Grant Agreement Preparation Forms

Transcription

1 Grant Agreement Preparation Forms number title Preparing for MID-SKA receiving concepts in South-Africa Call (part) identifier FP7-PEOPLE-2013-IRSES Funding scheme Marie Curie Actions International Research Staff Exchange Scheme (IRSES)

2 INTRODUCTION Grant Agreement Preparation Forms (GPF s) have been designed to facilitate the project negotiations and the production of the grant agreement. It is a main communication instruments between the co-ordinator representing the Partnership Agreement and the Commission and/or the REA s Officer. Essentially the forms are used to identify the beneficiaries that will sign/accede to the grant agreement, to determine the eligible costs and European Union contribution and to electronically capture structured information on work packages, efforts, milestones and deliverables. The forms also include a standard declaration to be signed by each beneficiary. To assist the filling in of the GPF s the following is made available: Annotations these are attached to the standard forms and should be read carefully Pre-filled legal information (see below) NEF NEF is an online tool to be used by the co-ordinator and the beneficiaries to edit the content of the GPF s Legal information is held in the A2.1 form. This information is pre-filled by the Commission and/or the REA services using either information taken from the Commission database or from the proposal. Depending on the validity of this information, the organisation concerned may have to supply to the Commission and/or the REA with a so called identification fiche and supporting legal documents. For instructions on this, see the annotations to the A2.1 form. The budget table (A3.1) is to be used in Part A of Annex I of the grant agreement.

3 A1: Our project Number Acronym 2 title 3 One form per project General information Preparing for MID-SKA receiving concepts in South-Africa Starting date 4 01/09/2013 Duration in months 5 36 Call (part) identifier 6 FP7-PEOPLE-2013-IRSES Marie Curie action-code IRSES : International Research Staff Exchange Scheme (IRSES) Scientific panel PHY : Physics Activity code(s) most relevant to your topic 7 FP7-PEOPLE-2013-IRSES : Marie Curie Action "International Research Staff Exchange Scheme" Free keywords 8 Does the proposal include any of the sensitive ethical issues detailed in the Research Ethical Issues table of Part B SKA, MID-SKA, Radio astronomy, Technology development, Receiving concepts, Aperture Arrays, Wideband Single Pixel Feed Receivers,Research networks and collaborations, Staff exchange NO Abstract 9 (max char.) enables knowledge and staff exchange between two leading European institutes in research, development and building radio astronomy instrumentation and three South African partners collaborating e.g. through the Square Kilometre Array precursor MeerKAT in the Karoo as framework for (inter)national human-capital, research and infrastructure. In Europe novel approaches to radio astronomy i.e. Aperture Array technology as used in the Low Frequency Array ( LOFAR ) and Wideband Single Pixel Feed Receivers give insight in gaps to be filled and requirements for future radio telescopes. For the SKA as the world largest radio telescope operating in the next decade, with a large fraction in the Karoo, a common long term focus is developing requiring intensified knowledge exchange. Specifically, organizes for strengthening relevant research networks through exchange of experienced and early-stage radio scientists and engineers between South African institutes to and from Sweden and the Netherlands. Through that, aims at a common design view on site related aspects for radio telescopes, to advance radio-optics, calibration, ICT, processing and technology views and (possibly green ) designs on MID-SKA centred in the Karoo. Knowledge from the project will be disseminated to a larger community by annual workshops. The workshops will exchange ideas focus to establish views on next collaborative steps. This project will exchange local knowledge about the future SKA site needed for building, operating and calibrating the instruments to be designed with the high level technological system design expertise of the European institutes. Simultaneously the experience with calibrating MEERKAT and LOFAR will be shared. Thus preparing all participants in this proposal in an optimal way for contributions to the SKA project. The proposed exchange program fits goals of the African-European Radio Astronomy Platform ( AERAP ) endorsed by the European Parliament :02

4 A2.1: Who we are Coordinator project 10 1 Coordinator short name 11 ASTRON One form (Beneficiary 42 ) Legal data If your organisation has already registered for FP7, enter your Identity Code legal name 13 short name 11 Status of validation 14 STICHTING ASTRONOMISCH ONDERZOEK IN NEDERLAND ASTRON VALID Legal address of the participant Street name 15 Oude Hoogeveensedijk Number 15 4 Postal code / Cedex 15 Internet homepage (optional) DWINGELOO 7991PD Netherlands Registration data of the participant Legal registration Place of registration 17 KVK Drenthe Date of registration 17 23/04/1949 VAT 8 Legal form 19 NL B01 NL9 Legal Entity Appointed Representative (LEAR) 20 Family name Wubs-Komdeur First name(s) Janneke Phone (0) Phone wubs@astron.nl Fax (0) :02

5 A2.2: Who we are Coordinator project 10 1 Coordinator short name 11 ASTRON One form (Beneficiary 42 ) Status of your organisation Certain types of organisations benefit from special conditions under FP7 participation rules. If you are one of these, please tick the appropriate box(es) below. 22 Your organisation is: Natural person Legal person Non profit Research Organisation Public body International organisation International organisation of european interest Secondary and higher education establishment Enterprise SME Indirect costs 41 : Actual indirect costs Simplified method Standard flat rate Special transitional flat rate :02

6 A2.3: Authorised Representatives Coordinator project 10 1 Coordinator short name 11 ASTRON One form (Beneficiary 42 ) First authorised representative to sign the grant agreement or to commit the organisation for this project Family name Garrett First name(s) Michael Albert Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 36 General Director Department/Faculty/Institute/Laboratory name/ Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone garrett@astron.nl Fax 21 Second authorised representative to sign the grant agreement or to commit the organisation for this project Family name de Vos First name(s) Marco Title 34 Dr. Gender 35 (Female F / Male M) M Position in the organisation 36 Managing Director Department/Faculty/Institute/Laboratory name/ Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone devos@astron.nl Fax :02

7 A2.4: How to contact us Coordinator project 10 1 Coordinator short name 11 ASTRON One form (Beneficiary 42 ) Contact persons for this project Person in charge of administrative, legal and financial aspects in this project Family name Van ardenne First name(s) Arnold Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Coordinator SKA at ASTRON staffmember to general director Address (if different from the legal address) Street name 15 Oude Hoogeveensedijk Number 15 4 Postal code / Cedex 15 DWINGELOO 7991PD Netherlands Phone Phone ardenne@astron.nl Fax 21 Person in charge for the project Family name Van ardenne First name(s) Arnold Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 35 Department/Faculty/Institute/Laboratory name/ Coordinator SKA at ASTRON staffmember to general director Address (if different from the legal address) 12 Street name 15 Oude Hoogeveensedijk Number 15 4 Postal code / Cedex 15 DWINGELOO 7991PD Netherlands Phone Phone ardenne@astron.nl Fax :02

8 A2.5: Our commitment Coordinator project 10 1 Coordinator short name 11 ASTRON One form (Beneficiary 42 ) Certified declaration 1- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I am fully aware that a grant agreement may not be awarded to an applicant who is, at the time of a grant award procedure, in one of the situations referred to in Articles referred to in Articles 106(1), 107 and 109(2)(a) of the Regulation (EU, Euratom) No 966/2012 of the European Parliament and of the Council of 25 October 2012 on the financial rules applicable to the general budget of the Union and repealing Council Regulation (EC, Euratom) No 1605/2002 [OJ L298, , p.1]. As a consequence, I certify that: In compliance with article 106(1) of the abovementioned Regulation, none of the following cases apply to our organisation: a) it is bankrupt or being wound up, is having its affairs administered by the courts, has entered into an arrangement with creditors, has suspended business activities, is the subject of proceedings concerning those matters, or is in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) it or persons having powers of representation, decision making or control over it have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata; c) it has been guilty of grave professional misconduct proven by any means which the contracting authority can justify including by decisions of the EIB and international organisations ; d) it is not in compliance with its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or with those of the country of the contracting authority or those of the country where the contract is to be performed; e) it or persons having powers of representation, decision making or control over it have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity, where such illegal activity is detrimental to the Union s financial interests; f) it is currently subject to an administrative penalty referred to in Article 109(1) of the above-mentioned regulation. In compliance with article 107 of the abovementioned Regulation, and as far as the current grant award procedure is concerned, our organisation: g) is not subject to a conflict of interest; h) has not made false declarations in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or does not fail to supply this information; i) is not in one of the situations of exclusion, referred to in the abovementioned points a) to f). 2- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I also certify that our organisation: is committed to participate in the abovementioned project; has stable and sufficient sources of funding to maintain its activity throughout its participation in the abovementioned project and to provide any counterpart funding necessary; has or will have the necessary resources as and when needed to carry out its involvement in the abovementioned project. 3- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I finally certify that all the information relating to our organisation set out in the different Grant Agreement Preparation Forms are complete, accurate and correct; and that the estimated costs meet the criteria for eligible costs for FP7 projects as established by the EU model grant agreement are notably based on our usual accounting and management principles and practices, and reflect the costs expected to be incurred in carrying out the foreseen work described in Annex I (description of work). 4- Our organisation is fully aware that the Commission and/or the REA may impose administrative or financial penalties on legal entities who are guilty of misrepresentation in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or fail to supply this information; have been declared to be in serious breach of their obligations under any contract/grant agreement covered by the budget of the Commission. Such penalties shall :02

9 A2.5: Our commitment be proportionate to the importance of the contract/grant agreement and the seriousness of the misconduct, and may consist in their exclusion from the contracts and grants financed by the budget of the Commission for a maximum period of ten years and payment of financial penalties. 5- As an authorised representative I certify that the information given in the form A2.2 is correct. legal name 13 Family name of authorised representative Date Family name of authorised representative Date STICHTING ASTRONOMISCH ONDERZOEK IN NEDERLAND Garrett First Name(s) Michael Albert Signature of the authorised representative to sign the grant agreement or to commit the organisation 38 de Vos First Name(s) Marco Signature of the authorised representative to sign the grant agreement or to commit the organisation :02

10 A2.6: Data Protection & Coordination Role Coordinator project 10 1 Coordinator short name 11 ASTRON Signed only by the Beneficiary 42 As beneficiary on behalf of all proposers I take note of the following statement: All personal data (such as names, addresses, CVs, etc.) will be processed in accordance with Regulation (EC) No. 45/2001 of the European Parliament and of the Council of 18 December 2000 on the protection of individuals with regard to the processing of personal data by the institutions and bodies of the European Union and on the free movement of such data (Official Journal L 8, ). Such data will be processed solely in connection with the assessment of the project by the Commission and/or the REA department responsible for FP7. On request, proposers may obtain access to their personal data and correct or complete them. Any questions relating to the processing of these data can be addressed to the project officer. Proposers may lodge a complaint against the processing of their personal data with the European Data Protection Supervisor at any time. Any sensitive information or material used as background or produced as foreground in this project is covered by a Security Aspect Letter (SAL) 39 which is provided. If sensitive information or material is found to be required at a later stage of the project, amendment to the grant agreement will be requested and a SAL will be provided. I also certify that our organisation is committed to act as the coordinator of this project. legal name 13 Family name of authorised representative Date Family name of authorised representative Date STICHTING ASTRONOMISCH ONDERZOEK IN NEDERLAND Garrett First Name(s) Michael Albert Signature of the authorised representative to sign the grant agreement or to commit the organisation 38 de Vos First Name(s) Marco Signature of the authorised representative to sign the grant agreement or to commit the organisation :02

11 A2.1: Who we are project 10 2 short name 11 CHALMERS One form per participant (Partner 44 ) Legal data If your organisation has already registered for FP7, enter your Identity Code legal name 13 short name 11 Status of validation 14 CHALMERS TEKNISKA HOEGSKOLA AB CHALMERS VALID Legal address of the participant Street name 15 - Number 15 GOETEBORG Postal code / Cedex Internet homepage (optional) Sweden Registration data of the participant Legal registration Place of registration 17 Bolagsverket Date of registration 17 27/12/1993 VAT 8 Legal form 19 SE AB Legal Entity Appointed Representative (LEAR) 20 Family name Stenudd First name(s) Kurt Phone Phone kurt.stenudd@chalmers.se Fax :02

12 A2.2: Who we are project 10 2 short name 11 CHALMERS One form per participant (Partner 44 ) Status of your organisation Certain types of organisations benefit from special conditions under FP7 participation rules. If you are one of these, please tick the appropriate box(es) below. 22 Your organisation is: Natural person Legal person Non profit Research Organisation Public body International organisation International organisation of european interest Secondary and higher education establishment Enterprise SME Indirect costs 41 : Actual indirect costs Simplified method Standard flat rate Special transitional flat rate :02

13 A2.3: Authorised Representatives project 10 2 short name 11 CHALMERS One form per participant (Partner 44 ) First authorised representative to sign the grant agreement or to commit the organisation for this project Family name Elgered First name(s) Gunnar Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Head of Department Department of Earth and Space Sciences Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone gunnar.elgered@chalmers.se Fax 21 Second authorised representative to sign the grant agreement or to commit the organisation for this project Family name Olofsson First name(s) Hans Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Director Onsala Space Observatory Dpt of Earth and Space Sciences / Onsala Space Observatory Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone hans.olofsson@chalmers.se Fax :02

14 A2.4: How to contact us project 10 2 short name 11 CHALMERS One form per participant (Partner 44 ) Contact persons for this project Person in charge of administrative, legal and financial aspects in this project Family name Jakobson First name(s) Ingrid Title 34 Ms. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Head of Administration Department of Space and Earth Science Address (if different from the legal address) Street name 15 Number 15 Postal code / Cedex 15 Phone Phone ingrid.jakobson@chalmers.se Fax 21 Person in charge for the project Family name Conway First name(s) John Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 35 Department/Faculty/Institute/Laboratory name/ Deputy Director Onsala Space Observatory Department of Space and Earth Science Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone john.conway@chalmers.se Fax :02

15 A2.5: Our commitment project 10 2 short name 11 CHALMERS One form per participant Certified declaration 1- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I am fully aware that a grant agreement may not be awarded to an applicant who is, at the time of a grant award procedure, in one of the situations referred to in Articles referred to in Articles 106(1), 107 and 109(2)(a) of the Regulation (EU, Euratom) No 966/2012 of the European Parliament and of the Council of 25 October 2012 on the financial rules applicable to the general budget of the Union and repealing Council Regulation (EC, Euratom) No 1605/2002 [OJ L298, , p.1]. As a consequence, I certify that: In compliance with article 106(1) of the abovementioned Regulation, none of the following cases apply to our organisation: a) it is bankrupt or being wound up, is having its affairs administered by the courts, has entered into an arrangement with creditors, has suspended business activities, is the subject of proceedings concerning those matters, or is in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) it or persons having powers of representation, decision making or control over it have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata; c) it has been guilty of grave professional misconduct proven by any means which the contracting authority can justify including by decisions of the EIB and international organisations ; d) it is not in compliance with its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or with those of the country of the contracting authority or those of the country where the contract is to be performed; e) it or persons having powers of representation, decision making or control over it have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity, where such illegal activity is detrimental to the Union s financial interests; f) it is currently subject to an administrative penalty referred to in Article 109(1) of the above-mentioned regulation. In compliance with article 107 of the abovementioned Regulation, and as far as the current grant award procedure is concerned, our organisation: g) is not subject to a conflict of interest; h) has not made false declarations in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or does not fail to supply this information; i) is not in one of the situations of exclusion, referred to in the abovementioned points a) to f). 2- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I also certify that our organisation: is committed to participate in the abovementioned project; has stable and sufficient sources of funding to maintain its activity throughout its participation in the abovementioned project and to provide any counterpart funding necessary; has or will have the necessary resources as and when needed to carry out its involvement in the abovementioned project. 3- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I finally certify that all the information relating to our organisation set out in the different Grant Agreement Preparation Forms are complete, accurate and correct; and that the estimated costs meet the criteria for eligible costs for FP7 projects as established by the EU model grant agreement are notably based on our usual accounting and management principles and practices, and reflect the costs expected to be incurred in carrying out the foreseen work described in Annex I (description of work). 4- Our organisation is fully aware that the Commission and/or the REA may impose administrative or financial penalties on legal entities who are guilty of misrepresentation in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or fail to supply this information; have been declared to be in serious breach of their obligations under any contract/grant agreement covered by the budget of the Commission. Such penalties shall :02

16 A2.5: Our commitment be proportionate to the importance of the contract/grant agreement and the seriousness of the misconduct, and may consist in their exclusion from the contracts and grants financed by the budget of the Commission for a maximum period of ten years and payment of financial penalties. 5- As an authorised representative I certify that the information given in the form A2.2 is correct. legal name 13 Family name of authorised representative Date Family name of authorised representative Date CHALMERS TEKNISKA HOEGSKOLA AB Elgered First Name(s) Gunnar Signature of the authorised representative to sign the grant agreement or to commit the organisation 38 Olofsson First Name(s) Hans Signature of the authorised representative to sign the grant agreement or to commit the organisation :02

17 A2.1: Who we are project 10 3 short name 11 RHODES One form per participant (Partner 44 ) Legal data If your organisation has already registered for FP7, enter your Identity Code legal name 13 short name 11 Status of validation 14 RHODES RHODES VALID Legal address of the participant Street name 15 Drostdy Road Number 15 GRAHAMSTOWN Postal code / Cedex Internet homepage (optional) South Africa Registration data of the participant Legal registration 7 Place of registration 17 GRAHAMSTOWN Date of registration 17 01/01/1904 VAT Legal form 19 unknown Legal Entity Appointed Representative (LEAR) 20 Family name Fourie First name(s) Stephen Phone Phone s.fourie@ru.ac.za Fax :02

18 A2.2: Who we are project 10 3 short name 11 RHODES One form per participant (Partner 44 ) Status of your organisation Certain types of organisations benefit from special conditions under FP7 participation rules. If you are one of these, please tick the appropriate box(es) below. 22 Your organisation is: Natural person Legal person Non profit Research Organisation Public body International organisation International organisation of european interest Secondary and higher education establishment Enterprise SME Indirect costs 41 : Actual indirect costs Simplified method Standard flat rate Special transitional flat rate :02

19 A2.3: Authorised Representatives project 10 3 short name 11 RHODES One form per participant (Partner 44 ) First authorised representative to sign the grant agreement or to commit the organisation for this project Family name Clayton First name(s) Peter Title 34 Dr. Gender 35 (Female F / Male M) M Position in the organisation 36 Deputy Vice Chancellor: Research & Development Department/Faculty/Institute/Laboratory name/ Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone p.clayton@ru.ac.za Fax 21 Second authorised representative to sign the grant agreement or to commit the organisation for this project Family name First name(s) Title 34 Gender 35 (Female F / Male M) Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone 1 21 Phone Fax :02

20 A2.4: How to contact us project 10 3 short name 11 RHODES One form per participant (Partner 44 ) Contact persons for this project Person in charge of administrative, legal and financial aspects in this project Family name Roberts First name(s) Jaine Title 34 Ms. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Director: Research Research Office Address (if different from the legal address) Street name 15 Number 15 Postal code / Cedex 15 Phone Phone j.roberts@ru.ac.za Fax 21 Person in charge for the project Family name Smirnov First name(s) Oleg Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 35 Department/Faculty/Institute/Laboratory name/ SKA Research Chair Department of Physics & Electronics Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone o.smirnov@ru.ac.za Fax :02

21 A2.5: Our commitment project 10 3 short name 11 RHODES One form per participant Certified declaration 1- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I am fully aware that a grant agreement may not be awarded to an applicant who is, at the time of a grant award procedure, in one of the situations referred to in Articles referred to in Articles 106(1), 107 and 109(2)(a) of the Regulation (EU, Euratom) No 966/2012 of the European Parliament and of the Council of 25 October 2012 on the financial rules applicable to the general budget of the Union and repealing Council Regulation (EC, Euratom) No 1605/2002 [OJ L298, , p.1]. As a consequence, I certify that: In compliance with article 106(1) of the abovementioned Regulation, none of the following cases apply to our organisation: a) it is bankrupt or being wound up, is having its affairs administered by the courts, has entered into an arrangement with creditors, has suspended business activities, is the subject of proceedings concerning those matters, or is in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) it or persons having powers of representation, decision making or control over it have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata; c) it has been guilty of grave professional misconduct proven by any means which the contracting authority can justify including by decisions of the EIB and international organisations ; d) it is not in compliance with its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or with those of the country of the contracting authority or those of the country where the contract is to be performed; e) it or persons having powers of representation, decision making or control over it have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity, where such illegal activity is detrimental to the Union s financial interests; f) it is currently subject to an administrative penalty referred to in Article 109(1) of the above-mentioned regulation. In compliance with article 107 of the abovementioned Regulation, and as far as the current grant award procedure is concerned, our organisation: g) is not subject to a conflict of interest; h) has not made false declarations in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or does not fail to supply this information; i) is not in one of the situations of exclusion, referred to in the abovementioned points a) to f). 2- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I also certify that our organisation: is committed to participate in the abovementioned project; has stable and sufficient sources of funding to maintain its activity throughout its participation in the abovementioned project and to provide any counterpart funding necessary; has or will have the necessary resources as and when needed to carry out its involvement in the abovementioned project. 3- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I finally certify that all the information relating to our organisation set out in the different Grant Agreement Preparation Forms are complete, accurate and correct; and that the estimated costs meet the criteria for eligible costs for FP7 projects as established by the EU model grant agreement are notably based on our usual accounting and management principles and practices, and reflect the costs expected to be incurred in carrying out the foreseen work described in Annex I (description of work). 4- Our organisation is fully aware that the Commission and/or the REA may impose administrative or financial penalties on legal entities who are guilty of misrepresentation in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or fail to supply this information; have been declared to be in serious breach of their obligations under any contract/grant agreement covered by the budget of the Commission. Such penalties shall :02

22 A2.5: Our commitment be proportionate to the importance of the contract/grant agreement and the seriousness of the misconduct, and may consist in their exclusion from the contracts and grants financed by the budget of the Commission for a maximum period of ten years and payment of financial penalties. 5- As an authorised representative I certify that the information given in the form A2.2 is correct. legal name 13 Family name of authorised representative Date RHODES Clayton First Name(s) Peter Signature of the authorised representative to sign the grant agreement or to commit the organisation :02

23 A2.1: Who we are project 10 4 short name 11 SU One form per participant (Partner 44 ) Legal data If your organisation has already registered for FP7, enter your Identity Code legal name 13 short name 11 Status of validation 14 STELLENBOSCH SU VALID Legal address of the participant Street name 15 RYNEVELD STREET WILCOCKS BUILDING STELLENBOSCH Number Postal code / Cedex South Africa Internet homepage (optional) Registration data of the participant Legal registration 7 Place of registration 17 Date of registration 17 01/01/1900 VAT 8 Legal form 19 ZA UNK Legal Entity Appointed Representative (LEAR) 20 Family name Malherbe First name(s) Cornelia Phone (0) Phone cvdm2@sun.ac.za Fax (0) :02

24 A2.2: Who we are project 10 4 short name 11 SU One form per participant (Partner 44 ) Status of your organisation Certain types of organisations benefit from special conditions under FP7 participation rules. If you are one of these, please tick the appropriate box(es) below. 22 Your organisation is: Natural person Legal person Non profit Research Organisation Public body International organisation International organisation of european interest Secondary and higher education establishment Enterprise SME Indirect costs 41 : Actual indirect costs Simplified method Standard flat rate Special transitional flat rate :02

25 A2.3: Authorised Representatives project 10 4 short name 11 SU One form per participant (Partner 44 ) First authorised representative to sign the grant agreement or to commit the organisation for this project Family name Theron First name(s) Therina Title 34 Dr. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Senior Director Research Research Development Address (if different from the legal address) 12 Street name 15 Victoria Street Number 15 1 Stellenbosch Postal code / Cedex South Africa Phone Phone ttheron@sun.ac.za Fax Second authorised representative to sign the grant agreement or to commit the organisation for this project Family name Cloete First name(s) Eugene Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Vice Rector (Research and Innovation) Rectorate Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone eugenecloete@sun.ac.za Fax :02

26 A2.4: How to contact us project 10 4 short name 11 SU One form per participant (Partner 44 ) Contact persons for this project Person in charge of administrative, legal and financial aspects in this project Family name Brand First name(s) Alweri Title 34 Mrs. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Legal Advisor Division for Research Development Address (if different from the legal address) Street name 15 RYNEVELD STREET WILCOCKS BUILDING STELLENBOSCH Number Postal code / Cedex South Africa Phone Phone alweri@sun.ac.za Fax Person in charge for the project Family name Davidson First name(s) David Title 34 Prof. Gender 35 (Female F / Male M) M Position in the organisation 35 Department/Faculty/Institute/Laboratory name/ Prof. and S.A. Research Chair in E.M. for SKA Dep. of Electrical and Electronic Engineering Address (if different from the legal address) 12 Street name 15 BANGHOEK STREET ENGINEERING FACULTY STELLENBOSCH Number 15 Postal code / Cedex South Africa Phone Phone davidson@sun.ac.za Fax :02

27 A2.5: Our commitment project 10 4 short name 11 SU One form per participant Certified declaration 1- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I am fully aware that a grant agreement may not be awarded to an applicant who is, at the time of a grant award procedure, in one of the situations referred to in Articles referred to in Articles 106(1), 107 and 109(2)(a) of the Regulation (EU, Euratom) No 966/2012 of the European Parliament and of the Council of 25 October 2012 on the financial rules applicable to the general budget of the Union and repealing Council Regulation (EC, Euratom) No 1605/2002 [OJ L298, , p.1]. As a consequence, I certify that: In compliance with article 106(1) of the abovementioned Regulation, none of the following cases apply to our organisation: a) it is bankrupt or being wound up, is having its affairs administered by the courts, has entered into an arrangement with creditors, has suspended business activities, is the subject of proceedings concerning those matters, or is in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) it or persons having powers of representation, decision making or control over it have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata; c) it has been guilty of grave professional misconduct proven by any means which the contracting authority can justify including by decisions of the EIB and international organisations ; d) it is not in compliance with its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or with those of the country of the contracting authority or those of the country where the contract is to be performed; e) it or persons having powers of representation, decision making or control over it have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity, where such illegal activity is detrimental to the Union s financial interests; f) it is currently subject to an administrative penalty referred to in Article 109(1) of the above-mentioned regulation. In compliance with article 107 of the abovementioned Regulation, and as far as the current grant award procedure is concerned, our organisation: g) is not subject to a conflict of interest; h) has not made false declarations in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or does not fail to supply this information; i) is not in one of the situations of exclusion, referred to in the abovementioned points a) to f). 2- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I also certify that our organisation: is committed to participate in the abovementioned project; has stable and sufficient sources of funding to maintain its activity throughout its participation in the abovementioned project and to provide any counterpart funding necessary; has or will have the necessary resources as and when needed to carry out its involvement in the abovementioned project. 3- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I finally certify that all the information relating to our organisation set out in the different Grant Agreement Preparation Forms are complete, accurate and correct; and that the estimated costs meet the criteria for eligible costs for FP7 projects as established by the EU model grant agreement are notably based on our usual accounting and management principles and practices, and reflect the costs expected to be incurred in carrying out the foreseen work described in Annex I (description of work). 4- Our organisation is fully aware that the Commission and/or the REA may impose administrative or financial penalties on legal entities who are guilty of misrepresentation in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or fail to supply this information; have been declared to be in serious breach of their obligations under any contract/grant agreement covered by the budget of the Commission. Such penalties shall :02

28 A2.5: Our commitment be proportionate to the importance of the contract/grant agreement and the seriousness of the misconduct, and may consist in their exclusion from the contracts and grants financed by the budget of the Commission for a maximum period of ten years and payment of financial penalties. 5- As an authorised representative I certify that the information given in the form A2.2 is correct. legal name 13 Family name of authorised representative Date Family name of authorised representative Date STELLENBOSCH Theron First Name(s) Therina Signature of the authorised representative to sign the grant agreement or to commit the organisation 38 Cloete First Name(s) Eugene Signature of the authorised representative to sign the grant agreement or to commit the organisation :02

29 A2.1: Who we are project 10 5 short name 11 UCT One form per participant (Partner 44 ) Legal data If your organisation has already registered for FP7, enter your Identity Code legal name 13 short name 11 Status of validation 14 OF CAPE TOWN UCT VALID Legal address of the participant Street name 15 PRIVATE BAG X3 Number 15 RONDEBOSCH Postal code / Cedex Internet homepage (optional) South Africa Registration data of the participant Legal registration 7 Place of registration 17 Date of registration 17 19/12/1997 VAT Legal form 19 Other Legal Entity Appointed Representative (LEAR) 20 Family name Wallace First name(s) Roger Phone Phone Roger.Wallace@uct.ac.za Fax :02

30 A2.2: Who we are project 10 5 short name 11 UCT One form per participant (Partner 44 ) Status of your organisation Certain types of organisations benefit from special conditions under FP7 participation rules. If you are one of these, please tick the appropriate box(es) below. 22 Your organisation is: Natural person Legal person Non profit Research Organisation Public body International organisation International organisation of european interest Secondary and higher education establishment Enterprise SME Indirect costs 41 : Actual indirect costs Simplified method Standard flat rate Special transitional flat rate :02

31 A2.3: Authorised Representatives project 10 5 short name 11 UCT One form per participant (Partner 44 ) First authorised representative to sign the grant agreement or to commit the organisation for this project Family name Wallace First name(s) Roger Title 34 Mr. Gender 35 (Female F / Male M) M Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Contracts Manager Research Contracts & IP Services Address (if different from the legal address) 12 Street name 15 Rhodes Avenue Number 15 2 Mowbray Postal code / Cedex South Africa Phone Phone roger.wallace@uct.ac.za Fax 21 Second authorised representative to sign the grant agreement or to commit the organisation for this project Family name Sablay First name(s) Warda Title 34 Ms. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Contracts Manager Research Contracts & IP Services Address (if different from the legal address) 12 Street name 15 Rhodes Avenue Number 15 2 Mowbray Postal code / Cedex South Africa Phone Phone roger.wallace@uct.ac.za Fax :02

32 A2.4: How to contact us project 10 5 short name 11 UCT One form per participant (Partner 44 ) Contact persons for this project Person in charge of administrative, legal and financial aspects in this project Family name Kraan-Korteweg First name(s) Renee Title 34 Prof. Gender 35 (Female F / Male M) F Position in the organisation 36 Department/Faculty/Institute/Laboratory name/ Head of Department Department of Astronomy Address (if different from the legal address) Street name 15 Number 15 Postal code / Cedex 15 Phone Phone kraan@ast.uct.ac.za Fax 21 Person in charge for the project Family name Kraan-Korteweg First name(s) Renee Title 34 Gender 35 (Female F / Male M) Position in the organisation 35 Department/Faculty/Institute/Laboratory name/ Head of Department Department of Astronomy Address (if different from the legal address) 12 Street name 15 Number 15 Postal code / Cedex 15 Phone Phone kraan@ast.uct.ac.za Fax :02

33 A2.5: Our commitment project 10 5 short name 11 UCT One form per participant Certified declaration 1- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I am fully aware that a grant agreement may not be awarded to an applicant who is, at the time of a grant award procedure, in one of the situations referred to in Articles referred to in Articles 106(1), 107 and 109(2)(a) of the Regulation (EU, Euratom) No 966/2012 of the European Parliament and of the Council of 25 October 2012 on the financial rules applicable to the general budget of the Union and repealing Council Regulation (EC, Euratom) No 1605/2002 [OJ L298, , p.1]. As a consequence, I certify that: In compliance with article 106(1) of the abovementioned Regulation, none of the following cases apply to our organisation: a) it is bankrupt or being wound up, is having its affairs administered by the courts, has entered into an arrangement with creditors, has suspended business activities, is the subject of proceedings concerning those matters, or is in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) it or persons having powers of representation, decision making or control over it have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata; c) it has been guilty of grave professional misconduct proven by any means which the contracting authority can justify including by decisions of the EIB and international organisations ; d) it is not in compliance with its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or with those of the country of the contracting authority or those of the country where the contract is to be performed; e) it or persons having powers of representation, decision making or control over it have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity, where such illegal activity is detrimental to the Union s financial interests; f) it is currently subject to an administrative penalty referred to in Article 109(1) of the above-mentioned regulation. In compliance with article 107 of the abovementioned Regulation, and as far as the current grant award procedure is concerned, our organisation: g) is not subject to a conflict of interest; h) has not made false declarations in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or does not fail to supply this information; i) is not in one of the situations of exclusion, referred to in the abovementioned points a) to f). 2- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I also certify that our organisation: is committed to participate in the abovementioned project; has stable and sufficient sources of funding to maintain its activity throughout its participation in the abovementioned project and to provide any counterpart funding necessary; has or will have the necessary resources as and when needed to carry out its involvement in the abovementioned project. 3- As an authorised representative to sign the grant agreement or to commit the abovementioned organisation, I finally certify that all the information relating to our organisation set out in the different Grant Agreement Preparation Forms are complete, accurate and correct; and that the estimated costs meet the criteria for eligible costs for FP7 projects as established by the EU model grant agreement are notably based on our usual accounting and management principles and practices, and reflect the costs expected to be incurred in carrying out the foreseen work described in Annex I (description of work). 4- Our organisation is fully aware that the Commission and/or the REA may impose administrative or financial penalties on legal entities who are guilty of misrepresentation in supplying the information required by the Commission and/or the REA as a condition of participation in the grant award procedure or fail to supply this information; have been declared to be in serious breach of their obligations under any contract/grant agreement covered by the budget of the Commission. Such penalties shall :02