Code of the Authorized Proposer
Project identification number

1. BASIC DATA ABOUT THE AUTHORIZED PROPOSER


1. 1. Basic information about Authorized Proposer
Authorized proposer
(full name of the relevant direct budget user)
Address
Contact person information
(first and last name, contact phone and e-mail address)



1. 2. Basic information about Investor
Investor (full name of the institution)
Address
Contact person information
(first and last name, contact phone and e-mail address)



1. 3. Basic information about other relevant actors (please add additional fields if necessary)
Full name of the institution
Address
Contact person information
(first and last name, contact phone and e-mail address)
Code of the Authorized Proposer
Project identification number

2. BASIC INFORMATION ABOUT THE PROJECT


2.1. Project Name
(The name of the project should be clear and concise so that it reflects the purpose of the project. It is recommended to contain up to a maximum of 10 words)




2. 2. Implementation start date
(In DD/MM/YYYY format)




2. 3. Estimated project completion date
(In DD/MM/YYYY format)
n up to a maximum of 10 words)
Code of the Authorized Proposer
Project identification number

3. PROJECT FINANCIAL DATA


3.1. Estimated project value
(please indicate the amount in original currency)




3.2. Project currency
(please mark the appropriate box with „X“ sign, or specify the 3-digit currency code as per ISO4217 standard)
RSD                           EUR                                   USD                         Other (please indicate)



3.3. Source of financing
(please indicate amount provided from one or more of the following sources)



                                                                       International Loan          International Loan       Domestic
                                            Budget
                                                                              (IFI)                     (bilateral)          Loan


in original currency
in RSD

3.4. Breakdown of project cost
(please indicate the estimated amount of project cost associated with each of the activities)

     Activity Name                          Amount




3.5. Loan guarantee
If the project is financed through a loan, please indicate whether it is a subject to a corresponding sovereign guarantee
            Yes                                No



Please provide the title of the Law on guarantee for the loan in question
                       Other (please
   EU                    specify)
             Private                   Total
assistance
Code of the Authorized Proposer
Project identification number

4. PROJECT IMPLEMENTATION SCHEDULE


4.1. Project activities implementation schedule
(please populate the list of activities in both preparatory and implementation phases ; first year of project implementation is the first year when any of the listed activities ar
(please add columns to reflect the required number of years, and rows to reflect the necessary number of project activities)
                                                               Year 1 (indicate first year of implementation)                                            Year 2

Activity name                                          Q1                  Q2               Q3              Q4               Q1              Q2




Total


4.2. Project financial implementation schedule
(Please indicate the share of total cost associated with each project activity in each of the quarters for the entire duration of project implementation, financial implementatio
(please add columns to reflect the required number of years, and rows to reflect the necessary number of project activities)
please add a separate table for each financing source involved, as stated in section 3.3. of the template


Source of financing                                                        (indicate source of financing as stated in section 3.3. of the template)
                                                               Year 1 (indicate first year of implementation)                                            Year 2

Activity name                                          Q1                  Q2               Q3              Q4               Q1              Q2




Total
ar when any of the listed activities are scheduled to start; please indicate the share of activity to be carried out in a specific quarter)


             Year 2                                                            Year 3                                                         Year 4

                 Q3               Q4              Q1               Q2               Q3              Q4               Q1               Q2         Q3




plementation, financial implementation is to be shown only when the funds are planned to be released to the implementing company)




             Year 2                                                            Year 3                                                         Year 4

                 Q3               Q4              Q1               Q2               Q3              Q4               Q1               Q2         Q3
ar 4

       Q4




ar 4

       Q4
Code of the Authorized Proposer
Project identification number

5. RISK MATRIX

Number               Description   Owner   Cause   Effect
Probability (low,                                                  Level of risk (low,
                    Estimated financial impact Response strategy
 medium, high)                                                      medium, high)
Code of the Authorized Proposer
Project identification number

6. COMMENTS FROM THE AUTHORIZED PROPOSER