Application for financing of a budgetary institution sample. On approval of forms of budget requests for financing expenses

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Financing Application Form

under the “Program for Supporting the Development of Municipal Entities on the Territory of the Russian Federation using Information and Communication Technologies”,

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(RMO-ICT Program)

2nd round

“Implementation of best energy saving practices at the municipal level”

The deadline for submitting applications for the competition is March 2012.

The program is funded by the US Agency for International Development
within the framework of the Cooperation Agreement with the Foundation for Sustainable Development (FSD)

Attention: The application is completed in accordance with the “Guidelines for drawing up an application for financing under the Program for Supporting the Development of Municipal Entities in the Russian Federation using Information and Communication Technologies, gg.”

(RMO-ICT Program), 2nd round.

An incorrectly completed Application or the absence of any information may result in its rejection.

2. Brief description of the work area

2. Involving the population in the process of solving energy saving problems;

3. Increasing the efficiency of informing residents of the settlement about the possibilities of using energy-saving technologies and the work of the dispatch information center;

4. Reducing costs for fuel and energy resources and settlement budget expenses for heating and maintenance of social buildings by 30% (240,000 rubles per year or 120,000 kWh);

5. Document savings for reinvestment in social development programs;

6. Based on the results of the project, it will be possible to replicate successful experience and results in other settlements in the region to ensure a sustainable impact on improving the life of the local community.

5. Explain what ICT will be used in the project and what effect it will have

1. On the basis of the established dispatch center, a specialized website will be developed to inform residents of the settlement about costs and opportunities for saving energy and resources, regular updating of the site and its further development will be ensured.

2. A public information terminal with an interactive portal and a database on the use of energy-saving technologies and increasing energy efficiency will be installed in the dispatch center. All social institutions and residents of the settlement will have the opportunity to access an information base on the use of energy-saving technologies and increasing energy efficiency.

3. The project provides for the distribution of information about energy-saving measures to social institutions, housing and communal services organizations.

That is, industrial and social ICT will be created that can solve pressing problems of residents, institutions and organizations in the territory of the Khomutovsky municipal formation of the Irkutsk region.

6. Justify why your project

cannot cause damage

state of the environment

The project is not hazardous to the environment, since it does not use technologies that could harm it

7. Areas of distribution

Khomutovskoye municipal formation, Irkutsk district, Irkutsk region

8. Duration of the project (number of months, but not more than 12)

10 months

9. Project start date
(must be the first day

04/01/2012

9. Project end date
(must be the last day of the month, but no later than March 31, 2013)

01/31/2013

Conducting an energy audit

Purchase of an information terminal with a vandal-proof screen

11. Applicant contribution (in US dollars)

– salaries of project implementers, including contributions to the Funds, costs of producing printed materials;

Purchasing energy-saving appliances

Carrying out activities based on the conclusion of the audit to improve the energy-saving class of buildings (insulating walls, eliminating air leaks, correct placement of energy appliances).

12. Funds from other sources (in US dollars)

6,600 (see List of letters of support)

MUP "Agrobytservis" - installation of an information terminal, delivery and materials ($720).

MUK Cultural and Sports Complex - installation and configuration of the interactive, information center premises, utility bills, communication services, etc.

13. Total costs for the intended project (in US dollars)

BRIEF INFORMATION ABOUT THE APPLICANT

A. Information about the organization

4. Partnerships

MINISTRY OF FINANCE OF THE REPUBLIC OF MORDOVIA

ORDER

ON APPROVAL OF FORMS OF BUDGET REQUESTS FOR FINANCING EXPENSES

In order to properly organize the budget process in the Republic of Mordovia, I order:

1. Approve:

form of budget request for financing expenses provided by the main managers of budget funds to the Ministry of Finance of the Republic of Mordovia for the purpose of their inclusion in the register of expenses for subsequent amendments to the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period, in accordance with Appendix 1 to this order;

form of a budget request for financing expenses for interbudgetary transfers provided by local governments of municipalities of the Republic of Mordovia to the main managers of budget funds for the purpose of their inclusion in the register of expenses for subsequent amendments to the law of the Republic of Mordovia on the republican budget of the Republic of Mordovia for the current financial year and for the planning period , according to Appendix 2 to this order.

2. The main managers of budget funds and local self-government bodies of municipalities of the Republic of Mordovia must ensure the submission of applications for financing expenses in the forms in accordance with Appendices 1 and 2 to this order.

3. This order comes into force from the date of its signing.

Vice-chairman
Governments - Minister of Finance
Republic of Mordovia
A.Yu.SIMONOV

Appendix 1. Budget request for financing expenses

Annex 1

Republic of Mordovia
dated 06/05/2014 N 74

(name of the main manager of budget funds)

Head of executive

public authority

Republic of Mordovia ____________/__________________________/

signature (signature decryption)

Chief Accountant ___________/___________________________/

signature (signature decryption)

________________

Appendix 2. Budget request for financing expenses for interbudgetary transfers<*>

Appendix 2
to the order of the Ministry of Finance
Republic of Mordovia
dated 06/05/2014 N 74

from _____________________________________________
(name of the municipality of the Republic of Mordovia)

Head of municipal

Education of the Republic of Mordovia ____________/_________________________/

signature (signature decryption)

Head of Financial Department ____________/_________________________/

signature (signature decryption)

________________

<*>Provided to the main manager of budget funds indicated in column 16 of the budget request, after agreement with the relevant sectoral government authority.

<**>The note must indicate the justification for the allocation of additional funds from the republican budget of the Republic of Mordovia.

________________________________________ (name of the regional office of the International Finance Corporation) address: _______________________________ from ___________________________________ (name or full name of the applicant) address: ______________________________, telephone: __________, fax: __________, email address: _____________ Application for funding Applicant ____________________________________________________________ ___________________________________________________________________________ ( name, address of location, OGRN, data of a document confirming the fact of entering information about a legal entity into the Unified State Register of Legal Entities, indicating the address of the location of the body that carried out state registration/full name of the individual entrepreneur, address of his place of residence, data of the document proving his identity, OGRNIP, data of the document confirming the fact of entering information about the individual entrepreneur into the Unified State Register of Individual Entrepreneurs, indicating the address of the location of the body that carried out state registration, TIN, data of the document confirming the registration of the applicant with the tax authority) is the initiator (or: representative of the initiator, etc.) of the investment project ___________________________________________________ (name reflecting the essence of the project) (hereinafter referred to as the “investment project”). 1. Brief description of the investment project: __________________________ __________________________________________________________________________. (essence of the project, location of implementation, contract scheme, main technical and financial parameters and characteristics, including a brief description of the industry, risk distribution and economic efficiency, environmental and social effects) (If available: 2. List of co-investors - ______________________________ ________________________________________________________________________________.) (names, Full name, addresses, type of activity of each, description of the assets they own, financial condition, experience in implementing similar projects, roles in the project, expected period of investment and conditions for exit from the project) (If available: 3. List of partners - _________________________________ _______________________________________________________________________________ .) (names, full names, addresses, type of activity of each, description of the assets they own, financial condition, experience in implementing similar projects, roles in the project) 4. The project management team is _______________________________________ __________________________________________________________________________. (Full name, positions, experience in implementing similar projects, education, scientific degrees, completion of additional training courses - MBA, CFA, etc., diplomas and certificates and a brief description of the main achievements in professional activity) (If available: 5 . List of counterparties for external, including technical, assistance - ___________________________________________________________________ __________________________________________________________________________.) (names, full names, addresses, type of activity of each, financial condition, experience in implementing similar projects, roles in the project, conditions for exit project) 6. Project management structure - _____________________________________ __________________________________________________________________________. (description of the management structure, divisions, distribution of levels of responsibility, heads of departments and the number of employees in them, the main provisions of the personnel policy; for outsourcing of certain functions - the names of contractors, as well as the main details and deadlines for the implementation of the relevant contracts) 7. Marketing and sales, commercial strategy project for the sale of manufactured goods or the provision of services - ______________________________ _________________________________________________________________________. (main sales markets for goods produced as part of the project, services provided as part of the project: local, domestic, regional, export; unit prices, sales goals and expected market share, potential consumers of products and sales channels; dynamics of demand development and prices, as well as competition over the past 3 - 5 years; forecast of market development for the duration of the project, taking into account the possibility that the market will be saturated with substitute goods and other factors determining the market potential; regardless of the volume of contracts concluded, detailed conclusions are presented specialized consulting companies for the analysis of these market segments and their forecasts) 8. Commercial strategy for the purchase of basic raw materials and materials necessary for the implementation of the project - _____________________________________________ ______________________________________________________________________________. (strategy for the acquisition of the main components of the production of goods, raw materials, materials, services, indicating volumes and prices, other basic conditions of long-term contracts for the sale of goods and services planned for concluding, a description of the planned main suppliers of raw materials and supplies, analysis of the risks of monopolistic behavior of such suppliers , ways to reduce the project’s dependence on suppliers, risks associated with their failure to fulfill supply obligations, and ways to reduce them; history of past supply contracts for each supplier; regardless of the volume of contracts concluded, detailed forecasts of price developments for the main supplied materials are presented, raw materials, services performed by specialized experts in the field of project implementation; tariff barriers or import restrictions affecting the project) 9. Technical aspects of the investment project and the proposed technical solution - _____________________________________________________ _____________________________________________________________________. (main aspects of the technical solution, justification for choosing a technical solution, its advantages over other potential solutions, examples of other projects where such a solution was successfully used, all technical risks of the project at each stage and ways to neutralize or reduce them) Detailed technical documentation is attached to the business - investment project plan. 10. Technical feasibility, labor availability, raw materials and environmental issues: __________________________________________________________ __________________________________________________________________________. (brief description of the production process; need for know-how and special qualifications; availability of labor and infrastructure - transport and communications, electricity and water supply, etc.; distribution of estimated operating costs by main expense items; sources, price and quality raw materials and relationships with subcontractors; import restrictions on required raw materials; the proposed location of the plant in relation to component suppliers, markets, infrastructure, and labor source communities; the proposed size of the plant in relation to other such plants; potential environmental issues and ways to solve them) 11. Analysis of operating costs, description of counterparties for the operation, maintenance and repair of facilities, the main conditions of contracts for operation and repair planned for conclusion - ________________________ ________________________________________________________________________________. (main conditions of contracts planned for the operation of facilities, a summary of information about contractors for the operation, maintenance and repair of facilities, including a description of their previous experience, the main risks associated with the operation of the project and ways to reduce them; forecast of the cost of equipment maintenance for a period not less than the repayment period of the requested investments, including the agreed prices and conditions of operation and repair, confirmed by technical experts) 12. Investment needs, project financing and profitability: 12.1. Estimate of total costs for the project, broken down by lease/purchase of land, construction, installation of equipment, working capital requirements, indicating the currency component - ___________________ ________________________________________________________________________________. (detailed calculation of capital costs and sources of their financing, revenue, operating expenses, payments to repay attracted loans, borrowings, as well as interest on them, payments to co-investors, forecasts of the initiator’s financial statements - income and expense reports, balance sheet, cash flow; all the parameters characterizing the project are summarized in a detailed financial model in *.xls format, including associated forecast reporting forms - profit and loss statement, balance sheet and cash flow statement, completed for the life of the project; all risks are taken into account in the financial model; all basic forecasts are based on the terms of concluded contracts and on reports from consultants on price forecasts) 12.2. The estimated financial structure of the enterprise, indicating the expected sources and conditions of equity and debt financing - ___________________________________________________________________________ _________________________________________________________________________. (names, full names, addresses, type of activity of each; names, currencies and volume of funds by sources of financing; terms and repayment schedules of loans and (or) credits; cost, terms and other basic conditions for securing obligations) In confirmation of the specified For information, the application is accompanied by documents on the intention to enter into loan agreements, draft decisions on the issue of securities and draft prospectuses of securities, documents confirming the availability of the necessary internal permits and resolutions approving the investment of funds in the project. The sum of all confirmed sources of project financing is equal to the sum of the project implementation costs, and all funds will be available to the initiator at the time of financial closure of the project. 12.3. The logic of the financial model and the assumptions used are _____________ __________________________________________________________________________. (a guide to using the financial model, which includes an overview of the model, a description of the logic of complex calculations, macro calculations with links to technical documentation, documents on financing conditions) 12.4. Type of financing through the IFC - _________________________ _______________________________________________________________, including (loan, equity participation, quasi-equity financing, combination of several financial products, etc.) loan - _____ (_______________) _______________ for a period of ___________________, participation in a joint stock company capital - ______ (________________) ________________ for a period of __________________, quasi-equity financing - _______ (_________________) _________________ for a period of __________________, other forms - ______ (________________) ___________ for a period of _______________. 12.5. Financial forecast, information on profitability and return on invested capital - _____________________________________________. 12.6. The most important factors on which profitability depends are _________ _________________________________________________________________________. (priorities, sources of financing and refinancing for cases where funds are not enough to fully repay the debt on the project) 12.7. Currency and interest rate risks - ___________________________________ __________________________________________________________________________. (the initiator's strategies for hedging currency and interest rate risks at all stages of the project, including risks in relation to the main concluded credit agreements, purchase and sale agreements, construction contracts, maintenance and repair contracts) 12.8. Analysis of situations when the proposed financing will not be available in the planned amount or its conditions will differ, and the consequences of this for the financial and economic characteristics of the project - _____ ________________________________________________________________________________. (description of each situation according to the scheme “circumstances - pessimistic, optimal, optimistic response scenarios”) 13. Methods for monitoring the impact of the project on the environment, compliance of the project with the legislation of the Russian Federation on environmental protection - __________________________________________________________ __________________________________________________________________________. (technical aspects of the project related to the impact on the environment and complying with the requirements of local, regional, federal legislation on environmental protection; improvement of the environmental situation in the region as a result of the project implementation; environmental benefits of the project implementation and environmental risks of the project, indicating measures aimed at managing such risks and their reduction; conclusion of an organization with experience in environmental research; brief description of the results of all studies conducted previously at the request of international financial organizations or presentation of additional requirements for the procedure for assessing the impact of a project on the environment) 14. Assessment of the social significance of the project, including including the creation of new jobs, etc. - _____________________________________________________ _____________________________________________________________________. (substantiation of the positive social effect associated with the implementation of the project - the creation of new jobs both at the implementation stage and during the operation of the project, both within the framework of the implementation of the project itself and in related areas, for example, with the initiator’s counterparties, the introduction of new modern and more cost-effective technologies, improving the quality of life, etc.) 15. Information on the main licenses and permits required by the initiator to implement the project, including both construction and subsequent operation, - ________________________________________________ ________________________________________________________________________________. (indicating the validity periods of licenses and permits related to the status of their renewal processes, as well as the risks and mitigating factors associated with situations where such licenses and permits are either not obtained or are not renewed within the expected period) 16. Government support and current legislation: 16.1. Compliance of the project concept with state economic development programs and state investment programs - _____ __________________________________________________________________________. (program details) 16.2. Benefits and other government support for the project or its individual parts - ___________________________________________________________________ __________________________________________________________________________. (links to regulations) 16.3. The expected contribution of the project to economic development is __________________ __________________________________________________________________________. 16.4. A brief description of the current legislation in the field of currency control, conditions for the import and export of capital - _____________________ __________________________________________________________________________. (links to regulations) 17. The available material base for the implementation of the investment project is _________________________________________________________________ ________________________________________________________________________________. (availability of property rights or other legal grounds necessary for the implementation of the project, certified control and measuring equipment, production and testing equipment with supporting documents) 18. Computer programs, technical and technological documentation, methodological documents necessary for the implementation of the project - ______________ __________________________________________________________________________. (list and details of supporting documents) 19. Estimated schedule for preparation and implementation of the project - ___________ __________________________________________________________________________. A business plan for an investment project with a detailed justification of the economic feasibility, volume and timing of investments, including the necessary design and working documentation, a description of practical actions for the implementation of investments will be developed and presented in the event of a fundamental interest in the project within ______ days. Based on the above, the applicant requests to consider the possibility of providing investments for the implementation of the project "_________________" in the amount of ______ (________________) ___________ with a payback period of _______ months on the terms agreed upon by the parties. (If the applicant wishes: Please send information on investment issues in electronic form.) Attachments: 1. Copies of the constituent documents of the legal entity (or a copy of the registration certificate of an individual entrepreneur). 2. Copies of documents confirming the presence of specialists on the staff of the applicant or project initiator and their qualifications (appointment orders or extracts from work books, diplomas, certificates). 3. Copies of title documents for premises intended for the implementation of the project, the rights to which are not registered in the Unified State Register of Rights to Real Estate and Transactions with It (if such rights are registered in the specified register, information about these premises). 4. Copies of documents confirming the right of the applicant or project initiator to computer programs and databases planned for use in the implementation of the project. 5. Documents containing information on the availability of production, testing and control equipment, information security means and other means necessary for the implementation of the project, with copies of documents on verification and marking of control and measurement equipment, as well as documents confirming the right of the applicant or initiator project for the use of the specified equipment and facilities. 6. Documents containing information about available technical documentation, national standards and methodological documents necessary for the implementation of the project. 7. Copies of documents confirming the existence of a production control system, including a quality management system. 8. Power of attorney of the representative dated "__"___________ ____ N ______ (if the application is signed by a representative). 9. Copies of documents confirming the powers of the sole executive bodies (authorized persons) of the initiator to carry out transactions on behalf of the initiator, the chief accountant of the initiator (decision on election, order of appointment, order of taking office, employment contract, power of attorney, etc.), and certified samples of signatures of the indicated persons and the seal of the initiator. 10. Certificate from the initiator stating that no insolvency (bankruptcy) case has been initiated against him in the manner prescribed by the legislation of the Russian Federation on insolvency (bankruptcy). (If available: 11. Documents characterizing the credit history of the initiator.) 12. List of attached documents. "__"___________ ____ Applicant (representative): __________________________ (signature)