Ousmane Dione Country Director for Ethiopia, Eritrea, Sudan, and South Sudan Eastern and Southern Africa Region 08-Feb-2022 Date: _____________ H.E. Ahmed Shide Minister Ministry of Finance Addis Ababa Ethiopia Excellency: Re: IDA Grant D9550-ET (Second Additional Financing for Ethiopia COVID-19 Emergency Response Project) Additional Instructions: Disbursement and Financial Information Letter I refer to the Financing Agreement between FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA (the “Recipient”) and the International Development Association (the “Association”) for the above-referenced Project. The General Conditions, as defined in the Financing Agreement, provide that the Recipient may from time-to-time request withdrawals of Grant amounts from the Grant Account in accordance with the Disbursement and Financial Information Letter, and such additional instructions as the Association may specify from time to time by notice to the Recipient. The General 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 (“DFIL”) 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 in the Association’s public website at https://www.worldbank.org and its secure website “Client Connection” at https://clientconnection.worldbank.org. The Disbursement Guidelines are an integral part of the DFIL, and the manner in which the provisions in the guidelines apply to the Grant is specified below. (i) Disbursement Arrangements • General Provisions (Schedule 1). The table in Schedule 1 sets out the disbursement methods which may be used by the Recipient, and conditions, information on registration of authorized signatures, processing of withdrawal applications (including minimum value of applications and processing of advances), instructions on supporting documentation, and frequency of reporting on the Designated Account. • Special Provision. Projects in situations of urgent need of assistance or capacity constraints: Disbursements under contracts for goods, works, non-consulting services and consulting services procured or selected through international open or limited competition or Direct Selection, as set out in the procurement plan, must be made only through Direct Payment and/or Special Commitment disbursement methods. 2 (ii) Electronic Delivery. Section 11.01 (c) of the General Conditions. The Recipient will deliver Withdrawal Applications (with supporting documents) electronically through the Association’s web-based portal “Client Connection” at https://clientconnection.worldbank.org. This option will be affected after the officials designated in writing by the Recipient who are authorized to sign and deliver Withdrawal Applications have registered as users of “Client Connection”. The designated officials will deliver Applications electronically by completing the Form 2380, which is accessible through “Client Connection”. By signing the Authorized Signatory Letter, 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 Association by electronic means. The Recipient may exercise the option of preparing and delivering Withdrawal Applications in paper form on exceptional cases (including those where the Borrower encounters legal limitations), and which were previously agreed with the Association. By designating officials to use SIDC and by choosing to 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 Use of Electronic Means to Process Applications and Supporting Documentation, available in the Association's public website at https://worldbank.org and “Client Connection”; and (b) to cause such official to abide by those terms and conditions. II. Financial Reports and Audits (i) Financial Reports. The Recipient must prepare and furnish to the Association not later than sixty (60) days after the end of each Ethiopian Fiscal calendar quarter, interim unaudited financial reports (“IFR”) for the Project covering the quarter. (ii) Audits. Annual and semi-annual (July 8-January 8) financial audits will be conducted, commencing with the fiscal year in which the first withdrawal was made. The annual audited Financial Statements must be submitted not later than six (6) months of the end of the period and the semi-annual audit report must be submitted not later than ninety (90) days of the end of the six (6) month period. III. Other Information For additional information on disbursement arrangements, please refer to the Loan Handbook available on the Association’s website (http://www.worldbank.org/) and “Client Connection”. The Association 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. 3 For more information about the website and registration arrangements, or if you have any queries in relation to the above, please contact the Association by email at AskLoans@WorldBank.org using the above reference. Yours sincerely, Ousmane Dione Country Director for Ethiopia, Eritrea, Sudan, and South Sudan Eastern and Southern Africa Region Attachments 1. Form of Authorized Signatory Letter 2. Interim unaudited Financial Report (IFR) With copies: Ministry of Finance P.O Box 1037 Addis Ababa Federal Democratic Republic of Ethiopia ashide@mofed.gov.et Ministry of Health P.O Box 1234 Addis Ababa Federal Democratic Republic of Ethiopia Lia.tadesse@moh.gov.et 4 Schedule 1 : Disbursement Provisions Basic Information Country Federal Democratic Republic of Closing Date Section III.B.2. of Schedule 2 to the Ethiopia Financing Agreement. Grant Recipient Ministry of Finance D9550-ET Number Name of the Project Second Additional Financing for Disbursement Four months after the closing date. Ethiopia COVID-19 Emergency Deadline Date Response Project Subsection 3.7 ** Disbursement Methods and Supporting Documentation Disbursement Methods Methods Supporting Documentation Section 2 (**) Subsections 4.3 and 4.4 (**) Direct Payment Yes Copy of records Reimbursement Yes Interim unaudited Financial Report (IFR) in the format provided in Attachment 2 of the DFIL Advance (into a Designated Yes Interim unaudited Financial Report (IFR) in the format provided in Attachment 2 of the DFIL Account) Special Commitments Yes Copy of Letter of Credit Designated Account (Sections 5 and 6 **) Segregated Variable Type Ceiling (Existing DA of the 1st AF- IDA D7910) Financial Institution – National Bank of Ethiopia (NBE) USD Currency Name Frequency of Reporting Quarterly Based on up to 6 months cash forecast as Amount Subsection 6.3 (**) per detail provided in the IFR Minimum Value of Applications (subsection 3.5) The minimum value of applications for , Direct Payment and Special Commitment is USD5,000 equivalent. Authorized Signatures (Subsection 3.1 and 3.2 **) The form for Authorized Signatories Letter is provided in Attachment 1 of this letter Withdrawal and Documentation Applications (Subsection 3.3 and 3.4 **) i) Authorized Signatures &(ii) Applications An authorized signatory letter in the Form attached (Attachment 2) should be furnished to the Association at the address indicated below providing the name(s) and specimen signature(s) of the official(s) authorized to sign Applications. Please provide completed and signed (a) applications for withdrawal, together with supporting documents, and (b) applications for special commitments, together with a copy of the commercial bank letter of credit, to the address indicated below: The World Bank, Loan Department, Delta Center, 13th Floor, Upper Hill, Menengai Road, Nairobi, Kenya. Tel: 254 20 2936 000 Attention: Loan Department Additional [Information][Instructions] All implementing entities will continue to use the existing separate project bank account Other * Sections and subsections relate to the “Disbursement Guidelines for Investment Project Financing”, dated February 2017 . 5 Attachment 1 – Form of Authorized Signatory Letter [Letterhead] Ministry of Finance [Street address] [City] [Country] [DATE] International Development Association 1818 H Street, N.W. Washington, D.C. 20433 United States of America Re: [Grant][Credit]1 No. D9550-ET (Second Additional Financing for Ethiopia COVID-19 Emergency Response Project) Attention: _______________________, Country Director I refer to the [Grant] [Credit] Agreement (“Agreement”) between the International Development Association (the “Association”) , acting as implementing of the ]2 and [name of recipient] (the “Recipient”), dated _______, providing the above [Grant] [Credit]. For the purposes of Section 2.03 of the General Conditions as defined in the Agreement, any 3[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] [Credit]. For the purpose of delivering Applications to the Association, including by electronic means, 4[each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient, acting 5[individually] 6[jointly], to deliver Applications, and evidence in support thereof on the terms and conditions specified by the Association. 1 Instruction to the Recipient: use “Credit” or “Grant” as applicable. Please delete this footnote in final letter that is sent to the Associations. 2 Instruction to the Recipient: add text in line with the Grant Agreement if applicable; if not applicable delete it. Please delete this footnote in final letter that is sent to the Associations 3 Instruction to the Recipient: stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete this footnote in final letter that is sent to the Association. 4 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 final letter that is sent to the Association. 5 Instruction to the Recipient: use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association. 6 Instruction to the Recipient: use this bracket only if several individuals must jointly sign each Application; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association. 6 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 Association by electronic means. In full recognition that the Association shall rely upon such representations and warranties, including without limitation, the representations and warranties contained in the Terms and Conditions of Use of 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 Association that it will cause such persons to abide by those terms and conditions. This Authorization replaces and supersedes any Authorization currently in the Association records with respect to this Agreement. [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ Yours truly, / signed / ______________ 7 Attachment 2 - Interim unaudited Financial Statements COVID-19 Emergency Response Project Interim Unaudited Financial Report Content Discussion of Financial performance, Notes & Explanations Consolidated Statement of Sources and Uses of Fund Summary of Expenditure by Component Summary of Expenditure by Implementing Entity Expenditure summary by Category Statement of Designated Account activity by account Fund Flow Statement by account Statement of Sources and Uses of Fund by Implementing Entity Statement of Cash Movement by Region/Implementing Entity Expenditure Apportionment table Cash forecast Supporting schedules (Advances and Payables aging analysis, bank reconciliation, etc.) Vaccine Distribution Report Ministry of Health 8 Ethiopia – COVID 19 Emergency Response Project Statement of Program Sources & Uses of Funds For The Quarter Ended_________(in Ethiopian Birr/USD) Actual Planned Variance Cumula Curr Cumula Curre Year tive ent Year tive Cumulativ nt to (To Quar to (To e Quart date date) ter date date) Current Year to (To date) er (In (In ETB (In (In (In ETB Quarter date (In (In ETB (In ETB Birr)/II(a ETB) ETB Birr)/II(a Particulars (In ETB)/I ETB)/II Birr)/II(a) ETB)/I )/II ) /I )/II ) Opening Balance Designated Account – Parent/ (III) Designated Account – AF 1 and 2/ (III) Balance at Federal and Regional Implementing entities (Cash/Bank balances plus receivables minus payables) Total Opening Balance Add: Sources IDA 65870 Parent IDA D5940 Parent IDA D7910 AF 1 IDA – AF 2 Total Source for the Period Total Available Fund For The Period Less: Program Expenditures Total Available Fund Less Total Expenditures Foreign Exchange Difference/ (IV) Net Fund Available Ending Balance IDA – Parent (Designated USD Acct.) IDA – AF 1 and 2 (Designated USD Acct.) 9 Balance at Federal and Regional (Cash/Bank balances plus receivables minus payables) Total Ending Balance Cash on Cash at Receivabl Payab Tota hand bank es les l MoH EPHI EPSA EFDA Regional balances (breakdown by region) NOTES: I - The amounts are drawn from the ledger accounts of the program II - Of the current fiscal year II(a) - for the whole life of the project III- The following rates were used for conversion: USD 1=XX Birr (Separately for opening and closing balances of DA) IV - The gain or loss on exchange rate is determined by the rate prevailing at the reporting date. V - Schedule for designated accounts, receivable and payables should be provided as a note to the IFR Sources of fund is converted at the exchange rate prevailing on the collection date. Prepared Approved By By___________________________ __________________________ Signature Signature ___________________________ ___________________________ Date Date ________________________________ ______________________________ 10 Ministry of Health Ethiopia – COVID 19 Emergency Response Project Expenditure Summary by Component- (in Ethiopia Birr/USD) For the Quarter Ended__________________ Actual Planned Variance Cu Cu Cu rre ye mul ye mul ye Cum nt ar ativ curren ar ativ Curr ar ulativ qu to e to t to e to ent to e to art dat date quarte da date quar da date/i Particulars er/i e /ii r te /ii ter/ii te i Expenditures Component 1 - Medical Supplies and Equipment Sub-component - 1.1 Drugs, medical supplies and equipment Sub-component - 1.2 Laboratory equipment, reagents, testing kits and other consumable supplies for laboratories Sub-component - 1.3 COVID-19 Vaccine, vaccination supplies (AF 1)7 Sub-component - 1.4 Cold Chain inputs and maintenance (AF 1)8 Sub-component - 1.5 Infection prevention and waste management – Vaccine related (AF 1)9 Sub-component - 1.6 COVID-19 Vaccine storage and transportation (AF 1)10 Sub-component – 1.7 ICU supplies, ventilators an supplies, oxygen plant AF - 2 7 This includes activities included under Part 1 of the Additional Financing ’s Financing Agreement 1(a) and (b) 8 This includes activities included under Part 1 of the Additional Financing’s Financing Agreement 1(c) and (d) 99 This includes activities included under Part 1 of the Additional Financing’s Financing Agreement 1(g) 10 10 This includes activities included under Part 1 of the Additional Financing’s Financing Agreement 1(h) 11 Sub Total Component 2 - Preparedness, Capacity Building and Training Sub-component - 2.1 Coordination at national, sub-national, regional and cross-country levels Sub-component - 2.2 Operationalization of emergency operation centers Sub-component - 2.3 Supportive supervision for subnational level diseases preparedness activities and Operating costs Sub-component - 2.4 Health screening at ports of entry Sub-component - 2.5 Strengthening call and hotline centers, public health emergency management and surveillance, building diagnostic capacity Sub-component - 2.6 Development of materials, expert deployment, training, capacity building, supervision and monitoring – Vaccine related (AF 1)11 Sub-component - 2.7 – Preparatory activities for local COVID 19 vaccine manufacturing – AF 2 Sub Total Component 3 - Community discussions and information outreach Sub-component - 3.1 Development of risk communication materials, community engagement and risk assessment Sub-component - 3.2 Establishment of information center, monitoring, and complaint handling Sub-component - 3.3 Monitoring and complaint handling (AF 1)12 Sub-component - 3.4 Development of strategies and deployment of risk officers (AF 1)13 11 This includes activities included under Part 2 of the Additional Financing’s Financing Agreement from 2(i) -(q) 12 This includes activities included under Part 3 of the Additional Financing’s Financing Agreement 3(h) and (i) 13 This includes activities included under Part 3 of the Additional Financing’s Financing Agreement 3(g) and (j) 12 Sub Total Component 4 – Quarantine, Isolation and Treatment centers Sub-component - 4.1 Establishment and equipping of quarantine, isolation and treatment centers, provision of nutrition and dignity kits Sub-component - 4.2 Establishment of the regulatory infrastructure and capacity – COVID 19 Vaccine, refurbishing and equipping a COVID-19 vaccine laboratory (AF 1)14 Sub-component - 4.3 Integrate COVID-19 Vaccine deployment activities with health facility level maternal and child treatment services AF-2 Sub-component - 4.4 Climate sensitive refurbishment and renovation of vaccine cold room AF-2 Sub Total Component 5 - Project Implementation and Monitoring Sub-component - 5.1 Project management Sub-component - 5.2 Recruitment and training of GMU and EPHI staff and consultants Sub-component - 5.3 Creation of accountability, grievances, and citizen and community engagement mechanisms. Grand Total Approved By________________ Prepared By___________________________ ___________ Signature __________________ Signature ___________________________ _________ 14 This includes activities included under Part 3 of the Additional Fina ncing’s Financing Agreement 4(b) 13 Date __________________ Date ________________________________ ______________ /i - Amounts are drawn from the ledger account of the program /ii - These are program to date figures 14 Ministry of Health Ethiopia – COVID 19 Emergency Response Project Expenditure Summary by Implementing entity (in Ethiopia Birr/USD) For the Quarter Ended__________________ Actual Planned Variance ye ye Curre curre ar Curre ar nt Cumulati nt to Cumula nt to Cumula quart year to ve to quart da tive to quart da tive to Particulars er/i date date/ii er te date/ii er/ii te date/ii Expenditure MoH Component 1 - Medical Supplies and Equipment Component 2 - Preparedness, Capacity Building and Training Component 3 - Community discussions and information outreach Component 4 - Quarantine, Isolation and Treatment centers Component 5 - Project Implementation and Monitoring SUB TOTAL EPHI Component 1 - Medical Supplies and Equipment Component 2 - Preparedness, Capacity Building and Training 15 Component 3 - Community discussions and information outreach Component 4 - Quarantine, Isolation and Treatment centers Component 5 - Project Implementation and Monitoring SUB TOTAL EPSA Component 1 - Medical Supplies and Equipment Component 2 - Preparedness, Capacity Building and Training Component 3 - Community discussions and information outreach Component 4 - Quarantine, Isolation and Treatment centers Component 5 - Project Implementation and Monitoring EFDA Component 1 - Medical Supplies and Equipment Component 2 - Preparedness, Capacity Building and Training Component 3 - Community discussions and information outreach Component 4 - Quarantine, Isolation and Treatment centers Component 5 - Project Implementation and Monitoring 16 Regions (Breakdown by each region) Component 1 - Medical Supplies and Equipment Component 2 - Preparedness, Capacity Building and Training Component 3 - Community discussions and information outreach Component 4 - Quarantine, Isolation and Treatment centers Component 5 - Project Implementation and Monitoring SUB TOTAL Grand Total Approved By_________________________ Prepared By___________________________ __ Signature Signature ___________________________ ___________________________ Date ___________________________ Date ________________________________ _____ /i - Amounts are drawn from the ledger account of the program /ii - These are program to date figures 17 Ministry of Health Ethiopia – COVID 19 Emergency Response Project Expenditure Summary by Category-(USD) For the Quarter Ended__________________ Actual Planned Variance ye ar ye Curr yea curre to Cumu Curre ar Cumul ent r to Cumulat nt d lative nt to ative quar dat ive to quart at to quart dat to Particulars ter/i e date/ii er e date/ii er/ii e date/ii Expenditures Category 1 for Parent IDA 65870 and D5940; Category 2 for AF -1 D7910, Category 1 and 2 for AF 2 Component 1 Goods Works Non-Consulting services Consulting services Operating cost Training Sub total Component 2 Goods 18 Works Non-Consulting services Consulting services Operating cost Training Sub total Component 3 Goods Works Non-Consulting services Consulting services Operating cost Training Sub total Component 4 Goods Works Non-Consulting services Consulting services 19 Operating cost Training Sub total Component 5 Goods Works Non-Consulting services Consulting services Operating cost Training Sub total Grand Total Approved By____________________ Prepared By___________________________ _______ Signature ______________________ Signature ___________________________ _____ Date ______________________ Date ________________________________ __________ /i - Amounts are drawn from the ledger account of the program /ii - These are program to date figures 20 Ministry of Health Ethiopia – COVID 19 Response Project Designated Account (Parent Project) Activity Statement For the quarter ended in USD Line description IDA Opening balance/i Advance received during the quarter Refund from DA during the quarter Less: Transfers out of the DA to the treasury during the quarter DA closing balance as at the quarter end carried forward to the next period Bank balance per bank statement Difference /I - enter the amount shown in the previous IFR 21 Ministry of Health Ethiopia – COVID 19 Response Project Designated Account (Additional Financing 1 and 2) Activity Statement For the quarter ended in USD Line description Balance in USD Opening balance/i Advance received during the quarter from IDA D7910 AF 1 Advance received during the quarter from IDA - AF 2 Refund from DA during the quarter Less: Transfers out of the DA to the treasury during the quarter DA closing balance as at the quarter end carried forward to the next period Bank balance per bank statement Difference /I - enter the amount shown in the previous IFR 22 Ministry of Health Ethiopia – COVID 19 Emergency Response Project STATEMENT OF FUND FLOW (IDA Additional Financing 1 and 2) DESIGNATED DOLLAR ACCOUNT NO. For the period ……………………………... USD BIRR OPENING BALANCE Add: Receipt Fund Received (IDA D7910 AF 1) as at Fund Received (from AF 2) as at Fund Available for use Less: Transfer and Expenditure Transfer to pool birr account as at Expenditures Bank services Charges Total transfer & expenditure closing balance Actual exchange rate of …………… ……………. closing balance /Leger birr account/ Add gain or (Loss) on Foreign exchange Balance After Gain/loss on foreign exchange Prepared By___________________________ Approved By __________________________ Signature ___________________________ Signature ___________________________ Date ________________________________ Date ______________________________ 23 Ministry of Health Ethiopia – COVID 19 Emergency Response Project STATEMENT OF FUND FLOW (IDA Parent Project) DESIGNATED DOLLAR ACCOUNT NO. For the period ……………………………... USD BIRR OPENING BALANCE Add: Receipt Grant fund IDA D5940 Received as at Credit Fund IDA 65870 Received as at Fund Available for use Less: Transfer and Expenditure Transfer to pool birr account as at Expenditures Bank services Charges Total transfer & expenditure closing balance Actual exchange rate of …………… ……………. closing balance /Leger birr account/ Add gain or (Loss) on Foreign exchange Balance After Gain/loss on foreign exchange Prepared By___________________________ Approved By __________________________ Signature ___________________________ Signature ___________________________ Date ________________________________ Date ______________________________ 24 Ministry of Health Ethiopia – COVID 19 Emergency Response Project Fund flow statement Pooled Bank a/c ______________ (Birr) For the period ………………… Birr Birr Balance brought forward Cash Transfer from DA (Parent) Cash Transfer from DA (AF1 and AF 2) Fund available for use Fund transfer Detail by implementing entity Total Transfer Bank service charge Incoming and Outgoing Total Transfer & bank service Charge Cash at Bank Prepared By___________________________ Approved By __________________________ Signature ___________________________ Signature ___________________________ Date ________________________________ Date ______________________________ 25 MINISTRY OF HEALTH Ethiopia – COVID 19 Emergency Response Project Statement of Sources and Expenditure by Implementing entity For the quarter…. Name Prior Gain Total of Begin Year/q Colle Tran Total on Compo Compo Compo Compo Compo Expen End Implem ning uarter ction sfer Fund Exch nent 1 nent 2 nent 3 nent 4 nent 5 diture ing enting Balan Adjust from Avail ange Sub- Sub- Sub- Sub- Sub- Bala Entity ce ment Mo able Rate compon compon compon compon compon nce H ent 1.1- ent 2.1- ent 3.1- ent 4.1 ent 5.1- 1.7 2.7 3.4 – 4.4 5.3 MoH EPHI EPSA EFDA Regions (breakd own by each region) Total 26 Ministry of Health Ethiopia – COVID 19 Emergency Response Project STATEMENT OF CASH MOVEMENT ____REGION/ENTITY For the period …… Amount in Birr Opening Balance Add: Cash transfers Transfers from MoH Fund Available for use Less: Expenditure Component 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Component 2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Component 3 27 3.1 3.2 3.3 3.4 Component 4 4.1 4.2 4.3 4.4 Component 5 5.1 5.2 5.3 Total expenditure Closing balance Breakdown of closing balance Cash and Bank balances Receivables Payables others Total Closing Balance Balances Prepared By___________________________ Approved By ____ Signature ___________________________ Signature ____ Date ________________________________ Date _________ Ministry of Health Ethiopia - COVID-19 Emergency Response Project 28 Expenditure Apportionment Worksheet (IN USD) For the Quarter Ended ------ Total Current quarter Remaining Category Allocation Documented so expenditure Total Documented undocumented far allocated balance IDA 65870 Category 1 IDA D5940 Category 1 IDA D7910 – AF 1 Category 1 IDA - Additional Financing 2 Category 1 Category 2 Total Grand Total 29 Ministry of Health Ethiopia – COVID 19 Emergency Response Project Expenditures Forecasts & Cash Requirements (In ETB/ USD) For the …… months from …... to …… Expenditures for the next ….. Months ETB USD Component 1 – Medical supplies and equipment (Disaggregated by Parent, AF 1, AF 2) Component 2 - Preparedness, Capacity Building and Training (Disaggregated by Parent, AF 1, AF 2) Component 3 – Community discussions and information outreach (Disaggregated by Parent, AF 1, AF 2) Component 4 – Quarantine, Isolation and Treatment centers (Disaggregated into Parent, AF 1, AF 2) Component 5 - Project Implementation and Monitoring (Disaggregated by Parent, AF 1, AF 2) Total Expenditures for the next 6 Months Ending Balance: Cash at bank and on hand Advances Payables Total Ending Balance Forecasted Expenditure Less Available Cash Requirement for the Next six months From IDA 65870 IDA D7901 – AF 1 IDA AF - 2 30 Receivable Aging Schedule Quarter ended -- Aging Sr. Particulars 6 Month -1 More than 1 NO. 1-3 Months 3-6 Months Total year Year 1 2 3 4 5 Total Payable Aging Schedule Quarter ended -- Aging Sr. Particulars 6 Month -1 More than 1 NO. 1-3 Months 3-6 Months Total year Year 1 2 3 4 Total 31 Ministry of Health COVID-19 Emergency Response Project Vaccine Distribution Report For the quarter ended……….. Measurement: # of vials Current Cumulative for the Cumulative for project Vaccine quarter year life 1. Reconciliation of procured and received vaccines 1 Vaccine procured Vaccines received at EPSA 2 warehouse 3 Difference (1-2) 2. Vaccines distributed by EPSA Central warehouse Balance brought forward (#7 4 of previous quarter report) Vaccines received at EPSA 5 Central warehouse Vaccines distributed to hubs 6 (detail in form 1) Vaccine remaining at EPSA 7 Central warehouse (4+5-6) 3. Vaccine distributed by EPSA Hubs Balance brought forward (#10 8 of previous quarter report) Vaccine distributed to woredas and health facilities 9 (Detail from form 1) 32 Vaccine remaining at the hubs 10 (detail from form 1) 4. Vaccine used for inoculation (to be obtained from MoH - EPI) 11 Vaccines used for inoculation 12 Vaccines damaged Vaccines available for 13 inoculation 5. vaccines available for inoculation Total remaining vaccines available at all levels 14 (7+10+13) 33 Form – 1 Measurement: # of vials Vaccine dispatched from Vaccine distributed to Vaccine EPSA central Vaccine received at the health centers and remaining at warehouse Hubs woredas Hub store Hub 1 Hub 2 Hub 3 Hub 4 Hub 5 Hub 6 Hub 7 Total Form - 2 Measurement: # of vials Vaccine damaged Vaccine Vaccine damaged Vaccine damaged Vaccines damaged during delivery damaged at at EPSA Hubs at health facilities during inoculation into the country EPSA Central Stores Opening Balance Damaged during the quarter Balance at the end of the quarter