.4. List of the management board/committee of your organisation

Name Profession Function Country of Nationality On the board since
Mr        
Ms        

 



Date: 2015-12-17; view: 406


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