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COMMUNITY INITIATIVE PROGRAMME
INTERREG III B ARCHIMED
FINAL PROJECT REPORT
PART 1
ACTIVITY REPORT
Submission Date:
CO-FINANCED BY THE EUROPEAN REGIONAL DEVELOPMENT FUND
2
A. GENERAL PROJECT INFORMATION
LEAD PARTNER: (Name of the Institution)
COUNTRY OF LEAD PARTNER:
NAME:
POSITION:
ADDRESS:
TEL. No: FAX:
LEGAL REPRESENTATIVE
E-MAIL:
SIGNATURE & STAMP
Has the legal representative of the lead partner been replaced since the signature of the Subsidy Contract?
If yes, please state the mane of the legal representative that was replaced.
NAME
POSITION:
ADDRESS:
TEL. No: FAX:
PROJECT MANAGER
E-MAIL:
Has the project manager of the lead partner been replaced since the signature of the Subsidy Contract?
If yes, please write the mane of the project manager that was replaced.
PROGRAMME AND PROJECT INFO
COMMUNITY INITIATIVE: INTERREG III
OPERATIONAL PROGRAM: INTERREG III B ARCHIMED
PRIORITY AXIS: Axis Number and Title
MEASURE:
TITLE OF THE PROJECT:
ACRONYM OF THE PROJECT:
JOINT CONVENTION – DATE OF SIGNATURE:
SUBSIDY CONTRACT NUMBER - DATE OF SIGNATURE:
3
LIST OF PROJECT PARTNERS
A. MEMBER STATES
PARTNER NAME OF THE INSTITUTION COUNTRY REGION
LEAD PARTNER (PP1)
PP2
PP3
PP4
PP5
PPn
B. NON-MEMBER STATES
PARTNER NAME OF INSTITUTION COUNTRY
PP..
4
PROJECT BUDGET (€)
TOTAL BUDGET EU CONTRIBUTION
(ERDF) NATIONAL
CONTRIBUTION
Budget according to the Subsidy Contract
Budget according to the Application form in force (last approved modification)
PROJECT TIMETABLE
START (mm/yyyy) END (mm/yyyy) DURATION (in months)
Timetable according to the Subsidy Contract
Timetable according to the Application form in force (last approved modification)
PROJECT COST(€) PER PARTNER
PARTNER COUNTRY PAID OUT EXPENSES CERTIFIED EXPENSES*
TOTAL EU CONTRIBUTION
(ERDF)
TOTAL EU CONTRIBUTION (ERDF)
Lead Partner
PP1 PP2 … PPn
TOTAL
*Please, mention the total amount of certified expenses until the submission date of the final report.
5
PROJECT MODIFICATIONS
Please list in chronological order all changes/modifications that have been approved by the Programme Authorities (Steering Committee/Managing Authority).
1st modification
Type of modification Specify the type of modifications (Budget, Timeframe, Partnership, Activities, Deliverables,
Outputs etc)
Date of approval Insert the reference number and date of Managing Authority’s correspondence
Description Give a short description of the reasons that lead to the modification of the project and how
these modification(s) affected the overall implementation for the project.
2nd modification
Type of modification
Date of approval
Description
n* modification
Type of modification
Date of approval
Description
6
B. EXECUTIVE SUMMARY OF PROJECT IMPLEMENTATION
Project’s activities and objectives (max. 1000 words)
Please provide an overview of project’s objectives and the main activities carried out during its lifetime.
7
Project’s achievements (max.750 words)
Please describe the project achievements with reference to the related work packages and actions in terms of:
1. Networks 2. Studies 3. Pilot Actions 4. Exchange of Know how 5. Information activities
Explain to what extent the objectives described above have been achieved and whether the project is fully operational.
Development of Transnational Partnership (max 450 words)
Please describe the development of the partnership throughout the project duration, especially the involvement of partners from several countries in its implementation. Highlight any problems that were arisen, their reasons and how the were solved. Refer to possible future co-operation of partners after project finalization.
Involvement of Non EU partners (max 300 words)
Please describe the involvement of non-EU partners to the implementation of the project, if applicable.
8
Project management (max 300 words)
Please describe the system of project management. Present bodies, their composition, tasks and performance. Please refer to any challenges faced.
Changes and Problems (max. 300 words)
Please describe any major changes/problems encountered, their reasons, their solutions and their impact to the overall implementation of the project in terms of:
1. Project Coordination 2. Implementation of activities 3. Cooperation between partners 4. Financial management
Experience gained during the project implementation and the added-value of working transnationally (max 300 words)
Please present the experience gained from the project implementation in terms of:
1. Project Coordination 2. Implementation of activities 3. Cooperation between partners 4. Financial management
9
Compliance with Programme, Priority Axis and Measure (max. 300 words)
Please explain how the project contributed to the objectives of the programme, priority axis and measure.
Contribution to EU Policies (max. 300 words)
Please review how the project has contributed to EU policies on equal opportunities, employment, spatial development and environment. How these policies were reflected in the project?
Follow up (max. 300 words)
Please answer the following questions:
1. What will happen to the partnership after the completion of the project? Will the partners continue to operate? 2. What will happen to the project’s results? Is there action plan for maintaining the results achieved? 3. Are there any follow-up projects planned? If yes, please give a short description.
IMPLEMENTATION OF ACTIONS Please list all actions carried out as shown in the table below and fill in the expenses paid out until completion as well as the certified expenses until the submission date of the final report.
WP No
Action No
Start (mm/yy)
End (mm/yy)
Description of activities, components, means
Responsible Partner
No
Involved Partners
No Location
Achieved output/ deliverables
Paid out expenses
(€)
Certified expenses
(€)
1.1.
1.2.
WP1
1.n.
2.1.
2.2.
WP2
2.n.
3.1.
3.2.
WP3
3.n.
n.1.
n.2.
WPn
n.n.
11
ATTENTION! ALL DELIVERABLES MUST BE SUBMITTED TO THE MANAGING AUTHORITY IN ELECTRONIC FORM AND/OR HARD COPY
DELIVERABLES PER PARTNER Please describe deliverables/outputs produced per partner as indicated in the table below and fill in the expenses paid out until completion as well as the certified
expenses until submission date.
Partner No Work-
package No
Action No
Deliverables / Outputs Start
(mm/yy) Concluded (mm/yy)
Paid out
expenses (€)
Certified expenses
(€)
PP1
(LEAD PARTNER) Total cost of deliverables cost of PP1
PP2
Total deliverables cost of PP2
PP3
Total deliverables cost of PP3
PP4
Total deliverables cost of PP4
PPn
Total deliverables cost of PPn
TOTAL
Total deliverables cost
OUTPUTS/ RESULTS/ IMPACTS ACHIEVED BY THE PROJECT
ACHIEVED OUTPUTS (contributing to the aims of the Measure)
INDICATOR CODE*
INDICATOR** UNIT OF MEASUREMENT
TARGET VALUE
ACHIEVED VALUE
REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND
TARGET VALUES
* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.
ACHIEVED PROJECT RESULTS (contributing to the Priority Axis or Measure)
INDICATOR CODE*
INDICATOR**
UNIT OF MEASUREMENT
TARGET VALUE
ACHIEVED VALUE
REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND
TARGET VALUES
* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.
EXPECTED IMPACTS
INDICATOR CODE*
INDICATOR** UNIT OF MEASUREMENT
TARGET VALUE
ACHIEVED VALUE
REASONS FOR DIFFERENCE BETWEEN ACHIEVED AND
TARGET VALUES
* To be completed by the Managing Authority ** Insert the indicators as listed in the application form in force.
ATTETINTION! SECTION C MUST BE FILLED SEPARATELY FOR EVERY PARTICIPATING PARTNER IN THE PROJECT
C. FINAL PROJECT REPORT PER PARTNER
FINAL REPORT OF LEAD PARTNER (PP1) - (name of Lead Partner)
DELIVERABLES PRODUCED AND THEIR AVAILABILITY
Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.
Deliverables foreseen in the Application Form
Deliverables produced by the Project
Work- package
No
Action No
Type of deliverable
Description / Title
Number Cost foreseen
Type of deliverable
Description / Title Number
Expense incurred
Location, responsibility and evidence
REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)
Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.
ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER
Please present in detail the actions for publicity and dissemination that have been carried out by mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /
interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,
videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached
A. Kind of events organized
Type Topic Target groups
Number of participants /
persons reached
WP
B. Kind of instruments/tools used and/or developed
Type Topic Target groups
Number of participants /
persons reached
WP
FINAL PROJECT REPORT PER PARTNER
FINAL REPORT OF PROJECT PARTNER 2 (PP2) - (name of Project Partner)
DELIVERABLES PRODUCED AND THEIR AVAILABILITY
Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.
Deliverables foreseen in the Application Form Deliverables produced by the Project
Work- package
No
Action No
Type of deliverable
Description / Title Number Type of
deliverable Description / Title Number
Location, responsibility and evidence
REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)
Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.
ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER
Please present in detail the actions for publicity and dissemination that have been carried out b mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /
interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,
videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached
A. Kind of events organized
Type Topic Target groups
Number of participants /
persons reached
WP
B. Kind of instruments/Tools used and/or developed
Type Topic Target groups
Number of participants /
persons reached
WP
FINAL PROJECT REPORT PER PARTNER
FINAL REPORT OF PROJECT PARTNER … (PPn) - (name of Project Partner)
DELIVERABLES PRODUCED AND THEIR AVAILABILITY
Please describe the deliverables foreseen in the Application Form versus deliverables produced by the Project (as mentioned in the Table “DELIVERABLES PER PARTNER”). Specify the type (database, manual, guidelines, study, survey, website etc.) and mention where they are located, their evidence, their availability and the person(s) in charge.
Deliverables foreseen in the Application Form Deliverables produced by the Project
Work- package
No
Action No
Type of deliverable
Description / Title Number Type of
deliverable Description / Title Number
Location, responsibility and evidence
REASONS FOR NOT PRODUCED DELIVERABLES (IF ANY)
Please explain in detail the reasons for not producing deliverables foreseen in the approved Application Form.
ACTIONS FOR PUBLICITY AND DISSEMINATION ORGANIZED BY THE PROJECT PARTNER
Please present in detail the actions for publicity and dissemination that have been carried out b mentioning: • type of organised events (project meeting, conference / seminar, exhibition, media event (press conference /
interview) internet events, etc), • type of used / developed tools/instruments (website, brochures, flyer, poster, books / other publications, articles,
videos, etc), • topic / content of event or of instrument • target groups • number of participants / persons reached
A. Kind of events organized
Type Topic Target groups
Number of participants /
persons reached
WP
B. Kind of instruments/Tools used and/or developed
Type Topic Target groups
Number of participants /
persons reached
WP
PLEASE ADD THE FINANCIAL TABLES FROM EXCEL FILE (PART 2a and 2b OF FINAL PROJECT REPORT)
EU COMMUNITY INITIATIVEINTERREG III B ARCHIMED
FINAL PROJECT REPORT
FINAL FINANCIAL REPORT
CO-FINANCED BY THEEUROPEAN REGIONAL DEVELOPMENT FUND
Submittion Date:
PART 2a
PROJECT TITLE:
PROJECT ACRONYM:
SUBSIDY CONTRACT
CODE NUMBER:
LEAD PARTNER
Please, indicate in the following tables all paid out and certified costs related to the project implementation. Fill in the “paid out” column all the costs that have occurred and been paid by the respective partner and in the “certified” column all the costs certified by the “Certifying Authorities” until submission date of the final report.
TABLES 1.1. TO 1.5. FINAL FINANCIAL INFORMATION CONCERNING THE ENTIRE PROJECT
IMPLEMENTATION
approved budget paid out certified
approved budget paid out certified
approved budget paid out certified
approved budget paid out certified
Partner 1 (LP) 0,00 € 0,00 € 0,00 €
Partner 2 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 €
… 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 €%Total
approved budget paid out
approved budget paid out
approved budget paid out
approved budget paid out
certified (=4)
approved budget paid out certified
Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Partner 2 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
… 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €%Total
Project funding per partner and source (€) PAID OUT AND CERTIFIED
EU Member State (Y/N)
CountryTotal (7)= 5 + 6MEDA (5) National Funding (6)
TOTALNON EU MEMBERS
Total (4+7) % Total
National Funding (2)
EU MEMBERS ONLY
% Total
PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE
(4) = 1+ 2
EU Member State (Y/N)
Country ERDF (1) Total
MEDA MEDA
paid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified paid out paid out certified paid out certified
Partner 1 (LP)
0,00 € 0,00 € 0,00 € 0,00 €
Partner 2 0,00 € 0,00 € 0,00 € 0,00 €
Partner 3 0,00 € 0,00 € 0,00 € 0,00 €
Partner 4 0,00 € 0,00 € 0,00 € 0,00 €
Partner 5 0,00 € 0,00 € 0,00 € 0,00 €
... 0,00 € 0,00 € 0,00 € 0,00 €
Partner n 0,00 € 0,00 € 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Percentage
MEDA MEDApaid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified paid out paid out certified paid out certified
Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 €
Partner 2 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 €
... 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €Percentage
MEDApaid out certified paid out certified paid out paid out certified paid out certified paid out certified paid out certified
Partner 1 (LP) 0,00 € 0,00 € 0,00 € 0,00 €
Partner 2 0,00 € 0,00 € 0,00 € 0,00 €Partner 3 0,00 € 0,00 € 0,00 € 0,00 €Partner 4 0,00 € 0,00 € 0,00 € 0,00 €Partner 5 0,00 € 0,00 € 0,00 € 0,00 €
... 0,00 € 0,00 € 0,00 € 0,00 €Partner n 0,00 € 0,00 € 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Percentage
Project costs (€) per year and partner PAID OUT AND CERTIFIED
ERDF NC
2009
TOTAL %
TOTAL %
TOTAL %
2007 2008
Total
ERDF NC TOTAL % ERDF
%
NC
PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE
2005 2006ERDF NC TOTAL % ERDF NC
Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified Paid out certified1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €1 0,00 € 0,00 €2 0,00 € 0,00 €3 0,00 € 0,00 €…n 0,00 € 0,00 €
Total 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
TOTAL5.External Expertise and Audit6. Equipment, Materials
and Rents 7. Operational Costs 8. Other
Add rows if needed
Project costs (€) per item and partner PAID OUT AND CERTIFIED
PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE
Partner n
0. Costs for project preparation
1. PersonnelWork
Package
Partner 1
4. Promotion and publications3. Travels and
accommodations
Partner 4
Partner 2
Partner 3
2. Meetings, conferences, seminars
Categories of Expenditurespaid out certified paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified
Costs for project preparation 0,00 € 0,00 €Personnel 0,00 € 0,00 €Meetings, Conferences, seminars 0,00 € 0,00 €
Travels and Accommodations 0,00 € 0,00 €Promotion and publications 0,00 € 0,00 €
External expertise and audit 0,00 € 0,00 €Equipment, materials and rents 0,00 € 0,00 €Operational Costs 0,00 € 0,00 €Other 0,00 € 0,00 €TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Work Package 5 Work Package 6 Total
Expenditures (€) by Work Package (WP) and Budget Lines (BL) PAID OUT AND CERTIFIED
Work Package 1 Work Package 2 Work Package 3 Work Package 4
PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE
paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified paid out certified
Partner 1
Partner 2Partner 3Partner 4Partner 5
….
TOTAL 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 € 0,00 €
Expenditures (€) by Work Package (WP) and Project Partners (PP) PAID OUT AND CERTIFIED
Work Package 5 Work Package 6Work Package 1 Work Package 2 Work Package 3 Work Package 4 TOTAL
PLEASE DON’T FILL ANY DATA OR MAKE ANY CHANGES IN THE CELLS MARKED WITH LIGHT BLUE
INTERREG IIIB ARCHIMED 2000-2006
Project CodeProject AcronymFinal Beneficiary
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Identification of the accounting document0.Costs for project preparation
1.PersonnelIdentification of the accounting document
No of Action
3.Meetings, Conferences, seminarsIdentification of the accounting document
TOTAL LIST OF THE JUSTIFICATIONS OF THE EXPENDITURES ACTUALLY PAID OUT
1
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Identification of the accounting document6.External expertise and audit
4.Travels and Accommodations
7.Equipment, materials and rentsIdentification of the accounting document
Identification of the accounting document
5.Promotion and publicationsIdentification of the accounting document
2
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Type of accounting Document
Number Issuing dateAccounting Document Issued by
Description of expenditures
Date of payment
Amount paid out
Amount justified towards the project
Certified Expenses
e.x WP 1.1e.x WP 1.2e.x WP n
TOTAL 0
Place……………………… Date………………………………… NameFunctionSignature (Legal representative of the LP or PP)Stamp
Identification of the accounting document
8.Operational CostsIdentification of the accounting document
9.Other
3
CIP INTERREG III B ARCHIMED
PROJECT COMPLETION STATEMENT
SUBSIDY CONTRACT NO:
PROJECT ACRONYM:
PRIORITY AXIS:
MEASURE:
LEAD PARTNER:
I, the undersigned ………………………………………………………………………………………… (Name of the legal representative of Lead Partner and position) representing ………………………………………………………………………………………………….. (Name and address of the institution of the Lead Partner)
With regard to the Subsidy Contract of the project (title) signed between the Managing Authority and the Lead Partner on (date) With regard to the Joint Convention of the project (title) signed between the Lead Partner and the participating partners of the project on (date) With regard to the Application Form of the project (title) as approved by the Steering Committee of the CIP Interreg III B ARCHIMED
as amended and currently in force, Declare that:
1. The information contained in the Final Progress Report is true and correct. 2. The Project has been completed in terms of the planned activities,
deliverables and outputs according to the timetable and the financial plan and it is in full compliance with the Subsidy Contract, the Joint Convention and the Application Form as amended and currently in force.
3. The date of project completion regarding both its activities and payments is indicated in the table below.
PROJECT COMPLETION DATE
ACTIVITIES
PAYMENTS
4. The total expenditure incurred in connection with the completion of the project
amounts to € … 5. All the relevant documents of the project (legal, financial, administrative,
audit) as well as all deliverables produced are archived by the Lead partner
and/or the project partners and will remain available for at least three years after the final payment from ERDF to the INTERREG III B ARCHIMED programme
. I, hereby, submit the following documents:
1. The Final Project Report (Word and Excel files). 2. The final Application Form duly signed and stamped in which a detailed
description of the project’s implementation until its completion is given. 3. All deliverables produced in the context of the project.
As the Lead partner of the project, I request the Managing Authority of the CIP INTERREG III B ARCHIMED programme to undertake all necessary actions in order to issue the Project Completion Certificate.
Date
Legal Representative,
(Signature and official stamp of the Lead Partner)