Ghana WASH Window-FDW – Model form Annex 3c: MODEL FINAL REPORT GWW project number: GWW…/…/… Title of the project: ………. Name applicant: ………. Reporting period ………. ………. Filing date progress report ………. Instructions: - This final report presents a summary of all the achieved results as defined in Annex 1 of the Administrative Decision (‘beschikking’). - This report and attached documents must be in English. - Send one (1) hard copy by postal mail to RVO.nl and one (1) copy by e-mail to the PPP project officer. - RVO.nl should receive the Final Report according to the date included in the Administrative Decision. - The final report should be signed by both Applicant and all project partners (not being the Applicant). - Blue text can be deleted from this format. A. General Contact information - Were there changes in contact information of the applicant or project partners during the reporting period? Yes No If there are any changes, please list them below, otherwise proceed with section B. Name of applicant/partner: Correspondence address: Visiting address: Name contact person: Email-address: IBAN: Other: Phone: BIC: B. Progress of project and result(s) achieved Summary - Please summarise (max 500 words) the general progress of the project so far. This includes achievements that are direct and indirectly linked to the project implementation. Also pay attention to the cooperation between the project partners and relevant external stakeholders. - In the next paragraphs specific progress at the level of the Results and Sub-results as included in the Administrative Decision is requested. GWW-FDW Tender 1 Annex 3c - page 1 160216 Progress achieved under Result 2 - Provide information on the progress of the Results and Sub-results as specified in Annex 1 of the Administrative Decision. - Were activities for result 2 carried out in the reporting period? Yes No If yes, please describe the specific activities carried out. - Are any sub-results of result 2 completed during the reporting period? Yes No If yes, please specify the sub-results and submit all the corresponding Means of Verification (MoVs) for the completed sub-results with reference and numbering in accordance to Annex 1 of the Administrative Decision. E.g. if sub-result 3 of result 2 is completed, please specify so with reference to sub-result 2.3 - Is result 2 fully completed? Yes No. All MoVs have been provided together with this, or earlier progress reports. Progress achieved under Result 3 - Were activities for result 3 carried out in the reporting period? If yes, please describe the specific activities carried out. Yes No - Are any sub-results of result 2 completed during the reporting period? Yes No If yes, please specify the sub-results and submit all the corresponding Means of Verification (MoVs) for the completed sub-results with reference and numbering in accordance to Annex 1 of the Administrative Decision. E.g. if sub-result 3 of result 3 is completed, please specify so with reference to sub-result 3.3 - Is result 3 fully completed? Yes No. All MoVs have been provided together with this, or earlier progress reports. In case of more than 3 results please add these manually Bottlenecks and risks - Please describe if there are any bottlenecks or risks identified or foreseen that could hinder the progress of the project. If any new bottlenecks or risks are foreseen, describe what measures the partnership will take to mitigate the bottlenecks and risks. Sustainability and cross-cutting themes ICSR With regard to the implementation of the project according to ILO Conventions 138 and 182 against child labour and ILO Conventions 29 and 105 against forced labour, you must establish that no use is made of child labour or forced labour at the partners involved in the partnership, or at the first essential supplier to the project. You are legally bound to provide RVO.nl with any information you may have about the possible use of child labour or forced labour by such partners or suppliers. If one of the aforementioned partners or suppliers is found to be using child labour or forced labour, or if you fail to pass on information you have received on this subject to RVO.nl the subsidy may be withdrawn. - Is one of the first essential suppliers or one of the project partners possibly using child labour or forced labour? Yes No If yes, please identify the partner and elaborate on the situation. - Please provide an evaluation on the status of the identified ICSR risks in the project plan and as part of Result 1 and how these risks were and will be minimized or mitigated. Describe whether all mitigating measures as described in the ICSR risk analysis of result 1 are successfully implemented. GWW-FDW Tender 1 Annex 3c - page 2 160216 Sustainability and cross cutting themes. Provide information on the sustainability of the project. Sustainability is defined as Financial, Institutional. Environmental, Technical and Social sustainability (FIETS) with a special focus to the cross cutting themes ‘Environment’, ‘Climate’, ‘Gender’ and ‘Good governance’. More information can be found in annex 3h FIETS-checklist. - In reference to Financial sustainability: Did the project generated revenues e.g. from project products or services during the project period? If so, please specify and quantify. - In reference to Technical sustainability: evaluate on: - The percentage of durable hardware purchased by the project that is still fully in use and is properly maintained and functioning? If this percentage is less then 100%, please clarify. - The method used for establishing the above mentioned percentage (e.g. sample size of methodology used) Ownership Hardware - Please describe how the ownership of the hardware that is purchased for this project is arranged. Describe who will be the owner of the Hardware, and, if relevant, how proper maintenance and functioning of the hardware is ensured? Please note that as defined at the end of the project the hardware must be owned by a local Legal entity. C. Monitoring and Evaluation - In the progress report on Result 1 and subsequent annual report project indicators were provided using the table ‘Project Indicators’. Provide an updated version of the table ‘Project Indicators’ to report on the situation at the end of this reporting period. A sample of (a part of) this table is given below. Replace this sample with the updated version of your project. If some of the targets are not met, evaluate why and if/when it is expected that these targets will be met. Also pay attention what will be necessary to reach these targets. Table 1 Project Indicators Indicator – Replace this sample table with Unit the updated table of your project Sanitation (liquid waste) and institutional WASH compliance Number of schools which are WASH compliant Volume of faecal sludge adequately treated (i.e. at faecal sludge treatment plant) # Litre Number of people that gained access to and make # Current situation Target use of an improved water source. Number of people that gained access to and make # use of improved sanitation facilities Sanitation – solid waste and drainage Number of households with access to solid waste # management … … D. Future prospects - Elaborate on the future prospects of the project or spin-off/effects of the project. At least pay attention to: GWW-FDW Tender 1 Annex 3c - page 3 160216 - How the sustainability and continuity of the taken interventions are guaranteed. Describe substantiate and quantify how Financial, Institutional, Environmental, Technical and Social sustainability is obtained. What future activities, related to the project or project results are foreseen by the partnership? E. Financial report - Please provide an audited report on the financial and labour realisation as well as the realisation on hardware purchases. Please use the mandatory Annex 3d (MS Excel) for this. The final financial report has to be audited according the Audit protocol, Annex 4 of the Administrative Decision. Where relevant, a textual clarification on the financial report can be given here. F. Project modifications Substantial changes in the project in relation to the Administrative Decision and original project plan have to be approved by RVO.nl. Substantial changes are defined as changes resulting in a different project results (output/outcome, reflected in MoVs), changes in partnership, planning, changes in staff at project management and senior level and changes in budget allocation >10% of a result budget. Please, keep in mind that reallocation of budget between Technical Assistance and Hardware is not allowed Update work plan - Please indicate whether the project work plan has been adjusted in the last reporting period. In case of an adjustment, please give a detailed description and motivation. In case of a substantial change approval of RVO.nl is needed. Project budget - Please indicate and explain the project expenditure compared to the approved budget. - Please indicate and explain whether a change in project budget allocation of more than 10% of a result budget was needed over the latest reporting period. - Please indicate and explain all possible changes in hardware, as compared to the originally approved budget, in Table 2 below. Changes in hardware already reported to RVO.nl in earlier progress reports or through a Request for Market Conformity Check (RMCC) can be excluded from this progress report. Table 2 Changes in hardware items compared to the hardware result 1 (Annex 3d). Please, only include hardware that will be Item1 Description and Quantity Price in € Motivation of proposed change2 list provided with the progress report on modified. New/ Original Adjusted approved amount amount in € in € Add more lines manually TOTAL 1 Please use item order as in the original Hardware List and label new HW with ‘NEW-’ e.g. ‘NEW-Description item 3’ 2 e.g. new HW replaces old item, budget left over, etc GWW-FDW Tender 1 Annex 3c - page 4 160216 G. List of annexes Please make sure all Annexes mentioned below are adhered to this report Annex 3d, Financial report - Final financial report for the entire project period - Audit report on project finance (see Audit protocol, Annex 4 of the Administrative Decision) Hardware (mandatory) - Copy of all hardware invoices adding up to the full reported amount of € ……. - Copy of all Market Conformity check Certificates on hardware (for more information refer to Annex 3f), received during the reporting period. - For all purchased hardware worth € 25.000,- or more: Annex 3g Protocol of Receipt. Means of verification (MoVs) - As specified under section B, ‘Progress of project and result(s) achieved. Please mark the MoVs with the corresponding number (e.g. Result 3.3.2) Other annexes - Other relevant annexes provided, please specify here. H. Declaration and signature - By signing this progress report the applicant and all partners declare that the information in this final report is accurate and complete: Applicant Organisation: Partner 1 Organisation: Name: Position: Name: Position: Date: Signature: Date: Signature: Partner 2 Partner 3 Organisation: Name: Organisation: Name: Position: Date: Position: Date: Signature: Signature: Partner 4 Organisation: Partner 5 Organisation: Name: Position: Name: Position: Date: Signature: Date: Signature: GWW-FDW Tender 1 Annex 3c - page 5 160216 - If the partnership has more than 5 partners, please add these manually to this document. GWW-FDW Tender 1 Annex 3c - page 6 160216