one blpl @,lo22 H. E. Rindra Hasimbelo Rabarinirinarison Minister of Economy and Finance Ministry of Economy and Finance Antananarivo Republic of Madagascar Re: Grant No. TF0B8069 and TF0B8068 (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 Global Financing Facility Trust Fund (GFF), 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 TF0B8069 and TF0B8068 ("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). 1 (ii) Withdrawal Applications (Electronic Delivery) 1 Section 7.0l(c) of the Standard Conditions -2- 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. Where a UN agency is contracted by the Recipient, the Recipient is responsible to ensure that the financial reporting requirements applicable to the UN Agency are stipulated in the agreement between the Recipient and the UN agency and met in a timely manner. (ii) Audits Each audit of the Financial Statements must 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 must be furnished to the Bank not later than six (6) months after the end of such period. Where a UN agency is contracted by the Recipient, the Recipient is responsible to ensure that the documentation requirements applicable to the UN agency, for project audit purposes, are stipulated in the agreement between the Recipient and the UN agency. 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 2 Section 2.07(a) and (b) of the Standard Conditions. -3- queries in relation to the above, please contact the Bank by email at AskLoans@WorldBank.org using the above reference. Yours sincerely, Z. Pswarayi-Riddihough untry Director for Madagascar stem and Southern Africa Region Attachments 1. Form of Statement of Expenditure (SOE) - 4- Schedule 1- Disbursement Provisions I A. Basic Information Country Madagascar Closing Date Section III.B.2. of Schedule 2 to GFF: the Grant Agreement. Grant Recipient Republic of Madagascar TF0B8069 Number Name of the Project Pandemic Preparedness and Basic Disbursement Four (4) months after the closing TF0B8068 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 pro forma invoice(s), if cited in the Letter of Credit) I C. Designated Account(s) 6 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 2,800,000 D. Minimum Value of Applications 8 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) ' All 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 Guidelinesfor Investment Project Financing", dated February 2017. 3 Subsection 3. 7 4 Section 2 5 Subsections 4.3 and 4.4 6 Sections 5 and 6 7 Subsection 6.3 8 subsection 3. 5 9 Subsection 3.1 and 3.2 10 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. In case of expenditure under any categories of the table under Schedule 2 Section III ("Withdrawal Table") of the Financing Agreement, payments to UN Agencies (if any) may be made through UN Advances (with or without a UN Commitment) disbursement mechanism. In case of a contract with a UN Agency requiring a UN Commitment, an application for issuance of UN Commitment is to be submitted by the Recipient. Subsequent payments and documentation of expenditures under the contract must be made in accordance with the Commitment letter to be issued by the Association and the contract between the Recipient and the UN agency. In case of a UN Advance (without UN Commitment), documentation of expenditure should be made once the final invoice is issued and/or based on the UN Financial Report. -6- Attachment 1 - Statement of Expenditure SOE Model 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 15 Category # The following expenditures have been incurred before the closing date of the loan/credit/grant (please tick) Yes [TE 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 9 x 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.