Rfa Exon Dairy

8/11/2019 Rfa Exon Dairy

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Agribusiness Support FundA Company Incorporated under Section 42 of Companies Ordinance 1984

1144-CCA, Block DD, Phase IV, D.H.A, Lahore. Phone: 042-35749081-3, 35899761-2

Fax: 042-35749084 www.asf.org.pk, Email: [email protected] 1OF 33

Dated: October 17, 2012

Jawad H. Shirazi

PartnerExon Dairy Farm

House # 20, Street # 6

Lane V, Cavalry Ext.

Lahore, Pakistan

Request for Application (RFA) # 007/12

Exon Dairy

Dear Sir,

This is with reference to Expression of Interest (EOI) submitted by Exon Dairy Farm in response

to Call for EOIs announced by ASF under USAIDs Agribusiness Project (UAP) dated May 20,2012. I am pleased to inform that your project namely Exon Dairyhas been shortlisted for the

next stage of grant cycle and you are hereby invited to submit a full grant application for the

aforementioned project. UAP plans to provide cost sharing grant amounting to PKR equivalent

of up to USD 25,000. The objective of this grant is modernization of existing dairy farm leading to

increased sales, employment generations, increase in household incomes.

Please note that following component(s) of your project will be supported by UAP under its

Grant Program and hence you are requested to kindly submit your grant application keeping

in view the below mentioned components of your project.

Bio Gas Plant

Silage Making Machine

Wanda Machine

IP based CCTV Camera with UPS

Plough & Rotavator

Solar Light with pole

Computer & Recording Software

Component(s) and associated costs other than the above, if any mentioned in your submitted

EOI, should not be included in the grant requestedfrom UAP, but mustappear in total project

budget to enable a complete view of the proposed project.

Please note that this RFA does not constitute a commitment on the part of ASF/UAP to obligate

monies, and that application preparation and submission are assumed by Exon Dairy Farm at its

own risks and costs. Also, ASF/UAP specifically notes that the execution of an award or the

obligation of monies is subject to the availability of funds. Specifically, no award or obligation

will be made until funds have been fully allocated and committed through ASF/UAPs internal

procedures for this specific project/activity.


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Request for Application No. 007/12 PAGE 2OF 33

Final decision on grant award will be made by the competent authority in accordance with

evaluation criteria provided in the attached RFA. . If your project is approved for a grant, UAP

will sign a grant agreement with you. The grant agreement will be negotiated, denominated

and funded in Pakistani Rupees. Payments will be made on a reimbursement basis in tranches

corresponding to achievement of mutually agreed upon milestones orin exceptional cases, on a

periodic advance and liquidation basis and/orin-kind support may be provided. The decision onabove mode of payments/ in-kind support/ type of grant agreement will be made by ASF/UAP

as part of an eventual analysis of your capability to manage grant funds. All costs funded by the

grant must be allowable, allocable and reasonable. A cost-sharing element (in an amount at

least equal to the funds provided by UAP) from you and/or an approved third party must be

contributed to the grant activity. See Annex F for cost share information. The Grant application

must be supported by a detailed and realistic budget as described in Annex B.

Please review the attached RFA and submit your complete application before November 17,

2012.

Please also note that ASF/UAP will not fund any projects or activities that are determined to

cause significant harm to the environment or increase tensions between ethnic or social groups

till proper mitigation measures are devised for such harms/ tensions and agreed between

ASF/UAP and the applicant.

In addition to the above, you must be willing to sign the following required certifications prior

to receiving a grant. UAP will provide the certifications once your proposal is approved for grant

funding.

Certification Regarding Terrorist Financing

Recipient Certificate of Compliance

Please submit your questions via email [email protected].

Sincerely,

________________________

Shad Mohammad

Chief of Party

USAIDs Agribusiness Project
mailto:[email protected]:[email protected]


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Annexes:

Annex A: Grant application form

Annex B: Budget forms

Annex C: Grant application preparation and submission guidelines

Annex D: Evaluation Criteria

Annex E: Certifications, Assurances, and Other Statements of ApplicantsAnnex F: Other Provisions/ Conditions

Annex G: Documents required with grant application; and

Annex H: Cost Share Guidelines/ Ineligible expenses


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Annex A: Grant application Form

[The UAP Team is available to answer any questions you may have and to assist you in

completing this grant application, if necessary.]

This application is in response to RFA No. 007/12titled Exon Dairy.

Section I (Basic Information)

1. Name of Applicant:

2. Legal status: (individual, partnership concern, limited company, association, sole

proprietor):

3. Date of Registration (required for all applicants other than individuals) :

4. Contact information:

Name of key contact person(s) and title:

Office address: Office phone:

Mobile: Fax:

E-mail: Website:

List the full names and titles of legal representative(s), owner(s), chief executive(s) and

key staff (president, directors, treasurer, etc), as applicable.

Name Title

5. Describe your organization and its purpose:

Abbas Sajjad (Partner), Jawad H. Shirazi(Partner),Nadeem Ahmad Gillani (CEO)

House # 2o, Street # 6, Lane V, Cavalry Ext. Lahore. 042-36675631

0300-8446659; 0300-8211676

[email protected]; [email protected]

Nadeem Ahmad Gillani CEO

Exon Dairy

Partnership


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Section II (Project Description).

6. Title of proposed activity:

7. Objective of proposed activity:

8. Background: What is the issue or problem that your activity will address? Why is it critical to

address this issue?

9. Describe your activity in detail (or attach a project description):

10.Please list the results to be achieved and the indicators you will use to measure success. In

addition to quantitative indicators, you may also suggest others ways to measure success or

impact.

11.Describe your method for selecting participants and beneficiaries. Mainly how you expect to

target women, by increasing employment opportunities and entrepreneurship.

12.Anticipated duration of proposed activity:

Overall length (total number of months)

Start and end date (day, month, and year)

EXON Dairy is located in District Sahiwal just around 10 kilometers away from the main city. The project started in2009 and its current herd size comprises of 100 cross breed animals all locally procured with 50% productive heads.From the inception it sells all the milk produced to the Nestle Pakistan Ltd. The project has gone through a learningcurve of three eventful years of dairy farming experience and the first breed of heifers is now calving on the farm.

Exon Dairy

and to create awareness and promote standard practices of dairy farming through a profitable commercial venture, and thus contribute the national economy. 3.To run Exon Dairy as a model hi-tech dairy farm to promote dairy farming among the farmers of adjoining area and to create awareness of use of latest dairymanagement practices such as mechanized milking, Silage Fodders, artificial inseminations techniques, computerized record maintenance, Bio Gas, Solar energypurpose built housing for cow comfort etc.

Efficiency improvement & Cost reduction by adding proposed machinery and equipment. Detailsattached

Installation of farm machinery for efficiency improvement, computerized data recording. Development ofBio Gas Plant for energy cost reduction and assurance of smooth supply of electricity.

1. Per unit cost reduction; 2. Milk Production improvement (liters per cow) 3.ROA & ROIImprovement

1. Farmers in the vicinity will be benefitted by buying Wanda from the Exon set up of commercial production of Wanda. 2. In Future the training centre will be set upfrom which the local farmers will benefit out of the trainings. 3. The Bio gas sourced tube well will be able to irrigate surrounding farmers lands. 4. The workershouseholds adjacent to the farm will benefit from the bio gas for their cooking needs. 5. The silage making machine will be rented to the surrounding dairy farmers.6.Women belonging to the worker families will have equal opportunity to join the expanded operations of the farm.

3 months

January 1 - March 31,2013

1. To strengthen the capacity of smallholders by sharing best practices and providing assistance tosmallholders operate autonomously and efficiently. 2. To create employment in the farming sector


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Section III (Project Implementation Plan)

13.Implementation plan: Main tasks, with estimated start and end dates for each task. Please

include all events, trainings, publications, etc.

Description of Main Tasks Name(s) of staff

responsible

Start Date End Date

Task 1:

Task 2:

Task 3:

Task 4:

Task 5:

Task 6:

Task 7, etc: (please add rows as needed)

14.Location(s) of the activity (add more rows as needed).

# Union Council Tehsil District Province

1

Section IV (Experience and Capacity)

15.List personnel who will be involved in implementing this project (CVs are required of all key

project personnel):

16.If available, please attach an organization chart, organizational profile, audited financial

statements, annual reports or any other relevant documentation.

Development of Bio Gas Plant

Procurement of Silage Making Machine, WandaMachineIP based CCTV Camera with UPS Plough& Rotavator

Installation of Solar Light with pole & Energyefficient tubewell pump

Implementation of Computer & Recording Software

Nadeem Ahmad Gillani




Jan 1, 2013

Jan 1, 2013

Jan 1, 2013

Jan 1, 2013

March 31, 2013

March 31, 2013

March 31, 2013

March 31, 2013

Sahiwal Sahiwal Sahiwal Punjab

Abbas Sajjad; Jawad H. Shirazi; Nadeem Ahmad Gillani (CVs provided in EOI attached,

refer Section No. 3(e)

(Attached)


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17.Mention and provide relevant documentation of any similar or any other relevant projects.

(Project Location, Nature, Value and Present Status)

18.Three references including complete contact information (existing or previous clients,

donors or vendors)

Section V (Cost)

19.Estimated cost in Pakistani Rupees per the attached budget:

Amount requested from UAP: PKR_________________

In-kind and/or other contribution from your organization: PKR _________________

Other donor(s) or third-party resources: PKR _________________

Total Estimated Cost PKR _________________

By affixing my signature below, I certify that to the best of my knowledge, the information

provided in this application is accurate and correct:

Submitted by (name and title): _________________________________________

Signature: __________________________Date: __________________________

N/A

Nestle Pakistan Limited

2,520,000/-

119,013,515/-

0/-

121,533,515/-

Abbas Sajjad (Partner)

November 16, 2012


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Annex B: BUDGET FORMS

2.1 Purpose

These forms, when properly completed, reviewed, and approved, serve as the mutually agreed-

upon roadmap for activity financial management. All activity costs must be identified. Costdata must be accurate; proposed amounts should not be unrealistically high or low. To be

successful, a grant activity must be adequately fundednot over-funded or under-funded.

2.2. Instructions

Budget Form

Salaries & WagesSalary or any other forms of direct payment of grant funds to anyApplicant employee (or consultant) who is directly engaged with the grant activityimplementation plan.

Operational Expenses - Other Direct Costs, this covers non-personnel-related costsallocated to implementation of the grant activity (e.g. supplies, Applicant office rent,utilities, etc.).

Consultation CostConsultation charges and other related costs.

Activity Service DeliveryExamples would be the rental of a training facility, or printingof training documents.

TransportationTransportation costs of activity equipment & consumables

Equipment & Consumables - Equipments & consumables purchased specifically for theproposed grant activity; must adhere to USAID local procurement regulations.

Contingencies: Other unforeseen costs necessary for successful completion of theproject , for example, rental of a training facility, or printing of training documents forenhancing staff efficiency/ develop capacity..

Monthly Budget Breakout Form

The monthly budget breakout form contains the same budget information broken out in the

anticipated monthly expenditures. This form helps in projecting cash flow needs.

All proposed grant activity costs must be within the normal operating practices of the Applicant

and in accordance with its (preferably written) policies and procedures.

All line items must be supported by budget notes with enough detail to permit a determination

that the cost is allowable, allocable and reasonable. The budget notes must provide the

reference specifications of items (model, make, capacity etc.) to be purchased under the grant.

Budgeted amounts must also be supported by documented evidence, and the Applicant must

be able to provide such backup to UAP if requested.


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BUDGET FORM

Applicant Name: ________________________________________________

Activity Title: ___________________________________________________

Budget Template

Activity Unit CostUnit

No.

Total

Estimated

Cost

Funds

requested from

UAP

Applicant

Cost Share

Salaries & Wages

Personnel

directly

engaged with

the grant

activity

implementation

plan.

Operational Expenses

Project relatedsupplies

Non-personnel

related costs

allocated to

implementation

of grant activity

Office Rent

Utilities

Fuel

Communication

Travelling Cost

Etc.

Office Equipment

& Supplies


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Consultation Cost

Consultant 1

Consultant 2

Transportation Cost

Machinery

transportation Transportation

costs of activity

equipment &

consumables

Material

transportation cost

Etc.

Equipment & Consumables

Equipments &

consumables

purchased

specifically for

the proposedgrant activity

Contingencies (if

any)

Total

Note:

- Budget notes are required for each line item in sufficient detail to facilitate a complete cost

allowability determination.


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[Provide monthly break-up (for each year) on format provided below.]

Monthly Budget Breakout Form

Applicant Name:_______________________________________________

Activity Title:____________________________________________________

Cash Flow Template

Description

Year 1

1st Quarter

2nd

Quarter

3rd

Quarter 4th Quarter Total

Balance b/f

Cash Outflows

Investment by Applicant

Salaries & Wages

Operational Expenses

Office Equipment & Supplies

Consultation Cost

Transportation Cost

Equipment & Consumables

Contingencies (if needed)

Cash Inflows

Product Sales


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UAP Grant

Balance c/f

Product Total

Sales (kg)

Rate

Sales Value (Rs)

Note:

- Each line item mentioned in the cash flow has to be in line with the items mentioned in budget.

- Incase of multiple products, kindly provide separate sales figures.

- Cash flows have to be provided as per project duration.

I certify that to the best of my knowledge and belief the above cost and sales data is accurate,

complete, current, and allowable:

Applicant Signature __________________________________

Date ______________________________________________November 16, 2012


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Annex C: Grant Application preparation and submission guidelines

The applicant must submit its grant application as per the format given in annex A

The application must be received at ASF office in hard copy along with all required

documents by the closing date and time indicated in the cover letter of this RFA. The name

and address of the applicant and the RFA number must be mentioned on the envelope andsent to:

Agribusiness Support Fund

144 CCA, Sector DD

Phase IV, DHA

Lahore

Phone: 042-35749081-3, 35899761-2

The applicant should also submit an electronic softcopy of the application via email with the

name and address of the applicant and the RFA number in subject line to

[email protected] (Syed Muslim Raza, Manager Grants and Contracts, Tel: 042-

35899762, 042-35749081-2).

The receipt of the application will be confirmed within three days.

The total size of each e-mail attachment should not exceed 3 MBs. Every page of the

application must be numbered. The application must have a table of contents. Large graphics

files are discouraged. Attached file format must be Microsoft (2007 - 2010 version) Word,

Excel or PDF.
mailto:[email protected]:[email protected]


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Annex D: Evaluation criteria:

EVALUATION CRITERIA

All applications will be evaluated using the evaluation criteria provided ahead. Applications

falling short of any of the following mandatory requirements will be rejected without being

considered for further evaluation.

--------------------------------------------------------------------------------------------

MANDATORY REQUIREMENTS

1. The purpose of the activity (ies) specified in the Application must be consistent with

UAP objectives (e.g., the proposed activity (ies) must contribute to increased sales /

employment generations / increase in household income / and growth in selected

industries/clusters, where possible segregated by Gender).

2. The results to be achieved must be linked to the grant objective as mentioned in the

cover letter.3. The verifiable indicators of achievement must be linked to the grant objectives.

4. The Grantee must contribute to the overall activity (ies) cost in-cash or in-kind.

5. The Grantee must be willing to comply with UAP/USAID environmental policy (in

accordance with 22 CFR 216).

Applications fulfilling the mandatory requirements will be evaluated against the criteria in the

table below:

Evaluation Category Maximum Points

Technical Approach

Innovation / value addition

Feasibility of design

Sustainability/financial self-reliance

10

10

10

Impact on target group

Job Creation

Increase in Income

Gender Awareness

Underserved Area (Project location)

10

10

10

10

Management & Programmatic Capacity

Personnel and team composition

Capability and Past Performance

10

10

Cost Share 10

Total Score 100


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A description of the above categories is as follows:

Technical Approach:

Innovation / value addition:The project focuses on new and innovative ideas / products /

services which can add value to the existing process or system

Feasibility of design. The proposed methodology reflects an understanding of the RFAs

program description and ASF/UAP scope of work. The designed interventions are appropriate

and the deliverable/milestones are concrete and achievable. The implementation plan

includes tasks/activities that are clearly described and organized in a sequential and logical

order; the proposed timelines allow for the maximization of resources and time, and they areclearly assigned to personnel.

Sustainability/financial self-reliance. The extent to which the funded activity will result in

building and strengthening the capacity of the local organizations, and whether the activity

itself is sustainable or will stimulate sustainability of the organization. If cost share is

requested in the RFA, add the following: The proposed cost share elements are relevant to the

objectives of the program and demonstrate the organizations commitment in investing

resources in the program. The application includes a logical and feasible proposal how the

cost share commitments will be met. If applicable, the strategy for collecting counterpart

contributions is feasible. If program income is expected: The proposal for collecting program

income is efficient and realistic. The plan for use of program income is well thought out and in

accordance with the Mandatory as Applicable Standard Provision No 23.

Impact on target group:

The application clearly demonstrates awareness about gender issues. The proposed approach

and indicators for measuring impact women employment and entrepreneurship are well

thought-out and will bring the expected results to the project. The extent to which the

proposed activity corresponds to the needs of target group(s) and will directly benefit them.

Also, the degree to which it will directly or indirectly stimulate other organizations and

resources to develop or implement activities supporting the objectives of the project. Project

will create some new jobs / will improve the skills of existing employees. Project will increase

the current household income of beneficiaries. Applicants are highly encouraged to come up

with projects that can benefit the underdeveloped areas of Pakistan.

Budget

Reasonableness, allowability and realism.

Cost efficiency

Remarks of Members of the

committee evaluating the

proposal.


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Management and programmatic capacity.

Personnel and Team composition: The proposed staff has the technical, managerial and

personal qualifications to adequately perform the role/tasks they have been assigned. The

assignment of tasks in the implementation plan and the proposed team configuration includes

an appropriate mix of experience and technical capabilities to maximize resources and meet

deadlines.

Capability and Past Performance.There is evidence that the organization has the capability to

undertake and accomplish the proposed activities. Appraisal will be based principally on at

least three reference checks done by the GEC; the background, qualifications, reputation,

appropriateness and skills of its key personnel; and the track record, reputation, and

achievements (including development of self-sufficient, sustainable activities) of the

organization involved.

Budget:

ASF/UAP will not assign a score to the budget because the technical merit of the applications

is more important than the proposed cost of the activity. However, ASF/UAP will not select an

application for award on the basis of a superior technical proposal without considering

cost. The budget will be evaluated on the basis of cost reasonableness, allowability, and

realism. Cost realism will be based on considerations such as the following:

- Are proposed costs realistic for the work to be performed (not to high and not too

low)?

- Do the costs reflect a clear understanding of RFA requirements?

- Are the costs consistent with the various elements of the application meaning thatcosts are linked to activities proposed?

The evaluation will also measure degree to which budgeting is clear and reasonable, reflects

best use of organizational and ASF/UAPs grant resourcesand provides reasonable cost share

consistent with the nature of the proposed activity and the applicants abilityto contribute.


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Annex E: Certifications, Assurances, and Other Statements of Applicants

[To be submitted as part of an Applicants application. To be signed by an authorized agent of

the applicant at the end of this Section]

PART I - CERTIFICATIONS AND ASSURANCES

1. ASSURANCE OF COMPLIANCE WITH LAWS AND REGULATIONS GOVERNING NON-

DISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS

(a) The recipient hereby assures that no person in the United States shall, on the bases set

forth below, be excluded from participation in, be denied the benefits of, or be otherwise

subjected to discrimination under, any program or activity receiving financial assistance from

USAID, and that with respect to the grant for which application is being made, it will comply

with the requirements of:

1. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which

prohibits discrimination on the basis of race, color or national origin, in programs and

activities receiving Federal financial assistance;

2. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits

discrimination on the basis of handicap in programs and activities receiving Federal financial

assistance;

3. Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits

discrimination based on age in the delivery of services and benefits supported with Federal

funds;

4. Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits

discrimination on the basis of sex in education programs and activities receiving Federal

financial assistance (whether or not the programs or activities are offered or sponsored by an

educational institution); and

5. USAID regulations implementing the above nondiscrimination laws, set forth in

Chapter II of Title 22 of the Code of Federal Regulations.

(b) If the recipient is an institution of higher education, the Assurances given herein extend to

admission practices and to all other practices relating to the treatment of students or clients

of the institution, or relating to the opportunity to participate in the provision of services or

other benefits to such individuals, and shall be applicable to the entire institution unless the

recipient establishes to the satisfaction of the USAID Administrator that the institution's

practices in designated parts or programs of the institution will in no way affect its practices in

the program of the institution for which financial assistance is sought, or the beneficiaries of,

or participants in, such programs.


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(c) This assurance is given in consideration of and for the purpose of obtaining any and all

Federal grants, loans, contracts, property, discounts, or other Federal financial assistance

extended after the date hereof to the recipient by the Agency, including installment payments

after such date on account of applications for Federal financial assistance which were

approved before such date. The recipient recognizes and agrees that such Federal financial

assistance will be extended in reliance on the representations and agreements made in this

Assurance, and that the United States shall have the right to seek judicial enforcement of this

Assurance. This Assurance is binding on the recipient, its successors, transferees, and

assignees, and the person or persons whose signatures appear below are authorized to sign

this Assurance on behalf of the recipient.

2. CERTIFICATION REGARDING LOBBYING

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the

undersigned, to any person for influencing or attempting to influence an officer or employee

of any agency, a Member of Congress, an officer or employee of Congress, or an employee of

a Member of Congress in connection with the awarding of any Federal contract, the making of

any Federal grant, the making of any Federal loan, the entering into of any cooperative

agreement, and the extension, continuation, renewal, amendment or modification of any

Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to

any person for influencing or attempting to influence an officer or employee of any agency, a

Member of Congress, an officer or employee of Congress, or an employee of a Member ofCongress in connection with this Federal contract, grant, loan, or cooperative agreement, the

undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying

Activities," in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the

award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and

contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall

certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when thistransaction was made or entered into. Submission of this certification is a prerequisite for

making or entering into this transaction imposed by section 1352, title 31, United States Code.

Any person who fails to file the required certification shall be subject to a civil penalty of not

less than $10,000 and not more than $100,000 for each such failure.

Statement for Loan Guarantees and Loan Insurance


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The undersigned states, to the best of his or her knowledge and belief, that: If any funds have

been paid or will be paid to any person for influencing or attempting to influence an officer or

employee of any agency, a Member of Congress, an officer or employee of Congress, or an

employee of a Member of Congress in connection with this commitment providing for the

United States to insure or guarantee a loan, the undersigned shall complete and submit

Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

Submission of this statement is a prerequisite for making or entering into this transaction

imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required

statement shall be subject to a civil penalty of not less than $10,000 and not more than

$100,000 for each such failure.

3. PROHIBITION ON ASSISTANCE TO DRUG TRAFFICKERS FOR COVERED COUNTRIES

AND INDIVIDUALS (ADS 206)

USAID reserves the right to terminate this [Agreement/Contract], to demand a refund or take

other appropriate measures if the [Recipient/ Contractor] is found to have been convicted of anarcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140.

The undersigned shall review USAID ADS 206 to determine if any certifications are required

for Key Individuals or Covered Participants.

If there are COVERED PARTICIPANTS: USAID reserves the right to terminate assistance to, or

take or take other appropriate measures with respect to, any participant approved by USAID

who is found to have been convicted of a narcotics offense or to have been engaged in drug

trafficking as defined in 22 CFR Part 140.

Signature __________________________________________Date_______________

Name_____________________________________________

Organization________________________________________


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4. KEY INDIVIDUAL CERTIFICATION NARCOTICS OFFENSES AND DRUG TRAFFICKING

I hereby certify that within the last ten years:

1. I have not been convicted of a violation of, or a conspiracy to violate, any law or

regulation of the United States or any other country concerning narcotic or psychotropic

drugs or other controlled substances.

2. I am not and have not been an illicit trafficker in any such drug or controlled

substance.

3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with

others in the illicit trafficking in any such drug or substance.

Signature: ____________________________

Date: ____________________________

Name: ____________________________

Title/Position: ____________________________

Organization: ____________________________

Address: ____________________________

Date of Birth: ____________________________

NOTICE:

You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition

on Assistance to Drug Traffickers. These regulations were issued by the Department of State

and require that certain key individuals of organizations must sign this Certification.

If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C.

1001.

5. CERTIFICATION REGARDING TERRORIST FINANCING

By signing and submitting this application, the prospective recipient provides the certification

set out below:


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1. The Recipient, to the best of its current knowledge, did not provide, within the

previous ten years, and will take all reasonable steps to ensure that it does not and will not

knowingly provide, material support or resources to any individual or entity that commits,

attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed,

attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in

paragraph 3.

2. The following steps may enable the Recipient to comply with its obligations under

paragraph 1:

a) Before providing any material support or resources to an individual or entity, the

Recipient will verify that the individual or entity does not (i) appear on the master list of

Specially Designated Nationals and Blocked Persons, which list is maintained by the U.S.

Treasurys Office of Foreign Assets Control (OFAC) and is available online at OFACs website:

http://www.treas.gov/offices/eotffc/ofac/sdn/t11sdn.pdf, or (ii) is not included in any

supplementary information concerning prohibited individuals or entities that may be providedby USAID to the Recipient.

b) Before providing any material support or resources to an individual or entity, the

Recipient also will verify that the individual or entity has not been designated by the United

Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999)

(the 1267 Committee) *individuals and entities linked to the Taliban, Usama bin Laden, or

the Al Qaida Organization]. To determine whether there has been a published designation of

an individual or entity by the 1267 Committee, the Recipient should refer to the consolidated

list available online at the Committees website:

http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm.

c) Before providing any material support or resources to an individual or entity, the

Recipient will consider all information about that individual or entity of which it is aware and

all public information that is reasonably available to it or of which it should be aware.

d) The Recipient also will implement reasonable monitoring and oversight procedures to

safeguard against assistance being diverted to support terrorist activity.

3. For purposes of this Certification-

a. Material support and resources means currency or monetary instruments or financial

securities, financial services, lodging, training, expert advice or assistance, safehouses, false

documentation or identification, communications equipment, facilities, weapons, lethal

substances, explosives, personnel, transportation, and other physical assets, except medicine

or religious materials.

b. Terrorist act means


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i. An act prohibited pursuant to one of the 12 United Nations Conventions and Protocols

related to terrorism (see UN terrorism conventions Internet site:

http://untreaty.un.org/English/Terrorism.asp); or

ii. An act of premeditated, politically motivated violence perpetrated against

noncombatant targets by subnational groups or clandestine agents; or

iii. Any other act intended to cause death or serious bodily injury to a civilian, or to any

other person not taking an active part in hostilities in a situation of armed conflict, when the

purpose of such act, by its nature or context, is to intimidate a population, or to compel a

government or an international organization to do or to abstain from doing any act.

c. Entity means a partnership, association, corporation, or other organization, group or

subgroup

d. References in this Certification to the provision of material support and resources shall not

be deemed to include the furnishing of USAID funds or USAID-financed commodities to theultimate beneficiaries of USAID assistance, such as recipients of food, medical care, micro-

enterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of

these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in

terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist

acts.

e. The Recipients obligations under paragraph 1 are not applicable to the procurement of

goods and/or services by the Recipient that are acquired in the ordinary course of business

through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the

Recipient has reason to believe that a vendor or supplier of such goods and services commits,

attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed,

attempted to commit, facilitated or participated in terrorist acts.

This Certification is an express term and condition of any agreement issued as a result of this

application, and any violation of it shall be grounds for unilateral termination of the

agreement by USAID prior to the end of its term.

Signed: ___________________________________

Name and Title: ____________________________

Name of Organization: _______________________

Date: _____________________________________


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6. SURVEY ON ENSURING EQUAL OPPORTUNITY FOR APPLICANTS

http://www.usaid.gov/forms/surveyeo.doc contains a survey on ensuring equal opportunity

for applicants. The applicants completion of the survey is voluntary. The absence of a

completed survey in an application may not be a basis upon which the application is

determined incomplete or non-responsive. Applicants who volunteer to complete and submit

the survey under a competitive or non-competitive action are instructed within the text of the

survey to submit it as part of the application process; applicants who chose to submit the

survey shall include it in the technical application in the annexes section.

PART II - OTHER STATEMENTS OF RECIPIENT

1. AUTHORIZED INDIVIDUALS

The recipient represents that the following persons are authorized to negotiate on its behalf

with the USAIDs Agribusiness Project and to bind the recipient in connection with this

application or grant:

Name Title Telephone No Facsimile No Email Address

2. TAXPAYER IDENTIFICATION NUMBER (TIN)

If the recipient is a U.S. organization, or a foreign organization which has income effectively

connected with the conduct of activities in the U.S. or has an office or a place of business or a

fiscal paying agent in the U.S., please indicate the recipient's TIN:

TIN: ________________________________

3. CONTRACTOR IDENTIFICATION NUMBER - DATA UNIVERSAL NUMBERING SYSTEM

(DUNS) NUMBER

(a) In the space provided at the end of this provision, the recipient should supply the Data

Universal Numbering System (DUNS) number applicable to that name and address. Recipients

should take care to report the number that identifies the recipient's name and address exactly

as stated in the proposal.

(b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the

recipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly

at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge

to the recipient. The recipient should be prepared to provide the following information:


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(1) Recipient's name

(2) Recipient's address.

(3) Recipient's telephone number.

(4) Line of business.

(5) Chief executive officer/key manager.

(6) Date the organization was started.

(7) Number of people employed by the recipient.

(8) Company affiliation.

(c) Recipients located outside the United States may obtain the location and phone number of

the local Dun and Bradstreet Information Services office from the Internet Home Page at

http://www.dbisna.com/dbis/customer/custlist.htm. If an offeror is unable to locate a local

service center, it may send an e-mail to Dun and Bradstreet at [email protected]. The

DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system.

DUNS: ________________________________________

4. LETTER OF CREDIT (LC) NUMBER

If the recipient has an existing Letter of Credit (LOC) with USAID or another US federal agency,

please indicate the LOC number:

LOC: _________________________________________

5. TYPE OF ORGANIZATION

The recipient, by checking the applicable box, represents that -

a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the

laws of the State of _____________________________________________, [ ] an individual [ ]

a partnership, [ ] a non-governmental nonprofit organization, [ ] a state or local governmental

organization, [ ] a private college or university, [ ] a public college or university, [ ] an

international organization, or [ ] a joint venture; or


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b) If the recipient is a U.S. entity, it [ ] is, [ ] is not a Gray Amendment entity, as defined

below.

c) If the recipient is a Gray Amendment Entity, it is [ ] a business concerns (as defined in

48 CFR 19.001) owned and controlled by socially and economically disadvantaged individuals

(as defined in 48 CFR 726.101), [ ] an institution designated by the Secretary of Education,

pursuant to 34 CFR 608.2, as a historically black college or university (HBCU) , [ ] a college or

university having a student body in which more than 40% of the students are Hispanic

American, or [ ] a private voluntary organization which is controlled by individuals who are

socially and economically disadvantaged (as defined in 48 CFR 726.101).

d) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the

laws of ________________________________________________________ (country), [ ] an

individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a

nongovernmental educational institution, [ ] a governmental organization, [ ] an international

organization, or [ ] a joint venture.

6. CERTIFICATION OF RECIPIENT

The potential grantee certifies that it agrees to comply with all ASF/ UAP and USAIDs rules

and regulations applicable to any potential grant agreement.

Solicitation (RFA) No. ___________________________________________________

Application No. _______________________________________________________

Date of Application ____________________________________________________

Name and Title of Potential grantee _______________________________________

Signature _________________________________________ Date ________________


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Annex F: Other Provisions

Part IStandard Provisions

Standard Provisions for Non-US Non-governmental Recipients are found at

http://www.usaid.gov/policy/ads/300/303mab.pdf

Part IISpecial Provisions

1. Value Added Tax (Vat) and Custom Duties

Pursuant to agreements with the Government of Pakistan (GOP), all imports and expenditures

under this award by the Grantee/Recipient and by non-local sub-grantees and subcontractors

(as defined below) will be exempt from Value-Added Tax (VAT) and customs duties imposed

by the GOP. Therefore, in accordance with paragraph 51 of OMB Circular No. A-122,

Attachment B, such VAT and customs duties shall not constitute allowable costs under this

award.

The Recipient and any non-local sub-grantees or subcontractors shall make reasonable efforts

to avoid Pakistani VAT at the point of sale by obtaining 0% VAT exemption. UAP and USAID

will assist the Recipient to obtain zero percent (0%) VAT status from the GOP. The Recipient

shall use this exemption to avoid paying any GOP VAT to local subcontractors and vendors by

obtaining approval from the GOP VAT Department for suppliers to issue 0% VAT invoices.

In cases where VAT cannot be avoided, the Recipient shall obtain original VAT receipts from

the vendors. Receipts must be submitted to UAP. UAP will submit those receipts to USAIDs

Financial Management Office on a monthly basis to enable USAID to process refund claimswith VAT authorities. The Grantee/Recipient is responsible for ensuring that sub-grantees or

subcontractors comply with this requirement.

All VAT claims for the sub-grantees and subcontractors shall be submitted to USAID through

UAP. Receipts for sub-grantees and subcontractors must be addressed to the project name /

name of the Grantee/Recipient to enable USAID to claim refunds.

Recipients that already have exemption mechanisms in place with the GOP should continue to

follow those procedures. Any refund of taxes received directly by the Recipient which were

allowed as award costs, should be credited either as a cost reduction or cash refund, asappropriate, to USAID.

"Non-local sub-grantees and subcontractors" means sub-grantees and subcontractors that are

present in Pakistan solely for the purpose of performing work financed by USAID or other tax-

exempt foreign donors.
http://www.usaid.gov/policy/ads/300/303mab.pdfhttp://www.usaid.gov/policy/ads/300/303mab.pdf


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2. Reporting Of Foreign Taxes

(a) The awardee must annually submit one report by April 6 of the next year. The reporting

period will cover from October 1 to September 30.

(b) Contents of Report. The reports must contain:

(i) Applicant name.

(ii) Contact name with phone, fax and email.

(iii) Award number(s); separate report needs to be provided for each award.

(iv) Amount of foreign taxes assessed by the GOP on commodity purchase transactions valued

at $500 or more financed with U.S. foreign assistance funds under this agreement during the

prior U.S. fiscal year.

(v) Only foreign taxes assessed by the foreign government in the country receiving U.S.assistance are to be reported. Foreign taxes by a third party foreign government are not to be

reported.

(vi) Any reimbursements on the taxes reported in (iv) received by the recipient through March

31. Any refund from the GOP that is received directly by the awardee should be reflected. For

refunds processed by USAID, we will fill in the VAT refunded amount. If a VAT refund receipt

was provided to USAID for refund processing the awardee will need to provide the month

under which the claim was submitted to USAID and the serial number of the invoice as

included in the claim.

(vii) Reports are required even if the contractor/recipient did not pay any taxes during the

report period.

(viii) Cumulative reports may be provided if the contractor/recipient is implementing more

than one program in a foreign country.

(c) Definitions. For purposes of this clause:

(i) Agreement includes USAID direct and country contracts, grants, cooperat ive agreements

and interagency agreements.

(ii) Commodity means any material, article, supply, goods, or equipment.

(iii) Foreign government includes only a GOP entity.

(iv) Foreign taxes means value-added taxes and custom duties assessed by a foreign

government on a commodity. It does not include foreign sales taxes.


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(d) Where. Submit the reports in Email attachment to:

[email protected]

(e) Sub-agreements. The awardee must include this reporting requirement in all applicable

subcontracts, sub-grants and other sub-agreements.

3. USAID Disability Policy - Assistance (December 2004)

(a) The objectives of the USAID Disability Policy are (1) to enhance the attainment of United

States foreign assistance program goals by promoting the participation and equalization of

opportunities of individuals with disabilities in USAID policy, country and sector strategies,

activity designs and implementation; (2) to increase awareness of issues of people with

disabilities both within USAID programs and in host countries; (3) to engage other U.S.

government agencies, host country counterparts, governments, implementing organizations

and other donors in fostering a climate of nondiscrimination against people with disabilities;

and (4) to support international advocacy for people with disabilities. The full text of thepolicy paper can be found at the following website:

http://www.usaid.gov/about_usaid/disability/.

(b) USAID therefore requires that the applicant not discriminate against people with

disabilities in the implementation of USAID funded programs and that it make every effort to

comply with the objectives of the USAID Disability Policy in performing the program under this

Sub-agreement. To that end and to the extent it can accomplish this goal within the scope of

the program objectives, the applicant should demonstrate a comprehensive and consistent

approach for including men, women and children with disabilities.

4. Implementation Of E.O. 13224 Executive Order On Terrorist Financing (March

2002)

The Applicant is reminded that U.S. Executive Orders and U.S. law prohibits transactions with,

and the provision of resources and support to, individuals and organizations associated with

terrorism. It is the legal responsibility of the applicant to ensure compliance with these

Executive Orders and laws. This provision must be included in all subcontracts/sub-awards

issued under this contract/agreement.


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Annex G: Documents required with grant application

Partnership / Sole Proprietorship

Copies of CNICs of all partners/proprietor

Bank statement (last six months)

Copy of NTN / Last filed Tax Return

List of major Customers / Suppliers (with

contacts)

Audited Financials (last 3 years)

Copies of Title Document/ Rent agreement

& utility bills of office premises

Ownership/ Lease documents for piece of

land where the project/activity will be

established

Letter(s) of commitment for matching the

funds (cost share) in cash or in-kind overthe life of grant from applicant or third

party duly signed by the Authorized

Organizational Representative stating the

exact amount of the matching funds or

value of the in-kind support that will be

contributed

Letter authorizing ASF/UAP to approach

applicants bank for information

Letter of proprietorship from bank (for

sole proprietorship) Copies of other Registration certificates, if

any (Sales Tax, Chamber Registration etc.)

Partnership Deed (for partnership)

Form C(if registered firm)

Any other information / document that

ASF/UAP may demand at any time


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Annex H: Cost sharing guidelines

ASF, pursuant to its Cooperative Agreement No. AID-391-A-12-00001 signed with USAID-

PAKISTAN, requires that in order to receive a grant, the grantee must provide a match in the

form of cash or in-kind contributions in an amount at least equal to the funds provided byUAP.

(A)All contributions, including cash and third party in-kind, shall be accepted as part of the

recipient's cost sharing or matching when such contributions meet allof the following criteria.

(1) Are verifiable from the recipient's records.

(2) Are not included as contributions for any other USAIDs assisted project or program.

(3) Are necessary and reasonable for proper and efficient accomplishment of project or

program objectives.

(4) Are allowable under the applicable cost principles.

(5) Are not paid by USAID-PAKISTAN under another award, except where authorized by US

Federal statute to be used for cost sharing or matching.

(6) Are provided for in the approved budget.

(7) Conform to other provisions of this part, as applicable.

(B) Values for recipient contributions of services and property shall be established in

accordance with the applicable cost principles. If USAID authorizes recipients todonate

buildings or landfor construction/facilities acquisition projects or long-term use, the value of

the donated property for cost sharing or matching shall be the lesser of:

(1) The certified value of the remaining life of the property recorded in the recipient's

accounting records at the time of donation, or

(2) The current fair market value. However, when there is sufficient justification, the USAID

Agreement Officer may approve the use of the current fair market value of the donated

property, even if it exceeds the certified value at the time of donation to the project.

(C) Volunteer services furnished by professional and technical personnel, consultants, and

other skilled and unskilled labor may be counted as cost sharing or matching if the service is


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an integral and necessary part of an approved project or program. Rates for volunteer services

shall be consistent with those paid for similar work in the recipient's organizations. In those

instances in which the required skills are not found in the recipient organization, rates shall be

consistent with those paid for similar work in the labor market in which the recipient

competes for the kind of services involved. In either case, paid fringe benefits that are

reasonable, allowable, and allocable may be included in the valuation.

(D)When an employer other than the recipient furnishes the services of an employee, these

services shall be valued at the employee's regular rate of pay (plus an amount of fringe

benefits that are reasonable, allowable, and allocable, but exclusive of overhead costs),

provided these services are in the same skill for which the employee is normally paid.

(E)Donated supplies may include such items as expendable equipment, office supplies,

laboratory supplies or workshop and classroom supplies. Value assessed to donated supplies

included in the cost sharing or matching share shall be reasonable and shall not exceed the

fair market value of the property at the time of the donation.

(F)The method used for determining cost sharing or matching for donated equipment,

buildings and landfor which title passes to the recipient may differ according to the purpose

of the award, if:

(1) If the purpose of the award is to assist the recipient in the acquisition of equipment,

buildings or land, the total value of the donated property may be claimed as cost sharing or

matching, or

(2) If the purpose of the award is to support activities that require the use of equipment,

buildings or land, normally only depreciation or use charges for equipment and buildings may

be made. However, the full value of equipment or other capital assets and fair rental charges

for land may be allowed, provided that the USAID Agreement Officer has approved the

charges.

(G)The value of donated property shall be determined in accordance with the usual

accounting policies of the recipient, with the following qualifications.

(1) The value of donated land and buildings shall not exceed its fair market value at the time

of donation to the recipient as established by an independent appraiser (e.g., certified real

property appraiser or General Services Administration representative) and certified by a

responsible official of the recipient.

(2) The value of donated equipment shall not exceed the fair market value of equipment of

the same age and condition at the time of donation.


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(3) The value of donated space shall not exceed the fair rental value of comparable space as

established by an independent appraisal of comparable space and facilities in a privately-

owned building in the same locality.

(4) The value of loaned equipment shall not exceed its fair rental value.

(i) The following requirements pertain to the recipient's supporting records for in-kind

contributions from third parties.

(1) Volunteer services shall be documented and, to the extent feasible, supported by the same

methods used by the recipient for its own employees,

(2) The basis for determining the valuation for personal services, material, equipment,

buildings and land shall be documented.

Non-auditable contributionsmay not be used to meet the minimum cost sharing or matching,

but can be indicated separately and attached to the budget detail form. A grant will not be

issued unless all matching funds over the life of the grant are secured with letters of

commitment. For third party cash or in-kind support, letters of commitment must be

submitted on donor organization letterhead, must include the signature of the Authorized

Organizational Representative (AOR), and must state the exact amount of the matching funds

or value of the in-kind support that will be contributed. There can be no stipulationson the

matching amount.


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INELIGIBLE EXPENSES

UAP grant funds may not be utilized for the following:

Profit

Military equipment

Surveillance equipment

Commodities and services for support of police and other law enforcement activities

Abortion equipment and services

Luxury goods and gambling equipment

Weather modification equipment

Private ceremonies, parties, celebrations, or "representation" expenses

(entertainment costs)

Purchases of restricted goods, such as agricultural commodities, motor vehicles,

pharmaceuticals, contraceptive products, pesticides, used equipment and fertilizers

without USAIDs AO approval.

Purchases of goods or services from countries1or suppliers as may be identified by

USAID's consolidated list of debarred, suspended, or ineligible subcontractors at

http://www.epls.gov/ or the United Nations Security (UNSC) sanctions committee

established under UNSC Resolution

(http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm)

Prior obligations of and/or, debts, fines, and penalties imposed on the Grantee.

Grant or sub-grant assistance to the Government of Pakistan, including federal,

provincial, divisional, district, and other local government units without a Mission

director deviation from ADS 303.

Alcoholic beverages

Purchases or activities unnecessary to accomplish grant purposes as determined bythe UAP.

1 As of March 2011 the foreign restricted countries are: Cuba Iraq Iran Laos Libya North Korea and Syria