EUROPEAN COMMISSION
DIRECTORATE-GENERAL HUMANITARIAN AID AND CIVIL PROTECTION - ECHO
GRANT APPLICATION
CALL FOR PROPOSALS 2015
PREVENTION AND PREPAREDNESS PROJECTS
IN CIVIL PROTECTION AND MARINE POLLUTION
DEADLINE FOR THE SUBMISSION OF PROPOSALS:
15 APRIL 2015
The Coordinator is responsible to collect and submit all the
forms requested on behalf of each Co-beneficiary
Please note that the Financial forms are in a separate file
FORMS A:
Summary and
Administrative
Information
Please refer to chapter 17.1 of the Guide for Applicants
Form A1
FOR COMMISSION USE ONLY
European Commission
DE ECHO
Proposal n°
PROJECT
Project title (max. 60 characters):
………………………………………………………………………………………...................................
Project acronym (max. 25 characters):
………………………………………………………………………………..
The project will be implemented in the following country(ies):
…………………………………………………………………………………………………………………
Starting date: ...................... Ending date: .......................... Duration in months (max 24): ……….
COORDINATOR AND BENEFICIARIES
Legal name and country of coordinator (CO - same as in Form A4):
.................................................
Legal name and country of beneficiary (BE1 - same as in Form A5):
……………………………………
Legal name and country of beneficiary (BE2 - same as in Form A5):
……………………………………
Legal name and country of beneficiary (BE3 - same as in Form A5):
……………………………………
(Continue as necessary)
CO-FINANCIER
Legal name and country of co-financier (same as in Form A6):
.....................................................................
PROJECT BUDGET AND REQUESTED EC FUNDING
Internal budget item
External budget item
Total project eligible cost:
……………. EUR
EC financial contribution requested: ……………. EUR ( = …….. % of total eligible costs)
PROJECT POLICY AREA/PRIORITIES
(Please choose only one policy area, prevention or preparedness, and only one priority
within each policy area)
PREVENTION PRIORITIES
Action-oriented projects focusing on “risk-proofing" of public and/or private
investments and development and testing of tools and methodologies for
tracking of resilient investments.
Pilot and demonstration projects with replication capacity focusing on urban
resilience to disasters. Projects should build upon existing knowledge and good
practices (e.g. resilient cities scoreboard and campaign, local resilience forums,
local climate change adaptation strategies).
Technical cooperation projects with the objective of implementing at all levels of
government methodologies aiming at developing multi-hazard assessments of
risks and risk management capabilities and risk management planning, including
cross border dimension.
PREPAREDNESS PRIORITIES
Actions aimed at improving cross border civil protection and marine pollution
cooperation, including regional cooperation, regarding interoperability and
preparedness for, direct response to and reducing impacts of natural and manmade disasters. Specific focus areas include better planning, preparing for
chemical, biological, radiological or nuclear events, mass evacuation, spills of
hazardous and noxious substances into the marine environment, major
emergencies requiring search and rescue at sea, aerial surveillance for marine
pollution, detection of illegal discharges and follow-up actions.
Actions aimed at enhancing operational cooperation in the framework of the
Mechanism, enabling countries to develop, exercise and register multinational
assets.
Actions aimed at increasing the countries’ preparedness for reception of
international assistance in the context of the EU Host Nation Support
Guidelines.
Form A2
COORDINATOR DECLARATION of honour on the exclusion criteria, financial
capacity and absence of conflict of interest
(Complete or delete the parts in grey italics in brackets)
[Choose options for parts in grey between square brackets]
The undersigned (insert name of the signatory of this form):
representing the following legal person: (only if the applicant is a legal person)
full official name:
official legal form:
full official address:
VAT registration number:
 declares that [the above-mentioned legal person][he][she] is not in one of the
following situations:
a) is bankrupt or being wound up, is having its affairs administered by the courts, has
entered into an arrangement with creditors, has suspended business activities, is the
subject of proceedings concerning those matters, or is in any analogous situation arising
from a similar procedure provided for in national legislation or regulations;
b) has been convicted of an offence concerning professional conduct by a judgment of a
competent authority of a Member State which has the force of res judicata;
c) has been guilty of grave professional misconduct proven by any means which the
contracting authorities can justify including by decisions of the European Investment
Bank and international organisations;
d) is not in compliance with all its obligations relating to the payment of social security
contributions and the payment of taxes in accordance with the legal provisions of the
country in which it is established, with those of the country of the contracting authority
and those of the country where the contract is to be performed;
e) has been the subject of a judgement which has the force of res judicata for fraud,
corruption, involvement in a criminal organisation, money laundering or any other illegal
activity, where such activity is detrimental to the Union's financial interests;
f)
is a subject of an administrative penalty for being guilty of misrepresentation in supplying
the information required by the contracting authority as a condition of participation in a
evaluation procedure or failing to supply this information, or having been declared to be
in serious breach of its obligations under contracts covered by the Union's budget.
 (Only for legal persons other than Member States and local authorities, otherwise
delete) declares that the natural persons with power of representation, decisionmaking or control1 over the above-mentioned legal entity are not in the situations
referred to in b) and e) above;
 declares that [the above-mentioned legal person][he][she]:
g) has no conflict of interest in connection with the grant agreement; a conflict of interest
could arise in particular as a result of economic interests, political or national affinity,
family, emotional life or any other shared interest;
h) will inform the contracting authority, without delay, of any situation considered a conflict of
interest or which could give rise to a conflict of interest;
1
This covers the organisation directors, members of the management or supervisory bodies, and cases where
one natural person holds a majority of shares.
i) has not granted and will not grant, has not sought and will not seek, has not attempted
and will not attempt to obtain, and has not accepted and will not accept any advantage,
financial or in kind, to or from any party whatsoever, where such advantage constitutes an
illegal practice or involves corruption, either directly or indirectly, inasmuch as it is an
incentive or reward relating to award of the contract;
j) provided accurate, sincere and complete information to the contracting authority within
the context of this evaluation procedure ;
 acknowledges that [the above-mentioned legal person][he][she] may be subject to
administrative and financial penalties2 if any of the declarations or information
provided prove to be false.
In case of award of grant, the following evidence shall be provided upon request and within
the time limit set by the contracting authority:
 For situations described in (a), (b) and (e), production of a recent extract from the judicial
record is required or, failing that, a recent equivalent document issued by a judicial or
administrative authority in the country of origin or provenance showing that those
requirements are satisfied. Where the applicant is a legal person and the national
legislation of the country in which the applicant is established does not allow the
provision of such documents for legal persons, the documents should be provided for
natural persons, such as the company directors or any person with powers of
representation, decision making or control in relation to the applicant.
 For the situation described in point (d) above, recent certificates or letters issued by the
competent authorities of the State concerned are required. These documents must
provide evidence covering all taxes and social security contributions for which the
applicant is liable, including for example, VAT, income tax (natural persons only),
company tax (legal persons only) and social security contributions.
For any of the situations (a), (b), (d) or (e), where any document described in two
paragraphs above is not issued in the country concerned, it may be replaced by a sworn
or, failing that, a solemn statement made by the interested party before a judicial or
administrative authority, a notary or a qualified professional body in his country of origin
or provenance.
If the applicant is a legal person, information on the natural persons with power of
representation, decision making or control over the legal person shall be provided only
upon request by the contracting authority.

certifies that [the above-mentioned legal
person] has the financial and operational capacity to carry out the proposed Action.

Name
Position
Date, Place
Signature
2
As provided for in Article 109 of the Financial Regulation (EU, Euratom) 966/2012 and Article 145 of the
Rules of Application of the Financial Regulation
Form A3
BENEFICIARY DECLARATION of honour on the exclusion criteria, financial
capacity and absence of conflict of interest
(Complete or delete the parts in grey italics in brackets)
[Choose options for parts in grey between square brackets]
The undersigned (insert name of the signatory of this form):
representing the following legal person: (only if the partner is a legal person)
full official name:
official legal form:
full official address:
VAT registration number:
 declares that [the above-mentioned legal person][he][she] is not in one of the
following situations:
a) is bankrupt or being wound up, is having its affairs administered by the courts, has
entered into an arrangement with creditors, has suspended business activities, is the
subject of proceedings concerning those matters, or is in any analogous situation arising
from a similar procedure provided for in national legislation or regulations;
b) has been convicted of an offence concerning professional conduct by a judgment of a
competent authority of a Member State which has the force of res judicata;
c) has been guilty of grave professional misconduct proven by any means which the
contracting authorities can justify including by decisions of the European Investment
Bank and international organisations;
d) is not in compliance with all its obligations relating to the payment of social security
contributions and the payment of taxes in accordance with the legal provisions of the
country in which it is established, with those of the country of the contracting authority
and those of the country where the contract is to be performed;
e) has been the subject of a judgement which has the force of res judicata for fraud,
corruption, involvement in a criminal organisation, money laundering or any other illegal
activity, where such activity is detrimental to the Union's financial interests;
f) is a subject of an administrative penalty for being guilty of misrepresentation in supplying
the information required by the contracting authority as a condition of participation in a
evaluation procedure or failing to supply this information, or having been declared to be
in serious breach of its obligations under contracts covered by the Union's budget.
 (Only for legal persons other than Member States and local authorities, otherwise
delete) declares that the natural persons with power of representation, decisionmaking or control3 over the above-mentioned legal entity are not in the situations
referred to in b) and e) above;
 declares that [the above-mentioned legal person][he][she]:
g) has no conflict of interest in connection with the grant agreement; a conflict of interest
could arise in particular as a result of economic interests, political or national affinity,
family, emotional life or any other shared interest;
3
This covers the organisation directors, members of the management or supervisory bodies, and cases where
one natural person holds a majority of shares.
h) will inform the contracting authority, without delay, of any situation considered a conflict of
interest or which could give rise to a conflict of interest;
i) has not granted and will not grant, has not sought and will not seek, has not attempted
and will not attempt to obtain, and has not accepted and will not accept any advantage,
financial or in kind, to or from any party whatsoever, where such advantage constitutes an
illegal practice or involves corruption, either directly or indirectly, inasmuch as it is an
incentive or reward relating to award of the contract;
j) provided accurate, sincere and complete information to the contracting authority within
the context of this evaluation procedure ;
 acknowledges that [the above-mentioned legal person][he][she] may be subject to
administrative and financial penalties4 if any of the declarations or information
provided prove to be false.
In case of award of grant, the following evidence shall be provided upon request and within
the time limit set by the contracting authority:
 For situations described in (a), (b) and (e), production of a recent extract from the judicial
record is required or, failing that, a recent equivalent document issued by a judicial or
administrative authority in the country of origin or provenance showing that those
requirements are satisfied. Where the partnrer is a legal person and the national
legislation of the country in which the partner is established does not allow the provision
of such documents for legal persons, the documents should be provided for natural
persons, such as the company directors or any person with powers of representation,
decision making or control in relation to the partner.
 For the situation described in point (d) above, recent certificates or letters issued by the
competent authorities of the State concerned are required. These documents must
provide evidence covering all taxes and social security contributions for which the
applicant is liable, including for example, VAT, income tax (natural persons only),
company tax (legal persons only) and social security contributions.
For any of the situations (a), (b), (d) or (e), where any document described in two
paragraphs above is not issued in the country concerned, it may be replaced by a sworn
or, failing that, a solemn statement made by the interested party before a judicial or
administrative authority, a notary or a qualified professional body in his country of origin
or provenance.
If the applicant is a legal person, information on the natural persons with power of
representation, decision making or control over the legal person shall be provided only
upon request by the contracting authority.

certifies that [the above-mentioned legal
person] has the financial and operational capacity to carry out the proposed Action.
Name
Position
Date, Place
Signature
4
As provided for in Article 109 of the Financial Regulation (EU, Euratom) 966/2012 and Article 145 of the
Rules of Application of the Financial Regulation
Form A4
COORDINATOR PROFILE
Coordinator Profile Information
Short Name
Legal information on the Coordinator
Participant ref.
Legal Name *
Legal Status
Public
VAT No
Private
Legal Registration No
Registration Date
* The legal name is the name under which the participant(s) is/are
registered in the official trade register
Natural person
International
organisation
Legal address of the Coordinator
PO Box
Street Name and No
Post Code
Town/City
Country Code
Country Name
Coordinator contact person information
Title
Function
First Name
Surname
Department / Service
Name
PO Box
Street Name and No
Post Code
Town/City
Country
Telephone No
Fax No
E-mail
Coordinator details
Website
Number of employees
Number of employees in department conducting project
Is Your Organisation independent (Yes or No)
If No, please indicate legal name(s) of
owner(s) who own 25 % or more
Is Your Organisation affiliated to any other
participant(s) in the project? (Yes or No)
If Yes, please indicate Participant Short
Name(s) and character of affiliations(s)
Brief description of the structure and the activities of the Coordinator
CO
Form A5
BENEFICIARY PROFILE (one separate form per Beneficiary)
Beneficiary Profile Information
Short Name
Legal information on the Beneficiary
Participant ref.
Legal Name*
Legal Status
Public
VAT No
Private
Legal Registration No
Registration Date
* The legal name is the name under which the participant(s) is/are
registered in the official trade register
Natural person
International
organisation
Legal address of the Beneficiary
PO Box
Street Name and No
Post Code
Town/City
Country Code
Country Name
Beneficiary contact person information
Title
Function
First Name
Surname
Department / Service
Name
PO Box
Street Name and No
Post Code
Town/City
Country
Telephone No
Fax No
E-mail
Beneficiary details
Website
Annual turnover
Last Financial Year
Number of employees
Number of employees in department conducting project
Is Your Organisation independent (Yes or No)
If No, please indicate legal name(s) of
owner(s) who own 25 % or more
Is Your Organisation affiliated to any other
participant(s) in the project? (Yes or No)
If Yes, please indicate Participant Short
Name(s) and character of affiliations(s)
Brief description of the structure and the activities of the Beneficiary
BE…
Form A6
CO-FINANCIER PROFILE AND COMMITMENT (one separate form per each co-financier)*
Legal Name and full address on the co-financier
Financial commitment
We will contribute the following
amount to the project:
….. €
Status of the financial commitment
Stamp and signature of the authorised person
Name and status of the authorised
person (obligatory):
Date of the signature
(obligatory):
Signature (obligatory):
* If the project includes co-financers other than the European Commission, this form is
compulsory. Complete one form per co-financer (A6/1, A6/2, A6/3, etc.)
Remember that the amounts in Form(s) A6 must be consistent with the amounts indicated in the
financial forms F0 and F1.
Form A7
OTHER PROPOSALS SUBMITTED FOR EUROPEAN UNION FUNDING
Please answer each of the following questions:
Have you or any of the beneficiaries already benefited from previous co-financing under any EU
civil protection financial instruments or programmes? (Title, year, amount of the co-financing and
duration)
Have you or any of the beneficiaries already benefited from previous European Union financing
(grants, procurements or loans) for activities that may relate to the present proposal (e.g. an RTD
project preceding the present proposal)? (title, year, amount of financing and duration)
Have you or any of the beneficiaries applied for European Union funding under any other financial
instruments for actions which form part of or are directly related to this proposal? With what
results? Please give full details!
Form A8
NOTIFICATION OF THE COMPETENT NATIONAL CIVIL PROTECTION / MARITIME
AUTHORITY
(The form must be filled and signed by the National competent civil protection/maritime authority. )
Name:
[name of the national central civil protection/maritime authority]
[name of the department in national central civil protection/maritime
authority]
Contact person:
[name of the contact person in the national authority]
[position/rank]
Full address:
[street/P.O. Box]
[town]
[country]
[phone]
[Fax]
[E-mail]
The project: [project title]
Lead by: …………………………………………… [name of coordinator organisation]
The National Central Civil Protection/Maritime Authority
Has been informed about the submission of the above mentioned project for the Prevention
and preparedness call 2015
Agrees to the development of an [name of the asset]
Agrees to the registration of an [name of the asset] in the CECIS
For the preparedness policy area, priority 2 – Actions aimed at enhancing operational
cooperation in the framework of the Mechanism, enabling countries to develop exercise
and register multinational assets – all boxes need to be ticked.
The Coordinator is aware that, where relevant, also the competent national civil protection/maritime
authorities of other Co-beneficiaries are to be informed/consulted.
Name:
Status/title:
Signature
Date
Place
Form A9
Legal Entity Form
The Legal Entity form is specifically adapted to the legal status of the beneficiaty (public
entity or private company) as well as to its country/ language is available on
http://ec.europa.eu/budget/contracts_grants/info_contracts/legal_entities/legal_entities_en.cfm
ATTENTION: One Legal Entity Form to be filled in per each beneficiary (coordinator
and co-beneficiary partners).
The document below is only an example. Please use the appropriate document
available from the above link.
Form A10
Financial Identification Form
The financial identification form specifically adapted to the country/ language of the bank
account is available on
http://ec.europa.eu/budget/contracts_grants/info_contracts/financial_id/financial_id_en.cfm
ONLY FOR THE COORDINATOR
Form A11
PARTNERSHIP STATEMENT (To be signed by the Coordinator and each Beneficiary)
A partnership is a relationship, involving shared responsibilities, between two or more entities for
the purpose of implementing an Action funded by the European Union, represented by the
European Commission. To ensure that the Action runs smoothly, the Commission thus requires
the below outlined good partnership principles to be acknowledged and upheld.
I, [LAST NAME, Name of the signatory of the statement], on behalf of
[Full official name of the entity]
[Official legal form of the entity]
[Full official address of the entity]
[VAT registration number of the entity]
declare to have read and approved the content of the proposal entitled [insert title of the proposal]
submitted for funding to the Commission and I undertake to comply with the following principles of
good partnership:
1.
The coordinator and the beneficiaries have read the Guide for Applicants and the Grant
Application Forms and understand the purposes and expected results of the Call for
proposals. Furthermore, the coordinator and the beneficiaries understand their role in
the Action before the submission of the application to the European Commission. They
commit to comply with the relevant eligibility criteria, as defined in the Call for
proposals.
2.
The coordinator and the beneficiaries have read the applicable Grant Agreement and
understand their respective obligations under the Grant Agreement. The beneficiaries
authorise the coordinator to sign the Grant Agreement with the Commission on their
behalf and to represent them in all dealings with the Commission in the context of the
implementation of the Action.
3.
The coordinator consults other beneficiaries regularly concerning the different aspects
of the implementation of the Action and keeps them fully informed.
4.
The beneficiaries receive copies of reports - narrative and financial – prepared for and
submitted to the Commission.
5.
Any requests for amendments to the agreement (e.g. changes to the activities
presented in Annex I to the Agreement, beneficiaries etc.) are agreed by the
coordinator and beneficiaries prior to submission to the Commission. Where no such
agreement can be reached and the request is nonetheless submitted to the
Commission the absence of agreement is to be mentioned in the request.
Name
Position
Date and place
Signature
Form A12
VAT DECLARATION APPLICABLE TO PUBLIC ENTITIES ESTABLISHED WITHIN THE
EUROPEAN UNION
(If they are public entities established within the EU, both the Coordinator and the
Beneficiaries need to complete this form.)
The undersigned [LAST NAME, Name of the signatory of the declaration], on behalf of
[Full official name of the entity]
[Official legal form of the entity]
[Full official address of the entity]
[VAT registration number of the entity]
declare that
the activities5 carried out in the frame of this project by this public law body are activities or
transactions falling within its public mandate under national law (VAT is not eligible6), or
the activities carried out in the frame of this project by this public law body are not
activities or transactions falling within its public mandate under national law (VAT is eligible)., or
some of the activities carried out in the frame of this project by this public law body are
activities or transactions falling within its public mandate under national law (VAT is not eligible)
and some of the activities carried out in the frame of this project by this public law body are
not activities or transactions falling within its public mandate under national law (VAT is
eligible).
Please note that your answer shall be based on national legislation. You may be asked to
substantiate your answer by providing an extract from the relevant national legislation at
liquidation stage.
Name:
Status/Title:
Signature
Date
Place
The term 'activities' is to be understood in a broad way, generally at the level of objectives of the project and not at
the level of specific tasks carried out within the project or type of cost incurred within the project.
6 VAT paid in relation to activities falling within the public mandate of the public law body may be eligible, if the
activities are exempt activities listed in Article 13(2) of the Council Directive 2006/112/EC of 28 November 2006 on the
common system of value added tax (OJ L 347/1, 11.12.2006). In such a case, please submit a separate statement
together with this form, listing such activities.
5
FORMS T:
Objective, actions
and expected
results
Project planning
and structure
Please refer to chapter 17.1 of the Guide for Applicants
Form T1 – Description of the action – Annex I
SUMMARY OF THE PROJECT (max 20 lines per box)
Title of the project
Prevention or preparedness
Priority covered
Internal or External
1. Summary of the project
Describe the context and the issue/challenge/gap that the proposal aims to address.
2.Objectives
Describe the general and specific objectives of the project in relation to the priority chosen.
3. Expected results
Describe the expected results of the project. What will be the short, medium and long term impacts
and the added value of these results? Please describe how the project will improve or complement
the existing market situation, latest developments or current practices in the relevant area?
Demonstrate the complementarity to the efforts already made in the relevant area
4. Final beneficiaries
Indicate who would be the potential beneficiaries and end-users of your project results. Please
demonstrate their interest and support (e.g. enclose letters of support).
5. Methodology/Organizational structure
Describe the methodology to be used to achieve the expected result, present briefly the
partnership and the project team who will be responsible for the project tasks. Describe the
preparatory work already done and the considerations for the composition of the partnership.
6. Implementing partnership and project team
Give details on how the implementing partnership will cooperate during the implementation of
the project; explain the roles and responsibilities of the different partner organisations and any
subcontracting arrangements (if applicable). If the successful project implementation necessitates
contribution /involvement of any other organisation (e.g. providing access to a venue or
information by a public authority, etc.) please explain the necessary arrangements.
7. Monitoring and risks mitigation
Explain how you will monitor the project and ensure timely and proper implementation. Describe
what are the risks that could jeopardise the successful project implementation and how do you
plan to mitigate those risks.
8. Evaluation
Explain how you will evaluate the results during and after the implementation of the actions. In
particular, explain which indicators (qualitative and quantitative) will be used and explain how you
will monitor and check the financial implementation of the project
9. Cost efficiency and value for money
Demonstrate that your project represents a good value for money and that you aimed for cost
efficiency in the estimated budget. You may include any comments of the horizontal nature in
relation to the items presented in the estimated budget.
10. European dimension
Demonstrate the European dimension and relevance of the project. There must be an added value
in developing and implementing the action in a transnational partnership at international level
rather than at national level. Please note that the EU funding should complement existing
actions/projects and not duplicate activities.
11. Strategies for dissemination
Explain your plans for dissemination of the results. Describe how the knowledge gathered/
generated during the project will be transferred outside the partnership.
12. Sustainability
Although a project is by definition limited in time, the aim is to make the results sustainable.
Present the plan to ensure the financial and technical sustainability of the project. (If applicable)
Form T2
Project Acronym
Task ID
Task Title
Start Date
End Date
Actions
(Maximum number of tasks – 10)
Deliverables
Form T3a
T3a - Task Form
Project Acronym
Task ID
Task Title
Objectives
DESCRIPTION
Action A.1
Name of the action:
Description (what, how and where):
Expected results:
Constraints, assumptions and solutions:
Responsible for implementing it:
Action will be subcontracted:
Yes/No/Partially
Action A.2
Name of the action:
Description (what, how and where):
Expected results:
Constraints, assumptions and solutions :
Responsible for implementing it:
Action will be subcontracted:
Yes/No/Partially,
Form T3b
Task ID
Start Date
Deliverable Date
Page 1 of
maximum 10 (1
task per page)
T3b- Task Form
Project Acronym
Task Title
End Date
Deliverable Description
Duration
Form T4 - CONTINUATION
Continuation after the project ends:
 What still needs to be done (which actions will have to be continued or maintained)

How will this be achieved, which resources will be necessary to continue the actions?

How will the equipment acquired be used?

Which personnel will continue to work on the project?