REQUEST FOR APPLICATIONS INTERNATIONAL FOUNDATION FOR ELECTORAL SYSTEMS (IFES) Request for Applications

Transcription

1 Intiland Tower, 19 th Floor Jl. Jendral Sudirman 32 Jakarta 12020, Indonesia Tel: Fax: REQUEST FOR APPLICATIONS INTERNATIONAL FOUNDATION FOR ELECTORAL SYSTEMS (IFES) Request for Applications Project to Strengthen Media and Civic Engagement in the Electoral Process: Public Information and Voter Education in Six Provinces (North Sumatra, Central Java, Maluku, Papua, West Papua and Aceh) in Indonesia RFA No November 18, 2013

2 Table of Contents 1. Request for Application Purpose Coverage & Participation General Information Background RFA Schedule Application Preparation Instructions Applicant s Understanding of the RFA Good Faith Statement Communication Addenda: IFES will make a good-faith effort to provide a written response to the questions or Application Instructions Application Submission Criteria for Selection Selection and Notification Program Description Program Requirements Specific requirement for national partner: Deliverables: Additional Terms & Conditions Non-Disclosure Agreement Intellectual Property Applications Governing Law Partial Awarding No Liability Entire RFA Applicant Certification Attachment A - Budget Template Attachment B - Pre-Award Assessment Form Page 2 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

3 1. Request for Applications 1.1. Purpose IFES is currently engaged in implementing the Elections 2014 Administration Program (EAP) funded by the United States Agency for International Development (USAID). The purpose of this Request for Applications (RFA) is to invite prospective applicants to strengthen media and civic engagement in the electoral process by working with civil society; to facilitate workshops with all stakeholders involved in the voter education process; and to facilitate the development and operations of media and public information centers in six provinces (North Sumatra, Central Java, Maluku, Papua, West Papua and Aceh). IFES is planning to award a sub-grant of up to ten months, with a total estimated cost not to exceed 5,500,000,000 IDR. An award will be made only after IFES makes a positive determination that the applicant possesses, or has the ability to obtain, the necessary management competence to carry out the grant activity, and will practice mutually agreed upon methods of accountability for funds and other assets funded by the United States Agency for International Development. IFES must be fully satisfied that the applicant has the capacity to adequately perform in accordance with the principles established by the Department of State and 22 CFR Coverage & Participation Issuance of this RFA does not constitute a commitment on the part of IFES to make an award nor does it commit IFES to pay for costs incurred in the preparation and submission of any application in response to this RFA. Further, IFES reserves the right to reject any or all applications received. 2. General Information 2.1. Background The International Foundation for Electoral Systems (IFES) is an independent, non-governmental organization providing professional support to electoral democracy. IFES promotes democratic stability by providing technical assistance and applying field-based research to the electoral cycle worldwide to enhance citizen participation and strengthen civil societies, governance and transparency. In recognition of this commitment, USAID has awarded IFES with the Election Administration Program (EAP). Academic institutions, civil society and the media have been involved in promoting public understanding of and engagement in the electoral process since the first democratic elections in Under the EAP, IFES has a mandate to support such organizations in their efforts, particularly in the fields of voter education and media RFA Schedule The following is a tentative schedule that will apply to this RFA, but may change in accordance with IFES needs or unforeseen circumstances. Changes will be communicated by to all parties. Issuance of RFA 18 November 2013 Written expression of interest due 22 November 2013 Technical Questions/Inquiries due 25 November 2013, 9:00 AM EST Page 3 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

4 Answers/Addenda from IFES 27 November 2013 RFA Closes 18 December 2013, 6:00 PM EST 3. Application Preparation Instructions 3.1. Applicant s Understanding of the RFA In responding to this RFA, the applicant accepts full responsibility to understand the RFA in its entirety, and in detail, including making any inquiries to IFES as necessary to gain such understanding. IFES reserves the right to disqualify any applicant who demonstrates less than such understanding. Further, IFES reserves the right to determine, at its sole discretion, whether the applicant has demonstrated such understanding. Such disqualification and/or cancellation shall be at no fault, cost, or liability whatsoever to IFES Good Faith Statement All information provided by IFES in this RFA is offered in good faith. Individual items are subject to change at any time. IFES makes no certification that any item is without error. IFES is not responsible or liable for any use of the information or for any claims asserted there from Communication Verbal communication shall not be effective unless formally confirmed in writing by a specified official in charge of managing this RFA process. In no case shall verbal communication govern over written communication Expression of Interest: organizations that would like to be considered as bidders on the project should send a written expression of interest of no more than two pages that provides an organizational profile and a brief suggested approach to the project, no later than 22 November, Only organizations that submit the expression of interest will be able to continue in the bidding process. Expressions of interest should be submitted to IFES by to edurbin@ifes.org AND zulkarnain@ifesindonesia.org Applicant Inquiries. Inquiries, questions, and requests for clarification related to this RFA should be submitted in writing, no later than 25 November and be directed to: IFES Indonesia Intiland Tower, 19th Floor Jl. Jend. Sudirman 32 Jakarta Indonesia Attention: Zulkarnain Lubis, Program Officer / Beth Durbin, Sr. Contracts & Grants Administrator Telephone: Fax: zulkarnain@ifesindonesia.org AND edurbin@ifes.org Formal Communications may include, but are not limited to: Questions concerning this RFA. Expressions of interest Errors and omissions in this RFA and enhancements. Applicants shall recommend to IFES any discrepancies, errors, or omissions that may exist within this RFA. Verbal and/or written presentations by top rated(2 or 3) bidders under this RFA. Page 4 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

5 Addenda to this RFA Addenda: IFES will make a good-faith effort to provide a written response to the questions or request for clarification that requires addenda by 27 November All questions, answers, and addenda will be shared with all interested organizations who have submitted expressions of interest Application Instructions All applications should include the following in order for it to be considered: 1. Technical Application The technical application must describe in detail the applicant s (a) Technical Approach; (b) Organizational Capacity; and (c) project work-plan to implement the Program Description in Article 4 of this RFA. The evaluation criteria can be found in Article 3.6. The technical application should be responsive to each element of the evaluation criteria. 2. Cost Application Budget and Budget Notes The Budget should reflect costs associated with the technical activities and deliverables. All applicants must fill out the following cost breakdown for the implementation of the project as described in this RFA. The budget should be presented in local currency. The line item totals should also be denominated in US Dollars, based on the currency exchange rate establish by the Central Bank at the time of application. Unit cost is required and in the case of discrepancies between unit cost and total costs, the unit cost will be taken as reference basis in the evaluation. If the applicant organization does not have indirect cost rates approved by a third party auditing company, then all the indirect costs should be converted and presented as direct costs. The applicant must agree to keep these costs valid for a minimum of 90 calendar days. The Budget shall be in the form of the Budget Template which is included in Attachment A to the RFA and which will be provided in Excel to all bidders who submitted an expression of interest. The Cost Application should include Budget Notes that describes each cost element of the Budget. 3. Key Personnel The following position(s) are considered key personnel on the national level: Director/Chairperson of the organization Voter Education Expert Regional Coordinator / Program Officer Regional Admin Officer Web Designer 4. There will be a number of additional positions at the regional level. An illustrative list follows. Provincial Voter Education Expert Voter Education Monitoring Officer Media Center Manager Program Officer IT Consultant 5. A brief outline of the applicant s organization and experience, including: Page 5 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

6 Full legal name and address of the organization Full legal name of organization s Director and / or Chief Executive Officer Applicant s DUNS number Applicant s background, its relationship and work experience with the government and other stakeholders Evidence of successful completion of a project of a similar and complexity, and if applicable, an overview of projects supported by other international organizations References: If applicable, contact information for three references from donor funded projects similar in scope and a brief description of their implementation (including location and year). 6. Filled out Pre-Award Assessment Form, which is included as Attachment B to this RFA Application Submission Applicants that pass the expression of interest phase and are invited to submit formal applications must send final applications in electronic copy via , on or prior to 18 December 2013, 6:00 PM EDT to Zulkarnain Lubis, Program Officer at zulkarnain@ifesindonesia.org and Beth Durbin, Sr. Contracts & Grants Administrator at edurbin@ifes.org 3.6. Criteria for Selection The evaluation of each response to this RFA will be based on its demonstrated competence, compliance, format, and organization. The purpose of this RFA is to identify those organizations that have the interest, capability, and financial strength to implement the project as described in Article 4 of this RFA. Evaluation Criteria: 1. Technical Proposal 40% 2. Past Performance 20% 3. Organizational Capacity 20% 4. Cost Proposal 20% Evaluation Criteria Grading: Does not meet expectations 0 Meets expectations 1 Exceeds expectations 2 Selection and Notification The top scoring 2 or 3 applicants based on the above described scoring will be selected to move into the Presentation phase and final of this process. Written notification will be sent to these applicants via . Those applicants notified will provide a verbal and written (PowerPoint) presentation to the Review Committee who will make the final selection. Page 6 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

7 4. Program Description Communication with external stakeholders is easily one of the most important institutional capabilities of any public institution, and one that election commissions often fail to sufficiently develop. Communication that leads to enhanced coordination is pivotal to the success of elections. It is also equally important to the public perception of an electoral institution s competence and credibility. The media, academic institutions and civil society can be a bridge that link citizens with their electoral institutions. Based on previous IFES surveys, just a month before Indonesia s 2009 parliamentary elections, nearly seven in ten surveyed citizens reported that they felt they did not have very much information about the elections, and 8% said they had no information at all. Only two in ten Indonesians believed they had at least a fair amount of information, and only 1% said they had a great deal of information about the 2009 elections. Improving on this general level of voter education in advance of the 2014 elections will represent a major challenge if funding for voter education (VE) from all government and civil society sources does not see a substantial increase, especially given trends of diminishing foreign assistance to VE with each election cycle. Given the shortage of available resources, all stakeholders would benefit from effective coordination of the resources available through all involved organizations. The 2009 elections saw the KPU struggling to open effective and proactive channels of communication with electoral stakeholders affected by the election management body s decisions such as political parties, candidates and the general voting population. While the KPU did manage to maintain a respectable level of credibility amongst the general public, the coverage in the media was often misinformed; it misinterpreted many of the actions of the election management body, and potentially discredited the process. Therefore, the relationship between the election management bodies and the media will be a key factor in establishing and maintaining the credibility of the 2014 elections. Communication, however, does not end with the media. Effective channels of communication must be maintained with direct participants in the election such as political parties and their candidates as well as civil society organizations that contribute to the election process through education, observation or advocacy. Managing such relationships can be difficult and there is a legacy of mistrust among some stakeholders that needs to be addressed. Likewise, ensuring that voters have the information they require in order to exercise their franchise ideally involves building educational partnerships between stakeholders in the election process. This program is intended to address communication and voter education issues in the lead up to and during the 2014 legislative and presidential elections. Audiences The first task in building a communications plan is to identify the audience or audiences with which one wishes to communicate. For election management bodies, the audiences are numerous and can be complex. Building and maintaining confidence in elections requires effective communication with all audiences. In Indonesia, external audiences can be divided into the following groups: The General Public: Clearly, voters are the largest and most important audience for an EMB but in any democracy there are also members of the general public who opt not to vote. It is important that both groups have confidence in the results of elections. Indonesian voters have had relatively high levels of confidence in results for elections in the modern democratic period since 1999 but also indicate low levels of knowledge about the electoral process. Page 7 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

8 Parties and Candidates: In a democracy, it is vital that the contestants in elections, that is political parties and candidates for elected office, have enough confidence in the election management bodies to accept the results of elections. While election results have been regularly contested in Indonesia, political parties demonstrated relatively high confidence in electoral management until the period following the 2004 elections when a corruption scandal over procurement resulted in some erosion of the KPU s independence. The period leading up to and following the 2009 general elections have been characterized by increasing mistrust of the election management and oversight bodies and, by extension, their regional sub-offices by political parties and their elected representatives. Other non-governmental stakeholders: In Indonesia, there are many civil society organizations that advocate for the rights of voters, engage in voter education and observe the process for the purpose of ensuring the integrity of the process. This diverse group of stakeholders can include national and local organizations from technocratic specialists in elections to religious mass based organizations to smaller groups that specialize in safeguarding the rights of marginalized groups. Executive government: Numerous ministries and agencies of government at the national and local level are engaged in ensuring effective and credible elections. The Ministry of Finance, the Ministry of Home Affairs, local government, the police and the military all contribute considerable resources to the election process. Legislative bodies and regional councils: The House of Representatives (DPR) is responsible for setting the electoral framework through election legislation and on-going oversight of the KPU as well as approving the budget for national elections. The Regional Representative Council (DPD) is Indonesia s upper national house and represents Indonesia s diverse regions. Provincial and local councils (DPRDs) play a role in budgeting as well as monitoring of local regulations and policies. Members of these bodies have all been participants in elections and their experience of the previous election necessarily colors the way they look at future elections. Mandated oversight bodies: Bawaslu and the ethics council. Media: The news media are primarily a medium through which the EMB can communicate with its biggest audience: the general public. Television, in particular is vital in reaching the more than 200 million citizens who need to be informed about elections. The media are also, however, an audience. The way that the news is reported can have enormous impact on the way that the audiences above view the credibility of the electoral process and it is therefore important that journalists and their editors have accurate and contextual information. Main Program activities: In order to be successful and selected to be chosen as IFES national partner, each applicant is expected to design a program that addresses the following points: Voter Education: During a six month period before and during the elections (see timeline below), IFES will engage a national partner to assist civil society in six key provinces to: 1) conduct an inventory of VE activities already planned by all stakeholders; 2) identify gaps; 3) put together a plan that coordinates activities between stakeholders to ensure maximum use of resources and that, where possible, identifies ways in which the gaps can be filled. Page 8 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

9 Organization of Voter Education Needs Workshops The national partner in cooperation with local civil society will host a voter education needs workshop in each of the designated provinces and, potentially at the national level. The provincial workshops will last a maximum of two days and will involve: civil society organizations involved in the election process as well as those that support or represent marginalized groups; in provinces with a history of violent conflict, networks involved in preventing conflict; the media and other stakeholders. KPU and Bawaslu commissioners and staff would be invited to attend and participate. The expected output of the workshop is a voter education plan or plan outline for that province. Development of Voter Education Work Plan The plan will include strategies for targeting voter education at youth and potentially marginalized voters, drawing upon survey information to better identify low levels of awareness and to identify how information is acquired/consumed (see Activity 2.1.2). Where possible, the strategy would also address conflict prevention and mitigation. Voter Education Monitoring The comprehensive voter education plan will include mechanisms to track and coordinate the voter education efforts of civil society organizations (including efforts by other USAID and international implementers), as well as provide these organizations and political parties with updated information critical to the development of accurate voter education and public information materials. The national partner is expected to provide regular reports on voter education activities conducted by each KPUD, local or national government, the police and civil society organizations. The reports will help to monitor progress against the provincial Voter Education Plan and to identify gaps in voter education. PSA Partnership Facilitation The national partner will seek to help local and national civil society organizations to arrange a beneficial partnership strategy with media organizations reducing costs and increasing coverage for public service announcements (PSAs). Rapid Response The national partner will also have the resources to provide some rapid-response voter education materials for civil society organizations or other stakeholders if gaps or needs are identified. Public Information Center: The role of the national partner is to facilitate six provincial media centers in the target provinces. The center will be staffed by trained journalists, media relations specialists and other personnel, provided by the national partner (local consultants seconded to the local partners where possible). Such a media center will be open to all journalists and will be a platform for improving the relationship between the media and election management bodies. During the 2014 election the Media Centers will also be instrumental in enhancing the KPU s voter education and results reporting capabilities. They will help facilitate the VE tracking. Page 9 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

10 Public Information Center Needs Assessment and Design The national partner in coordination with IFES will conduct a needs assessment for a provincial media center in the six provinces. The needs assessment will include identifying potential locations, set up, operational period, staffing needs, and determining an operational budget. Results Data / Display On Election Day for the April 9 Legislative Elections and the first round of the Presidential Election as well as a potential second round, the Center would provide up-to-date information about the voting process for members of the media. Following the closing of polls, the center would provide information about the counting and aggregation process, providing results as available from the KPU or KPUD. The Center would remain open and remain active until the final and formal election results are announced, up to a month after the election. Public Information Center Operations It is intended that, for each office, the national partner would request space for the public information center from the KPUD or find appropriate space nearby the KPUD office as well staff to operate it and that the national partner would provide staff and resources to support the operation of the center. Please note that IFES will not support any construction or renovation costs. The national partner will provide three staff in each media center as Media Center Manager/Coordinator, Program Officer and IT Coordinator. These staff members would work in collaboration with KPUD s own staff as necessary. The Public Information Center would also host a workshop on Electoral Journalism which is opened to all parties interested in covering and reporting on the election (academia, CSOs, government institutions, and political parties). In addition to staff resources, the national partner would provide, as necessary, one desk-top computer and one notebook computer for each center along with a scanner/printer, UPS device, internet access and video monitors for monitoring the media Program Requirements IFES seeks a local civil society group as our national partner to design and implement the program. The national partner may conclude sub-agreements with other non-profit organizations or for-profit companies as implementing partners at the national level. Any such partners should be identified in the proposal. The partner is expected to engage with local CSOs in each province but is not expected to include specific provincial organizations in its proposal. Final decisions about provincial level partners will be made in consultation with IFES after the completion of provincial needs assessments. Phase 1 - Needs Assessment Phase 2 - Planning and preparation Phase 3 - Implementation Page 10 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

11 IFES recognizes that each province may require a slightly different approach and that action plans and budgets for each province will be finalized after the completion of needs assessments. It is expected, however, that the proposal will include a basic plan and budget for activities in each province. The selected national partner will implement the program in three phases. It is understood that there may be overlap in the phases but it is expected that the applicant will provide a proposed timeline for implementation of the program Phase 1 Needs assessment and planning Engage national level staff. Meet with stakeholders in each province to evaluate existing voter education plans and existing plans for media coverage of the elections. Assess EMBs relationships with other stakeholders including civil society organizations, political parties and media. Identify gaps in staffing and other resources. Inventory civil society organizations, academic institutions and media that are active at the provincial level. Explore interest and willingness of stakeholders in each province to engage with the national partner on voter education and a media center. Identify appropriate space for media center. Identify potential local partners for hosting the voter education needs workshop Phase 2 Planning and Preparation Propose a plan to IFES for each participating province including a budget, staffing plan, training plan and timeline. Present plans to each of the participating stakeholders. Amend the plans with input from stakeholders and IFES. Identify final local partner for the voter education needs workshop and conclude written partnership agreement. Begin staff hiring for provincial media centers. Commence procurement for provincial media centers. Conduct training for newly hired staff and, as appropriate, KPUD staff assigned to the project Phase 3 Implementation Conduct six voter education needs workshops in partnership with local CSOs. Circulate results of the workshop to relevant stakeholders. Through the secretariat, compile feedback into a report of the consultation process, which may include written submissions by stakeholders. Facilitate meetings of partners to agree on the final draft. Open media centers Track voter education efforts and compile reports that can be shared with all stakeholders. Operate media centers through the end of the election cycle (when final results are released for the final round of the presidential election) Page 11 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

12 4.2. Specific requirement for the national partner: Candidates should have institutional expertise in performing complex review and analysis of the election legal reform and must have deeply nuanced understanding of Indonesia s electoral practice and performance. This project requires a specific institutional expertise and networks to organize high level expert meetings with specific target groups of national key stakeholders, as well as capacity to access and analyze legal reform process. The partner organization should also keep pace with the ongoing process of local election law and be familiar with the current elections laws. The partner organization should have familiarity with the USAID s Monitoring and Evaluation methods. Candidates should submit the application in English Deliverables: Report on needs assessments in six provinces: North Sumatra, Central Java, Maluku, Papua, West Papua and Aceh; Organization of Voter Education Needs Workshops in six provinces Development of a Voter Education Workplan for each of the six provinces; Establishment of a media center in each of the six provinces to operate for a total of seven months beginning no later than March 9, 2014; Monthly monitoring reports on voter education for each province and, if possible, how it relates to voter education in the rest of the nation. Reports following both the legislative and presidential election describing the impact of the program activities. Financial Reports 5. Additional Terms & Conditions 5.1. Non-Disclosure Agreement IFES reserves the right to require any applicant to enter into a non-disclosure agreement Intellectual Property Applicants should not use any intellectual property of IFES including, but not limited to, all logos, registered trademarks, or trade names of IFES, at any time without the prior written approval of IFES, as appropriate Applications All accepted applications shall become the property of IFES and will not be returned Governing Law This RFA and the applicants applications shall be governed by the laws of the District of Columbia, USA Partial Awarding IFES reserves the right to accept all or part of the application when awarding the subgrant. Page 12 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

13 5.6. No Liability Issuance of this RFA does not constitute a commitment on the part of IFES to make an award nor does it commit IFES to pay for costs incurred in the preparation and submission of any application in response to this RFA. Further, IFES reserves the right to reject any or all applications received or stop solicitation process at any time, without assigning any reason or liability. IFES shall not be liable to any applicant, person, or entity for any losses, expenses, costs, claims, or damages of any kind: Arising out of, by reason of, or attributable to, the applicant responding to this RFA; or As a result of the use of any information, error, or omission contained in this RFA document or provided during the RFA process Entire RFA This RFA, any addenda to it, and any attached schedules, constitute the entire RFA. Page 13 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

14 6. Applicant Certification This certification attests to the applicant s awareness and agreement to the content of this RFA and all accompanying calendar schedules and provisions contained herein. The applicant must ensure that the following certificate is duly completed and correctly executed by an authorized officer of your organization. This application is submitted in response to RFA No. issued by IFES. The undersigned is a duly authorized officer, hereby certifies that: (Applicant Name) agrees to be bound by the content of this application and agrees to comply with the terms, conditions, and provisions of the referenced RFA and any addenda thereto in the event of an award. Exceptions are to be noted as stated in the RFA. The application shall remain in effect for a period of 90 calendar days. The undersigned further certify that their firm (check one): IS IS NOT currently debarred, suspended, or proposed for debarment by any federal entity. The undersigned agrees to notify IFES of any change in this status, should one occur, until such time as an award has been made under this solicitation. Person[s] authorized to negotiate on behalf of this organization for purposes of this RFA are: Name: Signature: Name: Signature: Title: Date: Title: Date: Signature of Authorized Officer: Name: Signature: Title: Date: Page 14 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

15 7. Attachment A Budget Template (Illustrative) Budget Summary (in IDR) Personnel 0 Benefits 0 Travel 0 Supplies 0 Subgrants 0 Contractual 0 Other Direct Costs 0 Total Direct Costs 0 Cost Proposal - DETAIL BUDGET DESCRIPTION / TITLE 10 Months PERSONNEL Unit FTE Cost IDR Director/Chairperson/CEO FTE Voter Education Specialist FTE Regional Coordinator/Propgram Manager FTE Regional Finance & Administration Manager FTE Web Designer FTE FTE Media Center Manager/Coordinator FTE Program Officer FTE IT Coordinator FTE FTE Project Management % - Province 1- Name % - FRINGE BENEFITS Benefits TRAVEL Unit Cost Units - - Airfare - Origin Destination-Origin RT Page 15 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

16 8. Attachment B - Pre-Award Assessment Form SECTION A: General Information Please complete this section which provides general information on your organization. 1. Legal Name of Organization 2. Mailing Address 3. Street Address (if different) 4. Telephone Fax Number Other ( ) 5. What is your organization type (profit, non-profit, private volunteer organization, university, etc.)? 6. Is your organization incorporated or registered? Yes: No: 7. When and where was your organization incorporated or registered? 8. Please provide a copy of your organization s incorporation or registration certificate. Enclosed: Not enclosed (Explain): 9. What is your organization s tax status? Page 16 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

17 10. Please provide a copy of any information which describes your organization, its mission and history: Enclosed: Not enclosed (Explain): 11. Is your organization affiliated with any other organization: Yes: No: If yes, please provide details: 12. Please list the names of the following individuals: President/Director Secretary Chief Financial Officer Controller/Accountant 13. List the number of employees of your organization: Full-Time Employees: Part-Time Employees: Consultants: 14. Enter the beginning and ending dates of your organization s fiscal year: From (Month, Day) To (Month, Day) Financial Information. Please complete the requested information and provide a copy of your most recent financial reports. Current year information (indicate period) Revenues: U.S.D. $ Local Currency : Expenses: U.S.D. $ Local Currency : Assets U.S.D. $ Local Currency : Liabilities: U.S.D. $ Local Currency : Prior year information (indicate period) Exchange Rate: per $1 U.S.D. Revenues: U.S.D. $ Local Currency : Expenses: U.S.D. $ Local Currency : Exchange Rate: per $1 U.S.D. 15. Will your organization have other sources of U.S.Government funds during the period of the IFES subaward Yes: No: If Yes, what is the estimated value of U.S. Government funding that your organization receives per year? $ Page 17 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

18 SECTION B: Internal Controls Internal controls are procedures which ensure that: 1) financial transactions are approved by an authorized individual and are consistent with laws, regulations, and the organization s policies, 2) assets are maintained safely and controlled, and 3) accounting records are complete, accurate, and are maintained on a consistent basis. Please complete the following questions concerning your internal controls: 1. List the name and position title for the following area(s): Responsible for cash, bank accounts, or equipment. Cash: Bank Account: Equipment: Responsible for reviewing expenditures to make sure they are allowable. Responsible for keeping all receipts and other documentation to support expenses charged to this grant. Responsible for signing checks. Responsible for maintaining the accounting records. Responsible for reconciling bank statements to the accounting records. Responsible for preparing financial and narrative reports. 2. Describe the types of reconciliations performed, and how frequently they are performed. Type of reconciliation Frequency Page 18 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

19 3. Are timesheets maintained for each employee who is paid? Yes: No: 4. Is each employee s salary documented in an employment letter or contract? Yes: No: 5. Do you maintain inventory records? Yes: No: (if no, explain) 6. How often do you check inventory records to the actual inventory? Page 19 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

20 SECTION C: Accounting system The purpose of an accounting system is to: 1) accurately record all financial transactions, and 2) ensure that financial transactions are supported by invoices, timesheets or other documentation. The type of accounting system often depends upon the size of an organization. Some organizations may have computerized accounting systems while others use a manual system to record each transaction in a ledger. In all cases, IFES subaward funds must be properly authorized, used for the intended purpose and recorded in an organized and consistent manner. 1. Briefly describe your organization's accounting system. At a minimum, describe: a) any manual ledgers used to record transactions (general ledger, cash disbursements ledger, accounts payable ledger, etc); b) any computerized accounting system used (please indicate the type); c) how recorded transactions are summarized for financial reporting purposes, and d) the frequency of financial reports. 2. Do you have written accounting policies and procedures? Yes: No: 3. Are your financial reports prepared on a: Cash basis: Accrual basis: 4. Can the accounting records identify the receipts and payments of an IFES grant from the receipts and payments of other activities? Yes: No: 5. Can the accounting records summarize payments by budget category? Yes: No: 6. How will you ensure that line item and overall budget limits for the IFES subaward will not be exceeded? 7. Do you maintain invoices, vouchers, and timesheets for all payments made from subaward funds? Yes: No: 8. Are there any circumstances in which invoices, vouchers, and timesheets cannot or will not be obtained? Yes: (explain) No: Page 20 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

21 9. Briefly describe your organization s system for filing and maintaining supporting documentation. 10. Will you be able to maintain accounting records including invoices, vouchers, and timesheets for at least three years after the final financial report is submitted? Yes: No: (explain) 11. Do you have an audited indirect cost rate? Yes: (enclose approved rates) No: Page 21 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

22 SECTION D: Funds Control IFES subrecipients receiving advances of subaward funds must maintain a separate bank account for IFES funds. Access to the bank account should be limited to authorized individuals. Bank balances should be reconciled periodically to the accounting records. If cash cannot be maintained in a bank, it is very important to have strict controls over its maintenance and disbursement. 1. Can a separate bank account be established just for IFES subaward funds? Yes: No: 2. Will any cash from IFES funds be maintained outside the bank (in petty cash form, etc.)? Yes: No: If yes, please explain the amount of funds to be maintained, the purpose and person responsible for safeguarding these funds. 3. If you don t have a bank account, what do you do to make sure that cash is maintained safely? 4. If IFE S subaward funds will be held in a non-u.s. bank, please answer the following: a. Are bank deposits insured by the government? Yes: No: b. Do you intend to convert U.S. currency to foreign currency? Yes: No: c. Are there any government restrictions on the number of bank accounts a single organization may maintain? Yes: No: d. Are there any government or bank restrictions on the use of checks for making payments or withdrawals? (Please explain.) Yes: No: e. Are checks usually accepted by vendors? Yes: No: Page 22 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

23 f. Will it be possible for you to establish a bank account in U.S. dollars? Yes: No: g. Are there any government or bank restrictions, taxes, or other charges that will be placed on U.S. dollar bank accounts? (Please explain.) Yes: No: h. Are there any taxes or other charges when converting U.S. dollars to local currency? (Please explain). Yes: No: Page 23 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

24 SECTION E: Audit IFES subaward provisions may require an audit to be performed of your accounting records. Please provide the following information on prior audits of your organization. 1. Have external accountants ever performed an audit of your organization s financial statements? Yes: No: 2. If an audit was performed, please provide this office with a copy of your most recent report. Enclosed: 3. Does your organization have regular audits? Yes: No: a. If yes, who performs the audit and how frequently is it performed? b. If you receive an IFES subaward, will IFES subaward funds be included in such an audit? Yes: No: N/A (not applicable): c. If yes, would it appear as a separate project? Yes: No: N/A: d. Would the report be prepared in, or translated into English? Yes: No: N/A: 4. Are there any reasons (local condition, laws, or institutional circumstances) that would prevent an independent accountant from performing an audit of your organization? Yes: No: If yes, please provide details: Prepared by: Printed Name Signature Title Date Approved by: Printed Name Signature Title Date Page 24 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax:

25 Please include any additional comments here: Page 25 of 25 Intiland Tower19 th Floor Jl. Jendral Sudirman 32 Jakarta Tel: Fax: