Miscellaneous Provisions

Article VIII. Miscellaneous Provisions

Section 8.01 Notices and Requests

(a) Subject to Section 6.05, any notice or request required or permitted to be given or made under any Grant Agreement or any other agreement between the Parties contemplated by the Grant Agreement shall be in writing. Except as otherwise provided in Section 8.03(a), such notice or request shall be deemed to have been duly given or made when it has been delivered by hand or by mail, telex or facsimile (or, if permitted under the Grant Agreement, by other electronic means) to the Party to which it is required or permitted to be given or made at such Party's address specified in the Grant Agreement or at such other address as such Party shall have designated by notice to the Party giving such notice or making such request. Deliveries made by facsimile transmission shall also be confirmed by mail.

Section 8.02 Authorised Representatives

(a) Any Party may from time to time nominate, by notice in writing to the other party, a representative or representatives authorised to carry out such functions in relation to the Grant Agreement, as specified in the notice.

(b) Unless and until a Party ("Party A") receives notice in writing from the other Party ("Party B) that an authorised representative of Party B has been removed, Party A can rely on all acts done by an authorised representative of Party B that is within the scope of that authorised representative’s delegated authority (including as indicated in the nomination notice given by Party B to Party A appointing that authorised representative) without the need to make any further enquiries.

(c) Without limiting the operation of paragraph (b) of this Section, all acts done by an authorised representative of a Party within the scope of that authorised represe ntative’s delegated authority binds that Party.

Section 8.03 Action on Behalf of the Republic of Indonesia

(a) The representatives designated by the Republic of Indonesia in the Grant Agreement for the purpose of this Section, or any person authorised in writing by any such representative for that purpose, may take any action required or permitted to be taken pursuant to such Grant Agreement and execute any documents required or permitted to be executed pursuant to such Grant Agreement on behalf of the Republic of Indonesia.

(b) The representative so designated by the Republic of Indonesia or person so authorised by such representative may agree to any modification or amplification of the Grant

Agreement on behalf of the Republic of Indonesia by written instrument executed by such representative or authorised person; provided that, in the opinion of such representative, the modification or amplification is reasonable in the circumstances and will not substantially increase the obligations of the Republic of Indonesia under the Grant Agreement. The Commonwealth may accept the execution by such representative or other authorised person of any such instrument as conclusive evidence that such representative is of such opinion.

Section 8.04 Evidence of Authority

(a) The Republic of Indonesia shall furnish to the Commonwealth: (i) sufficient evidence of the authority of the person or persons who will, on behalf

of such Party, take any action or execute any documents required or permitted to be taken or executed by it under the Grant Agreement to which it is a party; and

(ii) the authenticated specimen signature of each such person.

Section 8.05 Calculation and Evidence

(a) A certificate from the Commonwealth as to any sum payable to the Commonwealth in accordance with any Grant Agreement shall be prima facie evidence of the amount outstanding, and any other certificate, calculation, determination, notification or opinion provided for in any Grant Agreement shall be conclusive, except for manifest error.

Section 8.06 Duplicates

(a) Each Grant Agreement may be executed in several duplicates, each of which shall be an original.

Section 8.07 Amendment

(a) Any provisions of any Grant Agreement may be amended only through a written amendment agreed and signed by both Parties.

Appendix C Disbursement and Withdrawal Procedures

1. Purpose

1.1 The purpose of this Appendix is to set out the Commonwealth’s procedures for disbursement and withdrawal of the grant proceeds relating to the Professional Development of Education Personnel through Australia’s Education Partnership with Indonesia.

2. Disbursement Methods

2.1 The Commonwealth disburses proceeds from the Grant Account established for each grant, to or on the order of the Republic of Indonesia, using one or more of the disbursement methods set forth below, as determined by the Commonwealth.

(a) Advance: the Commonwealth may advance grant proceeds into a Special Account of the Republic of Indonesia to finance Eligible Expenses as they are incurred and for which supporting documents will be provided at a later date (see Section 3, “Special Accounts”);

(b)

Reimbursement: the Commonwealth may reimburse the Republic of Indonesia for expenses eligible for financing pursuant to the Grant Agreement (“eligible expense”)

that the Republic of Indonesia has pre-financed from its own resources.

3. Special Accounts

3.1 The Republic of Indonesia will open one denominated Special Account into which the Commonwealth will, at the Republic of Indonesia’s request and in accordance with the

Grant Agreement, deposit amounts withdrawn from the Commonwealth’s Grant Account for the pur pose of paying for Eligible Expenses as they are incurred (“Special Account” or “SA”).

3.2 Type of Special Account. The Special Account shall be established solely for the purposes of receiving the Grant, and shall not contain funding from any other source or for any other purpose. Net interest earned on the balance of the SA (i.e. gross interest minus bank fees) must be reinvested in the SA, and must be used only to pay for Eligible Expenses.

3.3 Currency of the Special Account. The Special Account will be in Australian Dollar currency. The Republic of Indonesia bears all risks associated with foreign exchange fluctuations between the Australian Dollar and the Rupiah.

4. Withdrawal Process

4.1 Authorised Signatures. Before grant proceeds may be withdrawn from or committed to the Special Account, the authorised representative of the Republic of Indonesia must furnish to the Commonwealth: (a) the name(s) of the official(s) authorised to sign applications for withdrawal, and (b) the authenticated specimen signature(s) of the official(s) (Authorised Signatories Letter). The Republic of Indonesia must indicate clearly if more than one signature is required on applications, and must notify the Commonwealth promptly of any 4.1 Authorised Signatures. Before grant proceeds may be withdrawn from or committed to the Special Account, the authorised representative of the Republic of Indonesia must furnish to the Commonwealth: (a) the name(s) of the official(s) authorised to sign applications for withdrawal, and (b) the authenticated specimen signature(s) of the official(s) (Authorised Signatories Letter). The Republic of Indonesia must indicate clearly if more than one signature is required on applications, and must notify the Commonwealth promptly of any

4.2 Withdrawal Applications. Applications must be provided to the Commonwealth in the template as appended to the Grant Agreement (Appendix D). All Withdrawal Applications must be complete, correctly filled out and signed by an authorised official(s) (as advised to AusAID Jakarta using the Authorised Signatories Letter), and be sent to the address indicated below:

The Head of Australian Assistance for International Development (AusAID) Indonesia Australian Embassy Jl. H.R. Rasuna Said Kav. C15-16 Jakarta Selatan 12940, INDONESIA Facsimile Number: (62-21) 2550 5582

4.3 Withdrawal procedures. The procedure to withdraw the Grant into the SA is as follows:

i. Upon opening the Special Account, and once the Grant Agreement has been rendered effective, MoF should submit to AusAID Jakarta an Authorised Signatories Letter signed by the Republic of Indonesia’s authorised representative and a Withdrawal Application (WA) signed by the authorised official(s). The first Withdrawal Application will request the initial advance to be paid into the Special Account. The second Withdrawal Application will request the second advance to reach the Special Account’s ceiling as described in subsection 4.6 of this Appendix. Unless AusAID requests otherwise, there is no need to attach any other supporting documentation for Withdrawal Applications requesting advance.

ii. AusAID Jakarta will review the Withdrawal Application and, if satisfied, authorise AusAID Canberra to process the payment.

iii. AusAID Canberra, upon recommendation from AusAID Jakarta, will transfer funds to the Special Account. AusAID Jakarta will notify the contact person specified on the Withdrawal Application, as soon as the payment has been made. MoF will notify AusAID Jakarta and the Eligible Entities (appropriate MoEC’s Work Unit or Satuan Kerja /SATKER) when the funds have been received in the Special Account.

iv. The Indonesian treasury (KPPN) will receive and review Payment Order Letter (Surat Perintah Membayar /SPMs) from appropriate MoEC’s SATKERs as Eligible Entities, and, if satisfied that the expenses to which the SPM relate are Eligible Expenses, the KPPN will issue SP2D in three copies. The first copy will be submitted to Bank Operasional I (BO I) to release payment to respective treasurer and vendor/supplier (third party) as stated in the SP2D. The second copy of SP2D will be submitted to Eligible Entities along with other supporting documents for replenishment and reimbursement. The third copy of SP2D will be kept as archive in KPPN.

v. For the subsequent Withdrawal Applications, MoF will receive and review the Quarterly Progress Report described in Clause 2, Part B, Section V, Schedule 2 of this Agreement. If satisfied, it will submit a Withdrawal Application to AusAID Jakarta, attaching the Initiative Report and other supporting documentation, as detailed in subsections 5.2 and

5.3 of this Appendix.

vi. AusAID Jakarta will assess the Withdrawal Application, carrying out any checks it deems are appropriate to provide assurance that payments have only been made for Eligible Expenses. AusAID reserves the right to (a) approve the Withdrawal Application in its entirety for payment by AusAID Canberra; (b) return the Withdrawal Application if the attached supporting documentation is incomplete; or (c) approve part payment of the Withdrawal Application if there are some unsupported transactions. Any unsupported transactions that are substantiated at a later date will have to be documented through a new Withdrawal Application.

vii. Depending on whether more money is needed in the Special Account, the Withdrawal Application the Republic of Indonesia lodges with AusAID Jakarta will either:

(a) document the payments made from the Special Account during the quarter covered by the Initiative Report, using the Initiative Report (and any other information AusAID Jakarta requests) as evidence; or

(b) document the Special Account payments during the quarter covered by the Initiative and request another advance to the Special Account, using the Initiative Report as the supporting documentation evidencing Eligible Expenses.

viii. The withdrawal procedure is depicted in Diagram 1 below.

Diagram 1: Procedure to withdraw Australian grant financing

Australian “Grant Account” at Reserve Bank of Australia (RBA)

Advance Grant Category I to IV

Replenishment/ Reimbursement of

Special Account

AusAID

Advance Payment: Authorised Signatories Letter and Replenishment : Disbursement Letter, Withdrawal Application

Withdrawal Applications

and Initiative Report (Quarterly and Annual)

Submit Bank Statement

MoF’s Directorate

Submit Bank Statement

Executing Agency

General of Treasury

Bank Indonesia Special

(EA)

c.q Directorate Cash

Account for The Nationwide Professional Development of

Submit Draft of Withdrawal

Management (PKN)

Debit Order Letter

Education Personnel

Application and

(Surat Perintah Debit / SPD)

Financial Initiative Report

C irc u

Submit financial, progress &

(SE

Charge Order Letter

procurement reports with SP2D, SPM,

rL

la

(Surat Perintah Pembebanan/SPB)

n) tio

BAP and invoice attached ett

ud B ELIGIBLE ENTITIES (

KPPN

Bank Operational I

(appropriate Work Units/SATKER located at

(Payment Office)

PA

Central and Provinces)

Supporting Document Submit SPM with

Issuing SP2D

attached

DI Submit Payment Request (SPP)

Treasurers of Eligible

Payment transfer to Eligible Entities (Work Units /SATKER)

Entities;

and to Suppliers/Vendors

Vendors/Suppliers

Flow of Document

Flow of Fund

Executing Agency

Responsible for submission of application

BAP : Berita Acara Pembayaran – Minute of Payment SPP

: Surat Permintaan Pembayaran – Payment Request Letter SPM

: Surat Perintah Membayar – Payment Order Letter SP2D

: Surat Perintah Pencairan Dana – Fund Release Order Letter

4.4 Electronic Delivery. The Commonwealth may authorise the Republic of Indonesia to use electronic means, in a manner and on terms and conditions specified in writing by the Commonwealth, to deliver Withdrawal Applications and supporting documentation to the Commonwealth.

4.5 Minimum Value of Applications. The minimum value of a Withdrawal Application for advance or reimbursement is one hundred thousand Australian Dollars (AUD100, 000). The Commonwealth reserves the right not to accept Withdrawal Applications that are below the minimum value.

4.6 Ceiling of the Special Account. The maximum amount of grant proceeds that may be on deposit in the Special Account is thirty five million Australian Dollars (AUD35,000,000). The amount may be adjusted from time to time through written notice from the Commonwealth to the Republic of Indonesia.

4.7 Grant Disbursing Period. The Commonwealth processes Withdrawal Applications only after the Grant Agreement has been declared effective, in accordance with the terms of the Grant Agreement.

4.8 Disbursement Deadline Date. The grant disbursing period ends on Closing Date specified in the Grant Agreement (“Disbursement Deadline Date”). Normally, to support

orderly Initiative completion and closure of the Special Account, the Commonwealth does not accept applications for withdrawal or supporting documentation received after the Disbursement Deadline Date. The Republic of Indonesia should promptly inform the Commonwealth of any expected implementation delays or exceptional administrative issues before this date. The Commonwealth may notify the Republic of Indonesia of any exception that the Commonwealth may make to the Disbursement Deadline Date.

5. Supporting Documentation Requirements

5.1 The Republic of Indonesia must provide supporting documentation to the Commonwealth to show that Grant proceeds have been or are being used to finance Eligible Expenses. The supporting documentation is to satisfy the Commonwealth that all payments from the Special Account were made for Eligible Expenses, that each payment from this account went to a legitimate account (as evidenced, primarily, by registration at MoF) in a legitimate amount as evidenced, primarily, by the Fund Release Order Letter (Surat Perintah Pencairan Dana /SP2D) and Payment Order Letter (Surat Perintah Membayar / SPM) and yearly progress monitoring data.

5.2 Types of Supporting Documentation for Advance. All Withdrawal Applications (WA) requesting an advance to the Special Account, with the exception of the initial advance as stated in subsection 4.3(i) of this Appendix, must attach the following supporting documentation, as well as any other information that AusAID may request from time to time:

i. Initiative Report(s) covering the period since the last Withdrawal Application (these shall include interim unaudited financial statements in a format to be agreed between the Commonwealth and the Republic of Indonesia under Clause 2 and 3, Part B, Section V of Schedule 2 of the Grant Agreement);

ii. Bank Statements showing all of the transactions recorded against the Special Account since the last Withdrawal Application. For every debit transaction, the Bank Statements must clearly show the AUD amount charged to the account, the ii. Bank Statements showing all of the transactions recorded against the Special Account since the last Withdrawal Application. For every debit transaction, the Bank Statements must clearly show the AUD amount charged to the account, the

iii. a Statement of Expenditure (using the template to be agreed between the Commonwealth and the Republic of Indonesia under Clause 2, Part A, Section VI of Schedule 2 of the Grant Agreement and submitted in both hard-copy and electronic Microsoft Excel™ format), which links every debit transaction shown on the special account Bank Statements referred to in subsection 5.2(ii) of this Appendix to an SP2D;

iv. an SP2D ( Fund Release Order Letter) for every debit transaction on the Special Account bank statements : SP2Ds relating to the Special Account must also show the corresponding Eligible Expenses; and

v. a correctly completed withdrawal application Checklist (using the template at Appendix D to the Grant Agreement), signed by appropriate officials within MoEC.

5.3 Type of Supporting Documentation for Reimbursement. All Withdrawal Applications requesting reimbursement of the sBUN Account must attach the following supporting documentation, as well as any other information that AusAID may request from time to time:

i. Initiative Report(s) covering the period since the last Withdrawal Application (these shall include interim unaudited financial statements in a format consistent with the template attached to the Grant Agreement);

ii. Bank Statements for the sBUN Account, clearly marking the payments for which reimbursement is being sought;

iii. a Statement of Expenditure (using the template attached to the Grant Agreement and submitted in both hard- copy and electronic Microsoft Excel™ format), which links every debit transaction marked on the sBUN Account Bank Statements referred to in subsection 5.3(ii) to an SP2D;

iv. an SP2D for every debit transaction marked on the sBUN Account Bank Statements : SP2Ds relating to the Special Account must also show the corresponding Eligible Expenses; and

v. a correctly completed withdrawal application checklist (using the template at Appendix D to the Grant Agreement), signed by appropriate officials within MoEC.

5.4 In all cases, the Republic of Indonesia is responsible for retaining the original documents evidencing Eligible Expenses and making them available to the Commonwealth for audit or inspection.

5.5 Failure to Provide Audited Financial Statements. If the Republic of Indonesia fails to provide any of the audited Financial Statements required in accordance with, and within the period of time specified in, the Grant Agreement, the Commonwealth may at its discretion decide not to accept Withdrawal Applications supported by Summary Reports, even if such reports are accompanied by Records.

6. Terms and Conditions Applicable to Advances

6.1 Frequency of Reporting Eligible Expenses Paid from the Special Account. The Republic of Indonesia reports on the use of Grant proceeds advanced to the Special Account at intervals specified in the Grant Agreement.

6.2 The Republic of Indonesia must ensure that all amounts deposited in the Special Account are accounted for and their use reported prior to the Disbursement Deadline Date. After this date, the Republic of Indonesia must promptly refund to the Commonwealth any advances still unaccounted for or remaining in the Special Account.

6.3 Withholding Advances. In addition to the Commonwealth’s rights under Section 4 of the General Conditions, the Commonwealth is not required to make any deposit into the Special Account if:

(a) The Commonwealth is not satisfied that the Republic of Indonesia’s planned Initiative expenses justify the deposit. The Commonwealth may, by notice to the Republic of Indonesia, adjust the amount it deposits or withhold further deposits into the Special Account until it is satisfied that the financial needs of the Initiative warrant further deposits;

(b) The Republic of Indonesia fails to take action required pursuant to the determinations made by the Commonwealth under subsection 7.1 of this Appendix; or

(c) The Republic of Indonesia fails to provide any of the audited Financial Statements required in accordance with, and within the period of time specified in, the Grant Agreement.

6.4 Excess Advances. If at any time the Commonwealth determines that any amount deposited in the Special Account will not be required to cover further payments for Eligible Expenses (“Excess Amount”), it may, at its discretion, require the Republic of Indonesia to:

(a) Provide evidence satisfactory to the Commonwealth within a period specified by the Commonwealth that the Excess Amount will be used to pay for Eligible Expenses. If the evidence is not furnished within the time period specified, the Republic of Indonesia must promptly refund the Excess Amount to the Commonwealth; or

(b) Refund the Excess Amount. Upon notification by the Commonwealth, the Republic of Indonesia must promptly take the

action requested.

7. Ineligible Expenses

7.1 Ineligible Expenses Paid from the Special Account. If the Commonwealth determines that any payment out of the Special Account was not justified by the evidence furnished to the Commonwealth or was made for an expense which was not an Eligible Expense, the Commonwealth may, at its discretion and in addition to its rights under Section 4.06 of the General Conditions, require the Republic of Indonesia to:

(a) Provide additional evidence requested by the Commonwealth; (b) Deposit an equivalent amount into the Special Account; or (c) Exceptionally, provide substitute documentation evidencing other Eligible Expenses.

Upon notification by the Commonwealth, the Republic of Indonesia must promptly take the action requested.

8. Refunds

8.1 Republic of Indonesia’s Decision to Refund. The Republic of Indonesia may, upon notice to the Commonwealth, refund all or any amount of the Grant on deposit in the Special Account to the Commonwealth for credit to the Grant Account.

8.2 Consequence of Refunds. The Commonwealth shall determine whether refunds made to the Commonwealth in accordance with Sections 6 and 7 and subsection 8.1 of this Appendix will be credited to the Grant Account for subsequent withdrawal or be cancelled.

8.3 Other Obligations Unaffected by Refunds. Refunds of amounts of the Grant do not affect any rights or remedies of the Commonwealth under the Grant Agreement.

9. Interpretation

9.1 Interpretation of this Appendix. Despite Section 1.02 of the General Conditions, if a provision of this Appendix is inconsistent with the General Conditions, the General Conditions shall prevail to the extent of the inconsistency. However, a provision of this Appendix shall not be considered inconsistent with the General Conditions only because it grants the Commonwealth rights additional to those set out in the General Conditions.

Appendix D: Withdrawal Application Template

Instructions for Completing the Application for Withdrawal

Form 1060

NOTES: Application Use: Please use this form to request a payment and/or to document expenses under Australian Government grants executed by the Republic of Indonesia and administered by AusAID. Dual Form Functions: This form has been designed to handle two functions: (1) to request AusAID to make a payment from the Grant Account; and (2) to

document expenses financed under the Grant. In some instances, you will use the form for only one of the functions (e.g. to request an advance to a designated account, to document expenses paid from a designated account) whereas in other instances you will use it simultaneously for both functions (e.g. to request a direct payment or reimbursement and simultaneously document the expenses, to request a new advance to a designated account and concurrently document expenses paid from a previous advance).

Advances: You should request advances to designated accounts on the basis of planned project expenses and the ceiling in the disbursement letter. To ensure that funds are available only when needed, the advances may be paid in periodic installments as pr ovided by you on the “Requested Schedule for Advance Payments” Form 1061. You are required to document the expenses paid from the designated account at the end of (or during, should you so choose) the reporting period indicated in the disbursement letter. Advancing of funds and documenting of expenses are independent functions and you may choose to

submit a request for an advance separately and at different times from documenting the expenses. To request an advance, fill out sections A, B and D of the form. To document expenses paid from the advance(s), fill out sections A, C and D.

A. Application Type and Project Reference

1. Application Type: Check the applicable type. The sections of the form which need to be completed are shown in parentheses beside each type. 2. Financing Number: Insert the number of the Grant Agreement as it appears on the related legal agreement.

3. Beneficiary Reference: Provide your reference for the application for withdrawal. Number applications consecutively, beginning with number one.

B. Payment Instructions

[Fill in this section to request a payment]

4a-d.

Application Currency and Amount(s): Insert the currency name (4a) and the amount of the application should correspond: (i) for advances, to the currency of the designated account and to the share to be financed by the Grant(s) of the amount required – both in figures (4b) and words (4d). These expenses covered by the request. If the payment is to be made in a different currency than the currency of the application, enter the currency of for the planned project expenses; and (ii) for direct payments and reimbursements, to the currency and to the share financed by the Grant(s) of the payment in field 4c. For example, if the application is for AUD10,000,000 and the payment is to be made for the equivalent amount in IDR, you should 5. Name and Address of Beneficiary: Give the full name and address of the payment beneficiary. enter “Australian Dollars” in field 4a, “10,000,000” in field 4b, “Indonesian Rupiah” in field 4c and “Australian Dollars ten million and 00/100” in field 4d. 6. form. Amount to be Paid in Installments: If the advance to a designated account is to be paid in installments, i ndicate “yes” and attach Form 1061 to this

7a-c.

Worldwide Interbank Financial Telecommunication/Bank Identifier Code (SWIFT BIC) of the bank. If the SWIFT BIC is unavailable, provide the sort Beneficiary’s Bank: Give the full name and address of the beneficiary’s bank, the account number of the beneficiary at the bank and the Society for

code of the beneficiary’s bank in field 9. Intermediary Bank: F or payments in a currency which is not the currency of the country in which the beneficiary’s bank is located, give the full name

8a-c.

and address of the beneficiary’s bank in the country which issues the currency (known as the intermediary bank), the account number of the beneficiary’s bank at the intermediary bank and the SWIFT code of the intermediary bank. If the SWIFT BIC is unavailable, provide the sort code of 9. the intermediary bank in field 9. Special Payment Instructions: Precise payment instructions will help to ensure that a payment is made swiftly and correctly. Please give any special instructions that would help to expedite a payment in this field. For example, for banks which are not members of SWIFT, determine directly or through the supplier if another identifier is available such as a sort code and include the reference(s) here.

C. Documentation of Eligible Expenses

[Fill in this section for direct payments, reimbursements and to document expenses paid from an advance]

10. Documentation Type(s): Indicate the type of documentation that is attached to the application in accordance with the requirements specified in the disbursement letter. A direct payment requires copies of records (e.g. invoices, bills); a reimbursement or documentation of expenses paid from advances could include an interim financial report, a statement of expenditure, copies of records, or a combination thereof.

11a-b. Grant Category and Contract Reference: In cases where the documentation relates to one grant category or contract (i.e. mainly for direct payments), provide the grant category and contract information in these fields. For all other cases, please ensure a breakdown of expenses by

category is available in the supporting documentation. If expenses include may attach a list of the payments and related contracts if this cannot be derived from the supporting documentation. payments against contracts that are subject to AusAID’s prior review, you 12a-c. Documentation Currency and Amount: Give the currency name (12a) and amount of documented expenses eligible for Australian financing – both

application currency and amount (see fields 4a, b and d above). in figures (12b) and in words (12c). For direct payments and reimbursements, the documentation currency and amount should be the same as the

D. Assertions and Signature

13. Name of Beneficiary: Fill in the name of the beneficiary as it appears in the Grant Agreement(s). 14. Date Signed: Give the date on which the authorised signatory(ies) sign(s) the application for withdrawal.

15a-b. Name(s) and Title(s) of the Authorised Signatory(ies): Provide both the name and title of the signatory(ies) and obtain the signature(s) of the

16. Contact Details: Provide contact information in this field of the person/office to contact in case of questions. authorised signatory(ies).

Attachments

The following should be attached to this form, as appropriate:   Requested Schedule for Advance Payments Form 1061

Supporting documentation – see field 10

– see field 6

 [Optional] Summary of Grant Category and Contract Information Sheet – see fields 11a and 11b

APPLICATION FOR WITHDRAWAL

Instructions: You can use this form to request a payment and/or document expenses. Please complete and sign this form, and send it (with any required attachments) to AusAID, at the address found in the disbursement letter. For general enquiries, please send an email to accounts.processing@ausaid.gov.au .

A. Application type and project reference

1. Application type 2. Financing number a. Advance to designated account

(name or number of designated account)

__ Advance to designated account (fill sections A, B, D)

3. Beneficiary reference

__ Advance to and documentation of designated account (fill all sections) __

Documentation of prior advance(s) to designated account (fill sections A, C, D)

b. __ Reimbursement (fill all sections)

c. __

Direct payment

(beneficiary’s payment/invoice reference)

(fill all sections)

B. Payment instructions

4a. Application currency

4b. Application amount

4c. Equivalent payment currency (if different from application currency)

4d. Application amount (in words)

5. Name and address of beneficiary

6. Amount to be paid in installments? Yes ______ No ______ (if yes, complete Form 1061 , “Requested Schedule for Advance Payments”)

7a. Name and address of the beneficiary’s bank

7b. Account no. of the beneficiary

7 c. SWIFT code of the beneficiary’s bank

at the beneficiary’s bank

8a. Name and address of the intermediary bank

8b. Account no. of the beneficiary

8c. SWIFT code of the intermediary bank

at the intermediary bank

9b. Account no. of 9c. SWIFT code of the

9. Special payment instructions (if any)

C. Documentation of eligible expenses

11. Grant Category and contract reference – If expenses relate to more than __

10. Documentation type(s)

Interim financial report one grant category or contract reference, leave 11a and 11b blank and ensure this __

Statement of expenditure information is included in the supporting documentation. __

Copies of records (e.g. invoices, receipts)

11a. Grant Category reference 11b. Contract reference 12a. Documentation currency 12b. Documented amount

12c. Documented amount (in words)

D. Assertions and signature

The undersigned certifies, warrants and undertakes the following: A. If the undersigned is making a request for an advance to be deposited in a designated account: (1) the amount requested is consistent with the planned initiative

expenses furnished to AusAID; and (2) the documentation for this advance is/will be furnished to AusAID in accordance with the reporting period specified in the related legal agreement(s) or disbursement letter for this project. If the undersigned is documenting expenses paid from a designated account: (a) the expenses covered by the application are eligible for financing out of the proceeds of the grant in accordance with the terms of the related legal agreements; and (b) these expenses have not been financed previously from sources other than the Republic of Indonesia nor will the undersigned request financing for the expenses from any other source in the future.

B. If the undersigned is making a request for reimbursement or direct payment: (1) the expenses covered by the application are eligible for financing out of the proceeds of the grant in accordance with the terms of the related legal agreement(s); and (2) these expenses have not been financed previously from sources other than the Republic of Indonesia nor will the undersigned request financing for the expenses from any other source in the future.

C. The undersigned will make all records related to the expenses covered by this Withdrawal Application available for review by auditors and by AusAID staff.

13. By (name of beneficiary)

14. Date signed

15a. Print name(s) and title(s) of authorised signatory(ies)

15b. Signature(s)

16. Contact details

Name

Phone

Facsimile

Email

Appendix E: Indicative Disbursement Plan

Financial Grant Eligible Expenses

Unit of Learning 1 TOTAL

Year Category

DISBURSEMENT (AUD)

2013 Category 1 PPP

Supervisor PD

Province & District Officials PD

CPD new intake

Category 2 Management and operation cost for Central Training Team including monitoring &

evaluation costs, accommodation, travel, per diem (Monitoring activities & workshops

45%; Management/Coordination Workshop 55%)

Category 3 Procurement of materials and resource package for the Initiative (Hard copy Modules

40%; UoL CD for distance learning 40%; Implementation Guidelines 20%)

Category 4 Procurement of services to support web-based learning, MIS and M&E systems

2014 Category 1 PPP

Supervisor PD

Province & District Officials PD

CPD completion

CPD new intake

Category 2 Management and operation cost for Central Training Team including monitoring &

evaluation costs, accommodation, travel, per diem

Category 3

Procurement of materials and resource package for the Initiative

Category 4 Procurement of services to support web-based learning, MIS and M&E systems

2015 Category 1 Supervisor PD

CPD completion

CPD new intake

Category 2 Management and operation cost for Central Training Team including monitoring &

evaluation costs, accommodation, travel, per diem

Category 3

Procurement of materials and resource package for the Initiative

Category 4 Procurement of services to support web-based learning, MIS and M&E systems

2016 Category 1 Supervisor PD

CPD completion

Additional CPD completion

Category 2 Management and operation cost for Central Training Team including monitoring &

evaluation costs, accommodation, travel, per diem

Category 3

Procurement of materials and resource package for the Initiative

Category 4 Procurement of services to support web-based learning, MIS and M&E systems

TOTAL DISBURSEMENT (AUD)

The use of UoL rather than participants as the unit cost reflects the way the Headline Results are calculated – i.e. that the numbers of officials trained is calculated based on the number of individuals and the number of training programs or courses of learning that they take part in. In the case of CPD Level 1, there are 7 Units of Learning, which involve a course of study that can include lectures, workshops, group activities, self-learning, online learning and other activities. Each unit of learning covers approximately a 6- month period and is considered to constitute a “course of learning” under this definition.

_________________________________________________________________________________________________________________________________ Manual Prosedur Edisi Pertama Versi 2.0 – Juni 2014

Appendix F: Clarification Relating to Procurement for the Initiative

1. General The procedures to be followed for all procurements shall be those set forth in Presidential

Regulation No. 54/2010 of the Republic of Indonesia with: 1.1. the exception of Articles 96, 97, 98, 101, 102 and 104 that shall not be applied for any Initiative

procurements; and

1.2. the clarifications and modifications described in the following paragraphs to ensure compliance with the requirements of the Commonwealth.

2. Joint Ventures

A bidder declared the lowest evaluated responsive bidder shall not be required to form a joint venture or to sub-contract part of the supply of goods as a condition of award of the contract.

3. Preferences

No preference of any kind shall be given to national bidders or national goods/product.

4. Advertising

Bid documents shall also be made available, by mail or in person, to all who are willing to pay the required fee. Foreign bidders shall not be precluded from the bidding. If a registration process is required, a foreign firm declared the lowest evaluated bidder shall be given a reasonable opportunity for registering.

5. Bid Security

Bid security shall be, at the bidder’s option, in the form of a letter of credit or bank guarantee from a reputable bank.

6. Bid Opening and Bid Evaluation

(a) Bids shall be opened in public, immediately after the deadline for submission of bids, and if bids are invited in two envelopes, both envelopes (technical and price) shall be opened at the same time.

(b) Evaluation of bids shall be made in strict adherence to the criteria declared in the bidding documents and contracts shall be awarded to the lowest evaluated bidder.

(c) Bidders shall not be eliminated from detailed evaluation on the basis of minor, non- substantial deviations.

(d) No bidder shall be rejected merely on the basis of a comparison to the owner’s

estimate and budget ceiling without the Commonwealth’s prior concurrence.

7. Rejection of Bids

(a) Bids shall not be rejected and new bids solicited without the Commonwealth’s prior concurrence.

(b) When the number of responsive bids is less than three, re-bidding shall not be carried out without the Commonwealth’s prior concurrence.

8. Appendix G: Template for the Initiative Performance Assessment Framework

A Performance Assessment Framework (PAF) is to be jointly developed by the Commonwealth and the Republic of Indonesia with technical assistance from a contractor engaged by the Commonwealth, within 3 months of the entry into effect of this Agreement. Once developed and jointly agreed by GOA and the Partner Government the PAF will form an integral part of this agreement.

The PAF is dynamic in nature and this Agreement allows for the performance targets to be set and revised annually. The template below will be used as a guide by the Republic of Indonesia and the Commonwealth.

Key performance indicator

Target for 2014

Target for 2015 Target for 2016

Appendix H: The Initiative ’s Risk Management Plan (RMP) Template

A Risk Management Plan (RMP) is to be jointly developed by the Republic of Indonesia and the Commonwealth within 6 months of the execution of this Agreement. Once developed, the RMP will form an integral part of this agreement and be reviewed annually during implementation of the Initiative.

The RMP needs to address the following questions each year:  What changes are there in the risk profile?  What changes are there in the environment? What opportunities and risks do they present?  What new risks are emerging? What identified risks are declining?  Are the risks management strategies being implemented?  How can the risk management strategies be improved?

Risk rating with existing

controls in place

Is risk rating