H. E. Rindra Hasimbelo Rabarinirinarison Minister of Economy and Finance Ministry of Economy and Finance Antananarivo Republic of Madagascar Re: Grant No. TF0B8091 (Pandemic Preparedness and Basic Health Services Delivery Project) Additional Instructions: Disbursement and Financial Information Letter Excellency: I refer to the Grant Agreement ("Agreement") between the Republic of Madagascar ("Recipient"), and the International Development Association ("Bank"), acting as administrator of the Health Emergency Preparedness and Response Multi-Donor Trust Fund (HEPRTF), for the above-referenced project. The Standard Conditions, as defined in the Grant Agreement, provide that the Recipient may from time-to-time request withdrawals of Grant amounts from the Grant TF0B809 1 ("Grant") in accordance with the Disbursement and Financial Information Letter, and such additional instructions as the Bank may specify from time to time by notice to the Recipient. The Standard Conditions also provide 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 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. Sections and subsections in parentheses below refer to the relevant sections and subsections in the Disbursement Guidelines and, unless otherwise defined in this letter, the capitalized terms used have the meanings ascribed to them in the Disbursement Guidelines. (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 minimum value of applications and advances), instructions on supporting documentation, and frequency of reporting on the Designated Account(s). -2- 1 (ii) Withdrawal Applications (Electronic Delivery) The Recipient will 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 effected after the officials designated in writing by the Recipient who are authorized to sign and deliver 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 Bank by electronic 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 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 Bank's public website at https://www.worldbank.org and "Client Connection"; and (b) to cause such officials to abide by those terms and conditions. II. Financial Reports and Audits 2 (i) Financial Reports The Recipient must prepare and furnish to the Bank not later than forty-five (45) days after the end of each calendar quarter, interim unaudited financial reports ("IFRs") for the Project covering the quarter. (ii) Audits Each audit of the Financial Statements must cover the period of one (I) 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 must be furnished to the Bank 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 and "Client Connection". 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 1 Section 7.0l(c) of the Standard Conditions 2 Section 2.07(a) and (b) of the Standard Conditions. ,f -3- queries in relation to the above, please contact the Bank by email at AskLoans@WorJdBank.org using the above reference. Yours sincerely, 1 ' ~i-Riddihough Co ntry Director for Madagascar Ea em and Southern Africa Region Attachments I. Form of Statement of Expenditure (SOE) - 4- Schedule 1- Disbursement Provisions I A. Basic Information Country IMadagascar Closing Date Section III.B.2. of Schedule 2 to Grant HEPRTF: Recipient Republic of Madagascar the Grant Agreement. Number TF0B8091 Name of the Project Pandemic Preparedness and Basic Disbursement Four (4) months after the closing Health Services Delivery Project Deadline Date 3 date. B. Disbursement Methods and Supporting Documentation Disbursement Methods 4 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 1 of the DFIL Advance (into a Designated Yes Statement of Expenditure (SOE) in the format provided in Attachment 1 of the DFIL Account) Special Commitments Yes Copy of Letter of Credit (including proforma invoice(s), if cited in the Letter of Credit) I C. Designated Account(s) ° Type and Management Unit Segregated - managed by MoPH Ceiling Fixed Financial Institution - Central Bank of Madagascar USD Currency Name Frequency ofReporting ' Same as IFR: Quarterly Amount 300,000 D. Minimum Value of Applications The minimum value of applications for Reimbursement, Direct Payment and Special Commitment is 20% of the D.A. Ceiling. E. Authorized Signatories 9 Withdrawal and Documentation Applications "" (i) Authorized Signatures (subsection 3.1) The existing Blanket Letter N° 914-2021-MEF/SG/DGT/DDP/SADE/Rd signed by Rindra Hasimbelo Rabarinirinarison Minister of Economy and Finance dated on September 17, 2021 and its amendments. (ii) Applications (subsections 3.2 - 3.3) AII Withdrawal Applications and its supporting documentation will be electronically sent via the Association Bank's system Client Connection. For notes in Schedule 1: Sections and subsections relate to the "Disbursement Guidelines for Investment Project Financing", dated February 2017. 3 Subsection 3. 7 4 Section 2 ° 6 Subsections 4.3 and 4.4 Sections 5 and 6 7 Subsection 6.3 8 subsection 3.5 9 Subsection 3 .1 and 3 .2 I Subsection 3.3 and 3.4 -5- F. Additional Instructions (i) All other supporting documentation for SOEs should be retained by the project management or Recipient and must be made available for review by periodic World Bank missions and internal and external auditors (ii) Funds from the Designated Account may be transferred to Transactions Accounts denominated in Ariary or US dollars, opened during the preparation by each PIU at commercial bank to enable payment of eligible expenditures. Transactions and balance in these accounts are to be included in all project financial reports. -6- Attachment 1 - Statement of Expenditure SOE Modell Template (incl. listing of prior review payments) IDA - International Development Association Statement of Expenditures Financier Payment made during the period from to Loan/Credit/Grant # Application # The following expenditures have been incurred during the retroactive financing period (please tick) Yes Le Category # The following expenditures have been incurred before the closing date of the loan/credit/grant (please tick) Yes LNs Page # ONLY for the Designated Account 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Item Supplier's Brief Prior Contract# Contract Invoice Date of Total % Eligible Exchange Date of Amount No Name Description Review Currency Number Payment Amount of Financed Amount Rate Withdrawal Withdrawn of the (Contract?) (Client and Invoice from the from the from the Expenditure Connection Amount Covered by Bank (Col 9x Designated Designated (YES or #for Prior Application 10) Account Account NO) Review (Original+ Contracts) Amendment) (Net of (Col ll/12) Retention) 0.00 0.00 TOTAL 0.00 Supporting documents for this SOE are retained at (insert location) A separate form should be used for each category.