THE WORLD BAN MT IBRD IDA I WORLD BANKGROUP RODRIGO A. CHAVES Country Director, Indonesia Letter No.: CD-190/PAMSIMAS/XI/2015 November 10, 2015 Mr. Robert Pakpahan Director General of Budget Financing and Risk management Ministry of Finance Gedung Frans Seda Jalan DR. Wahidin Raya No. 1 Jakarta 10710 Indonesia Dear Mr. Pakpahan: Re: Support for the Third Water Supply and Sanitation for Low-Income Communities Project - PAMSIMAS (Grant No. TF094792) Fifth Additional Financing Amendment of Grant Agreement I refer to the Grant Agreement, dated August 11, 2009 (the "Original Grant Agreement"), as amended through April 23, 2014 (the "Fourth Additional Financing Amendment") (the "Grant Agreement"), between the Republic of Indonesia (the "Recipient") and the International Bank for Reconstruction and Development/International Development Association (the "World Bank"), acting as administrator of grant funds provided by the Government of Australia regarding the above- mentioned project (the "Project"). I refer also to the grant discussions between representatives of the Recipient and the World Bank pursuant to which the Recipient requested additional financing and an amendment to the Grant Agreement to reflect a scale-up of activities in approximately 440 additional villages. The World Bank is pleased to inform you that, after due consideration, it has agreed to the request for additional financing and to the amendments set forth below (the "Fifth Additional Financing Amendment"). Except as specifically provided for in this Fifth Additional Financing Amendment, all of the terms and conditions set out in the Original Grant Agreement, as amended by the First Additional Financing Amendment, the Second Additional Financing Amendment, the Third Additional Financing Amendment, and the Fourth Additional Financing Amendment, shall apply to this Fifth Additional Financing Amendment. References to "Grant" shall, except as the context otherwise requires, include the grant provided by the Original Grant Agreement, the First Additional Financing Amendment, the Second Additional Financing Amendment, the Third Additional Financing Amendment, the Fourth Additional Financing Amendment, and this Fifth Additional Financing Amendment. References to ISEB Tower 2, 12th Floor, J1. Jend. Sudirman Kay. 52-53, Jakarta 12190 3 +6221 5299 3000 * +6221 5299 3111 0 www.worldbank.org/id Mr. Robert Pakpahan 2 of 4 November 10, 2015 "this Agreement" shall mean the Original Grant Agreement together with the First Additional Financing Amendment, the Second Additional Financing Amendment, the Third Additional Financing Amendment, the Fourth Additional Financing Amendment, and the Fifth Additional Financing Amendment. 1. The first paragraph of the Grant Agreement is amended to provide for the grant of an additional eleven million six hundred thirty four thousand five hundred and twenty five United States Dollars (USD11,634,525) (the "Fifth Additional Grant") as follows: "In response to the request for financial assistance made on behalf of the Republic of Indonesia ("Recipient"), I am pleased to inform you that the International Bank for Reconstruction and Development/International Development Association ("World Bank"), acting as administrator of grant. funds provided by the Government of Australia under the Support for the Third Water Supply and Sanitation for Low Income Communities Project - PAMSIMAS Trust Fund proposes to extend to the Recipient a grant in an amount not to exceed seventy four million three hundred eighty three thousand six hundred and fourteen United States Dollars (USD74,383,614) ("Grant"), of which five million six hundred eleven thousand two hundred ninety two United States Dollars (USD5,611,292) comprises the original grant ("Original Grant"), eighteen million United States Dollars (USD18,000,000) comprises the first additional grant (the "First Additional Grant"), nine million United States Dollars (USD 9,000,000) comprises the second additional grant (the "Second Additional Grant"), thirteen million eight hundred thousand United States Dollars (USD13,800,000) comprises the third additional grant (the "Third Additional Grant"), sixteen million three hundred thirty seven thousand seven hundred ninety seven United States Dollars (USD16,337,797) comprises the fourth additional grant (the "Fourth Additional Grant"), and eleven million six hundred thirty four thousand five hundred and twenty five United States Dollars (USD11,634,525) comprises the fifth additional grant (the "Fifth Additional Grant") on the terms and conditions set forth or referred to in this letter agreement ("Agreement"), which includes the attached Annex, to assist in the financing of the project described in the Annex ("Project"). This Grant is funded out of the abovementioned trust fund for which the World Bank receives periodic contributions from the Donor to the trust fund. In accordance with Section 3.02 of the Standard Conditions (as defined in the Annex to this Agreement), the World Bank's obligations in connection with this Agreement are limited to the amount of funds made available to it by the Donor under the abovementioned trust fund, and the Recipient's right to withdraw the Grant proceeds subject to the availability of such funds." 2. Section 2.04 (a) of the Annex to the Grant Agreement is amended to read as follows: "(a) The Recipient shall monitor and evaluate the progress of the Project and prepare Project Reports in accordance with the provisions of Section 2.06 of the Standard Conditions and on the basis of the indicators set forth below. Each Project Report shall cover the period of one calendar quarter, and shall be furnished to the World Bank not later than one month after the end of the period covered by such report. ISEB Tower 2, 12th Floor, JL Jend Sudirman Ray. 52-53, Jakarta 12190 2 +6221 5299 3000 0 +6221 5299 3111 O www.worldbank.org/id Mr. Robert Pakpahan 3 of 4 November 10, 2015 1 Number of additional people with sustainable access to 1, 772,000 improved water facilities, differentiated by socioeconomic status 2 Number of additional people with sustainable access to 755,000 improved sanitation facilities, differentiated by socioeconomic status. 3 Number of villages developing community action plans 2,215 4 % of target communities free of open defecation 50% 5 % of targeted schools that have improved sanitation facilities 95% and hygiene programs 6 % of villages with improved water supply systems that are 90% effectively managed and financed 3. Except as specifically amended by the provisions of this Fifth Additional Financing Amendment, all terms and conditions of the Grant Agreement otherwise remain in full force and effect. 4. The World Bank hereby reallocates the proceeds of the Grant allocated in the Table in Section 3.01(c) of the Annex to the Grant Agreement as set out below: Category Amount of the Grant Percentage of Allocated Expenditures to be (expressed in USD) Financed (Exclusive of Taxes) (a) Component 1: 26,701,292 100% Community Empowerment and Local Institutional Development; and Component 3: Implementation Support and Project Management (b) Component 2: Village 47,682,322 100% of grant amount Incentive Grants disbursed to Participating Villages TOTAL AMOUNT 74,383,614 The World Bank will disclose this letter agreement and related information on this Project in accordance with the World Bank Policy on Access to Information. By entering into this agreement, the Recipient consents to disclosure of this agreement and related information on this Project. ISEB Tower 2, 12th Floor, JI. Jend. Sudirman Rav. 52-53, Jakarta 12190 2 +6221 5299 3000 6 +6221 5299 3111 O www.worldbank.org/id Mr. Robert Pakpahan 4 of 4 November 10, 2015 Please confirm your agreement to the amendments listed under sections 1 to 3 above by signing and dating both enclosed copies of this letter in the space provided and returning one signed copy to us. The above amendment will become effective as of the date of the Recipient's countersignature of this letter. Sincerel Rodri A. Cha) s Country Dire tor, I onesia AGREED: REPUBLIC OF INDONESIA By: Name: RKo b,,r t PpCf1 Title: D -rerl j 0 ~4y Date: 4y,Prni?r A/, lc/- ISEB Tower 2, 12th Floor, JL. Jend. Sudirman Ray 52-53, Jakarta 12190 R +6221 5299 3000 6 6221 5299 3111 0 www.worldbank.org/id