EEP Africa Concept Note CfP 14

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EEP Africa Concept Note CfP 14 You can use this document as an aid to collecting information for your submission to preview the questions and draft the responses before entering them in the form. Please note that submitting the Concept Note in a document format is not accepted. You will need to fill in the web-based form to submit your Concept Note. A. Project Key Data Full project title Brief project description (max. 1000 characters) Project type a. Feasibility study b. Pilot project c. Demonstration project d. Replication project e. Scale-up project f. Other Country / countries of implementation a. Botswana b. Burundi c. Kenya d. Lesotho e. Malawi f. Mozambique g. Namibia h. Rwanda i. Seychelles j. South Africa k. Swaziland l. Tanzania m. Uganda n. Zambia o. Zimbabwe p. Regional (If you selected Regional, please indicate the countries) Project sector a. Biofuels liquid b. Biogas c. Cookstoves d. Energy efficiency (not cookstoves) e. Geothermal f. Hybrid g. Hydropower h. Solar PV i. Solar thermal j. Solid biomass k. Waste to energy

l. Wind power m. Other (If you selected Hybrid, please specify). Project category a. On Grid b. Mini-Grid connected c. Mini-Grid stand-alone d. Stand-alone system e. Cookstove Business model specific questions in section B will be based on this selection. Expected starting date of the project (Starting date must be between 10/2018 and 3/2019) Project duration (months) Project implementation location (physical address or coordinates) Total project cost (EUR) Funding requested from EEP (EUR) Amount of co-financing Non-EEP co-financing share of total project cost Previously supported activities of EEP Previous EEP project code(s) I have read and understood the Concept Note Application Guidelines for non-eligible topics and the NDF Policy on Anticorruption and Integrity and confirm the project does not include the non-eligible elements. Information on lead applicant Name of organisation Type of organisation a. Company b. Non-profit or social enterprise c. Research institution Brief description of organization (max. 500 characters) Lead applicant's country of origin Month and year of registration Registration number of the organisation Years in operation for the organisation Name and position of mandated signatory contact person in the organisation Name and position of the primary contact person of the organisation Email (The primary email address we will use for communication in the application process) Telephone Mobile phone Address of the organisation

Website Other members of the partnership/consortium (Name(s) of the Project partner(s)) B. Technical Proposal B.1 Project Summary Please briefly describe the key components of the project and how they would support the objectives of EEP. (max. 2000 characters) B.2. Project Scope and Innovation Project Objectives and Additionality of EEP Funding Please provide a brief description of the current status of the project. (max. 1000 characters) Please describe the additionality of the EEP funding. Why is EEP funding needed? (max. 700 characters) Innovation Please explain the innovation of this project. How has the innovation been adapted to local markets? (max. 700 characters) The degree of innovation in the proposed project is a. Transformational (impact on regional level) b. Breakthrough (impact on local market level) c. Incremental (company/targeted partners and stakeholders) d. Limited The main innovation of the project is related to a. Technology b. Business model c. Financing d. Distribution model e. Development impact f. Synergy of partners g. Scale-up/replication/geographical expansion h. Other Level of innovation in: Technology /Business model / Financing model/ Distribution model /Other innovation components a. High b. Medium c. Low d. None If you wish, please elaborate on the answers above. (max. 700 characters) Technical viability Please provide information on how the project is technically viable and how it may contribute to a technical scale-up. (max. 700 characters) Technology risk

a. The technology is commonly established and the risk related to technology is considered as low. b. The technology in the proposed project has been in commercial use in other markets but has not been tested in the targeted market and operating environment. c. The technology has been piloted/demonstrated but has not been in commercial use. d. The technology is in an innovation/early development phase and has not yet been tested and/or proven. e. Technology is not a key question for the project implementation. Energy efficiency a. The project has a primary focus on energy efficiency. b. Energy efficiency has been integrated into all operations of the organisation. c. All products of the organisation are energy efficient. d. Energy efficiency is considered important and the organisation is considering how to integrate elements of energy efficiency into its products and operations. e. Energy efficiency does not play a major role in the project. B.3 Clear development rationale Please describe the planned development impacts of the project. How will the project contribute towards the objective of EEP and the Sustainable Development Goals? How will the project incorporate the cross-cutting objectives of climate change, poverty reduction, development effectiveness, inclusive development, gender equality and human rights? (max. 1500 characters) Who are the end beneficiaries of the project? What is the target customer segment? What level of energy services will the product/project provide? (1000 characters) Expected outputs Number of households with enhanced energy access a. Rural households b. Urban households c. Long-term estimate: Number of households with enhanced energy access 5 years after the project Number of direct jobs that the project will create a. For men b. For youth under 35 c. For women d. Temporary/permanent e. Long-term estimate: Number of direct jobs created 5 years after the project Private sector investment a. The amount the project developer anticipates to leverage through the project (EUR) b. Long-term estimate: Private sector investment 5 years after the project Cumulative tco2eq emission reductions a. Emission reductions (tco2eq) achieved through the project b. Long-term estimate: Emission reductions after the project Clean energy capacity created a. Capacity (MW) created through the project e.g. from renewable energy system(s) installed and/or products sold b. Long-term estimate: Capacity (MW) created 5 years after the project

Absolute amount of energy saved a. Energy saved (MWh/year) through installation of energy efficient technologies b. Long-term estimate: Energy saved (MWh/year) 5 years after the project Please briefly describe the expected date of achievement, assumptions for achieving the targets and methods used in calculating the targets. (max. 1000 characters) The development impact achieved through the project implementation is expected to be a. Significant with a specific focus on the very poorest and vulnerable as the target group (poverty-directed) b. Significant through the overall results of the project (poverty inclusive) c. Moderate through results in certain areas of poverty reduction etc. (poverty inclusive) d. Limited through indirect development impact (poverty-enabling) Monitoring of the development impact a. We are currently reporting development impact of our activities. b. We are currently measuring development impact but not reporting. c. We plan to measure the development impact in the project. d. Development impact is not a key measure in the project. Please explain the project s contribution to gender aspects (max. 700 characters) Share of women in leadership positions in the lead applicant organization Share of women employees compared to the total number of employees in the lead applicant organization Share of women entrepreneurs involved in project value chains B.4 Business and Financial Sustainability Please describe the key elements of the business model in respect of the commercial rationale, viability, long term bankability and competitive business growth. How financially viable is the business model currently and what is the long-term viability of the business model? What are the expected cash flows during and after the project? What risks are related to the expected cash flows? (max. 1500 characters) In how many years the operations of the organisation are expected to be financially sustainable? In how many years is the project expected to reach a financial close? How will the business model impact the targeted markets and its development as a whole? How does the project avoid or counteract market distortion? (max. 1000 characters) Business model specific questions, based on the project category selection In this section the set of questions is based on the selection of project category (On Grid, Mini-Grid connected, Mini-Grid stand-alone, Stand-alone system or Cookstove). The drop-down questions

relate to e.g. regulatory environment, licenses, off-takers, tariffs, project site, community involvement, social/cultural barriers, feedstock, markets and/or product distribution. Governance and Financial Sustainability Brief description of the governance structure of the organization (max. 700 characters) Please state the names of Board members, Executive management team and other individuals with significant influence in the organization (max. 1000 characters) Type of organisation: Company Ownership structure of the organisation is best described as follows: a. The organisation has one major shareholder with controlling share of the organization. b. The managing director is the major owner of the organisation (over 50% of the shares). c. The organisation has 3-5 major shareholders. d. The organisation has over 10 major owners. e. The ownership of the organisation is diversified in terms of number of owners and the origin of the owners. The major owners of the organisation are a. Nationals of the project country b. A local company/organisation that is owned by nationals of the project country c. A parent company/organisation within the EEP region d. A parent company/organisation outside the EEP region e. A publicly listed company outside the EEP region Management structure of the organisation is best described as follows: a. The organisation has a managing director but no Board of Directors. b. The organisation has a managing director and a Board of Directors. c. The organisation has a managing director and a Board of Directors that convenes regularly (at least 4 times a year). d. The organisation has a managing director and an independent Board of Directors that meets regularly (once a month). Type of organisation: Non-profit or social enterprise / Research institution Structure of the organisation is best described as follows: a. The organisation is a local or national organisation with projects in only one country. b. The organisation is a regional organisation with projects in several EEP countries. c. The organisation is an international organisation with operations in several continents. The current funding base for the organisation is best described as follows: a. The organisation has one major donor or funding partner. b. The organisation has 2-5 donors or funding partners. c. The organisation has 5-10 donors or funding partners, mainly based in Africa. d. The organisation has 5-10 donors or funding partners, mainly international agencies. e. The funding base of the organisation is diversified in terms of number and type of donors. Management structure of the organization is best described as follows: a. The organisation has a managing director / executive director but no independent Board of Directors.

b. The organisation has a managing director / executive director and an independent Board of Directors that meets once a year or less. c. The organisation has a managing director / executive director and an independent Board of Directors that meets regularly (at least 2 times a year). d. The organisation has a managing director / executive director and an independent Board of Directors that meets frequently (once a month). Number of permanent staff: At the time of application / At the end of 2017 / At the end of 2016 Yearly figures (EUR) Turnover/Total income/operating results (EBIT) / Total assets (Y1 / 2017; Y2 / 2016; Y3 / 2015) Main source of income in the organisation / Secondary source of income in the organisation a. Sales revenue b. Donor funding c. Donations d. Government funding Control environment in the organisation is best described as: a. The organisation has not established an internal control environment as of yet. b. Key control measure is that the project management monitors the project activities closely. c. The organisation has established an internal control environment but it has not been documented. d. The organisation has established an internal control environment, which has been documented and the system is regularly monitored. Financial administration in the organisation is best described as a. The organisation has not established accounting system. b. The organisation has established a functioning accounting system (accounting software in use). c. The organisation has established a functioning accounting system and prepares annual financial statements. d. The organisation has established a functioning accounting system and prepares annual audited financial statements. e. The organisation has audited financial statements for the last three years. Co-financing of the project Please describe the sources of co-financing of the project and level of commitment (confirmed, subject to due diligence procedures, negotiations ongoing etc.) for each source of co-financing. Please note that higher level of co-financing, commercial financing and confirmed co-financing is preferred. (max. 1000 characters) Co-financing of the project consists of (EUR) a. Equity b. Grant c. Loan d. Other What share of the total co-financing is public/private funding? (%) Funding requested: > 500.000 (repayable grant) What is your plan for the repayment of the grant and refinancing? (max. 700 characters)

What would be the milestone/target that you would need to reach to be able to repay the grant? (max. 700 characters) In how many years would you expect to be able to repay the grant? Scalability and Replication Do you plan to replicate/scale-up the project? Yes/No If yes, the replication/scale-up potential is a. + 0-50% of the project volume b. + 50-100% of the project volume c. + 100 200 % of the project volume d. + Over 200% of the project volume e. difficult to estimate The expected replication/scale-up will be achieved within a. 1 year after project completion b. 2-3 years after project completion c. 4-5 years after project completion d. Over 5 years after project completion Capacity and Expertise Summarise the experience / expertise of the key project staff of relevance to the project and the role of the lead partner and other project partners (max. 1000 characters) The capacity and expertise of the organisation is best described as a. The organisation has extensive expertise and track record of completing similar projects. b. The organisation has expertise and some track record of completing similar projects. c. Key project staff has expertise and track record of completing similar projects. d. The organisation/key staff have limited expertise and track record of completing similar projects due to the innovative nature of the project. e. The organisation/key staff have limited expertise and track record of completing similar projects. The role of the lead partner in the project is best described as: a. The lead partner is in charge of implementation of all project activities. b. The lead partner is in charge of implementation of key project activities. c. The lead partner coordinates the implementation of all project activities. d. The lead partner coordinates the implementation of some of the project activities. e. The lead partner has a major role as the contractual partner. The role of other project partners in implementation of project activities is a. Critical b. Significant c. Supportive d. Limited Risk analysis and mitigation Please describe the identified key risks in the project and the planned mitigation measures (max. 1000 characters)

The overall risk of the project is (as estimated by the management) a. Critical b. Significant c. Moderate d. Low The main risks with the project relate to a. Business model b. Technology c. Operating environment d. Market demand e. Sustainability f. Capacity of project developer/project management Risk mitigation measures to address the risks of the project a. Have been established to lower the risk to an acceptable level. b. Have been established but do not yet mitigate the risk adequately. c. Have been discussed but not yet established. d. Have not been identified in detail. Define the level of risk by the project related to responsibility issues (environment and social issues) in the current operations and in cooperation with possible sub-contractors a. High Risk: Projects with potential significant adverse social or environmental impacts that are diverse, irreversible or unprecedented. b. Substantial Risk: Projects with fewer potential adverse environmental and social impacts than high risk, limited in special extent, largely reversible and readily addressed through mitigation measures. c. Moderate Risk: Projects with limited potential adverse environmental and social impacts, site-specific, reversible and easily addressed through mitigation measures. d. Low Risk: Projects with minimal or negligible negative environmental or social potential impact.

C. Financial Proposal Project Budget - Costs EUR % of total costs A. Personnel costs B. Acquisition of Fixed Assets C. Acquisition of Goods D. External Services E. Transportation and Logistics F. Travel G. Office Costs H. Other Costs TOTAL PROJECT COSTS 100% Project Budget Financing EUR % of total financing A. EEP Contribution B. Own Contribution (Cofinancing) B.1 Lead Applicant Contribution B.2 Contribution by partner 1 B.3 Contribution by partner 2 etc. TOTAL FINANCING 100%