10YFP Trust Fund Projects - Application form (template for project proposal) Each entry has a limited number of characters allowed PART 1 - PROJECT SUMMARY (MAXIMUM 2 PAGES) Date: Title of project: Related 10YFP programme: programme area (if relevant): Targeted countries/regions: Applicant name: Applicant type: government / stakeholder Applicant contact information: List of partner(s): For each of the partners, please include their legal status, number of employees, year of creation, website address, latest activity report, and expected role in the project. Executing agency, if any, (if an executing agency is designated, it will receive funding): Start date: end date (maximum 24 months): Primary objectives (max. 1000 characters): Expected results (max. 1000 characters): Targeted beneficiaries of the project (max. 1000 characters): Project Executive Summary (max. 2000 characters): Is there a 10YFP National Focal Point in your country? YES/NO If you responded YES above, has the National Focal point been informed? YES/NO/N/A. Has the National Focal Point indicated support through an email or a letter? YES/NO/N/A Are you a partner of the 10YFP programme subject to the call for proposal? YES/NO If you have responded NO above, do you intent to become a partner of 10YFP programme? YES/NO SIGNATURES …. …. PART II: PROJECT PROPOSAL (MAXIMUM 8 PAGES) PROJECT BACKGROUND Context and project justification (Describe how the project responds to recognized needs, priorities and circumstances) (maximum 2500 characters) Link to relevant international, regional, national strategies and legal frameworks, relevant policies and institutional arrangements including relevant obligations in the WTO and MEAs (maximum 2000 characters) Relationship to the 10YFP and to 10YFP programme(s) (Explain 1) how the project will substantially contribute to the goals and principles of the 10YFP, to the three dimensions of sustainable development and hence to the shift to SCP patterns, and 2) how the project contributes to the 10YFP Programme’s objectives) (maximum 2500 characters) Relationship to and synergies with other relevant work and initiatives (list relevant work and initiatives, including complementarity with these) (maximum 2000 characters) PROJECT TOTAL BUDGET AND TOTAL AMOUNT REQUESTED FROM THE 10YFP TRUST FUND Amount requested from the 10YFP Trust Fund: US$ Co-funding – not compulsory : US$ or in-kind Project total budget: US$ Refer to budget form to provide additional compulsory information. PROJECT DESCRIPTION Project objective(s) (Describe in one sentence the main objective of this project) (maximum 500 characters) Describe how this project will take into account the lifecycle approach (analysis of both consumption and production side and multiple stages of a product’s life cycle) and related methodologies. (maximum 1800 characters) Describe the type of instruments i.e. policy instruments (economic, regulatory, social) that will be used. (maximum 2000 characters) Describe how the project is based on a scientific and policy knowledge base (provide reference to relevant scientific publications, policy relevant studies etc.). (maximum 1800 characters) Project Activities (A.1, A.2) Project outputs (output/deliverables and brief descriptions) (maximum 3000 characters) EXPECTED BENEFITS, EXPECT RESULTS, MEASURING PROGRESS Describe qualitatively (and quantitatively if possible) the expected benefits in terms of environmental, social (poverty eradication), economic, other benefits. (maximum 2000 characters) Describe the expected results directly resulting from the project implementation (both qualitative and quantitative, as far as possible) (maximum 2000 characters) Performance indicators to measure progress of the project: please select relevant SCP indicators among the list below : Greenhouse gas emission reduction (mitigation potential) Resource efficiency (water efficiency, material consumption, sustainable land use, waste reduction) Number of laws, policies, strategies, plans, agreements, or regulations promoting the shift to SCP patterns drafted, proposed, adopted/mainstreamed, or implemented (list and provide associated geographic area) Number of institutions and number of professionals with improved capacity to promote the shift to SCP patterns (list institutions and their location) Number of outreach products – brochures, webpages… - and awareness raising activities (list products and activities, as well as number of relevant stakeholders reached) Number of sectoral policy planning tools used/adapted (list planning tools and how they have been, or will be, used in practice) Person hours of training completed on SCP (report hours in terms of number of men and number of women) Performance indicators to measure progress of the project: please add any further relevant indicator you will use: Others (indicators specific to the project and relevant for the country): Describe how progress towards SCP patterns will be measured and project impacts and results will be assessed (methodology, indicator, baseline, data / information sources) (maximum 2000 characters) IMPLEMENTATION a) Implementation arrangements: (Describe suggested implementation and institutional set up) (maximum 2000 characters) b) Stakeholders: (Describe involvement and roles of stakeholders, promotion of collaboration between them through the project)(maximum 2000 characters) c) Risks and mitigation: (Describe the main risks and obstacles, related mitigation measures): (maximum 2000 characters) d) Sustainability: (Describe the ability and potential to sustain the activity after the end of the project): (maximum 2000 characters) e) Replicability: (Describe the ability and potential to scale-up over time, and to replicate in different contexts): (maximum 2000 characters) PROJECT WORK PLAN ACTIVITY A.1 Timeframe Responsible Partner Other Partners A.2 … MONITORING, REPORTING AND EVALUATION (maximum 2000 characters) Monitoring: Reporting: Evaluation: Please attach budget form duly completed Please attach information form duly completed Please attach evidence that National Focal Point – if nominated – has been consulted/informed (i.e. letter, copy of email etc.) Please attach other letters of support Other documents if any Annex 1b: Budget form Activity Budget Quantity Unit Unit Cost (USD) Total Cost (USD) Activity A.1 – Please use same name coding as above Sub-total Activity A.2 – Please use same name coding as above Sub-total Activity A.3 – Please use same name coding as above Sub-total Activity ... Total Cost Guidelines on UN rules and regulations for budget Please refer to UN rules and regulations, in particular, but not exclusively UN Financial rules: http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N13/408/57/PDF/N1340857.pdf?OpenElement Annex 1c: information form The information form need to be filled in by the executing agency, or the applicant if the applicant is expected to receive funds, in case of successful application. For each of the below questions, please anwaser YES/NO and indicate why. 1. Legal status and governance 1.1. Does legal status reflect a not-for profit status? 1.2. Has the entity been duly registered? 2. Financial and administrative capacity 2.1. Are its audited financial statements publicly available, showing sound financial management? 3. Technical capacity 3.1. Does the entity have the basic technical capacities to carry out the intervention? 4. Does the entity fail to meet relevant obligations or responsibilities required by the United Nations? 4.1. Does the entity fail to meet relevant obligations or responsibilities required by the United Nations? 4.2. Does the entity violate sanctions established by the UN Security Council? 4.3. Are there any issues with the entity that could pose a reputational risk to UNEP? 5. Already working with UNEP: 5.1. Is it currently working with any part of UNEP as an implementing partner? Are there any reasons the decision should be taken by the Partnership Committee? 6. Specific Technical Capacities 6.1 Does the organization have relevant proven experience in implementing similar activities (e.g., at a similar level of technical complexity; access to relevant information sources/networks)? 6.2 Has the organization previously managed activities in the same geographic area? 6.3 Has the organization previously managed efforts at a similar scale of funding? 6.4 Are there additional technical merits for partnering? 7. Strategic Capacity 7.1 Does the organizational mandate of the organization cover the purpose of the proposed activity? 7.2 Does the organization have an environmental or sustainability policy that reflects similar /complementary values to those of UNEP? 7.3 Does the organization have positive feedback from working with UNEP, the UN and/or other intergovernmental organizations?