Template for submitting data for the consideration of the Commission (Article 14(1) ESF)

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EUROPEAN COMMISSION European Social Fund Template for submitting data for the consideration of the Commission (Article 14(1) ESF) Version of June 2015 Please consult http://ec.europa.eu/esf/sco for possible updates.

Annex 1: Template for submitting data for the consideration of the Commission A. Contact details: The Managing Authority (MA) responsible for submitting the data and for contacting the Commission (to be filled in by the MA) A.1. Name A.2. Address A.3. Name of contact person A.4. Position of contact person A.5. Telephone A.6. Email The authority submitting the data for consideration of the Commission should be the one designated under Article 123(1) CPR. If the request covers several operational programmes, the authority should be entitled to act on behalf of all Managing Authorities involved. B. Main elements to be included in the Commission s delegated act B1. Member State: 2

B2. Summary of the main elements included in the delegated act (to be filled in by the MA in a structured format) Operational programme Priority axis Fund Category of region Estimated proportion of the total ESF financial allocation to which the SCO will be applied in % (estimate) Types of operation Corresponding indicator names CCI code 1 IEJ ESF Less developed CCI code 2 ESF More developed Code Description Code Description 20 % 1 IT training 1.1 Number of participants who complete the IT training 15 % 1 IT training 1.1 Number of participants who complete the IT training Unit of measurement for the indicator Number of participants who received a training certification Number of participants who received a training certification Type (standard costs or lump sum) standard costs standard costs Free field (if applicable, description of the standard costs or lump sum, and the formula for calculating it if it is not a set value) Corresponding standard scales of unit costs or lump sums (in national currency) Region 1 100 Region 2 200

C. Details by type of operation (to be completed for every type of operation) Did the Managing Authority receive support from an external company to set out the simplified costs below? (If so, please specify which external company.) Types of operation: 1.1. Description of the operation type 1.2 OPs / priority axes concerned 1.3 Indicator name 1 1.4 Indicator definition 1.5 Unit of measurement for indicator 1.6 Standard cost or lump sum 1.7 Amount (in national currency) 1.8 Adjustment(s) method 1.9 Arrangements to ensure the quality, collection and storage of data on achievements. Please list the body(ies) responsible for these arrangements, and set out how they will ensure the quality of data collected (guidance, training, etc.), the frequency of data collection, and where the data will be stored 1.10 Verification of data (who will verify the nature of the supporting documents, frequency of verification, method of verification): - verification of units attained - verification of the quality level attained 1.11 Possible perverse incentives or problems caused by this indicator, how they could be mitigated, and the estimated level of risk 1.12 Amounts expected to be reimbursed for operations where the standard costs or lump sum will be applied (in euros) 1.13 Arrangement to ensure fair application [> EUR 1 million] Please explain how the system will be introduced and applied in order to ensure that it is applied transparently and fairly. 1 Several complementary indicators (for instance one output indicator and one result indicator) are possible for one type of operation. In these cases, fields 1.3 to 1.11 should be filled in for each indicator.

Annex to the template: Calculation of the standard costs and lump sums Annex 1. Source of data used to calculate the standard costs and lump sum (who produced, collected and recorded the data; where the data are stored; cut-off dates; validation, etc.): Annex 2. Please specify why the proposed method and calculation is relevant to the type of operation: Annex 3. Please specify how the calculations were made, in particular including any assumptions made in terms of quality or quantities. Where relevant, statistical evidence and benchmarks should be used and attached to this annex in a format that is usable by the Commission (e.g. Excel and not PDF). Annex 4. Where relevant, please explain: - how revenue has been / will be taken into account; - how you have ensured that only eligible expenditure was included in the standard cost or the lump sum; - whether the support of an external contractor was used in filling in this template and its contents and, if so, which one. Annex 5. Optional assessment by the audit authority(ies) of the calculation method (fair, equitable and verifiable) and the arrangements to ensure the verification, quality, collection and storage of data: 5