BACID Fund for Know-How Transfer Actions

financed by the Austrian Development Agency

APPLICATION FORM

Application Number Project Number

Submission Date TO BE FILLED IN BY KDZ! Approval Date

Please fill in the Application Form electronically and submit it to bacid@kdz.or.at not later than 21st of April 2017.
If you need clarification or assistance during application process, please write to us at bacid@kdz.or.at or call at 01 / 89 234 92 -37.
Please consult the Guidelines for applicants before starting to prepare your application.
Please fill in only the fields marked in orange and replace explanatory text in brackets <> or [].
Before submitting the application, please check if Your application is complete by answering to the questions below:
1. You have completed the sheet Presentation of the Action of this file.
2. You have completed the sheet Action Budget of this file.
3. You and Your partners have completed and signed the Partnership Agreement Template, and
scanned it in order to submit it with the Application.
4. You have checked that Your organisation is fulfilling the eligibility criteria set out in the
Section 4.1.1 of the Guidelines for Applicants.
5. You have checked that Your partners and beneficiaries are fulfilling the eligibility criteria set
out in the Section 4.1.2 of the Guidelines for Applicants.
6. Your Action is taking place at the location specified in the Section 4.2.2 of the Guidelines for
Applicants.
7. The value of the grant requested is less/equal to 6.000 euro.
8. If needed for successful implementation of the Action, You and Your partners have ensured
own contribution.
9. CVs of ALL Experts to participate in the Action are enclosed to the Application.
10. You have read the Grant Contract Template and acknowledged it.
 Presentation of the Action and Implementation Report
Project Number* 0
* To be filled in by Contracting Authority.

1. Project Titile
2. Applicant Organisation
Legal status
Date and place of registration
Name of Contact person <Title Name Surname>
Address <street and number, city, country>
Phone
Email

3. Applicant's Experience relevant to the Action [Please describe briefly Your professional experience relevant to the topic of the Action.]
4.a Partner from beneficiary country* - 1 4.a Partner from beneficiary country* - 2
Beneficiary Country Beneficiary Country
Organisation Organisation
Legal status Legal status
Name of Contact person <Title Name Surname> Name of Contact person <Title Name Surname>
Address Address
Phone Phone
Email Email

4.b Partner 1 Experience relevant to the Action [Please describe briefly Your professional experience relevant 4.b Partner 2 Experience relevant to the Action [Please describe briefly Your professional experience relevant
to the topic of the Action.] to the topic of the Action.]
* Please copy these fields if more partners are involved in the Action and enter the data on each partner separately.

4.c. Expert Name Expert Position / Task in the Action Engaged by (Applicant / Partner 1 / Partner 2 / ) Expert CV to be enclosed to the Application
1
2
3
4
* Please copy these fields if more experts are to participate in the Action.

5.a Priority Theme

5.b Priority Topic

6. Type of
activities

7. Location of the <Country/s, Region/s, Cities/Municipalities>

Action

8. The action is in line with strategic guidelines defined at:

8.a Regional level [If applicable, list relevant regional strategies such as Danube strategy, SEE 2020, etc]

8.b National level [List national strategic documents that Action is in line with.]

8.c Local level [List local strategic documents that Action is in line with.]

9.a Target groups [Please list the groups that will be involved 9.b Number of [Please give the number (precise or 6.a Target groups [Please list the groups that WERE 6.b Number of [Please give the number of how many
in the activities on behalf of the partner beneficiaries approximate) of how many people from involved in the activities on behalf of beneficiaries people from beneficiary countries HAD
institutions] beneficiary countries will have direct the partner institutions] direct benefit from the Action]
benefit from the Action]

10. Synergies with [Please list any other Actions in the field implemented in the country and/or local level] 7. Synergies [Please list any synergies made with other Actions in the field implemented in the country and/or local
other Action made during level]
Action

BACID Fund for Know-How Transfer Actions: Building Administrative Capacities in the Danube Region and Western Balkans
11. Replication of [How will the results be disseminated and possibly replicated to other potential beneficiaries?] 8. Replication of [How WERE the results disseminated and replicated to other potential beneficiaries?]
results results

BACID Fund for Know-How Transfer Actions: Building Administrative Capacities in the Danube Region and Western Balkans
12. Objective of [Define objectives in 1 or few sentences] 9. Assessment of [Give a brief assessment on the results achieved]
the Action the objectives

13. Expected [What are the expected results of the Action? Present results in bullets.] 10. Results [What results WERE achieved by the Action? Present results in bullets.]
Results Achieved

14. Activities to be Act. 1: 11. Activities Act. 1:

undertaken in order Act. 2: implemented (add Act. 2:
to achieve the more lines if needed)
results (add more
lines if needed)

15.a Duration of [in days] 15.b Expeted <from MM/YY to MM/YY> 12.a Real duration [in days] 12.b Real <from MM/YY to MM/YY>
the Action implementation of the Action implementation
period period

13. Lessons learnt [Please desribe lessons learnt during implementation of the Action: what went well and what couldbe
improved in terms of design of the Action, partnership, BACID procedures?]

14. List of Annexes [Please list all the annexes enclosed to the Implementation Report.]

BACID Fund for Know-How Transfer Actions: Building Administrative Capacities in the Danube Region and Western Balkans
 Budget of the Action and Financial Statement
Project number* 0 * To be filled in by the Contracting Authority.
Estimated Budget of the Action Financial Statement on the cost encountered
(to be filled in after implementation of the Action)
DIFFERENCE
TOTAL BETWEEN
No Unit rate in SPENT in TOTAL ESTIMATED
Type of cost (please add No of of used used Exchange SPENT in AND SPENT JUSTIFICATION OF
No more lines if needed) Unit units Unit rate TOTAL units Unit currency currency rate used EURO AMOUNTS DIFFERENCE IN COSTS
1 Fees (please add one line maximum 450,00 euro per
per expert) day

<Expert position (e.g. per day 0.00 per day 0.00 0.00 0.00
Expert on public finances)>

<Expert position> per day 0.00 per day 0.00 0.00 0.00
<Expert position> per day 0.00 per day 0.00 0.00 0.00
<Expert position> per day 0.00 per day 0.00 0.00 0.00
2 Per diems (please add one maximum 170,00 euro per
0.00
line per expert) day
Per diems for <Expert
position from the budget per day 0.00 per day 0.00 0.00 0.00
heading 1. Fees>
Per diem for . per day 0.00 per day 0.00 0.00 0.00
Per diem for . per day 0.00 per day 0.00 0.00 0.00
Per diem for . per day 0.00 per day 0.00 0.00 0.00
3. Travel costs (please add costs of flight/bus/train 0.00
one line per expert) tickets

Travel costs of <Expert

position from the budget
heading 1. Fees> from per return 0.00
per return 0.00 0.00 0.00
<place of departure trip trip
departure> to <travel
destination>
 Travel costs of . per return 0.00
per return 0.00 0.00 0.00
trip trip
Travel costs of . per return 0.00
per return 0.00 0.00 0.00
trip trip
Travel costs of . per return 0.00
per return 0.00 0.00 0.00
trip trip
4. Costs of event (e.g.
refreshment, translation, 0.00
equipment, materials)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

TOTAL GRANT 0.00 0.00 0.00

Own Contribution
Foreseen Contributions Realized Contributions

Co-funding institution DIFFERENCE BETWEEN

(please add one line per Amount ESTIMATED AND SPENT JUSTIFICATION OF
institution) Description of cost (in Euro)* Description of cost Amount (in Euro) AMOUNTS DIFFERENCE IN COSTS

[e.g. costs of conference hall, [e.g. costs of conference hall,

refreshment, accommodation for refreshment, accommodation for
<name of the institution, participants, printing of participants, printing of publication,
city, country> publication, etc] etc] 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL 0.00 0.00 0.00

* In case of in-kind contributions, please enter the estimated value List of enclosed supporting documents (invoices, travel documents, time sheets, etc)

no description document number date

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