EL BANCO MUNDIAL BIRF*AIF I GRUPO DEL BANCO MUNDIAL _______ 3 ,201_ His Excellency Mr. Ivin Acosta Montalvin Minister of Finance and Public Credit Ministry of Finance and Public Credit Managua, Nicaragua Re: NICARAGUA: Caribbean Coast Food Security Project IGAFSP Grant No. TFO18703) Addition al Instructions: Disbursement Letter I refer to the Grant Agreement ("Agreement") between the Republic of Nicaragua (the "Recipient") and the Internationl Development Association acting as Supervising Entity of the Global Agriculture and Food Security Program ("World Bank" or "Association"), for the above, 2015. The Agreement provides that the World 'z- 3 r-k referenced Project, dated Bank may issue additional insiructions regarding the withdrawal of the proceeds of Grant TF018703 ("Grant"). This leiter ("Disbursement Letter"), as revised from time to time, constitutes the additional instruct ions. The attached World Ba, k Disbursement Guidelines for Projects, dated May 1, 2006, ("Disbursement Guidelines") (Attachment 1), are an integral part of the Disbursement Letter. The manner in which the provisions in the Disbursement Guidelines apply to the Grant is specified below. Sections and siibsections in parentheses below refer to the relevant sections and subsections in the Disbursemeit Guidelines and, unless otherwise defined in this letter, the capitalized terms used have the meanings ascribed to them in the Disbursement Guidelines. I. Disbursement Arrangementsi (i) Disbursement Methods (section 2). under the Grant: * * * The following Disbursement Methods may be used Reimbursement Advances Direct Payment (ii) Disbursement Deadline Date (subsection 3.7). The Disbursement Deadline Date is 4 months after the Closing Date specified in the Grant Agreement. Any changes to this date will be notified by the World Bank. (iii) Disbursement Conditions (vubsection 3.8). Please refer to the Disbursement Condition(s) specified in the Grant Agreement. 1818 H Street N.W., Washington, D.C 20433 RCA 248423. J WUI 64145 LJ FAX (202) 477-6391 L Phone (202) 473-1000 II. Withdrawal of Grant Proceeds (i) Authorized Signatures (subsection 3.1). A letter in the Form attached (Attachment 2) should be furnished to the World Bank at the address indicated below providing the name(s) and specimen signature(s) of the official(s) authorized to sign Applications: The World Bank 1818 H Street, N.W. Washington, DC 20433 United States of America Attention: J. Humberto Lopez, Country Director (ii) Applications (subsections 3.2 - 3.3). Please provide completed and signed applications for withdrawal, together with supporting documents, to the address indicated below: Banco Mundial SCN Quadra 02, Lote A Edificio Corporate Finance Center 70 Andar 70712-900 Brasilia, D.F. Brazil Attention: Loan Department (iii) Electronic Delivery (subsection 3.4). The Association may permit the Recipient to electronically deliver to the Association Applications (with supporting documents) through the Association's Client Connection, web-based portal. The option to deliver Applications to the Association by electronic means may be effected if: (a) the Recipient has designated in writing, pursuant to the terms of subparagraph (i) of this Section, its officials who are authorized to sign and deliver Applications and to receive secure identification credentials ("SIDC") from the Association for the purpose of delivering such Applications by electronic means; and (b) all such officials designated by the Recipient have registered as users of Client Connection. If the Association agrees, the Association will provide the Recipient with SIDC for the designated officials. Following which, the designated officials may deliver Applications electronically by completing Form 2380, which is accessible through Client Connection (https://clientconnection.worldbank.or). The Recipient may continue to exercise the option of preparing and delivering Applications in paper form. The Association reserves the right and may, in its sole discretion, temporarily or permanently disallow the electronic delivery of Applications by the Recipient. (iv) Terms and Conditions of Use of SIDC to Process Applications. 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 Credentialsin connection with Use of Electronic Means to Process Applications and Supporting Documentation ("Terms and Conditions of Use of Secure Identification Credentials") provided in Attachment 3; and (b) to cause such official to abide by those terms and conditions. (v) Minimum Value of Applications (subsection 3.5). The Minimum Value of Applications is US$100,000 for Direct Payments. (vi) Advances (sections 5 and 6) to the Ministry of Family, Communal, Cooperative and Associative Economy (MEFCCA). * Type of Designated Ac ount (subsection 5.3): Segregated. * Currency of Designated Account (subsection 5.4): United States Dollars. * Financial Institution ar which the Designated Account Will Be Opened (subsection 5.5): Central Bank of Nicaragua. * Ceiling (subsection 6.11: US$ 2,500,000 III. Reporting on Use of Grant Proceeds (i) Supporting Documentation (rection 4). Supporting documentation should be provided with each application for withdrawal .s set out below: * For requests for Reimb ursement: 0 Statement of Expenditures (Attachment 4 - Statement of Expenditure with supporting doiumentation) supported by records evidencing eligible expenditures (e g., copies of receipts, supplier invoices) for payments made under contracts For: > Goods aid Works costing US$150,000 equivalent per contract or more; > Consult .nt firms and Non-Consultant Services costing US$100,000 equivalent per contract or more; and > Individual consultants costing US$50,000 equivalent or more. o Statement of Etpenditures (Attachment 5 - Statement of Expenditure without supporting documentation) for payments, including Operating Costs and Training, that do not exceed the thresholds established above; o Information about contracts subject to the Bank's prior review as indicated in column 4 of each Statement of Expenditures (Attachments 4 and 5); and o Customized Statement of Expenditure without supporting documentation in the form attached Attachment 6) for eligible expenditures incurred by Eligible Beneficiaries fc r IDP Subprojects. * For requests for Advances to a Designated Account: o Statement of Expenditures (Attachment 4 - Statement of Expenditure with supporting documentation) supported by records evidencing eligible expenditures (e.g., copies of receipts, supplier invoices) for payments made under contracts for: > Goods and Works costing US$150,000 equivalent per contract or more; > Consultant firms and Non-Consultant Services costing US$100,000 equivalent per contract or more; and > Individual consultants costing US$50,000 equivalent or more. o Statement of Expenditures (Attachment 5 - Statement of Expenditure without supporting documentation) for payments, including Operating Costs and Training, that do not exceed the thresholds established above; o Information about contracts subject to the World Bank's prior review as indicated in column 4 of each Statement of Expenditures (Attachments 4 and 5); o Customized Statement of Expenditure without supporting documentation in the form attached (Attachment 6) for eligible expenditures incurred by Eligible Beneficiaries for IDP Subprojects; and o Designated Account Activity Statement in the form attached (Attachment 7) with a copy of the Designated Account Bank Statement. * For requests for Direct Payment: Records evidencing eligible expenditures (e.g., copies of receipts, supplier invoices). (ii) Frequency of Reporting Eligible Expenditures Paid from the Designated Account (subsection 6.3): Quarterly. IV. Additional Disbursement Instructions Per Schedule 2, Section I, B, of the Grant Agreement, each Eligible Beneficiary shall: (i) carry out the IDP Subproject for which the Sub-grant was given with due diligence and efficiency and in accordance with sound technical, economic, financial, managerial, and environmental and social standards and practices, acceptable to the World Bank, including in accordance with the provisions of the Anti-Corruption Guidelines applicable to the recipients of Grant proceeds other than the Recipient, the Safeguard Instruments and the POM; (ii) procure the goods and services to be financed out of the proceeds of the Sub-grant in accordance with the provisions of Section III of Schedule 2 to this Agreement; (iii) enable the Recipiimt and the World Bank to inspect activities carried out under the IDP Subproject, its operation and any relevant records and documents; (iv) maintain policies and procedures adequate to enable the Recipient to monitor and evaluate, in accc rdance with indicators acceptable to the World Bank, the progress of the activities carried out under the IDP Subproject and the achievement of its objectives; (v) (A) maintain rezords and prepare financial reports in accordance with requirements spe ified in the POM, both in a manner to reflect the operations, resources and expenditures related to the IDP Subproject; and (B) have such financial reports/statements available for any type of review or audit as requested by MEFCCA or t ie World Bank, in accordance with consistently applied auditing standards accepta)le to the World Bank, and promptly furnish the statements as so audited to the Lecipient and the World Bank; and (vi) prepare and furnish to the Recipient and the World Bank all such information as the Recipient or th[e World Bank shall reasonably request related to the foregoing. V. Other Important Informatiun For additional information on disbursement arrangements, please refer to the at website public the World Bank's av ailable on Handbook Disbursement at Connection" "Client website secure its ar d http://www.worldbank.org http://clientconnection.worldban k.or. Print copies are available upon request. If you have not already c one so, the World Bank recommends that you register as a user of the Client Connection website (http://clientconnection.worldbank.org). From this website you will be able to download Applications, monitor the near real-time status of the Grant, and retrieve related policy, financial, and procurement information. For more information about the G. Montoya Yolaina contact please arrangements, registration and website [email protected] of th: World Bank Nicaragua country office. If you have any queries in relation to the above, please contact the World Bank Loan Department by sending an ema I to [email protected] and placing the grant number and name in the subject line. Yours sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION Luis Constantino Country Manager Managua Office Latii America and the Caribbean Region Attachments 1. 2. 3. 4. 5. 6. 7. World Bank Disbursement Guidelines, May 2006 Authorized Signature Sample Letter Terms and Conditions of Use of Secure Identification Credentials Statement of Expenditure with supporting documentation Statement of Expenditure without supporting documentation Customized Statement of Expenditure Sample Designated Account Activity Statement Attachment 2 Institución Dirección 23 de febrero de 2015 The World Bank Group 1818 H Street, N.W. Washington, DC 20433 USA Atención: J. Humberto Lopez, lirector Re: NICARAG UA: Caribbean Coast Food Security Project GAFSP TF No. Carta de Autorización Suplementar para Solicitudes de Desembolso Electrónicos Hago referencia al Acuei do de Donación ("Acuerdo") entre la Asociación Internacional , de Fomento (el "Banco") y la Ripublica de Nicaragua (el "Beneficiario"), de fecha en definido ha sido conforme Estándares, de las Condiciones 201_. Para fines de la Sección 3.04 el Acuerdo, cualquiera de las pe rsonas, cuyos especímenes de firmas están siendo presentados abajo, está autorizada en nombr e del Beneficiario a firmar solicitudes de desembolsos bajo esta Donación. Para fines de entrega de una Solicitud a la Asociación, [cada una] [cualquier dos /tres] de las personas, cuyos especímenes de firmas son presentados abajo están autorizadas en nombre del Beneficiario, actuando [individualmente] [conjuntamente], a entregar Solicitudes de Desembolsos bajo la Donación y respectiva evidencia de documentación de soporte, incluyendo medios electrónico,-, en los términos y condiciones especificados por el Banco. El Beneficiario confirma que autoriza a dichas personas a aceptar Las Credenciales de Identificación Segura (SIDC) y entregar Solicitudes de Desembolsos y su respectiva documentación soporte al Banco por medios electrónicos. Reconociendo plenamente que el Banco podrá confiar en esas declaraciones y garantías, incluyendo, sin limitaciones, las declaraciones y garantías contE nidas en los Términos y Condiciones del Uso de las Credenciales de Identificación Segura en conforinidad con el Uso de los Dispositivos Electrónicos para Procesar Solicitudes o Documentación de Soporte (Términos y Condiciones del Uso del SIDC),el Beneficiario declara y garantiza al Banco que asegurará que esas personas acaten esos términos y condiciones. Esta autorización substituye y reprime cualquier Carta de Firmas Autorizadas enviadas previamente al Banco Atentamente, [Nombre y Título] Espécimen de firma: Nombre del firmante Cargo del firmante Email del firmante Espécimen de firma: Nombre del firmante Cargo del firmante Email del firmante Espécimen de firma: Nombre del firmante Cargo del firmante Email del firmante Attachment 3 Terms and Condihions of Use of Secure Identification Credentials in coniection with Use of Electronic Means to Process Applications and Supporting Documentation March 1, 2013 The World Bank (Bank) 2 will provide secure identification credentials (SIDC) to permit the Borrower 3 to deliver applicationc for withdrawal and applications for special commitments under the Agreement(s) and supporting documentation (such applications and supporting documentation together referred to in these Terms and Conditions of Use as Applications) to the Bank electronically, on the terms and conditions of use specified herein. SIDC can be either: (a) hardwa e-based (Physical Token), or (b) software-based (Soft Token). The Bank reserves the right to dc termine which type of SIDC is most appropriate. A. Identification of Users. 1. The Borrower will be require:d to identify in a completed Authorized Signatory Letter (ASL) duly delivered to and rec,ived by the Bank each person who will be authorized to deliver Applications. The Bank will provide SIDC to each person identified in the ASL (Signatory), as provided below. The Borrower shall also immediately notify the Bank if a Signatory is no longer Eiuthorized by the Borrower to act as a Signatory. 2. Each Signatory must registir as a user on the Bank's Client Connection (CC) website (https://clientconnection.vorldbank.org) prior to receipt of his/her SIDC. Registration on CC will require that th. Signatory establish a CC password (CC Password). The Signatory shall not reveil his/her CC Password to anyone or store or record the CC Password in written or ol her form. Upon registration as a CC user, the Signatory will be assigned a unique identif ting account name. B. Initialization of SIDC. 1. Prior to initialization of SIDC by a Signatory, the Signatory will acknowledge having read, understood tnd agreed to be bound by these Terms and Conditions of Use. 2. Where a Physical Token is to be used, promptly upon receipt of the Physical Token, the Signatory will access CC using his/her account name and CC Password and register his/her Physical Token and set a personal identification number (PIN) to be used in connection with the use (f his/her Physical Token, after which the Physical Token will be 2 "Bank" includes IBRD and IDA. "Borrower" includes the borrower of in IBRD loan, IDA credit, or Project Preparation Facility advance and the recipient of a grant. initialized for use by the Signatory exclusively for purposes of delivering Applications. Where a Soft Token is to be used, the Signatory will access CC using his/her account name and CC Password and set a personal identification number (PIN) to be used in connection with the use of his/her Soft Token, after which the Soft Token will be initialized for use by the Signatory exclusively for purposes of delivering Applications. Upon initialization of the SIDC, the Signatory will be a "SIDC User". The Bank will maintain in its database a user account (Account) for each SIDC User for purposes of managing the SIDC of the SIDC User. Neither the Borrower nor the SIDC User will have any access to the Account. 3. Prior to first use of the SIDC by the SIDC User, the Borrower shall ensure that the SIDC User has received training materials provided by the Bank in use of the SIDC. C. Use of SIDC. 1. Use of the SIDC is strictly limited to use in the delivery of Applications by the SIDC User in the manner prescribed by the Bank in the Agreement(s) and these Terms and Conditions. Any other use of the SIDC is prohibited. 2. The Bank assumes no responsibility or liability whatsoever for any misuse of the SIDC by the SIDC User, other representatives of the Borrower, or third parties. 3. The Borrower undertakes to ensure, and represents and warrants to the Bank (such representation and warranty being expressly relied upon by the Bank in granting SIDC) that each SIDC User understands and will abide by, these Terms and Conditions of Use, including without limitation the following: 4. Security 4.1. The SIDC User shall not reveal his/her PIN to anyone or store or record the PIN in written or other form. 4.2. The SIDC User shall not allow anyone else to utilize his/her SIDC to deliver an Application to the Bank. 4.3. The SIDC User shall always logout from CC when not using the system. Failure to logout properly can create a route into the system that is unprotected. 4.4. If the SIDC User believes a third party has learned his/her PIN or has lost his/her Physical Token he/she shall immediately notify [email protected]. 4.5. The Borrower shall immediately notify the Bank at [email protected] of any lost, stolen or compromised SIDC, and take other reasonable steps to ensure such SIDC are disabled immediately. 5. Reservation of Right to Disable SIDC 5.1. The Borrower shall reserve the right to revoke the authorization of a SIDC User to use a SIDC for any reasoi . 5.2. The Bank reserves the right, in its sole discretion, to temporarily or permanently disable a SIDC, de-activate a SIDC User's Account or both. 6. Care of Physical Tokens 6.1. Physical Tokens wil remain the property of the Bank. 6.2. The Bank will phy;ically deliver a Physical Token to each Signatory designated to receive one in a manner to be determined by and satisfactory to the Bank. 6.3. Physical Tokens contain delicate and sophisticated instrumentation and therefore should be handled with due care, and should not be immersed in liquids, exposed to extreme temperatures, cr ished or bent. Also, Physical Tokens should be kept more than five (5) cm from devices that generate electromagnetic radiation (EMR), such as mobile phones, phone-enabled FDAs, smart phones and other similar devices. Physical Tokens should be carried and stored separate from any EMR device. At close range (less than 5 cm), these devices can )utput high levels of EMR that can interfere with the proper operation of electronic equipment, including the Physical Token. 6.4. Without derogatin o from these Terms and Conditions of Use, other technical instructions on the proper use and care of Physical Tokens are available at http://www.rsa.com. 7. Replacement 7.1. Lost, damaged, c )mpromised (in terms of 4.5, above) or destroyed Physical Tokens will be replaced ait the expense of the Borrower. 7.2. The Bank reserve; the right, in its sole discretion, not to replace any Physical Token in the case of mist se, or not to reactivate a SIDC User's Account. Attachment 4 ASOCIACIÖNINTERNACIONAL DE FOMENTO C.rtfic.do d. G.d (con docum.ntac6n) PRESTAMOICREDTO/DONACION NO.: NO.SOLICITUD: NO.HOJA: GASTOSINCLUIDOS: Contratosde Obras supenores a US$ (entrar monto de lacarla de desembolsos) Cortratos de Bienes superioresa US$ (entrar montode lacarta de desembolsos) Contretosde Firmas Consutorassuponoresa US$ (entrar montode la carta de desembolsos) Cordratosde ConsultoresIndmdualessuperloresa US$ (entrar mantode la carta de desembolsos) 1 2 Nombr. del Provee.de, Bree d dcriplci gado 3 4 Contrato Códige del SZjeto a g.a relån proevl (SI . NO) NO. CATEGORIA: 5 6 7 6 9 10 11 12 13 Regist det contrat. en C.C. Men.d. d.1 centrato Monto Total del Contrato Mento acumulado dI con.trato (InelIdo ee SOEs anterieres) Número d. la Factura . Recibe Feeha del Pago Monto Pagade al Proeedor % Financ. per BIRF Mente Ad.elble (Col 11 X 12) CUENT. DESIGNADASOLAMENTE 14 15 16 Cantidad Taes Fecha Debitada d. Dåbito Cuent. Cnble Cuent. Designada Designada (Col 13 X 14) 000 000 000 000 0 00 0 00 000 000 000 000 000 0.00 000 0.00 0.00 000 TOTAL 6.00 k~onsCClones: Columnh 1: ~neone el nomrebm de prosedor Columna 2: Hacerua brew descrlpeln def gasto (ejemplo honoreriosdic/2012, consuftora, serclo de limplea, Åäticos. ser~cios de audItoria,etc), COlumnm3: :dertifkcarcual tipo de gasto fumhocho (ejemp4o CS consuMlaorIa / CW· GO bienes / OP costos operratlPos 1 / NCS ser0cios de no consultora / SP Subproyects) Ceumun.4: iorar al el contratok1o no sonetido a rsión preMadeaBanco Mundial. Columfn*6: snmar nämero de registro del contratoen ClientConnection Columna 6: Informarmoneda delconlrato Clmna 7: Informar k*ier del contrato(en la monadaque fue indicadaen lacolumna 6) Column. 8: Inrmmr .or del cortrato que ya fle pegado,Incluidoen SOEs enterlores Cotum 9: el número de la factura o reco del prowedor Co ne. 10: eln,.a fecha del pag. el p ~oedor Co.,..m 11: Inlnormor~ pagado Elprowedor, en la monedaindcada en la factor. Co..... 12: Indcar el pomsentual de finncianlento (deacuerdoal coneno de préstamddonacid) Columea 13: Calcuo del mono adnisible paratinanclmiento (rsultado de la multplicación de columna 11 per la 12) Para loscasos en que El porcentualde financlamientoes de 10010%, os vors de sa columnaserån le mImospresentadosen la coluimna 11 Columna 14: leder la tasa dambio Faer lener en cuenta qc tae sa de de camblo a ser utlizada e ser a tasa de Intenalizaciónde los fondos. Es decir , el rovecto dee tilizar lanisma tasa quelae ilizada ar. trnsormarles dlares que elBanco eid al proyecto en monae local Ee punto esmey impotante ya el Banc. n reconoce diferencasda cambiocomo qasto eleible de finanmieento Columnm 15: Fechaqu en la cul el pryeo retiré losfodo. la cuenta designada(en dölares)y los en6ó a lacuna opertie (en monedalocal) Columna 16: Clico de lacolunna 13 x columna 14, Esa columna reela en monto equenle en ddlares del gasto realzado, que será considerado por al Banco paradocumetac1ón enTrenamieneto Inormar l- la Attachment 5 ASOCIACIÓNINTERNACIONALDE FOMENTO C.rtficoda d. Gatos (.In documentación) NO.: PRESTAMO/CREDITOIDONACION NO.SOLICITUD: NO. HOJA: GASTOSINCLUIDOS: Contratos de Obras intenoresa US$ (entrar montode la carta de desemboisos) Contratos de Bienes interores a US$ (etrar monto de la carta de desembolsos) Contratos de FirmasConsultoras In.ores a US$ (entrarmonto de la carta de desembolsos) Contratosde ConsuftoresIndimduales ineriores a US$ (entrar montode lanada dc desembolsos( 4 5 Contrato Sult revIsIn prevla (SI o NO) Regtro del contrato en C.C. 1 r Nombro del Proveedor crlecónn del gasto dlao.del gasta ] NO.CATEGORIA: 6 7 Monedo del contrato Monta Total d Contrato Monto a del contrato (incluido en SOEsanteriores 9 10 Número d. la Factura Recibo Fechadel Pago o 1 Monte P al Proveedor 12 % Fn por olHr 13 Mente ble 12) (Uol 11 A CUENTADESIGNADASOLAMENTE 16 | 15 14 Cantidad Debitada Fecha Te d ieragnaca tUema amelo (Col 13 X 14) Designada 000 000 000 000 000 000 000 000 000 000 000 000 000 000 0.00 0.00 TOTAL 0.00 InstruCCiones: Columna 1: Intormeel nombredel proveedor seMlvios de auditoría,atc) Columna 2; Hacer unabravadescripcióndel gesto(ejemplo, honoraros dic/2012,consultoría, sercio de lmpieza, cual tipo de gastofue hecho (ejemplo CS consultora / CW obras > GO bienes / OP costos opertios / TR entrenamento/NCS: seracios de noconsultora SP Subproyectos) Columna 3: Column 4: Informarsi el contratofue a n sometido a reísión preva delBanco Mundial Columna 5: ntormarnúmero de registro delcontrato en Client Connection Calume 6: normar monedadel contrato Columna 7: irdormarsolordelcortralo (en la monedaquefue indicada en la columna 6) del cortrato que ya tuepagado, incluido en SOEs anteriores : normar Clea. Indor el número dola lactura a rmcibodelprosedor Calamnia t9: Columna 10: Infonmarlecha del pagoal proeedor aor pagadoal proedor, en la monedaindicadaen la tectura Columna 11: Inar (de acuerdoal convenio de préstamrdonación) el parcentualde financiamuento Columna 12: el de fínencuameno ea de 100%,los aoros de esa colamna serán los mImospresentadasen la clumne 11 Columna 13: Calicolodel moo admisibleparafinanciamíento(resutada de la mutiplicacióde la clumna 11 parle 12). Paralos nasos en que parcentual lasa que toeutilIzada catotranstormarlea delarasque el Sanao tondos. Es decir ue al areoectodebeutilizar lo rnismatda Columna 14 lndar la tasada eombin Famr tonaren asordeque taco de cambeo ser tilzade debe conlalaso de ntemebación de de financiamento como nasto de cambio diferencias Banco o reonoce uy imporante, ya el monedalocal 1. Fc~ha sí nii e prayato retiró losfondos de cuentadesignada dólanal y losemo a la cuenta oceralm ten moneda mal Columna 16: Cálculo de la columna13 x columna 14. Esa columnareflejaen montoequialerte en dólaresdel gasto realizado, queserá considerado porel Banco para documentación. viáticos, Identificar alor Indicar Colkimna le la (en eieqble los al prosecto en Attachment 6 ASOCIACIÓN INTERNACIONAL DE FOMENTO CERTIFICADO DE GASTOS (sin documentos justificativos) CATEGORIA 2 - Sub Proyectos PDI (Plan de Desarrollo Innovador) TF No.: FECHA: No. SOLICITUD: No. HOJA No. CATEGORIA: 1 2 Nombre del PDI (Benefidário Elegible) Fechade firma del Convenio 3 Numero del Convenio 4 5 6 7 8 Descipcion de actividades Financiadas Moneda y Monto del Convenio Monto Acumulado Convenio Monto Pagdo en esta Solicitud Fechadal Pago 9 % Finae. por AIF CUENTADESIGNADA(DA)SOLAlENTE 10 11 12 13 Monto Solcitado (Col 7>X9) Tasa de Cambio Cantidad Debitada Cuenta Designada Fecha Débito Cuenta Designada (Col10/ Col11 Sub Total Pág. 01 TOTALES Certificamos quelas cantidades arribaconsignadas se hanpagadopor concepto de la debidaelecución de actividades del Proyecto de acuerdocon los términosy condiciones del Convenlo de Donación. La documentación justificatio se facilitará parasu examena las misiones de la Asociación Internacional de Fomentoo a los auditoresextenos designados a tal efecto. C$ - - $ - Attachment 7 CONCILIACION DE LA CUENTA DESIGNADA PRESTAMO/CREDITO/DONACIÓN No: NOMBRE DEL BANCO: NÚMERO DE CUENTA: USD 1. Total de Depósitos 2. Menos Total Documentado 3. Saldo por Recuperar 4. Saldo al 1 ¡ 0.00 0.00 de Acuerdo al Estado Bancario Adjunto 0.00 0.00 0.00 0.00 5. Monto de la Solicitud No. 6. Más monto pendiente de Reembolso por el Banco 1/ 7. Más retiros efectuados aún no solicitados al Banco 2/ 8. Menos montos debitado.s después de la fecha del Estado Adjunto 9. Menos intereses generacios por la Cuenta Designada 10. Total (4 + 5 + 6 + 7+ 8 - 9' 0.00 11. Discrepancias entre (3 y 9) 0.00 OBSERVACIONES: 1/ Valor pendiente de reembolso por el Banco No. de Solicitud Monto 2/ Retiros efectuados aun ro solicitados al Banco Fecha Descripción Aqui se incluirt una explicación del del Punto 8), o sea en que fue gastado el diner) que aún no fue solicitado al Banco. Esto es exigido cuando este importe supera el 15% del depósito en la Cuenta Designada. Monto 0.00 1. Suma de todos los inportes adelantado! por el Banco a la Cuenta Designada 2. Surna de todos los importes documenta( os 3. Linea 1 menos Linea 2 4. Saldo igual al estado de cuenta bancáric presentado. (Converter para dólares) 5. Informar el importe total a ser document ido en la solicitud que se está presentando 6. Solo en el caso de tener irnportes pendi:ntes de pagar por el banco de Solicitudes anteriores. 7. Este irrporte es la parte que fue retirada de la Cuenta Designada y no corresponde a gastos que se están incluyendo en el próxiro SOE Refiere a nuevos gastos qu:, aún no han sido incluidos en SOE 8. Aqui solo iria algo si hubieran retirado un nuevo imiporte de la Cuanta Designada, posterior a la fecha del estado de cuenia bancário que está siendo presentado FOR OFFICIAL USE ONLY Prepared by: Maria Virginia Hormazabal, Finance Officer Cleared with and cc: Augusto Garcia,TTL Sofia De Abreu Ferreira, Counsel
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