LIFE 2020 NGO4GD - Technical Application Forms

LIFE 2020 Call for Proposals from NGOs on the European
Green Deal (NGO4GD)

TECHNICAL APPLICATION FORMS
Table of Content
A1 - GENERAL PROJECT INFORMATION................................................................3
A2 – COORDINATING BENEFICIARY PROFILE.......................................................4
A3 - COORDINATING BENEFICIARY DECLARATION.............................................6
A4 - CO-FINANCER PROFILE AND COMMITMENT FORM......................................7
B1 - DESCRIPTION OF THE INTERVENTION............................................................8
B2 – DETAILED DESCRIPTION OF THE WORK PACKAGES..................................9
B3 – ESTIMATED TOTAL ELIGIBLE COSTS PER WORK PACKAGE..................10
B4 – TIMETABLE.......................................................................................................11
The Financial Application Forms are contained in a separate file in Excel format.
FOR ADMINISTRATION USE ONLY
LIFE20 PRE-NGO/Country/number
LIFE 2020 Call for Proposals from NGOs on the European Green Deal
(LIFE NGO4GD)
A1 - GENERAL PROJECT INFORMATION
Name of the Beneficiary:
Project title (max. 200 characters):
Project acronym (max. 25 characters):
The project will be implemented in the following Country/ Regions:
Name of the Country: Name of the Region(s):
Expected start date: Expected end date:
PROJECT BUDGET AND REQUESTED EU FUNDING
Total project budget: €

Total eligible project budget: €
EU financial contribution requested: € = % of total eligible costs
max. 300.000 € max. 60% of total eligible costs
3
A2 – COORDINATING BENEFICIARY PROFILE
COORDINATING BENEFICIARY Profile Information
Legal Name
Short Name Legal Status
(max.10 characters)
VAT No
VAT Reimbursement YES 󠅲☐ NO 󠅲☐
Legal Registration No
Registration Date
PIC Number (not

compulsory):
Coordinating Beneficiary contact person information
Surname First Name
Title Function
E-mail address
Telephone number
Department / Service
Street Name and No PO Box
Post Code Town/City
Member State
Coordinating Beneficiary legal address and legal representative information
Surname First Name
Title Function
E-mail address
Telephone number
Department / Service
4
Post Code Town/City
Member State
Website of the Coordinating Beneficiary
Website
Brief description of the activities of the Coordinating Beneficiary (max 3200 characters)
5
A3 - COORDINATING BENEFICIARY DECLARATION
The undersigned hereby certifies that:

1. The specific actions listed in this proposal do not and will not receive aid from the European
Structural and Investment Funds or other European Union funding programmes. In the event that
any such funding will be made available after the submission of the proposal or during the
implementation of the project, my organisation will immediately inform the Contracting Authority.
2. My organisation …………………………………………………….. has not been served with bankruptcy orders,
nor has it received a formal summons from creditors. My organisation is not in any of the
situations listed in Articles 136(1), 136(4) and 141 of the EU Financial Regulation [Regulation (EU,
Euratom) 2018/1046 of the European Parliament and of the Council of 18 July 2018 on the financial
rules applicable to the general budget of the Union, amending Regulations (EU) No 1296/2013, (EU)
No 1301/2013, (EU) No 1303/2013, (EU) No 1304/2013, (EU) No 1309/2013, (EU) No 1316/2013,
(EU) No 223/2014, (EU) No 283/2014, and Decision No 541/2014/EU and repealing Regulation (EU,
Euratom) No 966/2012, OJ L 193, 30.7.2018, p. 1)].
3. My organisation will conclude with the co-financiers any agreements necessary for the completion
of the work, provided these do not infringe on their obligations, as stated in the grant agreement
with the Contracting Authority. Such agreements will be based on the model proposed by the
Contracting Authority.
4. My organisation will not apply for more than one project under the LIFE 2020 Preparatory Action
Projects for NGOs call for proposals.
I am legally authorised to sign this statement on behalf of my organisation.

I have read in full the Model LIFE Grant Agreement with Special and General Conditions and the Financial
Guidelines (provided with the LIFE application files).
I certify to the best of my knowledge that the statements made in this proposal are true and the
information provided is correct.
At ................................................. on.......................................................
Signature of the Coordinating Beneficiary:
Name(s) and status of signatory: .........................................................................................
6
A4 - CO-FINANCER PROFILE AND COMMITMENT FORM
(complete for each co-financer)
Legal Name and full address on the co-financer

Legal Name
Post Code Town/City
Member State
Financial commitment
We will contribute the following amount
to the project: ….. Euro
Status of the financial commitment
Comments
At ................................................. on........................................................
Signature of the Co-financer: ……………….
Name(s) and status of signatory: ……………….
YOU MAY DUPLICATE THIS PAGE
7
B1 - DESCRIPTION OF THE INTERVENTION
(max 1 page)
Please provide
o A description of the background situation and the relevant stakeholders
o An analysis of the existing needs
o The specific objectives of the intervention and how it will contribute to the objectives of the call for proposals
8
B2 – DETAILED DESCRIPTION OF THE WORK PACKAGES
(max 10 pages)
Each work package (WP) must have a reference and a name and full consistency must be ensured throughout the Application
Form. A maximum of 5 WP can be described.
Work Package 1: [Name, e.g. Awareness Campaign]
Duration: MX - MX
Activities & Means
1.1 [Activity Name]:
Description… (what, how, where, when and why?)
1.2 [Activity Name]:

Description… (what, how, where, when and why?)
Expected Results
 List the expected results providing quantitative and qualitative data and how they are going to be monitored.
Deliverables
 Deliverables are project outputs. Refer only to major outputs providing quantitative and qualitative data.


Milestones
 Milestones are control points in the project that help to chart progress. Use them only for major outputs.
Expected risks and constraints:
Continuation/valorisation of results:
To insert additional work packages, copy WP1.
9
B3 – Estimated total eligible costs per work package
(max 1 page per WP)
Means required (resources allocation must be explained and justified including estimated person/days needed for staff and experts) etc. Please ensure full coherence with the Financial
Forms.
Cost (€) Justification
Direct personnel costs calculated on the basis of unit

costs
Travel and subsistence costs
Durable goods
Other direct costs
Total direct costs
Indirect costs (standard flat rate of 7% of the total

eligible direct costs)
TOTAL COSTS (total direct costs + indirect costs)
To insert additional work packages, copy WP1.

10
B4 – TIMETABLE
(max 4 pages)
Fill in cells in grey to show the duration of all activities ordered by work package and using the number and name. Repeat lines/columns as necessary.
Note: Use the project month numbers instead of calendar months. Month 1 marks always the start of the project. In the timeline you should indicate the timing of each
main activity per WP.
MONTHS
ACTIVITY
M M M M M M M M M M M M M M M M M M M M M M M M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Activity 1.1 - …
Activity 1.2 - …
Activity …
Work Package 2: [Name]
Activity 2.1 - …
Activity 2.2 - …
Activity …
11

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LIFE 2020 Call for Proposals from NGOs on the European

Green Deal (NGO4GD)

A1 - GENERAL PROJECT INFORMATION................................................................3

A2 – COORDINATING BENEFICIARY PROFILE.......................................................4

A3 - COORDINATING BENEFICIARY DECLARATION.............................................6

A4 - CO-FINANCER PROFILE AND COMMITMENT FORM......................................7

B1 - DESCRIPTION OF THE INTERVENTION............................................................8

B2 – DETAILED DESCRIPTION OF THE WORK PACKAGES..................................9

B3 – ESTIMATED TOTAL ELIGIBLE COSTS PER WORK PACKAGE..................10

Name of the Beneficiary:

Project title (max. 200 characters):

Project acronym (max. 25 characters):

The project will be implemented in the following Country/ Regions:

Name of the Country: Name of the Region(s):

Expected start date: Expected end date:

PROJECT BUDGET AND REQUESTED EU FUNDING

Total project budget: €

COORDINATING BENEFICIARY Profile Information

Short Name Legal Status

VAT Reimbursement YES 󠅲☐ NO 󠅲☐

PIC Number (not

Coordinating Beneficiary contact person information

Surname First Name

Street Name and No PO Box

Post Code Town/City

Coordinating Beneficiary legal address and legal representative information

Surname First Name

Street Name and No PO Box

Website of the Coordinating Beneficiary

The undersigned hereby certifies that:

I am legally authorised to sign this statement on behalf of my organisation.

Signature of the Coordinating Beneficiary:

Name(s) and status of signatory: .........................................................................................

Legal Name and full address on the co-financer

Street Name and No PO Box

Post Code Town/City

Status of the financial commitment

Signature of the Co-financer: ……………….

Name(s) and status of signatory: ……………….

YOU MAY DUPLICATE THIS PAGE

Work Package 1: [Name, e.g. Awareness Campaign]

1.2 [Activity Name]:

To insert additional work packages, copy WP1.

Direct personnel costs calculated on the basis of unit

Travel and subsistence costs

Other direct costs

Total direct costs

Indirect costs (standard flat rate of 7% of the total

TOTAL COSTS (total direct costs + indirect costs)

To insert additional work packages, copy WP1.

Work Package 1: [Name, e.g. Awareness Campaign]

Work Package 2: [Name]

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