LIFE Environment and Resource Efficiency TECHNICAL APPLICATION FORMS Part A administrative information

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1 LIFE Environment and Resource Efficiency TECHNICAL APPLICATION FORMS Part A administrative information Page 1 of 32 Printed out on : 12/05/ :03

2 LIFE15 ENV/IT/ LIFE 2015 FOR ADMINISTRATION USE ONLY LIFE Environment and Resource Efficiency project application LIFE15 ENV/IT/ Language of the proposal: Italiano (it) Project title: LIFE EASME ENV TEST 2 Project acronym: LIFE EASME ENV TEST 2 The project will be implemented in the following Member State(s) and Region(s) or other countries: Italy Toscana Expected start date: 03/10/2016 Expected end date: 31/12/2017 LIST OF BENEFICIARIES Name of the coordinating beneficiary: vv LIST OF CO-FINANCERS PROJECT BUDGET AND REQUESTED EU FUNDING Total project budget: Total eligible project budget: EU financial contribution requested: 3,000 Euro 3,000 Euro 1,000 Euro (= 33.33% of total eligible budget) SECTOR Water Page 2 of 32

3 LIFE15 ENV/IT/ A2 Coordinating Beneficiary Profile Information Legal Name vv Short Name qq Legal Status VAT No Public body Legal Registration Private commercial Registration Date Private non- commercial X Pic Number Legal entity is SME Employee number Legal address of the Coordinating Beneficiary Street Name and No v Post Code 444 PO Box Town / City v Member State Italy Coordinating Beneficiary contact person information Title Mr. Function rr Surname rr First Name rr address Department / Street Name and No rr Post Code 444 PO Box Town / City rr Member State Austria Telephone No 555 Fax No Website of the Coordinating Beneficiary Website Brief description of the Coordinating Beneficiary's activities and experience in the area of the rrr Page 3 of 32

4 Page 4 of 32 LIFE15 ENV/IT/ A3

5 LIFE15 ENV/IT/ A7 OTHER PROPOSALS SUBMITTED FOR EUROPEAN UNION FUNDING Please answer each of the following questions: Have you or any of your associated beneficiaries already benefited from previous LIFE cofinancing? (please cite LIFE project reference number, title, year, amount of the co-financing, duration, name(s) of coordinating beneficiary and/or partners involved): Have you or any of the associated beneficiaries submitted any actions related directly or indirectly to this project to other European Union funding programmes? To whom? When and with what results? For those actions which fall within the eligibility criteria for financing through other European Union funding programmes, please explain in full detail why you consider that those actions are better suited to financing through LIFE and are therefore included in the current project: g Page 5 of 32

6 LIFE15 ENV/IT/ TECHNICAL APPLICATION FORMS Part B - technical summary and overall context of the project Page 6 of 32

7 LIFE15 ENV/IT/ B1 SUMMARY DESCRIPTION OF THE PROJECT (Max. 3 pages; to be completed in English) Project title: LIFE EASME ENV TEST 2 Project objectives: Actions and means involved: Expected results (outputs and quantified achievements): g Is your project significantly climate-related? Yes No X g Is your project significantly biodiversity-related? Yes No X The proposal addresses the following project topic(s): Planning and establishment in urban and rural areas of natural water retention measures that increase infiltration, storage of water and remove pollutants through natural, or "natural-like" processes and thereby contribute to the achievement of the WFD and the Floods Directive (FD) objectives and to drought management in water scarce regions. Reasons why the proposal falls under the selected project topic(s): g Page 7 of 32

8 LIFE15 ENV/IT/ B2 ENVIRONMENTAL PROBLEM TARGETED PROJECT PILOT / DEMONSTRATION CHARACTER OF THE PROJECT Page 8 of 32

9 LIFE15 ENV/IT/ B3 EU ADDED VALUE OF THE PROJECT AND ITS ACTIONS SOCIO-ECONOMIC EFFECTS OF THE PROJECT EFFORTS FOR REDUCING THE PROJECT'S "CARBON FOOTPRINT" g Page 9 of 32

10 LIFE15 ENV/IT/ B4 STAKEHOLDERS INVOLVED AND MAIN TARGET AUDIENCE OF THE PROJECT (OTHER THAN PROJECT PARTICIPANTS) g Page 10 of 32

11 LIFE15 ENV/IT/ B5 EXPECTED CONSTRAINTS AND RISKS RELATED TO THE PROJECT IMPLEMENTATION AND MITIGATION STRATEGY Page 11 of 32

12 LIFE15 ENV/IT/ B6 CONTINUATION / VALORISATION AND LONG TERM SUSTAINABILITY OF THE PROJECT'S RESULTS AFTER THE END OF THE PROJECT Which actions will have to be carried out or continued after the end of the project? How will this be achieved? What resources will be necessary to carry out these actions? To what extent will the results and lessons of the project be actively disseminated after the end of the project to those persons and/or organisations that could best make use of them (please identify these persons/organisations)? Page 12 of 32

13 LIFE15 ENV/IT/ TECHNICAL APPLICATION FORMS Part C detailed technical description of the proposed actions Page 13 of 32

14 LIFE15 ENV/IT/ C0 A. Preparatory actions (if needed) B. Implementation actions (obligatory) LIST OF ALL PROPOSED ACTIONS B1 IMP C. Monitoring of the impact of the project actions (obligatory) C1 MON D. Public awareness and dissemination of results (obligatory) D1 PUB E. Project management (obligatory) E1 MAN Page 14 of 32

15 LIFE15 ENV/IT/ C1b DETAILS OF PROPOSED ACTIONS B. Implementation actions (obligatory) ACTION B.1: IMP Description and methods employed (what, how, where, when and why): g Beneficiary responsible for implementation: qq Assumptions related to major costs of the action: Page 15 of 32

16 LIFE15 ENV/IT/ C1b B1's PROJECT DELIVERABLE PRODUCTS Deliverable name Deadline B1's PROJECT MILESTONES Milestone name Deadline Page 16 of 32

17 LIFE15 ENV/IT/ C1c C. Monitoring of the impact of the project actions (obligatory) ACTION C.1: MON Description and methods employed (what, how, where, when and why): Beneficiary responsible for implementation: qq Assumptions related to major costs of the action: hh Page 17 of 32

18 LIFE15 ENV/IT/ C1c C1's PROJECT DELIVERABLE PRODUCTS Deliverable name Deadline C1's PROJECT MILESTONES Milestone name Deadline Page 18 of 32

19 LIFE15 ENV/IT/ C1d D. Public awareness and dissemination of results (obligatory) ACTION D.1: PUB Description and methods employed (what, how, where, when and why): Beneficiary responsible for implementation: qq Assumptions related to major costs of the action: g Page 19 of 32

20 LIFE15 ENV/IT/ C1d D1's PROJECT DELIVERABLE PRODUCTS Deliverable name Deadline D1's PROJECT MILESTONES Milestone name Deadline Page 20 of 32

21 LIFE15 ENV/IT/ C1e E. Project management (obligatory) ACTION E.1: MAN Description and methods employed (what, how, where, when and why): Beneficiary responsible for implementation: qq Assumptions related to major costs of the action: gnb Page 21 of 32

22 LIFE15 ENV/IT/ C1e E1's PROJECT DELIVERABLE PRODUCTS Deliverable name Deadline E1's PROJECT MILESTONES Milestone name Deadline Page 22 of 32

23 LIFE15 ENV/IT/ C2 DELIVERABLE PRODUCTS OF THE PROJECT Name of the Deliverable Number of the associated action Deadline MILESTONES OF THE PROJECT Name of the Milestone Number of the associated action Deadline ACTIVITY REPORTS FORESEEN Please indicate the deadlines for the following reports: Progress Reports nï ½1, nï ½2 etc. (if any; to ensure that the delay between consecutive reports does not exceed 18 months) Mid term report payment request (for project longer than 24 months or with Eu contibution of more than EUR300,000) Final Report with payment request (to be delivered within 3 months after the end of the project) Type of report Deadline Progress report 17/11/2016 Midterm report 13/07/2017 Final report 04/01/2018 Page 23 of 32

24 LIFE15 ENV/IT/ C3 TIMETABLE Action Action numbe Name of the action I II III IV I II III IV I II III IV I II III IV I II III IV I II III IV A. Preparatory actions (if needed) B. Implementation actions (obligatory) B.1 IMP C. Monitoring of the impact of the project actions (obligatory) C.1 MON D. Public awareness and dissemination of results (obligatory) D.1 PUB E. Project management (obligatory) E.1 MAN Page 24 of 32

25 LIFE15 ENV/IT/ FINANCIAL APPLICATION FORMS Part F financial information Page 25 of 32

26 LIFE15 ENV/IT/ R1 - Budget Budget breakdown cost categories Total cost in Eligible Cost in % of total eligible costs 1. Personnel 1,000 1, % 2. Travel and subsistence % 3. External assistance % 4. Durable goods Infrastructure % Equipment % Prototype % 5. Land Not applicable 6. Consumables % 7. Other costs 2,000 2, % 8. Overheads % Total 3,000 3, % Contribution breakdown In % of total % of total eligible costs EU contribution requested 1, % 33.33% Coordinating Beneficiary's contribution 2, % Associated Beneficiaries' contribution % Co-financers contribution % Total 3, % Page 26 of 32

27 Cost category in Euro Project action LIFE15 ENV/IT/ R2 - Costs per Action Total Personnel (Days) Travel External assistance Infrastructure Equipment Prototype Consumables Other B1 IMP 1,000 (10) Overheads Total 1,000 (10) ,000 3, ,000 3,000 Page 27 of 32

28 Costs per Beneficiary Short name LIFE15 ENV/IT/ R2a Personnel (Days) Travel External assistance Infrastructure Equipment Prototype Consumables Other Overheads EU contrib. Total eligible costs % of total eligible costs qq 1,000 (10) Total 1,000 (10) Share of total eligible costs 33.33% , ,000 3, % , ,000 3, % 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 66.67% 0.00% 33.33% % Page 28 of 32

29 LIFE15 ENV/IT/ FC Coordinating Beneficiary's contribution Country code Beneficiary short name Total costs of the actions in (including overheads) Beneficiary's own contribution in Amount of EU contribution requested in IT qq 3,000 2,000 1,000 Associated Beneficiaries' contribution Country code Beneficiary short name Total costs of the actions in (including overheads) Associated beneficiary's own contribution in Amount of EU contribution requested in TOTAL Associated Beneficiaries TOTAL All Beneficiaries 3,000 2,000 1,000 Co-financers contribution TOTAL Co-financer's name Amount of cofinancing in 0 Page 29 of 32

30 LIFE15 ENV/IT/ F1 Direct Personnel costs Calculation => A B A x B Beneficiary Action Daily rate (rounded to Number of person-days Direct personnel short name number Type of contract Category/Role in the project the nearest costs ( ) qq B 1 Permanent staff or ff ,000 civil servant TOTAL => 10 1,000 Page 30 of 32

31 LIFE15 ENV/IT/ F7 Other costs Beneficiary short name Action numbe Procedure Description Costs ( ) qq B 1 vvv vv 2,000 TOTAL => 2,000 Page 31 of 32

32 LIFE15 ENV/IT/ Attachments Proposal attachments Included? Simplified financial statement Public body declaration Project performance indicators Attachment title Attachment type Yes No simplified financial statement (Excel file) public body declaration project performance indicators Page 32 of 32