Application Form

Open Call for Proposals in relation to Reception/Asylum

Asylum, Migration and Integration Fund 2014 – 2020This project proposal may be considered for part-financing by the European Union

Co-financing rate: 75% EU Funds 25% Beneficiary Funds

Sustainable Management of Migration Flows

Asylum, Migration and Integration Fund

Open Call for Proposals in relation to Reception/Asylum

Application Form

The total amount of funds available for the actions identified for this call, under the Reception / Asylum national objective is € 2,000,000, split 75% EU funds (equal to € 1,500,000 and 25% Beneficiary funds equal to € 500,000). Subject to availability of Funds, up to a maximum of 75% of the total eligible cost of projects can be co-financed by the Fund.

The information provided in this application will be utilised to ensure that the project activities are eligible for funding and will be completed within the set targets and complements the objectives set in the Asylum, Migration and Integration National Programme available for download from:

http://eufunds.gov.mt/en/EU%20Funds%20Programmes/Migration%20Funds/Pages/AMIF-2014-2020.aspx

Guidance Notes are also being provided together with the Application Form as part of this open call for applications.

The Applicant must respect the following instructions:

Applications should be type written and, signed This application form is applicable to the following national objective falling under Specific Objective 1 of the AMIF

National Programme.

Specific Objective National Objective EU Contribution

(75%)Beneficiary’s Share (25%) Total

1 Reception / Asylum € 1,500,000 € 500,000 € 2,000,000

1 spiral bound original copy duly completed and signed in original by the person authorised to enter into legally binding commitments on behalf of the applicant. Each page must be initialised by the project leader;

1 spiral bound copy of the application form; 1 electronic version on CD or pen drive of this application form must be submitted. It is important that the full

application form, including all annexes, are provided; Applicants should refer to the notes annexed to this document when completing this form; Regulation EU (No.) 516/2014 regulates the Asylum, Migration and Integration Fund. Applicants should be aware of

the requirements of this regulation and the rules of its implementation. Regulation EU (No.) 514/2014 is available on:http://eufunds.gov.mt/en/EU%20Funds%20Programmes/Migration%20Funds/Pages/AMIF-2014-2020.aspx

Any enquiries about the completion of this form should be sent to fpd.meaim@gov.mt until Wednesday 21st June 2017.

Applications should be submitted in person to the Funds & Programmes Division, Ministry for European Affairs and the Implementation of the Electoral Manifesto, Triq il-Kukkanja, Santa Venera SVR 1141 by not later than noon, Friday 23rd June 2017.

For Office Use Only Reference Number: MT/2017/AMIF/Date of Receipt:

Asylum, Migration and Integration Fund 2014 – 2020This project proposal may be considered for part-financing by the European

Union

Co-financing rate: 75% EU Funds 25% Beneficiary Funds

Sustainable Management of Migration Flows

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Asylum, Migration and Integration Fund

National Objective – Reception / AsylumPlease fill in all relevant sections of this application. It is compulsory to annex ALL documents requested in the check list, where applicable. Please consult the Asylum, Migration and Integration Fund National Programme to find all the information pertaining to the Specific Objective and the National Objective.

For the application to be considered complete all attachments marked as obligatory need to be submitted at Application Stage. Those documents marked as required should also be submitted at Application Stage however if not so submitted, the Responsible Authority will take note and allow the applicant one week from request by the Responsible Authority to submit the said documents. Only complete applications with all the documents listed hereunder can be reviewed by the Project Selection Committee.

CHECK-LIST

The Responsible Authority requests 1 original spiral bound copy of the application form (each page initialised by the project leader, with final page duly signed by all parties), 1 spiral bound photocopy and a soft copy (on CD or pen drive) of each application and its annexes.OBLIGATORY: 1 spiral bound grant application in original form, with salient sections duly completed and signed in original by the person authorised to enter into legally binding commitments on behalf of the applicant (each page initialised by project leader and signed at the back with all applicable signatures)

REQUIRED: 1 spiral bound copy including the annexes to the Application Form

REQUIRED: Soft copy (on CD or pen drive) of the application form and its annexes (preferably in word format in relation to the Application Form)

REQUIRED: Annex I: Log frame on the implementation of the project

REQUIRED: Annex II: Declaration by Partner Organisation (one for each partner organisation) (where applicable)

OBLIGATORY: Annex III: ‘Detailed Budget Estimate Report’ duly completed (Excel Format – including sub-worksheets)

OBLIGATORY: Annex IV: ‘Timescale’ duly completed (Excel Format )

REQUIRED: Annex V: Declaration from the VAT Department (for entities who are claiming VAT as an eligible cost) stating that the organisation claiming VAT will not be recovering VAT for this particular project – applicable also for partners which will be receiving funds from the project)

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REQUIRED: Annex VI: CV of Project Leader ideally in Europass format. The CV of the Legal Representative is required in case the Project leader has not as yet been recruited or assigned at application stage. 1

REQUIRED: Annex VII: Organigram/Organisation Chart of the Administration Structure of the proposed project (not of the whole entity)

REQUIRED: Annex VIII: Correspondence with the State Aid Monitoring Board on the project proposal as per Part 11 of the Application Form

REQUIRED: Annex IX: Declaration from the head of the organisation stating that the organisation is not receiving an operational grant from the European Union budget (required only for all partners)

REQUIRED: Annex X: Proof of Co-Financing for VOs and NGOs2 (applicable for lead applicants as well as for partners which are VOs and NGOs and will be co-financing the project). The following documentation need to be submitted depending on the category:

VO s / NGO s Category 1 (where the total revenue does not exceed 20,000euro over the last three consecutive calendar years):

Management Accounts submitted of years 2016 and 2015 in line with Schedule 2 of LN492.2001;

Category 2 (where the total revenue for the last three consecutive calendar years is over 20,000euro)but not exceeding 200,000euro

Management Accounts submitted of years 2016 and 2015 in line with Schedule 2 of LN492.2001

Category 3 (where the total revenuefor the last three consecutive calendar year exceeds 200,000euro)

Audited financial statements of years 2016 and 2015 but if year 2016 audited accounts are not available, management accounts are requested (where 2017 is current year) in line with Schedule 2 of LN 492.2001;

New VOs / NGOs, that are registered in 2017 with the Office of the Commissioner for Voluntary Organisations

Management accounts from date of inception; Declaration by treasurer and another signatory that funds are available to match the co- financing share; If the co-financing is to be financed by a loan, sanction letter is to be submitted;

1 Ideally in Europass format: http://europass.cedefop.europa.eu/mt/documents/curriculum-vitae2? Following the submission of a project proposal, the RA retains the right to consult with the Commissioner for Voluntary Organisations to check that the co-financing as declared by the Voluntary Organisation is available/likely to be met. This assessment by the Commissioner for Voluntary Organisations will be made on the basis of the information provided by the Applicant.

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REQUIRED: Annex X: Proof of Co-Financing for Local Councils (not required in case of government bodies, but applicable for lead applicants and partners who are Local Councils which are co-financing the project). The following documentation needs to be submitted as proof of co-financing:

Audited financial statements of years 2016 and 2015 but if year 2016 audited accounts are not available, management accounts are requested (where 2017 is current year). Where the audited accounts do not provide evidence of sufficient liquidity, assurance from the bank should be presented3

REQUIRED: Annex X: Proof of Co-Financing for Private Entities (not required in case of government bodies, but applicable for lead applicants and partners who are private entities which are co-financing the project).

The following documentation needs to be submitted as proof of co-financing: Audited financial statements of years 2016 and 2015 but if year 2016 audited accounts are not available, management accounts are requested (where 2017 is current year). Where the audited accounts do not provide evidence of sufficient liquidity, assurance from the bank should be presented

REQUIRED: Annex XI: Joint declaration by executive/head/major and treasurer/financial controller/ executive secretary that funds are available to match the co-financing share. If the co-financing is to be financed by a loan, bank sanction letter is to be requested. (This Annex is not required in case of government bodies but required at application stage in case of VOs, NGOs, private entities and Local Councils which are lead applicants or partners co-financing the project)

3 Following the submission of a project proposal, the RA retains the right to consult with the Director of Local Government to check that the co-financing as declared by Local Council is available/likely to be met. This assessment by the Director of Local Government will be made on the basis of the information provided by the Applicant.

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REQUIRED: Annex XII: One copy of the Deed of Foundation/Statute/Articles of Association (not required in case of government bodies and Local Councils /required at application stage in case of VOs, NGOs whether they are lead applicants or partners)

REQUIRED: Annex XIII: Copy of certificate of enrolment as a voluntary organisation (where applicable) or a copy of application and acknowledgement (not required in case of government bodies and Local Councils /required at application stage in case of VO’s and NGOs whether they are lead applicants or partners)

REQUIRED: Annex XIV: Financial Identification Form & Bank Details (not required in case of government bodies/required at application stage in case of VOs, NGOs, private entities and Local Councils whether they are lead applicants or partners which are co-financing the project)

REQUIRED: Annex XV: Legal Entity Form (not required in case of government bodies/required at application stage in case of VOs, NGOs, private entities and Local Councils whether they are lead applicants or partners)

REQUIRED: Annex XVI: in case staff costs are beng caimed an Income Tax Compliance Certificate – (a certificate issued not earlier than three months from the date of the application, by the Inland Revenue Department confirming that the organisation has no liabilities in respect of Income Tax or is otherwise honouring an agreement for settling any outstanding amounts) and the Final Settlement and Social Security Contributions Compliance Certificate – (a certificate issued by the Inland Revenue Department confirming that the organisation has no liabilities in respect of the Final Settlement System (FSS) and of Social Security Contributions (SSC) or is honouring an agreement for settling any outstanding amounts) is to be submitted (not required in case of government bodies/required at application stage in case of VOs, NGOs, private entities whether they are lead applicants or partners in case staff costs of their entities are being claimed)

Annex XVI: Other supporting documentation:-

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

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Contents

PART 1: BASIC INFORMATION 7

PART 2: PARTNER ORGANISATION(S) 9

PART 3: OBJECTIVES 11

PART 4: PROJECT DESIGN 13

PART 5: BUDGET 14

PART 6: COMPLEMENTARITY 18

PART 7: SUSTAINABILITY OF THE PROJECT 18

PART 8: READINESS 18

PART 9: VISIBILITY AND PUBLICITY 19

PART 10: CONDITIONALITY 20

PART 11: STATE AID 21

PART 12: DECLARATION 22

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Part 1: Basic Information1.1 Title of Project: (10 word title/ 90 characters) This should be indicative of what the project aims to achieve in relation to Reception & Asylum

1.2 Summary of the project: Please give a short description of your project. The description should provide an overall explanation of what the project is about. Please note that if your project is approved, this paragraph shall be used for publication. Therefore be accurate and include, the activities to be undertaken, the objectives, the duration in months, the countries involved, the estimated number of participants, and the methods applied. This summary should be completed in English. Please be concise and clear.

1.3 Applicant’s Details: Please insert the details of the applicant organisation in the respective fields hereunder.

Name of Organisation (please indicate the name and the acronym if applicable)

Legal Status (kindly tick the appropriate box)

Government entity Voluntary Organisation Non-Governmental Organisation Education / Research Institution International Organisation Intergovernmental Organisation Other (please specify)

Organisation activity level

Local National EU Member States International (within and outside EU Member States)

Describe your Organisation: Please give a short description of your organisation and describe your competencies and motivation to complete the proposed project. Kindly also provide a summary of any activities that were carried out by your organisation related to the subject targeted by this Fund.

Number of staff employed : Please provide the number of staff employed with the applicant organisation

Full-time staff:

Part-time staff:

Organisation’s main source of finance: Please specify thesource of financing of the organisation eg. Fund Raising, Capital Vote in the Government’s Budget

Postal Address:

Telephone No.: Email address:

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VAT No: (if Applicant is registered with the VAT Department)

1.4 Person authorised to sign the contract on behalf of the applicant (legal representative). Please insert here the name of the Head of the Applicant Organisation or CEO. The same person should sign the Application at the end together with the Project Leader.Surname: First name: Title:

ID Card No.: Position / function:

1.5 Project Leader (Person in charge of the Project) – Please identify the project leader within the organisation which will be responsibile for the implementation of the project. Kindly Attach CV of Project Leader or Legal Representative if the Project Leader is not yet identifiable. 4

Surname: First name: Title:

ID Card No.: Position / function:Email:

Telephone: Fax:Mobile No.:Please state experience in project management and in the area of migration or asylum. Also indicate level of knowledge of EU funding rules.

1.6 Persons directly involved in the management of the project - List the persons who will be directly involved in the management of the project. The project leader is the person who will heading the management of the project and will have final responsibility of its overall progress.Name and surname Position within the

OrganisationRole in relation to the project

Email address

1.7 Organisational structure of persons working on the project5: Specify the organisational structure of the persons directly involved in the management of the project and kindly explain whether the structure of the people managing the project will require any major changes within the current organisation structure, the current role of the people involved, which structure of responsibility will be followed etc.

4 CV must ideally be in Europass format - http://europass.cedefop.europa.eu/mt/documents/curriculum-vitae5 Attach an Organigram/Organisation Chart of the Administration Structure of the proposed project reflecting how project management will flow through the organisation - Annex VII.

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Part 2: Partner Organisation(s)2.1 Define the role of the Partner OrganisationA. Partners which implement activities and for which they will receive money and will be contributing or not contributing to

the co-financing of the project B. Partners (associate partners) which will not be receiving money and will not be contributing to the co-financing of the

project but will implement activities C. Partners (co-funding partners) which will not be receiving money nor implement activities but will be contributing to the

co-financing of the project. 2.2 List of partners involved in this project

Applicant organisation NOT to be included in the listName of Organisation Country Address Amount of co-

financing on the total amount of the project

(when applicable)

Indicate type of Partner (A, B, or C as per section 2.1 above)

Please attach Annex II: The Declaration by Partner Organisation (one for each partner organisation)

In case of partner organisations, please fill in the details below for each partner organisationOrganisation 1 Organisation 2

Name of OrganisationContact personRole in projectEmail addressWeb addressTelephone numberFax number

Organisation 3 Organisation 4Name of OrganisationContact personRole in projectEmail addressWeb addressTelephone numberFax numberIf more than 4 partner organisations will take part in the project, please annex additional information to this section. For each partner organisation please attach a Declaration by Partner Organisations (Annex II)

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2.3 How will each partner organisation be involved?

Specify in bullet form in a max. of 200 words

Explain how other organisations, if at all, will be involved in the project eg. will they be involved in the management of the project, how much of the share will they take, what would be the role of the different organisations involved etc. The entity from which the project leader is appointed will be the representative lead organisation (Final Beneficiary) and the ultimate responsible co-ordinator of the project.

Part 3: Objectives3.1 Relevance to the Specific Objectives and the National Objective of the Asylum, Migration and Integration Fund

Kindly tick the boxes below, as an assurance that the project proposed will be contributing towards the below objectives.

Specific Objective - Asylum National Objective – Reception / Asylum Type of Action:

Renovation of Open Centres

Integration of Asylum Seekers

Provision of Material Aid

Provision of Support Services

3.2 Overall Project Objective

The project should contribute to the National Programme’s Specific Objective and National Objective identifed above and in line with the objectives of the Fund as described in Regulation (EU) No. 516/2014 . The text delineating the national objective with respect to Reception & Asylum is being reproduced hereunder. In this section please describe:

The general aim of the project. How does it support the Asylum Migration and Integration Fund’s objectives; Whether and how the planned activities and working methods will achieve the objectives of the National Objective applied for in this project

application. Describe the strategy which will be utilised in relation to the activities of the project.

“The renovation of current buildings and the setting up of new Open Centre to increase capacity by 400, bringing the total of 2400, providing separate accommodation to different categories, including minors and other vulnerable persons.

Material aid will continue to be provided especially health and other essential services (including services by NGOs)”

“Integration programmes will be provideed in detention and Open Centres. The target group living in the community shall access to ‘mainstream’ services”.

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[900 characters]

3.3 Duration of the project

Please indicate the indicative month and year when the planning on the project commenced, the month and year when the Activities of the project start to be implemented, and finally when the final report on the project will be submitted.)6

Start date of the planning of the project:

Date when planning on the project commenced

Start date of the implementation of the project:

Date when the activities of the project start to be implemented

End date of the project:

Date when the final report on the project will be submitted. This date should not exceed 31st

December 2022

3.4 Date(s) and location(s) of main activities (where applicable)*

The dates identified above (in section 3.3) should be followed and further broken down per activity. Date Activity Location

*Add more rows if necessary

3.5 Inclusion of Vulnerable Target Groups

Does your project involve specific target groups of TCNs (e.g. women, minors, persons with special needs or others facing situations that make their evaluation more difficult). If so, please describe how they will be involved in this project.Number of vulnerable persons7 directly involved in the project (out of the total number of TCNs or other particpants as indicated in section 3.6 of this Appication Form):Kindly provide the methodology used to calculate number of vulnerable persons that will be involved in the project:

6 This Fund may also cover actions that are currently being implemented by the organisation provided these fall within the eligibility period (1st January 2014-31st December 2022) and, abide by the eligibility rules, visibility procedures and the Programme’s manual of procedures.7 Vulnerable as defined in Regulation 14.1 of subsidiary legislation 420.06 shall include include victims of trauma or torture, children, women, victims or potential victims of trafficking, asylum seekers with disabilities, older asylum-seekers, lesbian, gay, bisexual, transgender or intersex (LGBTI) asylum seekers

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3.6 Indicators (It is important that the figures given hereunder are realsitic)3.6.1 Common indicators8

Kindly quantify the results that will be achieved as per the common indicators identifed in the National Programme. Please note that if the project is selected and a Grant is awarded, the Beneficiary is bound to achieve these results. Hence these should be realistic.

C1 – Number of target group persons provided with assistance through projects in the field of reception and asylum systems supported under the Fund

C2.2 – The percentage in the total reception accommodation capacity

3.6.2 Other indicators

Below is the list of other indicators as listed in COMMISSION DELEGATED REGULATION (EU) 2017/207 of 3 October 2016 which needs to be contributed to on the common monitoring and evaluation framework provided for in Regulation (EU) No 514/2014 of the European Parliament and of the Council laying down general provisions on the Asylum, Migration and Integration Fund and on the instrument for financial support for police cooperation, preventing and combating crime, and crisis management

a) Number of places adapted for unaccompanied minors supported by the Fund as compared to the total number of places adapted for unaccompanied minors;d) Number of persons in the reception system (stock at end of the reporting period);

e) Number of persons in the reception system as compared to the number of asylum applicants;

f) Number of accommodation places adapted for unaccompanied minors as compared to the number of unaccompanied minors;Please list other output, result or impact indicators which can be achieved with the project

Please indicate how you plan to disseminate the results of the project (if applicable)

8 Indicators should be quantified and measurable. Please note that if the project is selected and a Grant is awarded the Beneficiary is bound to achieve these indicators hence these should be realistic.

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Part 4: Project Design4.1 Project's methodology in relation to the National Objective

These should be reflected in column C of Annex 1 – LogframeHow will the project be implemented?

What specific problem / issue does your project address and how do you intend to tackle it?

Describe how the target group will be involved in the project (if applicable)

What are the favourable factors that may contribute to the correct implementation of your project?

What are the potential risks and difficulties you may encounter?

4.2 Background and preparation of the project

Please describe the project prepatory and the needs assessment undertaken

4.3 Project evaluation

Describe how the project and its outputs will be evaluated during its implementation

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Part 5: BudgetFor further information please consult the Eligibility Rules uploaded at the following link together with the Manual of Procedureshttp://eufunds.gov.mt/en/EU%20Funds%20Programmes/Migration%20Funds/Pages/Manual-of-Procedures--2014-2020.aspx5.1 VAT Declaration

The information provided in this section should be double checked with the VAT Department if in doubt. If VAT can be recovered by the organisation from the VAT Department, then the VAT amount cannot be co-financed through the project and will be considered ineligible. If on the other hand VAT cannot be recovered from the VAT department, proof of such should be provided together with this Application Form, and the VAT amount will be considered as an eligible cost for co-financing.Can your organisation recover VAT from the VAT Department?

Yes No

If No, please provide the Declaration from the VAT Department stating that the organisation claiming VAT will not be recovering VAT for this particular project9

5.2 Detailed Budget Breakdown

Give a detailed breakdown on the manner in which each item is calculated. Explanations should be given in the table below.

Projects supported by the Fund must be of a non-profit making nature. Before deciding on the actual costs to be included in the budget, market research should be carried out in order to ensure that the planned expenses correspond to reality as much as possible.

If, at the end of the project, the sources of income, including receipts, exceed the expenditure, the contribution to the project from the Fund shall be reduced accordingly. All sources of income for the project must be recorded in the Beneficiary’s accounts or tax documents, and must be identifiable and controllable.

Expenditure € Income €Direct costs: EU contribution (75% of the eligibile

direct costs):Indirect costs:

Indicate percentage of Direct Costs up to a maximum of 7% - this requires to be realistic and eventually justifiable:

Indicate percentage: %

Contribution from applicant and partners in the project:

Contribution from third parties:Receipts generated by the project:

Total Eligible Cost: Total Income:The budget shall be balanced: Total Eligible Cost shall be equal to Total Income

€Grant amount requested from the programme:

% Grant requested from the programme / Total eligible costs (maximum 75%)

5.3 Items of Expenditure

In order for Items of Expenditure to be eligible, the expenditure must be:

Within the scope, objectives and the eligible actions of the Fund; Essential to carry out the activities covered by the project, forming part of the National Programmes, as approved by the Commission; Reasonable and comply with the principles of sound financial management, in particular, value for money and cost-effectiveness; Incurred by the Beneficiary and / or partners in the project, which shall be established and registered in Malta, except in the case of international

public sector organisations set up by intergovernmental agreements, and specialised agencies set up by such organisations, the International Committee of the Red Cross (ICRC) and the International Federation of National Red Cross and Red Crescent Societies. The rules applicable to the beneficiary shall apply mutatis mutandis to the partners in the project;

Linked to the target groups referred to in Regulation No. (EU) 516/2014; Incurred in accordance with the specific provisions in the Grant Agreement.

Projects supported by the Fund shall not be financed by other sources covered by the European Union budget. Projects supported by the Fund shall also be co-financed by Beneficiary’s funds sources for each budgeted item.

Below please provide a budget breakdown per cost category. Before identifying the costs to be charged to the project, kindly go through the Eligibility Rules uploaded on the following link to check which expenditure can be part-financed through the project.http://eufunds.gov.mt/en/EU%20Funds%20Programmes/Migration%20Funds/Pages/Manual-of-Procedures--2014-2020.aspx

Ineligible expenditure

The following costs are not eligible:a) VAT, except where the Beneficiary / Partner provides an official tax certificate stating that the entity cannot recover VAT;b) Return on capital, debt and debt service charges, debit interest, foreign exchange commissions and exchange losses, provisions for losses or

potential future liabilities, interest owed, doubtful debts, fines, financial penalties, litigation costs, and excessive or reckless expenditure;c) Entertainment costs exclusively for project staff; reasonable hospitality costs at social events justified by the project, such as an event at the end of

9 Annex V – This is also applicable for partners.

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the project or meetings of the project steering group, are permitted;d) Costs declared by the Beneficiary and covered by another project or work programme receiving an operational grant from the European Union

Budget;e) Purchase of land; f) Contributions in kind.

Category of expenditure Description of item

Quantity to be procured

Value of each item

Eligible VAT

Total Eligible Cost

Ineligible VAT and other ineligible costs

Grand Total(inc. VAT and other inelgible costs)

A Staff costsB Service costsC Travel and

SubsistenceD EquipmentE Real estateF Consumables,

supplies and general services

G SubcontractingH Costs deriving

directly from requirements linked to EU co-financing

I Expert feesJ Specific expenses in

relation to third country nationals falling within the scope of the Fund

K Indirect Eligible Costs at %

TOTAL

5.4 Operational GrantThe Applicant should state by ticking the box below if an operational grant is received from the European Union Budget. If yes is ticked, then indirect costs cannot be claimed on the project. In relation to partner organisations, kindly fill in Annex IX to this Application

Does your organisation receive an operational grant from the European Union budget? Yes No

5.5 Disbursement Table

A yearly forecast of the expenditure to be carried out must be indicated in the table. This is important in order for the Responsible Authority to plan availability of funds.Disbursement Year 2017 2018 2019 2020 2021 2022Net TotalVATTotal (inc. VAT)

5.6 Procurement10

List the expected procurement procedures and total value of each one. VAT should be quoted separately. Please note that NGOs and private entities should also apply the principle of good governance, transparency and competition and should procure in line with the Programme’s Manual of Procedures11.

10 For more information on the tendering thresholds, please refer to the Manual of Procedures, Chapter 5: Procurement.11 Please refer to the Manual of Procedures for more information.

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Title of procrement procedure Type of procedure Estimated value (exc.

VAT)€

VAT

€

Total (inc. VAT)

€

5.7 Previous experience

Have you, already obtained financial support for a project directly related to this proposal within this programme or under any other programmes in the last five financial years (including Community actions)?

No Financial Support has ever been received

Yes Financial Support has been received. If the yes box is ticked please complete the table.

Year Programme Project Identification Number

Applicant Organisation

Project title

Is this proposal a continuation of a previous accepted project? Yes (please quote project identification number) No

EU funds obtained by the applicant organisation in the three previous years (both at Community level and / or National level)

Year of Award Name of Programme

Project Identification Number

Amount of the grant agreement (co-financing element) 12

Final amount of the actual expenditure incurred13

12 This is the EU contribution amount allocated in the Grant Agreement. 13 This is the final EU contribution amount of actual expenditure incurred.

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Part 6: ComplementarityPlease describe: The extent to which the project is compatible with existing national policies in the relevant area (where applicable); The extet to which the project complements other actions funded by the general budget of the EU or as part of the national programmes; Avoidance of duplication of effort with existing projects or servcies in Malta and Gozo

Part 7: Sustainability of the ProjectDescribe how the benefits of the project will continue to be delivered after the grant support comes to an end. (max. 200 words)

Part 8: Preparedness / ReadinessPlease describe: How ready the project is to start (have procurement procedures been launched?) Have participants been identified? Have the relevant partners identified their respective roles and functions? Is there anything hindering the start of implementation? Are the actors involved properly trained and knowledgeable on the objectives of the Fund? Do you require and have in hand Planning Authority applications?

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Part 9: Visibility and PublicityApart from the compulsory visibility requirements as per Manual of Procedures on all publications funded through this project, please describe how you will ensure the visibility of the project (marketing of the project is different from visibility requirements e.g. articles in newsletters etc.)

Identify and indicate the intended publicity tools to be used

One should note that, as part of their project, Beneficiaries are responsible for notifying the public, about the aid obtained from the Fund, as outlined in the Commission Delegated Regulation (EU) No. 1048/2014, laying down information and publicity measures for the public and information measures for beneficiaries. As outlined in the Regulation, the Beneficiary shall place a permanent prominent plaque of significant size no later than three months after the completion of any project that fulfils the following conditions:

The total Union contribution to the project exceeds €100,000; The operation consists of purchasing a physical object or of financing infrastructure or construction projects. The plaque shall state the type and name of the project. In addition, the following information shall take up 25% of the plaque:

The symbol of the European Union; The Maltese Flag; A reference to the Asylum, Migration and Integration Fund; A reference to the co-financing element; The statement Sustainable Management of Migration Flows selected by the Responsible Authority, highlighting the added value

of the intervention of the Union.

Where a project receives funding under the Asylum, Migration and Integration Fund, the Beneficiary shall ensure that those being involved in the project have been informed of that funding. Any document, including any attendance or other certificate, regarding such a project shall comprise a statement showing that the project is co-financed by the Fund.

Tool / Action Access point Mark with an ‘X’ as appropriatePrint media Newspapers

Journals and magazinesInternational publications

Broadcast media TVRadio

Events Domestic eventsLaunch conferenceClosure conferenceExhibitions

Internet and websites WebsitesSocial mediaMailshots

Seminars, conferences or workshops

Related stakeholders

Organised ad hocPromotional material Supplied during national events or events

focused on different target groups (e.g. pens, note pads, etc)

Direct mail actions Distribution to households on a national or regional basis

Posters SectoralOn site

Project signage, billboards, plaques

On site

Other

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Part 10: ConditionalityAny conditionality that hinders the progress of the project must be clearly stated here.

Indicate any circumstances that might condition the successful implementation and completion of the project e.g. unavailability of co-financing share, overloaded staff that might find it difficult to cope with the additional work entailed through this project, dependence on the grant of particular permits, etc.

Any risks, even if not within the control of the project, which might influence the successful completion of the project should also be listed.

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Part 11: State aid14

Kindly reply by ticking the respective box the questions below11.1 Does the project involve State aid? Yes No11.2 Have discussions with the State Aid Monitoring Board (SAMB) been held? Yes No11.3 If you have answered Yes to question 11.2, please outline the outcome of the discussions held with SAMB and any reference to correspondence with SAMB:

11.4 If you have answered No, to questions 11.1 and 11.2, please explain how it has been concluded that the project does not involve state aid.

14 Proposals involving State aid are not eligible under this Call and the RA retains the right to consult with the State Aid Monitoring Board during the Project Selection phase.

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Part 12: DeclarationTo be completed by the person authorised to enter into legally binding commitments on behalf of the applicant.

I, the undersigned, declare that the entries and the details in this Application Form and any other details enclosed, including the project description, are to the best of my knowledge and belief, correct, and the EU Funds applied for are the minimum required for the project to proceed as described.

I also confirm and declare the following:(1) I am not aware of any reason why the project may not proceed or be delayed other than those reasons declared and

the commitment can be made within the timescales indicated in the National Programme to which this project relates.(2) My organisation / group has the financial and operational capacity to complete the proposed project.(3) My organisation / group has taken the appropriate measures to ensure the protection and safety of participants directly

involved in the project.(4) Any funds awarded will be used for the purpose stated in this Application Form.(5) This project is not being supported through other finances from the EU budget or any other sources.(6) I will abide by the principle of good governance, fairness, transparency and competition in any employment contracts

and procurement of supplies / works / services.

I acknowledge that the project will be subject to regular monitoring / auditing and undertake to keep adequate records for this purpose in line with instructions received from the Responsible Authority and the Manual of Procedures.

In addition, I take note that under the provisions of the Financial Regulation applicable to the general budget of the European Union, grants may not be awarded to applicants who are in any of the following situations:a) if they are bankrupt or being wound up, are having their affairs administered by the courts, have entered into an

arrangement with creditors, have suspended business activities, are the subject of proceedings concerning those matters, or are in any analogous situation arising from a similar procedure provided for in national legislation or regulations;

b) if they have been convicted of an offence concerning their professional conduct by a judgement which has the force of res judicata;

c) if they have been guilty of grave professional misconduct proven by any means which the contracting authority can justify;

d) if they have not fulfilled obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which they are established or with those of the country of the contracting authority or those of the country where the contract is to be performed;

e) if they have been the subject of a judgement which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity detrimental to the European Union's financial interests;

f) if following another procurement procedure or grant award procedure financed by the European Union budget, they have been declared to be in serious breach of contract for failure to comply with their contractual obligations;

g) if, on the date of the grant award procedure, they are subject to a conflict of interest;h) if, on the date of the grant award procedure, they are guilty of misrepresentation in supplying the information required

by the contracting authority as a condition of participation in the grant award procedure or fail to supply this information.

I confirm that neither I, nor the organisation / group for which I am acting as legal representative are in any of the situations described above, and I am aware that the penalties set out in the Financial Regulation may be applied in the case of a false declaration.

In the event that my application is successful, I authorise the European Commission and the Responsible Authority to publish on its internet site or in any other appropriate medium: The name and address of the Beneficiary of the grant; The subject of the grant; The amount awarded and the rate of funding of the costs of the approved work programme.

I understand that:(1) if the information included in the Application Form is found to be not factually correct, the project application may be

rejected.(2) if the application is not complete in all relevant detail and every aspect, including this section, it may also be rejected.

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The applicant undertakes to inform the Responsible Authority of all changes affecting the activities as described in this form.

The applicant allows the Responsible Authority to make available and use all data provided in this Application Form for the purposes of managing and evaluating the Asylum, Migration and Integration Fund. All personal data collected for the purpose of this project shall be processed in accordance with Regulation (EU) No. 516/2014.

Data subjects may, on written request, gain access to their personal data. They should address any questions regarding the processing of their personal data to the Responsible Authority. Data subjects may lodge a complaint against the processing of their personal data with the European Data Protection Supervisor at any time.Authorised signatory of the applicant organisation:

Name and surname of Project Leader15

IN BLOCK LETTERS

Signature:(+ stamp of the applicant if available)

DesignationCEO / Head of Applicant OrganisationLegal Representative of the Organisation

IN BLOCK LETTERS

Signature:(+ stamp of the applicant if available)

DesignationName and surname of Permanent Secretary16

IN BLOCK LETTERS

Signature:(+ stamp of the applicant if available)

Designation

15 The Project Leader is the person responsible for the implementation of the project and has the authority to take decisions during the course of implementation. The Project Leader must be from the applicant organisation, who may be recruited for the duration of the project including its closure and cannot be an appointed external body. This is required since the Project Leader carries the overall financial and legal responsibility for the implementation of the project and hence, his/her direct association with the Beneficiary organisation is fundamental, especially with a view to ensure that the grant will be used exclusively for the purpose stipulated in the project proposal. There shall be only ONE Project Leader responsible for the whole project, even if the project is composed of different components. In such cases, informal arrangements should be made to co-ordinate the different components.16 In case of public sector organisations.

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