USAID Liberia Civil Society Activity (CSA)
Request for Application (RFA)
Issuance Date: January 6, 2023
Closing Date: February 6, 2023 (30 days after issuance date)
Closing Time: 5:00 PM (GMT)
Subject: Request for Applications (RFA) Number: CSA-RFA-08 Monitoring and Research/Investigation into Public School Registration Fees
Reference: Issued Under USAID/Liberia Civil Society Activity
USAID Contract No. 72066922C00003
The Liberia Civil Society Activity (CSA) is a five-year program funded by the United States Agency for International Development (USAID) implemented by DAI Global, LLC (DAI). The goal of the activity is to strengthen Liberians’ ability to advocate for policy reforms, policy implementation, and service delivery improvements through multi-stakeholder coalitions that build feedback loops among the GOL, CSOs, and citizens around reform priorities. The project provides opportunities for CSOs to build linkages with their peers and constituencies at national and subnational levels. Through these linkages, CSOs can communicate reform achievements back to their constituencies and engage them in policy dialogue.
Furthermore, the program promotes greater collaboration with Liberian traditional leaders and media outlets to communicate reform priorities to citizens across the country. Better connections with constituencies will not only help the CSA devise best-fit solutions to local problems, but also facilitate behavior change leading to greater civic awareness and citizen participation.
The Civil Society Activity is designed to address these challenges and take advantage of the emerging opportunities described above. The civil society activity will build on significant investments—such as USAID LAVI, USAID Local Empowerment for Government Inclusion and Transparency (LEGIT) Activity, and USAID Media Development Activity—to transform how Liberian civil society advocates for sustainable policy reforms and effective policy implementation. The activity will support the formation of coalitions representing diverse constituencies around key policy priorities, including the implementation of reforms supported by LAVI.
In line with the new focus on fostering a citizen-state compact, CSA will help coalition members extend their reach past Monrovia to provide mechanisms for the collection of citizen feedback. Sustainable coalitions will elevate citizens’ aspirations and concerns through feedback loops, use this input to co-design adaptive advocacy strategies, and communicate policy achievements back
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to citizens to encourage continued engagement. The activity will also build financial resilience and adaptability of coalition members so they can replicate these approaches beyond the life of the activity.
The Liberia Civil Society Activity has four complementary objectives:
1) Linkages between CSOs with shared priorities strengthened to increase their impact 2) Civil society’s ability to serve as a conduit for information between constituents and officials enhanced
3) Supported CSOs’ financial and organizational sustainability enhanced
4) Ongoing capacity development services available on the local market
In execution of the objective number 1 & 2 above, CSA is soliciting proposals from qualified registered local Liberian organizations who have met the eligibility criteria indicated in Section A below. Successful applicant(s) will be required to implement the program described in section D of this RFA in achieving the program goal and expected output.
Please refer to the Program Description for a complete statement of goals and expected results.
Pursuant to 2 CFR 700.13, it is USAID policy not to award profit under assistance instruments such as grant awards. However, all reasonable, allocable, and allowable expenses, both direct and indirect, which are related to the grant program and are in accordance with applicable cost principles (2 CFR 200 Subpart E for all non-profit organizations, and the Federal Acquisition Regulation (FAR) Part 31 for all for-profit organizations), may be paid under the grant.
For non-US organizations, the Standard Provisions for Non-US Nongovernmental Organizations (ADS 303mab) will apply. For US organizations, 2 CFR 200 and the Standard Provisions for U.S. Nongovernmental Organizations (ADS 303maa) will apply. See Annex 1 for the web address links to these Standard Provisions.
The estimated total funds available to implement Monitoring and Research/Investigation into Public School Registration is $75,000 USD per award under this RFA and number of awards anticipated is up to 10, depending on the quality of the proposals received and the availability of funds. DAI reserves the right to fund any or none of the applications submitted.
Subject to the availability of funds, DAI intends to form coalitions of five to ten registered Liberian civil society organizations who shall each be awarded a grant for a period up to one year to advocate for improvement regarding issues identified in the education sector up to a maximum amount of US $75,000 each. The coalitions shall consist of at least three subnational CSOs with linkages to diverse constituencies outside of Monrovia, at least one “nontraditional” partner such as a private sector firm, business association, media organization, or a faith-based group and at least one member that represents the interests of a marginalized group.
DAI, as primary implementer of the USAID Liberia Civil Society Activity, reserves the right to fund any or none of the applications submitted.
For the purposes of this program, this RFA is being issued and consists of this cover letter and the following components:
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Section A – Grant Application Instructions
Section B – Special Grant Requirements
Section C – Selection Process
Section D – Program Description
Annexes
Applications must be received at the USAID Liberia Civil Society Activity offices in Monrovia, Liberia not later than 30 days after the date of issuance indicated at the top of this cover letter at the place designated below for receipt of applications. Applications and modifications thereof shall be submitted in pdf (preferred) or other electronic format to the USAID Liberia Civil Society Activity at CSA_GrantApplications@dai.com .
Award will be made to the responsible applicant(s) whose application(s) offers the best value.
Issuance of this RFA does not constitute an award commitment on the part of DAI, nor does it commit DAI to pay for costs incurred in the preparation and submission of an application. Further, DAI reserves the right to reject any or all applications received. Applications are submitted at the risk of the applicant. All preparation and submission costs are at the applicant’s expense.
Any questions concerning this RFA or a request for the Microsoft Word version of the application templates (Annex 03, Annex 04 and Annex 05) should be submitted in writing not later than 5 days prior to the closing date shown above to CSA_Grants@dai.com. Applicants should retain for their records one copy of all enclosures which accompany their application.
Thank you for your interest in USAID Liberia Civil Society Activity.
Sincerely,
Steve Terravecchia
Chief of Party
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Monitoring and Research/Investigation into Public School Registration Fees Table of Contents
Section A – Grant Application Instructions……………………………………………………………………. 5 1. Application Procedure…………………………………………………………………………………………… 5 A. Completion and submission of applications………………………………………………………. 5 B. Preparation Instructions – Technical…………………………………………………………………. 5 C. Preparation Instructions – Financial and Administrative Documentation……………7 B. Special Grant Requirements……………………………………………………………………………………….8 C. Selection Process…………………………………………………………………………………………………….. 11 D. Program Description………………………………………………………………………………………………. 14 Annex 1: Mandatory Standard Provisions……………………………………………………………………. 18 Annex 2: Certifications, Assurances, Other Statements of the Recipient………………………19 Annex 3: Application Form……………………………………………………………………………………………19 Annex 5: Budget………………………………………………………………………………………………………….. 21 Annex 6: CV Form and BioData Form……………………………………………………………………………22 Annex 7: Financial Capability Questionnaire…………………………………………………………………25 Annex 8: Instructions for Obtaining an Unique Entity ID (SAM)…………………………………….35 Annex 9: Self Certification for Exemption from Unique Entity ID (SAM)Requirement…..36 Annex 10: Application Checklist……………………………………………..…………………………………….37
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Section A – Grant Application Instructions
Eligibility Requirements
To be eligible for consideration by DAI under this RFA, organizations must meet the following eligibility requirements:
Application Submission Requirements
⮚ Applications may be submitted only via email using the address indicated above (CSA_GrantApplications@dai.com)
⮚ Applications must include:
Deadlines
Applications must be received at USAID Liberia Civil Society Activity not later than the submission due date indicated in the cover letter. Applications and modifications thereof shall be submitted in pdf (preferred) or other electronic format to USAID Liberia Civil Society Activity at CSA_GrantApplications@dai.com .
Late Applications
All applications received by the deadline will be reviewed for responsiveness and programmatic merit according to the specifications outlined in these guidelines and the application format. Section C of this RFA addresses the evaluation procedures for the applications. Applications which are submitted late or are incomplete run the risk of not being considered in the review process.
Page Limitation: Applications should be specific, complete, presented concisely and shall not exceed 12½ pages (exclusive of annexes).
Applications submitted in response to this RFA must include the following information:
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The application must include a cover page that provides general information about the organization including, but not limited to, its email and physical addresses, names and addresses of its head and contact person, purpose/mission of the organization, etc.
The applicant must provide a summary of the project and any necessary background information and clearly indicate what the project will accomplish, in addition to why and how it will be implemented.
The applicant must provide a history and description of their organization and include information about its past experience in implementing similar activities.
The applicant should provide details about the problem that the organization is trying to solve as well as the goal of the advocacy.
The applicant should detail tangible or specific changes in Knowledge, Attitudes, Practices, Behaviors your organization and or coalition anticipate that this grant will achieve.
The applicant must specify the steps or activities that would be implemented to deliver the proposed project and which organization(s) or team members will be responsible for each.
The applicant should define, to the maximum extent possible at the application stage, results and benchmarks for monitoring the performance towards attainment of program objectives. The results and benchmarks must align with one or more of the relevant CSA objectives/sub-objectives and indicators indicated in section vi of the application template (see Annex 3).
The applicant must describe how the activity will ensure the active participation of women, persons with disabilities and other marginalized communities and how the project activities will affect women and girls, persons with disabilities and other marginalized communities.
The applicant should describe how the project or its benefits will continue after grant funding ends.
The applicant should describe the potential impact that the proposed activity will have on the problem being solved or addressed.
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The applicant should propose the names of key personnel who will implement the proposed project including their roles and responsibilities. Each applicant should provide, as part of their application, detailed curriculum vitae that demonstrate the Key Personnel’s ability to perform the duties outlined in the statement of work and in accordance with the evaluation factors found herein. DAI will evaluate the CV to determine the individual’s knowledge, skills and abilities in the areas listed herein.
All proposals must include a completed budget; see Section C for more details.
Applicants are encouraged, but not required or compulsory, to propose in-kind or financial contributions in their applications. If an applicant does propose to provide contributions (e.g. in-kind items, labor time, venue rental costs, etc.) they must provide sufficient details regarding any such proposed in-kind or supplemental contributions by your organization.
In-kind contributions by grantees are allowable as cost share, in accordance with 2 CFR 200.306. This includes such things as proportionate shares of management and other employee time, equipment, office supplies, and other costs of program operation. Rates for employee services shall be consistent with those paid for similar work in the recipient’s organization. The value of equipment (i.e., computers) shall not exceed the fair market value of equipment of the same age and condition. The basis for determining the valuation of services, equipment and supplies shall be documented in the application.
Applicants may also want to submit other material as attachments along with their applications such as letters of reference, newspaper clippings reporting on the organization’s activities, brochures or other promotional material. Support letters demonstrating partnerships and cooperation with local government are of particular interest. However, attachments should be limited to 5 pages and they will not be returned to the applicants.
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All U.S. and foreign organizations which receive a grant with a value of $25,000 and above are required to obtain a Unique Entity ID (SAM) prior to signing of the agreement. Organizations are exempt from this requirement if the gross income received from all sources in the previous tax year was under $300,000. DAI requires that grant applicants sign the self certification statement if the applicant claims exemption for this reason.
For those required to obtain an Unique Entity ID (SAM), see Annex 8- Instructions for Obtaining an Unique Entity ID (SAM)- DAI’S Vendors, Subcontractors and Grantees. For those not required to obtain an Unique Entity ID (SAM), see Annex 9- Self Certification for Exemption from Unique Entity ID (SAM)Requirement
The applicant shall bear in mind the following special requirements for any grants awarded in response to this RFA:
Separate Account: At DAI’s sole discretion, DAI may require the grantee to establish a separate bank account to house all funds provided under the grant, as well as all interest income.
Permitted Uses of Program Income: The Grantee will inform DAI of any program income generated under the grant and agrees to follow USAID’s disposition requirements for such program income, which is in accordance with 2 CFR 200.307. Program income earned under this agreement shall be applied and used in the following descending order:
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If the terms and conditions of the award do not specify how program income is to be used, then number 2) (above) shall apply automatically. Grantees who are commercial organizations may not apply Option 1) to their program income.
Use of Funds: Funds provided under any grant awarded shall be used exclusively to implement activities relating to Monitoring and Research/Investigation into Public School Registration Fees . Diversion of grant funds to other uses will result in cancellation of award and retrieval of funds disbursed to the grant recipient.
Reporting Procedures: A description of reporting requirements will be included in the Grant Agreements. The types of reporting required, along with the schedule of reporting, will depend on the grant type and project duration. Reporting forms will be provided to grant recipients. Types of reporting will generally include the following:
Issuance of the final installment of grant funds is contingent upon DAI’s receipt and acceptance of Final Financial and Final Program Reports.
Project Monitoring: DAI staff will monitor projects in terms of both programmatic and financial aspects. Grant recipients will be expected to facilitate monitoring by making relevant information available to DAI staff.
Restrictions: The Grant Funds provided under the terms of this Agreement shall not be used to finance any of the following:
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i.) Activities which may lead to degrading the quality or renewability of natural resources.
ii.) Activities which may lead to degrading the presence or health of threatened ecosystems or biodiversity.
iii.) Activities which may lead to degrading long-term viability of agricultural or forestry production (including through use of pesticides).
iv.) Activities which may lead to degrading community and social systems, including potable water supply, land administration, community health and well-being or social harmony.
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Other: As mentioned, grants will be made available to qualified Liberian civil society organizations in grant amounts ranging up to $75,000 USD (all grants will be distributed in USD or local currency equivalent). Payment will be made according to a monthly or installment schedule, and in no event will more than 90% of the total agreed budget be disbursed prior to receiving and approving the Final Financial and Final Program Report.
Within 5 working days of the deadline for submitting applications, a review panel will convene. The review panel will include relevant technocrats from CSA who shall be voting members and non-voting to include representatives from USAID and CSA Core Partners (CENTAL, Accountability Lab and NAYMOTE) who shall serve as observers for the grant selection process. Throughout the evaluation process, DAI shall take steps to ensure that members of the review panel do not have any conflicts of interest or the appearance of such regarding the organizations whose applicants are under review. An individual shall be considered to have the appearance of a conflict of interest if that person, or that person’s spouse, partner, child, close friend or relative works for or is negotiating to work for or has a financial interest (including being an unpaid member of a Board of Directors) in any organization that submitted an application currently under the panel’s review. Members of the panel shall neither solicit nor accept gratuities, favors, or anything of monetary value from parties to the awards.
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All applications that meet the application requirements will be reviewed by the review panel. Verification of the application submission requirements will be conducted at the USAID Liberia Civil Society Activity Headquarters by its grants staff.
If suitable applications are received, one or more awards will be made (at DAI’s discretion) within 21 working days of the review panel meeting provided that the awardee(s) furnish(es) DAI with all the required documentation as itemized in Section A of this RFA.
The applications will be evaluated according to the evaluation criteria set forth below. To the extent necessary (if award is not made based on initial applications), negotiations may be conducted with each applicant whose application, after discussion and negotiation, has a reasonable chance of being selected for award. Award will be made to responsible applicants whose applications offer the best value.
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Awards will be made based on the ranking of applications by the review panel according to the evaluation criteria and scoring system identified below:
The following criteria should be adjusted as necessary to suit project needs.
The applicant’s past experience and capabilities in conducting projects of a similar nature. Very good = 15 points; good = 10 points; average = 5 points; poor = 0 point
How clear and achievable are the problem statement and advocacy goal? Very good = 5 points; good = 4 points; average = 3 points; poor = 0 point
What tangible or specific changes in knowledge, attitudes, practices, and/or behaviors does your organization and or coalitions anticipate that this grant will achieve
Very good = 5 points; good = 4 points; average = 3 points; poor = 0 point
Is the design innovative, creative and realistic?
Very good = 30 points; good = 15 points; average = 5 points; poor = 0 point
Alignment of proposed monitoring and evaluation activities with CSA indicators
Very good = 15 points; good = 10 points; average = 5 points; poor = 0 point
To what extent does the proposed project include gender equity and social inclusion? Very good = 10 points; good = 7 points; average = 5 points; poor = 0 point
Is the project or its benefits likely to continue after grant funding ends?
Very good = 5 points; good = 4 points; average = 3 points; poor = 0 point
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Is the project likely to improve monitoring and Research/Investigation into Public School Registration Fees Is there evidence of buy-in and involvement?
Very good = 5 points; good = 4 points; average = 3 points; poor = 0 point
Is the cost reasonable in terms of the expected results?
Very good = 10 points; good = 7 points; average = 5 points; poor = 0 point
DAI and USAID reserve the right to fund any or none of the applications received
Signing of Grant Agreements
Upon USAID concurrence of the applicant, a Grant Agreement will be prepared. After DAI and the successful applicant have signed the Grant Agreement, DAI will provide training on financial management and reporting on grant funds. All reporting and contractual obligations will be explained to the grant recipients. Before receiving the first grant installment, all DAI may require grant recipients must open a separate bank account as how grant funds will be transferred from DAI to the grant recipient.
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Title: Monitoring and Research/Investigation into Public School Registration Fees Thematic Window: Education
CSA Project Activity Locations: Montserrado, Bong, Nimba, Lofa, Margibi and Grand Bassa Counties
Organization(s): Civil Society Organizations (both National and Sub-national CSOs)
Period of Performance: March 2023 – March 2024
Education Sector Thematic Area
To determine the challenges and opportunities for service delivery in the education sector, CSA conducted several foundational research activities during its first year. The GeoPoll SMS survey of February and March 2022 indicated that citizens consider education to be their second highest priority after jobs. To further understand why the survey respondents made this choice, two of CSA core partners, i n April 2022, CENTAL and NAYMOTE conducted nationwide key informant interviews and focus group discussions in 14 counties which further revealed the full extent of issues that affect the education sector. Then in July and August, USAID Civil Society Activity conducted a political economy analysis (PEA) conducted across three counties. – Bong, Nimba and Grand Bassa with the objective of identifying the dynamics of the challenges, the opportunities and entry for advocacy towards policy reforms, creating and strengthening service delivery systems, and greater accountability and transparency.
Based on findings from these foundational research activities CSA has identified various advocacy goals which have been consolidated under six categories for the education sector.
This Statement of Work (SOW) for in-depth research/investigation into Registration Fees in a targeted County will support CSA in reaching category 5 of the education sector thematic areas.
Goal of the SOW
The goal for this SOW is to enhance transparency and community oversight of the management of registration fees for public school students. These fees include the different types and amounts collected from pre-grade, elementary, junior high and senior high students. Sixty percent of the fees for junior and senior high are transferred to the central administration of the Ministry of Education (MOE) while all of the pre-grade and elementary registration fees are retained by the schools. The activities for this grant will include investigating and reporting on the actual distribution between MOE and the schools and how
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the schools use their allocations. In the instances where entire amounts are sent to the MOE, the monitoring and research activities will seek to find out how much do the schools receive in rebates.
Other activities for this SOW will, among others, include exploring how this and other types of own-source revenues can be used to facilitate the provision of basic education materials, school supplies and other operating costs of public schools around the country. The results and outcomes would be used for greater coordination and partnerships among the authorities of the Ministry of Education, parents, and public-school administrators at the local level.
Recently, in the draft FY 2023 national budget, the government of Liberia committed new funding of 2.5 million USD for the elimination of registration fees and all forms of financial burdens imposed on parents in public schools, at retaining enrollment. Activities for this grant will also track and monitor the government’s commitment to provide 2.5 million for this purpose, and the impact this allocation will have on the application of public school registration policy.
Program Strategy
Under this SOW, the Liberia Civil Society Activity is seeking to award grants to civil society organizations and research organizations that demonstrate experience of working in the education sector, including working with stakeholders in Montserrado, Margibi, Grand Bassa, Bong, Nimba and Lofa Counties. Applications for Montserrado, (or sections of applications that deal with Montserrado), should be mainly focused on introduction or reforms of policies, regulations, and laws. Such organizations should show evidence of good research and advocacy capacities and how such capacities will be employed to implement this grant. Specifically, the partner will research the registration fees provided by schools to MOE and the degree and extent to which they are returned to schools. The partner will research the total amount of registration fees per academic year in select public schools, and the system for remittance of fees from schools to MOE and from MOE back to the schools. If remittances are delayed or not paid in full, the research will note reason(s) for the delay or reason (s) why remittance from MOE back to the schools are not paid in full. The partner will then provide recommendations for how schools can use their own-source revenue to facilitate the provision of basic education materials and school supplies in public schools around the country. The partner will be required to provide a coordination mechanism that clearly lays out how the grantee intends to work with other CSA coalition partners during the project implementation.
Successful applicants will be selected based on how they articulate their methodologies and approaches for working with national and local stakeholders on agreeable guidelines and indicators for monitoring and reporting on the issues covered by this SOW. They will be organized into a coordinated coalition of CSOs with identical or similar thematic focus across the selected counties. CSA will provide the required technical support to Awardees/Grantees to further define and strengthen their methodologies and strategies for engaging with their stakeholders and with other CSO partners to co-create on the guidelines for reporting and communicating their findings.
Expected Deliverables/Outcomes
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Description of Program Activities
The applications/proposals for the Fixed Amount Award should adequately and concisely describe how the Awardee will work with other CSOs in a coalition to undertake the activities under one or more of the following areas of concentration, and how proposed activities will contribute to the goal of the SOW. Based on self-assessment and capacity, each applicant should select from one or more of the five following concentration areas that contribute to the goal and objectives of the SOW. The following activities under each area are illustrative and applicants are encouraged to include other creative ideas in their applications that also contribute to the advocacy strategy and goal. Applicants can also submit proposals to work in one or more of the counties named above.
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Annex 1: Mandatory Standard Provisions
Mandatory Standard Provisions for US Nongovernmental Recipients: https://www.usaid.gov/sites/default/files/documents/303maa.pdf
or
Mandatory Standard Provisions for Non-US Nongovernmental Recipients: https://www.usaid.gov/sites/default/files/documents/303mab.pdf
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Annex 2: Certifications, Assurances, Other Statements of the Recipient
In accordance with ADS 303.3.8, DAI will require successful grant applicants to submit a signed copy of the following certifications and assurances, as applicable:
In addition, the following certifications will be included Part II – Key Individual Certification Narcotics Offenses and Drug Trafficking (Note: Only as required per ADS 206 for Key Individuals or Covered Participants in covered countries.)
Part III – Participant Certification Narcotics Offenses and Drug Trafficking (Note: Only as required per ADS 206 for Key Individuals or Covered Participants in covered countries.)
Part IV – Representation by Organization Regarding a Delinquent Tax Liability or a Felony Criminal Conviction
Part V – Other Statements of Recipient
Part VI – Standard Provisions for Solicitations
(Note: Parts V & VI – Are included in the grant file as part of the grant application.)
Annex 3: Application Form
Kindly click on the icon below to access the application form (Annex 3)
Annex 3 – Application
Template
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Annex 5: Budget
Kindly click the icon below to access the grant budget and budget notes template:
Annex – 5 Budget and
Budget Notes Template
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Annex 6: CV Form and BioData Form
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ANNEX 6
Curriculum Vitae
Proposed position in the project:
Name (First, Middle, Last):
Citizenship:
Education:
Name and location of institution | Major(s) or Degree(s) obtained: |
Language proficiency – indicate proficiency on a scale of 1 (poor) to 5 (native):
Language | Reading | Speaking | Writing |
Membership of NGOs or other professional bodies:
Key skills and qualifications relevant to the project (e.g. computer literacy, etc.):
Employment history:
Position Title | Employer’s name and address | Dates of employment | Short description of tasks performed | |
From (month, year) | To (month, year) | |||
Other relevant information : (e.g. publications, seminars /courses etc.) :
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Kindly click on the icon below to access the biodata form
Employee Biodata
Form
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Annex 7: Financial Capability Questionnaire
Accounting System and Financial Capability Questionnaire
For DAI Grant Recipients
The main purpose of this questionnaire is to understand the systems adopted by your institution for financial oversight and accounting of grant funds, especially those provided through the U.S. Federal Government. The questionnaire will assist DAI program and accounting staff to identify the extent to which your institution’s financial systems match the requirements of the U.S. Federal Government. This information will help the program staff work with you and your institution to review any problem areas that may be identified; thereby avoiding any problems or oversights which would be reportable should an audit of the program or institution be required.
The questionnaire should be completed by the financial officer of your institution in collaboration with DAI program staff. This questionnaire is informational only and will not have any bearing on the agreement to support your institution based on the technical merit of the proposal. Therefore, please answer all questions to the best of your knowledge.
While 2 CFR 200 does not cover awards to non-U.S. recipients, DAI shall rely on the standards established in that regulation in determining whether potential non-U.S. recipients are responsible to manage Federal funds. A determination shall be made on the potential recipient’s ability, or potential ability, to comply with the following USAID and federal-wide policies:
1) 2 CFR 200 Subpart D (Financial and Program Management).
2) 2 CFR 200 Subpart D (Property Standards);
3) 2 CFR 200 Subpart D (Procurement Standards); and
4) 2 CFR 200 Subpart D (Performance and Financial Monitoring and Reporting).
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SECTION A: General Information
Please complete this section which provides general information on your institution. Name of Institution:
Name and Title of Financial Contact Person:
Name of Person Filling out Questionnaire:
Mailing Address:
Street Address (if different)
Telephone, Fax, Email (if applicable)
Enter the beginning and ending dates of your institution’s fiscal year: From: (Month, Day) To: (Month, Day)
SECTION B: Internal Controls
Internal controls are procedures which ensure that: 1) financial transactions are approved by an authorized individual and are consistent with U.S. laws, regulations and your institution’s policies; 2) assets are maintained safely and controlled; and 3) accounting records are complete, accurate and maintained on a consistent basis. Please complete the following questions concerning your institution’s internal controls.
Yes: No:
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Yes: No:
Yes: No:
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Yes: No:
Yes: No:
Yes: No:
Yes: No:
If yes, how long are such records kept?
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Yes: No:
Yes: No:
SECTION C: Fund Control and Accounting Systems
Fund Control essentially means that access to bank accounts and/or other cash assets is limited to authorized individuals. Bank balances should be reconciled periodically to the accounting records. If cash cannot be maintained in a bank, it is very important to have strict controls over its maintenance and disbursement.
An Accounting System accurately records all financial transactions and ensures that these transactions are supported by documentation. Some institutions may have computerized accounting systems while others use a manual system to record each transaction in a ledger. In all cases, the expenditure of funds provided by the USAID-funded program must be properly authorized, used for the intended purpose, and recorded in an organized and consistent manner.
A fund accounting system:
Yes: No:
If yes, please explain the amount of funds to be maintained, the purpose and person responsible for safeguarding these funds.
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Cash basis: Accrual basis:
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Yes: No:
Yes: No:
Yes: No:
Yes: No:
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SECTION D: Audit
The grant provisions require recipients to adhere to USAID regulations, including requirements to maintain records for a minimum of three years to make accounting records available for review by appropriate representatives of USAID or DAI, and, in some cases, may require an audit to be performed of your accounting records. Please provide the following information on prior audits of your institution.
Yes: No:
Yes: No:
Yes: No:
If yes, please provide a copy of your most recent report.
Yes: No:
If yes, who performs the audit and how frequently is it performed?
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Yes: No:
If yes, please provide details:
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CHECKLIST AND SIGNATURE PAGE
DAI requests that your institution submit a number of documents along with this completed questionnaire. Complete this page to ensure that all requested information has been included.
Complete the checklist:
Copy of your organization’s most recent audit is attached.
If no recent audit, a “Balance Sheet” “Income Statement” for the most current and previous fiscal year.
All questions have been fully answered.
An authorized individual has signed and dated this page.
Incorporation Papers or Certificate of Registration and Statute is attached. Information describing your institution is attached.
Optional:
Organizational chart, if available is attached (if applicable).
The Financial Capability Questionnaire must be signed and dated by an authorized person who has either completed or reviewed the form.
Approved by:
_________________________
Print Name
_________________________
Signature
__________________________
Title Date _____________
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Annex 8: Instructions for Obtaining a Unique Entity ID (SAM) – DAI’S Vendors, Subcontractors and Grantees
Form 3.9 Attachment
A – Instructions for Obtaining an Unique Entity ID.docx
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Annex 9: Self Certification for Exemption from Unique Entity ID (SAM) Requirement
Form 3.10 – Self
Certification for Exemption from Unique Entity ID Requirement (2).pdf
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Annex 10: Application Checklist
Before submitting your application, please check to make sure the following are included:
☐ The application is submitted in electronic format
☐ Budget is included (Annex 5)
☐ In the budget, the applicant’s contribution is identified (if applicable) ☐ The CVs and Biodata Forms are included (Annex 6)
☐ The statement of liability is signed and stamped (cover page of application form – Annex 3) ☐ Completed Financial Capability Questionnaire (Annex 7)
☐ Audited Financial Reports: Copy of the applicant’s most recent financial report, which has been audited by a certified public accountant or other auditor satisfactory to DAI. If no recent audit, a “Balance Sheet” and “Income Statement” for the most current and previous fiscal year.)
☐ Incorporation Papers or Certificate of Registration and Statute
☐ Organizational Chart (Optional)
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