11-Mar-2024 __________________ H.E. Michel Patrick Boisvert Minister of Economy and Finance Ministry of Economy and Finance 5, Avenue Charles Sumner Port-au-Prince, Republic of Haïti Re: JSDF Grant No. TF0C3335 (Promoting the Productive Inclusion of Persons with Disability Project) Additional Instructions: Disbursement and Financial Information Letter Your Excellency: I refer to the Letter Agreement (“Agreement”) between the Republic of Haiti (“Recipient”) and the International Development Association (“Bank”), acting as administrator of the Japan Social Development Fund (JSDF), for the above-referenced Project. The Standard Conditions, as defined in the Letter Agreement, provide that the Recipient may, from time to time, request withdrawals of Grant amounts from the Grant TF0C3335 (“Grant”) in accordance with the Disbursement and Financial Information Letter (“DFIL”), and such additional instructions as the Bank may specify from time to time by notice to the Recipient. The Standard Conditions also provide that the Disbursement and Financial Information Letter may set out Project specific financial reporting requirements. This letter constitutes such Disbursement and Financial Information Letter and may be revised from time to time. I. Disbursement Arrangements, Withdrawal of Grant Funds, and Reporting of Uses of Grant Funds The Disbursement Guidelines for Investment Project Financing, dated February 2017 (“Disbursement Guidelines”), are available on the Bank's public website at https://www.worldbank.org and are an integral part of the Disbursement and Financial Information Letter. The manner in which the provisions in the Disbursement Guidelines apply to the Grant is specified below. (i) Disbursement Arrangements The table in Schedule 1 provides the disbursement methods which may be used by the Recipient, information on registration of authorized signatories, processing of Withdrawal Applications (including the minimum value of applications and advances), instructions on supporting documentation, and frequency of reporting on the Designated Account(s). (ii) Withdrawal Applications (Electronic Delivery) The Recipient shall deliver Withdrawal Applications (with supporting documents, “Applications”) electronically through the Bank’s web-based portal “Client Connection” at https://clientconnection.worldbank.org. This option will be effective after the officials designated in writing by the Recipient, who are authorized to sign and deliver Applications, have registered a s users of “Client Connection.” The designated officials shall deliver Applications electronically by completing Form 2380, which is accessible through “Client Connection.” By signing the Authorized Signatory Letter, which can 7, Rue Ogé, Pétion-Ville, Haïti Tel: (509) 2812 2200 / 2812 2201 -2- be delivered manually or electronically, the Recipient confirms that it is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Bank by these means. The Recipient may exercise the option of preparing and delivering Applications in paper form on exceptional cases (including those where the Recipient encounters legal limitations) and which were previously agreed with the Bank. By designating officials to use SIDC and deliver the Applications electronically, the Recipient confirms through the Authorized Signatory Letter its agreement to (a) abide by the Terms and Conditions of Use of Secure Identification Credentials in connection with the Use of Electronic Means to Process Applications and Supporting Documentation, available in the Bank's public website at https://www.worldbank.org and “Client Connection” at https://clientconnection.worldbank.org; and (b) to cause such officials to abide by those terms and conditions. II. Financial Reports and Audits (i) Financial Reports The Recipient shall prepare and furnish to the Bank not later than forty-five (45) days after the end of each calendar semester interim unaudited financial reports (“IFRs”) for the Project covering the semester. (ii) Audits Each audit of the Financial Statements shall cover the period of one (1) fiscal year of the Recipient, commencing with the fiscal year in which the first withdrawal was made. The audited Financial Statements for each such period shall be furnished to the Bank by the Recipient not later than six (6) months after the end of such period. III. Other Important Information For additional information on disbursement arrangements, please refer to the Loan Handbook available on the Bank’s public website at https://www.worldbank.org and “Client Connection” at https://clientconnection.worldbank.org, the Bank recommends that you register as a user of “Client Connection.” From this website, you will be able to prepare and deliver Applications, monitor the near real-time status of the Grant, and retrieve related policy, financial, and procurement information. For more information about the website and registration arrangements, or if you have any queries in relation to the above, please contact the Bank by email at askloans@worldbank.org using the above reference. Yours sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION ________________________ Laurent Msellati Country Manager for Haiti Latin America and Caribbean Region Attachments 1. Form of Authorized Signatory Letter 2. Form of Statement of Expenditure (SOE) 3. Form of Designated Account Reconciliation Statement -3- Schedule 1: Disbursement Provisions Basic Information Country Republic of Haiti Section 3.03 of the Annex to the Closing Date Recipient Republic of Haiti Letter Agreement. Grant No. TF0C3335 Promoting the Productive Inclusion of Disbursement Four (4) months after the closing Name of the Project Persons with Disability Deadline Date date Disbursement Methods and Supporting Documentation Disbursement Methods Methods Supporting Documentation Direct Payment Yes Copy of records (e.g., invoices and receipts) Reimbursement Yes Statement of Expenditure (SOE) in the format provided in Attachment 2 of the DFIL Advance (into a Designated Statement of Expenditure (SOE) in the format provided in Attachment 2 of the DFIL Yes Account) Designated Account Reconciliation Statement in the format provided in Attachment 3 of the DFIL Special Commitments Yes Copy of Letter of Credit (including pro forma invoice(s), if cited in the Letter of Credit) Designated Account Type Segregated Ceiling Fixed Financial Institution - Banque de la République d’Haïti Currency USD Name Frequency of Reporting Monthly Amount 200,000 Minimum Value of Applications (subsection 3.5) The minimum value of applications for Reimbursement, Direct Payment and Special Commitment is USD 50,000 equivalent. Authorized Signatures Withdrawal and Documentation Applications The form for Authorized Signatories Letter is provided in Attachment 1 of this letter The form for Authorized Signatory Letter is provided in Attachment 1 of this letter. The ASL and all Withdrawal Applications with their supporting documentation will be submitted electronically via the Bank’s “Client Connection” system. Additional Information N/A Other N/A ` -4- Attachment 1 – Form of Authorized Signatory Letter Form of Authorized Signatory Letter [Letterhead] Ministry of Finance [Street address] [City] [Country] [DATE] The World Bank 1818 H Street, N.W. Washington, D.C. 20433 United States of America Attention: [Country Director] Dear [Country Director]: Re: Grant No. ______ (name of Project) I refer to the [Grant] [Letter] Agreement (“Agreement”) between the [International Bank for Reconstruction and Development/International Development Association] (“[Bank”])], acting as [an implementing agency of the Global Environmental Facility] [administrator of the Global Partnership on Output-based Aid] [administrator of the name of the trust fund], and [name of recipient] (the “Recipient”), providing the above Grant. For the purposes of Section 3.04 (b) of the Standard Conditions, as defined in the Agreement, any [ 1 one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Recipient to sign applications for withdrawal [and applications for a special commitment] under this Grant. For the purpose of delivering Applications to the Bank, 2[each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient, acting 3[individually] 4[jointly], to deliver Applications and evidence in support thereof on the terms and conditions specified by the Bank. 5 [This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Bank by electronic means. In full recognition that the Bank shall rely upon such representations and warranties, including without limitation, the representations and warranties contained in the Terms and Conditions of Use of 1 Instruction to the Recipient when sending this letter to the Bank: Stipulate if more than one person needs to sign Applications, how many or which positions, and if any thresholds apply. Please delete this footnote in the final letter that is sent to the Bank. 2 Instruction to the Recipient: Stipulate if more than one person needs to jointly sign Applications; if so, please indicate the actual number. Please delete this footnote in the final letter that is sent to the Bank. 3 Instruction to the Recipient: Use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete it. Please delete this footnote in the final letter that is sent to the Bank. 4 Instruction to the Recipient: Use this bracket only if several individuals must jointly sign each Application; if this is not applicable, please delete it. Please delete this footnote in the final letter that is sent to the Bank. 5 Instruction to the Recipient: Add this paragraph if the Recipient wishes to authorize the listed persons to accept Secure Identification Credentials and to deliver Applications by electronic means; if this is not applicable, please delete the paragraph. Please delete this footnote in the final letter that is sent to the Bank. -5- Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation (“Terms and Conditions of Use of SIDC”), the Recipient represents and warrants to the Bank that it will cause such persons to abide by those terms and conditions.] This Authorization replaces and supersedes any Authorization currently in the Bank records with respect to this Agreement. [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ Yours truly, / signed / ______________ [Position] -6- Attachment 2 – Statement of Expenditure Credit/Grant No.: Application No.: Category No.: SOE No.: 1 2 3 4 5 6 7 8 Supplier’s Type of Good or Currency and % Exchange Currency and Date of Remarks Name Service Total Amount Financed Rate Amount Paid from Payment (CW/GO/CS/OP/TR) / of Invoice by Grant Designated Account Brief Description Covered by (if Applicable) Application -7- Attachment 3 – Designated Account Reconciliation Statement DESIGNATED ACCOUNT RECONCILIATION STATEMENT LOAN/CREDIT/PPF/COFINANCIER NUMBER ______________ ACCOUNT NUMBER ______________ WITH (BANK) __________________________ 1. TOTAL ADVANCED BY WORLD BANK (OR COFINANCIER) _______________________ 2 LESS: TOTAL AMOUNT RECOVERED BY WORLD BANK - _______________________ 3. EQUALS PRESENT OUTSTANDING AMOUNT ADVANCED TO THE DESIGNATED ACCOUNT (NUMBER 1 LESS NUMBER 2) = _______________________ =========================================================== 4. BALANCE OF SPECIAL ACCOUNT PER ATTACHED BANK STATEMENT AS OF DATE ______________________ _______________________ 5. PLUS: TOTAL AMOUNT CLAIMED IN THIS APPLICATION NO. _______________ + _______________________* 6. PLUS: TOTAL AMOUNT WITHDRAWN AND NOT YET CLAIMED REASON: ___________________________________ + _______________________* 7. PLUS: AMOUNTS CLAIMED IN PREVIOUS APPLICATIONS NOT YET CREDITED AT DATE OF BANK STATEMENTS APPLICATION NO. AMOUNT * _________________ _________________ _________________ _________________ SUBTOTAL OF PREVIOUS APPLICATIONS NOT YET CREDITED + _______________________ 8. MINUS: INTEREST EARNED - _______________________* 9. TOTAL ADVANCE ACCOUNTED FOR (NO. 4 THROUGH NO. 9) = _______________________ 10. EXPLANATION OF ANY DIFFERENCE BETWEEN THE TOTALS APPEARING ON LINES 3 AND 9: ________________________________________________________________________________________________________ ____________________________________________________________________________________________ 11. DATE: __________________________ SIGNATURE: _________________________ TITLE: ___________________