Questionnaire of Participant in Competitive Selection for Participation
in the Municipal Finance Strengthening Initiative Project Roll-out (MFSI-II)
(Energy Efficiency Component)
1.
2.
3.
4.
5.
City name
Oblast, Autonomous Republic of
Crimea
Population, persons
Development budget amount less debt
obligations (Hr thou)
Availability of report on energy saving
activities in previous years
Actual in 2011 _____________
Plan for 2012 _____________
Yes / No
(underline as needed)
______________________________
(link to online resource)
6.
7.
Applications to International Finance
Organizations (IFOs) with regard to
implementation of energy saving
projects
Availability / development of
municipal energy saving program
(municipal energy plan)
______________________________
(name of IFO, application date)
______________________________
Yes / No
(underline as needed)
______________________________
(name of program/planned program)
______________________________
8.
Availability / development of energy
saving project
Yes / No
(underline as needed)
______________________________
(name of project)
9.
Cooperation with the Municipal
Heating Reform (MHR) Project
10. Approximate list of the city’s
communal service enterprises that will
be engaged in implementing the
energy efficiency component under
MFSI-II Project
11. Contact person
______________________________
Yes / No
(underline as needed)
1. __________________________
2. __________________________
3. __________________________
4. __________________________
5. __________________________
……………………………………..
______________________________
(surname, given name, patronymic in full)
______________________________
______________________________
(title)
______________________________
(telephone number)