s application formr w - millennium foundation kosovo · 2020-02-28 · specific obstacles you fo...

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millenniumkosovo.org/womeninenergy/grants

Power by Millennium Foundation Kosovo and Millennium Challenge Corporation

Implemented by GFA Consulting Group and HPC AG

APPLICANT DETAILS

Name of the Company:

Contact Person/ Authorised representative:First NameLast Name

Address:House number:Street:Postcode:City:

Phone:

Emal:

Business Acceleration Support and Grants

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Women Energy Entrepreneurs

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COMPANY INFORMATION

TYPE OF BUSINESS / SELECT ONE OPTION

Industry Sector:

Year company was founded:

Number of company branches / outlets:

Please list the cities where the branches /outlets are located:

COMPANY OWNERSHIP STRUCTURE / STATE PERCENTAGE

% Women Owned:

% Other Owners:

Company Registrati n Number:

COMPANY SIZE (MUST BE > 5 EMPLOYEES) / INDICATE AS APPROPRIATE

Number of employees (fulltime equivalent throughout the year):

Number of women employed (total):

Number of women from ethnic minorities employed:

Number of women with disabilities employed:

Annual turnover EUR:

Annual balance sheet EUR:

Company Management StructureAnnex A

On a separate page attached to this application form, briefly describe the structure of your organization and/or attach an organization chart to your Application.

Business VisionAnnex B

Company’s development / growth plans. Highlight any specific obstacles you foresee. Highlight any support you may seek from other institutions or friends and family. Include tables with your sales development over the past 3 years (less if the company has not es-tablished that long) and the next three your forecast and state what investments are required to reach these sales forecasts.

Outline vision for equipment Investments that support your targeted growthAnnex C

Briefly describe your envisaged equipment investment plan, including the associated target (e.g. capacity increase, move to new facility, replacing obsolete equipment, etc.) Be as precise as possible with regards to the technology you plan to invest in and what how this will support your growth plans.

Motivational StatementAnnex D

Please describe why you should participate in The Business Acceleration Program, how you think this will improve your business and what the wider impact might be regarding your industry sector, other women entrepreneurs in Kosovo.




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PROJECT INFORMATION

Investment Planned (You can select more than one)

Production equipment / machinery

Auxiliary equipment / machine

Building related energy efficiency measures

Renewable energy (e.g. Solar PV)

Project description describe the project including the en-visaged target (e.g. capacity increase, move to new facility, replacing obsolete equipment, etc.) investment measures planned. Be as precise as possible with regards to the technology you plan to invest in (add an additional page if neces-sary).

Estimated investment cost for project in EURO

If you plan to invest in several pieces of equipment or energy

please list the cost for each item

Equipment Item / Name

Cost in EURO

1.

2.

3.

4.

Project location

Building number, street

Postcode

City

Project Development Stage

I have a project idea but no formal quotations about the new equipment / planned investment measures yet

I already have formal offers from suppliers and attach these. I also have:

Feasibility Study

Own energy audit

Other—please specify:




(if different from applicant's address)

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Declaration

1. We/I, the undersigned Applicant, apply for the participationin the Business Acceleration Programme and that I can applyfor a grant under the Women in Energy Programme of MFK inKosovo, for the support of my investment project as part of myparticipation in the Business Acceleration Programme but thatthere is no guarantee that I will receive such a grant.

2. We/I understand that the grant is connected to coaching servicesprovided under the Business Acceleration Programme facilitatedby the Miller Center.

3. We/I hereby agree and understand explicitly that all servicesprovided by the Implementation Consultant and the MillerCenter are free of charge to us/me and no payment is supposedto be offered by us/me and/or our/my vendors or suppliers to theImplementation Consultants and Miller Center Representatives,nor may any payment be requested by the ImplementationConsultants and Miller Center Representatives.

4. We/I hereby agree and understand explicitly that we will receiveadvice from the engineers of the WEE programme to optimizeour technologies investment project, which may be eligible for agrant under the Women in Energy Programme of MFK in Kosovo.For this more detailed assessment within the framework of ‘fine-tuning’ the investment project, we/I hereby agree to provideaccess for the Implementation Consultants to our/my facilitiesand financial, technical and other information requested bythe Implementation Consultants for the performance of suchassessment.

5. We/I hereby declare that no other grant support has been/isexpected to be received for the above-mentioned investmentproject.

6. We/I hereby confirm that my/our business and/or the investmentproject planned doesn’t involve any activity which is in conflictwith:

• MCC cost principles - https://www.mcc.gov/resources/doc/guidance-cost-principles-for-government-affiliates-2

• Threshold agreement restrictions on the use of program funds,outlined in the program agreement (2.4 of the Thresholdagreement)

(i) for assistance to, or training of, the military, police, militia,national guard or other quasi-military organization or unit;

(ii) for any activity that is likely to cause a substantial loss of UnitedStates jobs or a substantial displacement of United Statesproduction;




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(iii) to undertake, fund or otherwise support any activity that is likelyto cause a significant environmental, health or safety hazard,as further described in the “MCC Environmental Guidelines”posted at www.mcc.gov (the “MCC Website”) or otherwise madeavailable by MCC to the Government (“MCC EnvironmentalGuidelines”) (to the extent applicable to the Threshold Programand as may be further instructed by MCC from time to time); or

(iv) to pay for the performance of abortions as a method of familyplanning or to motivate or coerce any person to practice abortions, to pay for the performance of involuntary sterilizations as amethod of family planning or to coerce or provide any financialincentive to any person to undergo sterilizations or to pay for anybiomedical research which relates, in whole or in part, to methodsof, or the performance of, abortions or involuntary sterilizationas a means of family planning.

7. We hereby agree that MFK, MCC and the ImplementationConsultants may publish information about the project, includingnaming the undersigned company, as a beneficiary under theMFK Women in Energy Programme in the context of promotingenergy efficiency as a tool for boosting business performanceand publicising the results/success of the project.

8. We/I understand that we/I shall use the grant for theimplementation of an eligible project only. In case of misuse ofgrants we/I understand that we/I will be requested to refund thegrant.

9. I confirm that We/I will obtain all necessary consents andstatutory approvals (building control, town & country planningetc.) and have authority to install the technologies on the site(including permission from the owner of the facility if applicable).

10. If requested by the Implementation Consultants and/or MFK, we/I agree to give access to any information and/or records related tothe investment project and grant access to the premises wherethe project has been implemented.

11. We/I confirm that information provided in this Application Formis correct, precise and complete, and filled in to the best of myknowledge.

Full name of person signing Position of person signing

Signature Place, Date




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Evaluation CriteriaMFK calls on women entrepreneurs and women-business owners to submit proposals that address the following criteria:

Basic Eligibility Criteria—40% of the evaluation score:• At least 51% women owned• 5 employees or more• In business for at least 2 years or more

Business Vision—30% of the evaluation score: Company’s development / growth plans. Highlight any specific obstacles you foresee. Highlight any support you may seek from other institutions or friends and family. Include tables with your sales development over the past 3 years (less if the company has not established that long) and the next three your forecast and state what investments are required to reach these sales forecasts.

Motivational Statement—20% of the evaluation score:Please describe why you should participate in The Business Acceleration Program, how you think this will improve your business and what the wider impact might be regarding your industry sector, other women entrepreneurs in Kosovo.

Outline vision for equipment Investments that support your stated growth targets—10% of the evaluation score:Briefly describe your envisaged equipment investment plan, including the associated target (e.g. capacity increase, move to new facility, replacing obsolete equipment, etc.) Be as precise as possible with regards to the technology you plan to invest in and what how this will support your growth plans.




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s application formr w - millennium foundation kosovo · 2020-02-28 · specific obstacles you fo...

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