Test

Section 1: Current Business Information

Company Legal Name *

Is the Company Registered at MoNE? *

Year of Establishment

Company Registration Certificate Please upload a copy of the most recent company registration certificate

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Company Ownership Breakdown Please List the owners of the company by name and percentage of ownership and contacts information

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Name

Percentage Of Ownership

Phone Number

Grant ID

Company Ownership Certificate Please upload a copy of the most recent company ownership certificate including shareholders names and ownership percentages

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Company Management Contact Information

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Grant ID

Name

Job Title

Telephone

Focal Point Contact Information Company representative and contact person during the application review process

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Grant ID

Name

Job title

Telephone

If you have current business which sector is it? *

Other, Please Specify

Current Business Location? *

If you have a current business, what is the total number of employees? Broken down by men and women. *

Do you have an external auditor? *

Name of Auditor?

Through which bank does the company carry out its banking operations? Name and branch

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Bank Name

Branch

Grant ID

Do you have financial management/accounting software? *

Name of Software?

Do you have a written manual for financials, administration, and procurement? *

Some, but needs development.

Upload most recent audited financial statements

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Upload the VAT Clearance documents (If avaaailable)

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Upload the Deductiaf on from Source (If available)

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Section 2: New Proposed Investment Information

New Proposed Project Investment Name *

In which sector the new proposed project investment falls? *

Other, Please Specify

Location of the new proposed Project? *

Address of the proposed new project? *

Is the new proposed project new business or expansion of current one? *

How many months would it take to implement the new project and starts operations? Enter the number of months required *

Status of the proposed project *

Please provide a brief overview of the proposed new project investment Please discuss: - Market opportunity - Products and offerings - Target market - Competitive advantage *

Business Model Please briefly describe the proposed project business/revenue model. How will the proposed project operate? *

Please list direct competitors and competing products/services. Include competitors similar products/services and how you will compete *

What is the total capital investment size required for the new investment? Enter the amount in (USD) $ *

What is the available amount of the total capital investment size? Enter the amount in (USD) $ *

What is the percentage of available funds in the form of equity? *

What is the percentage of available and or possible funds in the form of debt/loan? *

If the project is in preparation phase, what amount of total investment cost that has been already disbursed/paid? Enter amount in (USD) $; enter 0 If the project is still in the conceptualization & Planning phase *

What is the financing gap of the project? Enter amount in (USD) $ *

What is the purpose/use of the financial support you are requesting? *

Please specify the type of assets you want F4J-ICF grant to support? Please provide a detailed description of asset/s and/or any cost component (Including name, type, function, specifications, and cost estimate) *

Upload all available documentations pertaining to the assets required in previous question, if available? e.g. Price Offers, Quotations, Bills of Quantities, etc...

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Have you received any form of grant, loans, and or technical assistance from other sources/donors? Please list all support received in the past five years, if any. *

Name of Donor

Name of Project

Amount

Have you secured the required licenses, permits, and documents from relevant Palestinian authorities? e.g., EQA, Industrial License, etc... *

Upload obtained licenses and permits, if available

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How many new jobs you expect the new investment will create? Direct jobs only *

How many of these jobs will be for women? *

List the direct jobs in detail. (Job Title, Gender, Full-Time/ Part-Time)

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Job title

Gender

Full/Part Time

Grant ID

Do you have a business plan/feasibility study for the proposed project? *

Do you have a financial model for the proposed project? *

Upload the proposed project financial model and business plan/feasibility study, if available. Financial model format: Excel, Business Plan: Word or PDF.

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Section 3: Case for Intervention

What are the external threats/risks that are preventing you from investing in the proposed project? Mention the current market and institutional failure that your project shall face. *

How the grant financing support will help in addressing the above mentioned risks? *

Are the raw materials and project inputs for sourced locally or internationally? Please specify which one will be bought from local and international suppliers. *

Country

Type of Supplier

Will the new proposed project contribute to a sustainable and environmentally friendly future? *

Please Clarify

Will the new proposed project utilize any renewable energy sources and or more energy efficient machines and equipment? *

Please Clarify

Are there any products of the project that can be recycled? *

Please Specify

How will the new proposed project impact other businesses in the value chain (horizontal and vertical) and on the broader sector within which it operates?Explain. *

Please Specify

Will the new proposed project use recycled inputs in any of the production operations? *

Please Clarify

Submit

Thank you! Your grant request has been submitted successfully.