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Funding Application Form
under the "Program for Supporting the Development of Municipalities in the Russian Federation using information and communication technologies,
years."
(RMO-ICT Program)
2nd round
"Implementation of the best energy saving practices at the municipal level"
The deadline for submitting Applications for the competition is March 2012.
The program is funded by the US Agency for International Development
within the framework of the Cooperation Agreement with the Fund " Sustainable development» (FUR)
Attention: The application is made in accordance with the "Guidelines for preparing an application for funding under the "Program for Supporting the Development of Municipalities in the Russian Federation using information and communication technologies,"
(RMO-ICT Program), 2nd round.
An incorrectly completed Application or the absence of any information may result in its rejection.
2. Brief description of the region of work
2. Involvement of the population in the process of solving energy saving problems;
3. Improving the efficiency of informing the residents of the settlement about the possibilities of using energy-saving technologies and the work of the dispatching information center;
4. Reduction of expenses for fuel and energy resources and expenses of the settlement budget for heating and maintenance of social buildings by 30% (240,000 rubles per year or 120,000 kWh);
5. Documenting savings for reinvestment in social development programs;
6. Based on the results of the project implementation, it will be possible to replicate successful experience and results in other settlements of the region to ensure a sustainable impact on improving the life of the local community.
5. Explain what ICT will be used in the project and what effect it will have
1. On the basis of the established dispatch center, a specialized website will be developed to inform the residents of the settlement about the costs and opportunities for saving energy and resources, regular content of the site and its further development will be ensured.
2. An information terminal will be installed in the dispatch center public access with an interactive portal and a database on the use of energy-saving technologies and energy efficiency. All social institutions and residents of the settlement will have access to information base on the use of energy-saving technologies and energy efficiency.
3. The project provides for the distribution of information on the implementation of energy-saving measures to social institutions, organizations of housing and communal services.
That is, industrial and social ICT will be created that will be able to solve urgent problems of residents, institutions and organizations on the territory of Khomutovsky municipality Irkutsk region.
6. Justify why your project
can't do damage
environmental conditions
The project is not dangerous for the environment, as it does not use technologies that can harm it
7. Areas of distribution
Khomutovskoe municipality of the Irkutsk district of the Irkutsk region
8. Duration of the project (number of months, but no more than 12)
10 months
9. Project start date
(should be the first day
04/01/2012
9. End date of the project
(must be the last day of the month, but no later than March 31, 2013)
01/31/2013
Conducting an energy audit
Acquisition of an information terminal with an anti-vandal screen
11. Applicant's fee (in USD)
– salary of the project executors, including deductions to the Funds, costs for the production of printed materials;
Purchase of energy-saving appliances
Carrying out activities based on the conclusion of the audit to improve the energy-saving class of buildings (wall insulation, elimination of air leaks, proper placement of energy appliances).
12. Funds from other sources (in USD)
6,600 (see list of letters of support)
MUP "Agrobytservis" - installation of an information terminal, delivery and materials (720 dollars).
MUK Cultural and sports complex - installation and configuration of the interactive, the premises of the information center, utility bills, communication services, etc.
13. Total cost of the proposed project (in USD)
SUMMARY OF THE APPLICANT
A. Organization Information
1. Organization | Administration of the Khomutovsky Municipal Formation Administration of the Rural Settlement of the Irkutsk District |
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2. Status of the organization | |||
3. The direction of the organization | municipal government, the municipal authority in the territory |
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4. Responsible official of the organization | Deputy head of administration of the settlement |
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5. Project accountant (Full Surname First Name Patronymic) | |||
6. Work phone of the Project Accountant | |||
7. City (location of the organization) | With. Khomutovo |
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8. Full mailing address organizations | |||
9. Actual address of the organization | Irkutsk region, with. Khomutovo, st. Kirova, 7/a |
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Executor |
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Purchase of equipment - information terminal with anti-vandal screen | April May | 1 terminal | Settlement administration |
April May | Terminal and dispatch center software | Settlement administration |
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Terminal installation | May June | 1 terminal | MUP Agrobytservis |
3. Performance of works on energy inspection (energy audit) | April June | Library buildings, sports complex building, recreation center | |
3. Website development | April June | Settlement administration |
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Creation and equipment of a dispatching information center (hereinafter referred to as the dispatching center) | July - September | dispatch center | |
Conducting training seminars for employees involved in the project | July - September | 2 seminars | Settlement administration |
Holding gatherings of citizens informing about the project, placing information in the media | July - September | At least 1 run | Settlement administration |
Preparation of energy passports of buildings, development of recommendations | Aug. Sept | 3 passports | Administration of the settlement (involved specialized organization) |
6.Production and printing of a brochure | July August | 400 copies of 10 pages | |
5. Filling the site | July - September | Settlement administration |
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Commissioning of the dispatch center | dispatch center | ||
Development of an energy efficiency settlement program | Energy Efficiency Program | Settlement administration |
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Purchase and installation of energy-saving equipment | October November | ||
October November | Administration of the settlement, MUK KSK |
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8. Brochure distribution | October December | 1 brochure | MUK KSK, dispatch center |
5. Filling the site | October December | Works on entering data, updating information | Settlement administration, dispatch center |
7. Carrying out activities for energy saving of buildings | Administration of the settlement, MUK KSK |
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8. Brochure distribution | 1 brochure | MUK KSK, dispatch center |
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Replication of the results of the project - articles in the media, posting data on the Internet | 2 publications in the media, publication in electronic journal FUR, data on the site | Settlement administration, MUK KSK, dispatch center |
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9. Preparation of the final report | Final report | Settlement administration |
4. Partnerships
MINISTRY OF FINANCE OF THE REPUBLIC OF MORDOVIA
ORDER
ON APPROVAL OF FORMS OF BUDGET APPLICATIONS FOR FINANCING EXPENSES
In order to properly organize the budget process in the Republic of Mordovia, I order:
1. Approve:
the form of a budget application for financing expenses provided by the main managers of budget funds to the Ministry of Finance of the Republic of Mordovia in order to include them in the register of expenses for subsequent amendments to the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period, in accordance with Appendix 1 to this order;
the form of the budget application for financing the costs of interbudgetary transfers, provided by the authorities local government municipal formations of the Republic of Mordovia to the main managers of budgetary funds in order to include them in the register of expenses for subsequent amendments to the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period, in accordance with Appendix 2 to this order.
2. The main managers of budgetary funds and local governments of municipalities of the Republic of Mordovia to ensure the submission of applications for financing expenses in the forms, in accordance with Annexes 1 and 2 to this order.
3. This order comes into force from the date of its signing.
Vice-chairman
Government - Minister of Finance
Republic of Mordovia
A.Yu.SIMONOV
Annex 1. Budget request for financing expenses
Attachment 1
Republic of Mordovia
dated 05.06.2014 N 74
(name of the main manager of budgetary funds)
Details of the regulatory legal act of the Republic of Mordovia, establish his spending obligation of the Republic of Mordovia | Details of the normative legal act of the Republic of Mordovia, implementing the budget obligation | The amount of funds provided for by the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period (thousand rubles) | Note<*> |
|||||||||||||||
This year | Planned period | This year | Planned period | Name GRBS | ||||||||||||||
Head of Executive
body state power
Republic of Mordovia ____________/__________________________/
signature (signature decryption)
Chief Accountant ___________/___________________________/
signature (signature decryption)
________________
Appendix 2. Budget request for financing expenses on interbudgetary transfers<*>
Annex 2
to the order of the Ministry of Finance
Republic of Mordovia
dated 05.06.2014 N 74
from _______________________________________________
(name of the municipality of the Republic of Mordovia)
Name (direction) of expenses | Details of the regulatory legal act of the Republic of Mordovia, establishing the expenditure obligation of the Republic of Mordovia to provide interbudgetary transfers | Details of the regulatory legal act of the Republic of Mordovia, implementing the budgetary obligation to provide interbudgetary transfers | The volume of interbudgetary transfers provided for by the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period (thousand rubles) | The amount of funds required in addition to the amount of funds provided for by the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period (thousand rubles) | The amount of funds provided for by the decision on the budget of the municipality of the Republic of Mordovia (thousand rubles) | The amount of funds transferred from the republican budget of the Republic of Mordovia as of 20__ (thousand rubles) | The amount of funds transferred from the budget of the municipality of the Republic of Mordovia as of 20__ (thousand rubles) | Indicators of the budget classification of the Russian Federation | Note<**> |
|||||||||||||
This year | Planned period | This year | Planned period | This year | Planned period | Name GRBS | ||||||||||||||||
Head of the municipal
formation of the Republic of Mordovia ____________/_________________________/
signature (signature decryption)
Boss financial management ____________/_________________________/
signature (signature decryption)
________________
<*>Provided to the main manager of budgetary funds, indicated in column 16 of the budget request, after agreement with the relevant sectoral public authority.
<**>The note must indicate the rationale for the allocation of additional Money from the republican budget of the Republic of Mordovia.
______________________________________ (name of the regional branch of the International Finance Corporation) address: _______________________________ of ___________________________________ (name or full name of the applicant) address: ______________________________, telephone: __________, fax: __________, address Email: _____________ Application for funding Applicant _______________________________________________________________ ___________________________________________________________________________ (name, address of location, OGRN, details of the document confirming the fact of entering information about the legal entity in the Unified State Register of Legal Entities, indicating the address of the location of the body that carried out state registration/FULL NAME. individual entrepreneur, address of his place of residence, data of the document proving his identity, OGRNIP, data of the document confirming the fact of entering information about the individual entrepreneur in the Unified State Register individual entrepreneurs, indicating the address of the location of the body that carried out the state registration, TIN, data of the document on the applicant's registration with the tax authority) is the initiator (or: the representative of the initiator, etc.) investment project ___________________________________________________ (name reflecting the essence of the project) (hereinafter referred to as the "investment project"). 1. Brief description of the investment project: ____________________ ________________________________________________________________________________. (essence of the project, place of implementation, contract scheme, main technical and financial parameters and characteristics, including short description industry, distribution of risks and economic efficiency, environmental and social effects) (If available: 2. List of co-investors - ______________________________ _______________________________________________________________________________.) (names, full name, addresses, type of activity of each, description of their assets, financial condition, experience in implementing similar projects, roles in the project, expected investment period and conditions for exiting the project) (If available: 3. List of partners - _________________________________ _______________________________________________________________________________.) (names, full name, addresses, type of activity of each, description of belonging their assets, financial condition, experience in implementing similar projects, roles in the project) 4. Management team project - _______________________________________ ________________________________________________________________________. (Full name, positions, experience in implementing similar projects, education, scientific degrees, additional training courses - MBA, CFA, etc., diplomas and certificates and a brief description of the main achievements in professional activity) (If available: 5. List of contractors for external, including technical, assistance - _________________________________________________________________ _______________________________________________________________________________.) (names, full name, addresses, type of activity of each, financial condition, experience in implementing similar projects, roles in the project, conditions for exiting the project) 6. Project management structure - __________________________________________ __________________________________________________________________________. (description of the management structure, divisions, distribution of levels of responsibility, heads of departments and the number of employees in them, basic provisions personnel policy; for outsourcing of certain functions - the names of contractors, as well as the main details and the deadline for the implementation of the relevant contracts) 7. Marketing and sales, the commercial strategy of the project for the sale of manufactured goods or for the provision of services - ______________________________ ________________________________________________________________________________. (main sales markets for goods produced within the framework of the project, services provided within the framework of the project: local, domestic, regional, export; unit prices, sales targets and estimated market share, potential consumers of products and distribution channels; dynamics of demand development and prices, as well as competition over the past 3-5 years; market development forecast for the duration of the project, taking into account the possibility that the market will be saturated with substitute goods and other factors that determine the market potential; regardless of the volume of contracts concluded, detailed conclusions are provided specialized consulting companies on the analysis of these market segments and their forecasts) 8. Commercial strategy for the procurement of basic raw materials and materials necessary for the implementation of the project - ______________________________________ ________________________________________________________________________________. (strategy for the acquisition of the main components of the production of goods, raw materials, materials, services, indicating volumes and prices, other main conditions of long-term contracts for the sale of goods and services planned for conclusion, a description of the planned main suppliers of raw materials and materials, an analysis of the risks of monopoly behavior of such suppliers ways to reduce the dependence of the project on suppliers, the risks associated with their default on deliveries, and ways to reduce them; the history of the execution of supply contracts in the past for each supplier; regardless of the volume of contracts concluded, detailed forecasts of the development of prices for the main supplied materials are presented, raw materials, services performed by specialized experts in the field of project implementation, tariff barriers or import restrictions affecting the project) 9. Technical aspects of the investment project and the proposed technical solution - __________________________________________ __________ ________________________________________________________________________. (the main aspects of the technical solution, the rationale for choosing a technical solution, its advantages over other potential solutions, examples of other projects where such a solution was successfully used, all the technical risks of the project at each stage and ways to neutralize or reduce them) Detailed technical documentation is attached to the business - investment project plan. 10. Technical feasibility, availability work force, raw materials and environmental issues: _____________________________________________________________ __________________________________________________________________________. (short description production process; the need for know-how and special qualifications; availability of labor force and infrastructure facilities - transport and communications, electricity and water supply, etc.; distribution of estimated operating expenses by main items of expenditure; sources, price and quality of raw materials and relations with subcontractors; import restrictions on required raw materials; the proposed location of the enterprise in relation to suppliers of components, sales markets, infrastructure facilities and settlements - sources of labor; the anticipated size of the enterprise compared to other such enterprises; potential environmental problems and ways to solve them) 11. Analysis of operating costs, description of counterparties for the operation, maintenance and repair of facilities, the main conditions of the contracts for operation and repair planned for conclusion - ________________________ ________________________________________________________________________________. (the main conditions of the contracts for the operation of facilities planned for conclusion, summary information about contractors for the operation, maintenance and repair of facilities, including a description of their previous experience, the main risks associated with the operation of the project, and ways to reduce them; forecast of the cost of equipment maintenance for a period not less than the maturity of the requested investment, including the agreed prices and conditions of operation and repair, confirmed by technical experts) 12. Needs for investments, project financing and profitability: 12.1. Estimated total costs for the project, broken down into rent / purchase of a land plot, construction, installation of equipment, working capital requirements, indicating the currency component - ___________________ ________________________________________________________________________________. (detailed calculation of capital expenditures and sources of their financing, revenue, operating expenses, payments to repay attracted loans, loans, as well as interest on them, payments to co-investors, forecasts of the financial statements of the initiator - income and expense reports, balance sheet, cash flow; all the parameters characterizing the project are summarized in a detailed financial model in *.xls format, including related forecast reporting forms - income statement, balance sheet and cash flow statement, completed for the life of the project, all risks are taken into account in the financial model; all basic forecasts are based on the terms of the concluded contracts and on the reports of consultants on price development forecasts) 12.2. Alleged financial structure enterprises with an indication of the proposed sources and conditions of equity and debt financing - ___________________________________________________________________________ __________________________________________________________________________. (name, full name, address, type of activity of each; name, currency and amount of funds by sources of financing; terms and schedules for repayment of loans and (or) credits; cost, terms and other basic conditions for securing obligations) In support of the specified information, the application is accompanied by documents on the intention to conclude loan agreements, draft decisions on the issuance valuable papers and draft prospectuses, documents confirming the existence of the necessary internal permits and resolutions approving the investment in the project. The sum of all confirmed sources of funding for the project is equal to the sum of the costs of the project, and all funds will be available to the initiator at the time financial closure project. 12.3. The logic of the financial model and the assumptions used is _____________ ________________________________________________________________________________. (guidelines for using the financial model, which includes an overview of the model, a description of the logic of complex calculations, macro calculations with links to technical documentation, documents on the terms of financing) 12.4. IFC financing type - _________________________ ______________________________________________________________, including (loan, equity, quasi-equity financing, combination of several financial products, etc.) capital - ______ (________________) ________________ for a period of __________________, quasi-equity financing - _______ (_________________) _________________ for a period of __________________, other forms - ______ (________________) ___________ for a period of _______________. 12.5. Financial Forecast, information on profitability and the amount of return on invested capital - _____________________________________________. 12.6. The most important factors on which profitability depends are _________ __________________________________________________________________________. (priorities, sources of financing and refinancing in cases where the funds are not enough to fully repay the debt under the project) 12.7. Currency and interest risks - _________________________________ ________________________________________________________________________________. (initiator's strategies for hedging currency and interest risks at all stages of the project, including risks in relation to the main loan agreements concluded, sales contracts, construction contracts, maintenance and repair contracts) 12.8. Analysis of situations when the proposed financing will not be available in the planned volume or its conditions will be different, and the consequences of this for the financial and economic characteristics of the project - _____ ________________________________________________________________________________. (description of each situation according to the scheme "circumstances - pessimistic, optimal, optimistic scenarios of response") 13. Methods for monitoring the impact of the project on environment, compliance of the project with the legislation Russian Federation on environmental protection - ______________________________________________________________ ________________________________________________________________________________. (technical aspects of the project related to the impact on the environment and meeting the requirements of local, regional, federal legislation on environmental protection; improvement of the environmental situation in the region as a result of the project; environmental benefits of the project and environmental risks of the project, indicating measures aimed at managing such risks and their mitigation; conclusion of an organization with experience in environmental research; a summary of the results of all studies previously conducted at the request of international financial institutions or presentation of additional requirements to the procedure for assessing the impact of the project on the environment) 14. Assessment of the social significance of the project, including the creation of new jobs, etc. - ____________________________________________________ ________________________________________________________________________________. (justification of the positive social effect associated with the implementation of the project - the creation of new jobs both at the stage of implementation and during the operation of the project, both within the framework of the implementation of the project itself and in related areas, for example, among the counterparties of the initiator, the introduction of new modern and more economical technologies, improving the quality of life, etc.) 15. Information on the main licenses and permits required by the initiator for the implementation of the project, including both construction and subsequent operation - _______________________________________________ ________________________________________________________________________________. (indicating the duration of licenses and permits related to the status of their renewal processes, as well as the risks and mitigating factors associated with situations where such licenses and permits are either not obtained or renewed as expected) 16. Government support and current legislation: 16.1. Compliance of the project concept with the state economic development programs and state investment programs - _____ __________________________________________________________________________. (program details) 16.2. Benefits and other governmental support of the project or its separate parts - __________________________________________________________________ ________________________________________________________________________________. (links to legal acts) 16.3. The expected contribution of the project to the development of the economy is __________________ ________________________________________________________________________________. 16.4. a brief description of current legislation in the field of currency control, conditions for the import and export of capital - _____________________ __________________________________________________________________________. (links to regulatory legal acts) 17. Available material base for the implementation of the investment project - _________________________________________________________________ _________________________________________________________________. (availability on the right of ownership or on other legal grounds of real estate objects necessary for the implementation of the project, certified control and measuring equipment, production and testing equipment with supporting documents) 18. Computer programs, technical and technological documentation, methodological documents necessary for the implementation of the project - ______________ ________________________________________________________________________. (list and details of supporting documents) 19. Estimated schedule for the preparation and implementation of the project - ___________ ________________________________________________________________________. A business plan for an investment project with a detailed justification of the economic feasibility, volume and timing of investments, including the necessary design and working documentation, a description of the practical steps to implement the investment will be developed and submitted in case of fundamental interest in the project within ______ days. Based on the foregoing, the applicant asks to consider the possibility of providing investments for the implementation of the project "_________________" in the amount of ______ (________________) ___________ with a payback period of _______ months on the terms agreed by the parties. (If the applicant wishes: Please send information on investment issues in electronic form.) Applications: 1. Copies of constituent documents legal entity(or a copy of the certificate of registration of an individual entrepreneur). 2. Copies of documents confirming the availability of specialists in the staff of the applicant or project initiator and their qualifications (appointment orders or extracts from work books diplomas, certificates, certificates). 3. Copies of title documents for the premises intended for the implementation of the project, the rights to which are not registered in the Unified State Register of Rights to Real Estate and Transactions with It (if such rights are registered in the specified register, information about these premises). 4. Copies of documents confirming the right of the applicant or project initiator to computer programs and databases planned for use in the implementation of the project. 5. Documents containing information on the availability of production, testing and control and measuring equipment, information security tools and other means necessary for the implementation of the project, with copies of documents on verification and marking of control and measuring equipment, as well as documents confirming the right of the applicant or initiator project for the use of the specified equipment and facilities. 6. Documents containing information about the available technical documentation, national standards and methodological documents necessary for the implementation of the project. 7. Copies of documents confirming the existence of a production control system, including a quality management system. 8. Power of attorney of the representative from "__" ___________ ____, N ______ (if the application is signed by the representative). 9. Copies of documents confirming the powers of the sole executive bodies (authorized persons) of the initiator to make transactions on behalf of the initiator, the chief accountant of the initiator (decision on election, order on appointment, order on taking office, employment contract, power of attorney, etc.), and certified sample signatures of the indicated persons and the seal of the initiator. 10. Certificate of the initiator that no insolvency (bankruptcy) proceedings have been initiated against him in accordance with the procedure established by the legislation of the Russian Federation on insolvency (bankruptcy). (If available: 11. Documents characterizing the credit history of the initiator.) 12. Inventory of attached documents. "__"___________ ____ Applicant (representative): __________________________ (signature)
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