Sustainable Condom Solutions Project (SCSP)

FUNDING OPPORTUNITY COVER PAGE Issuance Date: May 4, 2015 RFA Clarification Questions Due: May 18, 2015 Closing Date and Time: June 16, 2015, 4:00 PM Abidjan time Subject: Request for Applications (RFA) Number: RFA-624-15-000003 RFA Title: Sustainable Condom Solutions Project (SCSP) Ladies and Gentlemen: Pursuant to the authority granted with the Foreign Assistance Act of 1961, as amended, the United States Government (USG), represented by The United States Agency for International Development (USAID)/West Africa is seeking applications from U.S. and non-U.S. qualified organizations for funding to support a program entitled “Sustainable Condom Solutions Project (SCSP)”. The overall goal of the program is to reduce the transmission and acquisition of HIV in the highest prevalence regions of Côte d’Ivoire among vulnerable populations through the consistent and correct use of condoms. Please refer to the Program Description for a complete statement of goals and expected results. Subject to availability of funds, USAID intends to award one Cooperative Agreement for approximately $4,970,000.00 in total USAID funding to be allocated over the 5 year period. USAID reserves the right to fund any or none of the applications submitted. Award will be made to the responsible applicant whose application offers the greatest value to the U.S. Government While for-profit firms may participate, pursuant to 2 CFR 200.400(g), it is USAID policy not to award profit under assistance instruments. However, all reasonable, allocable and allowable expenses, both direct and indirect, which are related to the agreement program and are in accordance with applicable cost standards, may be paid under the Cooperative Agreement. Applicants under consideration for an award that have never received funding from USAID will be subject to a pre-award audit to determine fiscal responsibility, ensure adequacy of financial controls and establish an indirect cost rate. For the purposes of this project, this RFA is being issued and consists of this cover letter and the following: 1. Section I- Funding Opportunity Description (Program Description); 2. Section II- Award Information; 3. Section III- Eligibility Information; 4. Section IV- Application and Submission of Information; U.S. Agency for International Development No. 24 Fourth Circular Rd. CT P.O.Box 1630, Accra-Ghana Tel: 233-21-741200 Fax: 233-21-741365 www.usaid.gov/missions/warp USAID/West Africa - RFA-624-15-000003 PAGE 2 OF 59 5. Section V- Application Review Information (Selection Criteria); 6. Section VI- Federal Award and Administration Information; 7. Section VII- Federal Awarding Agency Contacts; 8. Section VIII- Other Information. The preferred method of distribution of USAID assistance information is via the Internet. This RFA and any future amendments can be downloaded from the www.grants.gov web site. All interested parties are highly encouraged to register on www.grants.gov to receive automatic notification of amendments issued to this RFA. It is the responsibility of the recipient of the application document to ensure that it has been received from the internet in its entirety, and USAID bears no responsibility for data errors resulting from transmission or conversion processes. For the purposes of this RFA, the term “Grant” is synonymous with “Cooperative Agreement”; "Grantee" is synonymous with "Recipient"; and "Grant Officer" is synonymous with "Agreement Officer". Applications must be received by the closing date and time indicated at the top of this cover letter. Late applications will not be considered for award. Applications must be directly responsive to the terms and conditions of this RFA. Telegraphic or fax applications are not authorized for this RFA and will not be accepted. USAID may make award on the basis of initial applications received, without discussions or negotiations. Therefore, each initial application should contain the applicant's best terms from a cost/business and technical standpoint. USAID reserves the right (but is not under obligation to do so), however, to enter into discussions with one or more applicants in order to obtain clarifications, additional detail, or to suggest refinements in the program description, budget, or other aspects of an application. Oral discussions may be conducted. Award will be made to the responsible Applicant whose application best meets the objectives of this RFA and the selection criteria contained herein. Issuance of this RFA does not constitute an award commitment on the part of the U.S. Government, nor does it commit the U.S. Government to pay for costs incurred in the preparation and submission of an application. In addition, final award of any resultant cooperative agreement depends on funds availability. Further, the Government reserves the right to reject any or all applications received. Applications are submitted at the risk of the applicant; should circumstances prevent award of a Cooperative Agreement, all preparation and submission costs are at the applicant’s expense. Any questions concerning this RFA should be submitted to sgabriel@usaid.gov and a copy to accracontract@usaid.gov by the RFA Clarification Questions due date specified above. If there are problems downloading the RFA from www.grants.gov, contact the Grants.gov help desk at 1.800.518.4726 or support@grants.gov. Applicants are encouraged to retain for their records, one copy of each enclosure that accompanies their application. Thank you for your interest in USAID programs. Sincerely, Yves B. Kore Supervisory Regional Agreement Officer USAID/West Africa USAID/West Africa - RFA-624-15-000003 PAGE 3 OF 59 USAID/West Africa - RFA-624-15-000003 PAGE 4 OF 59 TABLE OF CONTENTS SECTION I - FUNDING OPPORTUNITY DESCRIPTION ................................................... 4 SECTION II – AWARD INFORMATION .............................................................................. 18 SECTION III – ELIGIBILITY INFORMATION....................................................................... 20 SECTION IV – APPLICATION AND SUBMISSION INFORMATION................................... 21 SECTION V – APPLICATION REVIEW INFORMATION..................................................... 30 SECTION VI - AWARD AND ADMINISTRATION INFORMATION...................................... 33 SECTION VII – AGENCY CONTACTS................................................................................ 37 SECTION VIII – OTHER INFORMATION ........................................................................... 38 ATTACHMENTS.................................................................................................................. 39 USAID/West Africa - RFA-624-15-000003 PAGE 5 OF 59 SECTION I - FUNDING OPPORTUNITY DESCRIPTION 1. INTRODUCTION One of the core Global Health priorities for the United States Agency for International Development (USAID) is fostering an AIDS-free generation. One of the objectives in achieving an AIDS-free generation is to prevent more than 12 million new infections globally1 . The Fiveyear Sustainable Condom Solutions Project (SCSP) supports this global objective through activities that aim to prevent the sexual transmission of HIV among both key [Men Who Have Sex with Men (MSM) and Commercial Sex Workers (CSW)] and priority (e.g. clients of CSWs, young women 15-24 years old, truckers, migrants) populations. The project will build national capacity to support sustainable systems; increase the availability and accessibility of condoms; and implement a strategic and tailored approach to increase the demand and use of condoms. It will consider the differing needs of men, women, and key populations. It will take a flexible approach that enables adaptation to key opportunities and barriers to condom use identified through a learning agenda. The project will work within the PEPFAR framework and guidelines for “Long Term Strategy” (LTS) countries to advance the sustainability of PEPFAR programming in Cote d’Ivoire and transfer, as appropriate, services to the Government of Côte d’Ivoire (GoCI) and the private sector. Through this collaborative approach, USAID will support a coordinated total market approach (TMA) that will expand access to condoms and lubricants across all income and risk segments defined under the PEPFAR/Côte d’Ivoire (CI) strategy. By building capacity in the GoCI, engaging local partners and the private sector, pursuing donor coordination while enhancing the ability of the MOH to coordinate working groups and establish policy, the SCSP will embrace USAID Forward’s Local Systems Framework as well as Aid Effectiveness principles. The project will address three critical problems:  There is a current bottleneck in condom distribution in Côte d’Ivoire. The U.S. Government (USG) procures condoms but has been unable to adequately distribute them. Condom programming gaps include a lack of available condoms at clinics frequented by People Living with HIV/AIDS (PLWHA), a limited number of condoms being distributed to key and priority populations, and a lack of condoms available at “hotspots”.  There is low condom usage by both key and priority populations. Notably, there seems to have been a decrease in condom use by men and women with multiple sexual partners in recent years, as reported in the 2005 AIDS Indicator Survey (AIS) and the 2012 Demographic and Health Survey (DHS).  National coordination is lacking in condom programming and needs to be increased. Capacity in forecasting, distributing, creating pricing policies, and promoting condoms must be built. 2. BACKGROUND HIV Prevalence Recent data from the 2012 DHS described Côte d’Ivoire as a mixed epidemic country marked by significant geographic and population heterogeneity. The overall HIV prevalence in Côte 1 https://www.aids.gov/federal-resources/around-the-world/pepfar/ USAID/West Africa - RFA-624-15-000003 PAGE 6 OF 59 d’Ivoire is 3.7%, and HIV prevalence among the general population (15-49 years old) is 4.6% among females and 2.7% among males. HIV prevalence rates in both women and men increase rapidly with age within this age group (15-49)2 . Figure 1: HIV Prevalence Rates, by age and sex In addition, the prevalence rate was higher among young women compared to men (15-24 years old) in both urban (2.5% vs. 0.1%) and rural (1.7% vs. 0.6%) areas. PEPFAR/CI currently focuses on two key population (KP) groups: CSW and MSM. A 2013 triangulation study reported that HIV prevalence among CSWs in Côte d’Ivoire ranged from 25- 30% and from 15-20% for MSM3 . The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GF) supported an Integrated Bio-Behavioral Survey (IBBS) with CSWs in Abidjan in 2013, and the HIV/AIDS prevalence was found to be about 11%4 . In 2012, FHI360 conducted an IBBS among MSM in Abidjan and found an 18% HIV/AIDS prevalence5 . The PEPFAR prevention program in Côte d’Ivoire also reaches priority populations based on prevalence levels, higher risk sexual behaviors, and vulnerability. Priority populations include clients of CSW, young women (15-24 years), at-risk adult men (e.g. those with multiple partners and those who engage in transactional sex), truckers, and the military. Geographic Focus As indicated by the 2005 AIS and the 2012 DHS, certain geographic areas have increased in prevalence such as the North-West (2.5%), South-West (4.3%), and the Center-North (4.4%). The rest of the country had a net decrease in prevalence. The city of Abidjan (5.1%) has the highest prevalence. 2 HIV/AIDS prevalence among young women aged 15-19 years is 0.8% and increases to 3.6% in the 20-24 age group compared to 0.1% and 0.5% among males in the same age groups. The sharpest increase in prevalence occurred between women in the 15-19 and 20-24 age cohorts (from 0.8% to 3.6%); it then increases to 5.6% for those aged 25-29 years and 6.8% for those aged 30-34 years. It reaches a maximum of 7.7% among women and 7.9% among men at 45-49 years. 3 Ministry of Health and the Fight Against AIDS, Côte d’Ivoire; Enda Sante; and Johns Hopkins University, Department of Epidemiology, Key Population Programs. Triangulation des donnes auprès des PS et des HSH en Côte d'Ivoire, 2013. 4 Johns Hopkins University, Enda Sante, "Etude de la Prévalence, de la Prévention, et de la Prise en Charge du VIH Chez les Populations Clés en Côted'Ivoire, 2014" 5 Study on HIV Prevalence and Associated Risk Factors among Men Who Have Sex with Men in Abidjan, Côte d'Ivoire (SHARM-CI): “HIV and Associated Risk Factors among MSM in Abidjan, Côte d’Ivoire” (FHI 360 Report, January 22, 2013) 0.8 3.6 5.6 6.8 5.4 7.3 7.7 0.5 0.5 1.3 2.6 4.9 7.7 7.9 15-19 20-24 25-29 30-34 35-39 40-44 45-49 prevalence rate Age HIV prevalence rate Women Men USAID/West Africa - RFA-624-15-000003 PAGE 7 OF 59 To increase the impact of limited funds and to control the epidemic, the PEPFAR program layers prevention services -- Anti-Retroviral Therapy (ART) for Prevention, Prevention of Mother to Child Transmission of HIV (PMTCT), HIV testing and counseling (HTC), and condoms -- in the 14 health regions highlighted in the Figure 2 below (shaded sections). The 14 regions represent 93% of the national HIV need and population density. The goal is to reduce incidence in these 14 focus regions while maintaining basic services in the five other regions in which PEPFAR works. PEPFAR does not support the twentieth region (Sud-Comoe in the Southeast) since the GF supports clinical efforts there. The GF also funds a key population prevention program in partnership with PEPFAR throughout the country. One channel of condom distribution will be through current PEPFAR partners and focused in the 14 regions below. Figure 2: PEPFAR/Côte d’Ivoire’s Focus Regions Condom Usage The 2012 DHS reported that the majority of Ivoirians have knowledge that condom usage can prevent HIV infection. In spite of this, there has been a drop in the consistent use of condoms by high-risk groups, such as men and women reporting multiple sexual partners from the 2005 AIS to the 2012 DHS. KPs also report low consistent use of condoms. The 2012 DHS reported that:  Of the 3.5% of women (aged 15-49) who reported having multiple sexual partners, 29.7% reported condom use during their last sexual encounter (dropping from 33.6% in 2005 AIS).  Of the 28.5% of men (aged 15-49) who reported having multiple sexual partners, 32.9% reported condom use during their last sexual encounter (dropping from 51.6% in 2005).  Of the 11% of men (aged 15-49) who reported having paid for sex in the past twelve months, 62% reported that they used a condom during their most recent paid sexual intercourse (increasing from 2% of men who reported having paid for sex in the past USAID/West Africa - RFA-624-15-000003 PAGE 8 OF 59 twelve months, and 75.5% reporting that they used a condom during their most recent paid sexual intercourse in 2005).  Less women (60%) than men (80%) reported knowledge of HIV risk reduction with condom usage (remaining the same for women, 60.4%, and increasing slightly for men at 74.4% when comparing 2012 to 2005 data). There are also a number of KP studies that have been conducted in Côte d'Ivoire to learn about condom use by various types of sexual partners. A 2014 study on CSWs in Abidjan found that condom use at last sex among new and regular clients was quite high -- about 87% and 82% -- but that condom use at last sex with a non-paying partner was only about 15%4 . Only 15% of CSWs reported using condoms during anal sex4 . CSW also provided reasons for not using condoms. The largest two reasons for not using condoms with a new client and a regular client were “more money paid for unprotected sex” (69% and 67%) and “belief that condoms are not necessary (33% and 43%)4 . Eighty-nine percent of CSWs reported that they believed using a condom was not necessary as the reason why they did not use a condom with a non-paying partner4 . Condom use also declines as the amount of money paid for sex increases4 . For MSM, the 2012 Study on HIV Prevalence and Associated Risk Factors among MSM in Abidjan, Côte d'Ivoire (SHARM-CI) stated that only 34% reported always using a condom during anal sex over the last 12 months5 . Almost 70% of MSM reported using a condom at last anal sex with a man5 . Of the 79% of MSM who reported having had sex with a woman in their lifetime, 64% reported using a condom during their last sexual intercourse with a woman5 . 3. RELATIONSHIP TO THE NATIONAL RESPONSE AND RELEVANT USG GUIDANCE National Response Côte d’Ivoire’s national response to the HIV/AIDS epidemic is led by the Ministry of Health and the Fight Against AIDS (MSLS), which oversees the implementation of the national strategic plan for the fight against AIDS and STIs (PSN). The PSN seeks to reverse the spread of HIV and mitigate its impacts on the Ivoirian population, in particular for highly vulnerable populations. The project is aligned with the PSN, and will continue support to the follow-on National Plan to ensure a strong condom strategy. It will contribute to the achievement of Result 1 (and two of its sub-results) from the strategy: Result 1: The proportion of new HIV infections and incidence of sexually transmitted infections (STIs) will be reduced by 30% in the general population and key priority groups by 2015. Sub-result 1.1: Incidence of HIV and STIs will reduce by 25% in the general population. USAID/West Africa - RFA-624-15-000003 PAGE 9 OF 59 Sub-result 1.2: Incidence of HIV and STIs will reduce by 50% in key priority groups. The key to the success of this project and the establishment of a sustainable condom system is ensuring that the MOH plays a central role. The project will also work with the NPSP (Nouvelle Pharmacie de la Sante Publique de Cote d’Ivoire) which is the national warehouse and distributor of all pharmaceuticals and HIV/AIDS commodities. One of the three objectives of this project is to build the capacity of the MOH to forecast and distribute condoms. The NPSP will play a role as well as the national warehouse and distributor of national commodities. There are several departments within the newly established National Program for HIV Control (PNLS) of the MOH which will be involved. They are:  The Prevention Department;  The Care and Treatment Department; and  The Highly Vulnerable Populations Department. The Direction of Hygiene, Environment and Health under the General Direction of Health (DGS), and the Direction of Nursing and Maternal Care under the DGS will also play a role. The newly created National Program that combines Maternal and Child Health and the family planning/reproductive health programs will be engaged by the SCSP as well. Relationship to Other Donor Programs Partnerships will be strengthened with other donors such as the GF, UNFPA, and KfW (German Development Bank) to ensure greater coordination and collaboration in condom forecasting, procurement, distribution and tracking at the national level. PEPFAR/CI will also work more closely with existing prevention and clinical Implementing Partners (IPs) to strengthen their current condom programs as well as involve them in strategic planning sessions to develop national condom commodity plans. The SCSP will work with the commercial sector and civil society in national planning as well. The SCSP will coordinate closely with existing donor programs that carry out condom procurement, distribution, and/or condom promotion. Further, the project will also advocate for the government to provide leadership in segmenting the marketplace and coordinating the inputs of various donors involved in this area. In recent years, GF, KfW, the French Development Agency (AFD), and UNFPA have been involved in some aspect of condom programming. Recent program activities funded by these donors related to this project include:  GF: The most recent Global Fund grant for HIV/AIDS, from October 2011 to September 2016, includes funding for condom procurement and distribution through Agence Ivoirienne de Marketing Social (AIMAS), a sub-recipient on the GF grant. Project documents describe the scope of those activities as relatively limited. The GF’s key population program also procures and distributes condoms to its beneficiaries. The SCSP will work closely with the GF to ensure coordination of approaches and geographic areas.  German Development Bank (KfW): KfW has supported AIMAS since 1995. AIMAS is in their fourth phase of a three year project (11/2014 - 10/2017) with a total value of 15.9 million Euro including projected sales revenue and government contributions. Over half USAID/West Africa - RFA-624-15-000003 PAGE 10 OF 59 is going to the purchase of contraceptive products including 66 million condoms over the three-year period. About 40% of this funding will be dedicated to HIV/AIDS activities including the purchase, promotion, and distribution of condoms and various HIV/AIDS Behavior Change Communication campaigns. The other 60% will be geared towards family planning work, a pilot social franchise network, and family planning promotion.  French Development Agency (AFD): AFD is currently funding a $9.4 million family planning (FP) project in Côte d’Ivoire, and condoms and lubricants are part of the FP package of commodities. Their strategy consists of reinforcing national resources to pilot a reproductive health program, improving the accessibility of FP services in both public and private sectors, strengthening distribution systems for FP commodities in the private sector, and promoting FP services. The SCSP will be coordinated with these promotional activities.  UNFPA: The UNFPA provides free, ‘no logo’ condoms to Non-Governmental Organizations (NGO) reaching various population groups. UNFPA will procure 200,000 female condoms ($123,000 value), and 18 million male condoms ($575,000 value) through 2016. The SCSP will work closely with UNFPA to advocate for the adoption of a TMA to condom programming and to ensure that free condoms do not ‘crowd out’ the private sector. Relationship to Other PEPFAR Programming PEPFAR/Côte d’Ivoire is managed and implemented by five major USG agencies:  United States Agency for International Development (USAID),  Centers for Disease Control and Prevention (CDC),  Department of State,  Department of Defense (DOD), and  The Health Resources and Services Administration (HRSA). The SCSP will work within this PEPFAR framework and provide TA to IPs across all agencies to improve condom programming. 4. PROBLEM STATEMENT, PROGRAM GOAL, INTERMEDIATE RESULTS ILLUSTRATIVE ACTIVITIES, AND INDICATORS Problem Statement Côte d’Ivoire does not have a sustainable condom system that will ensure access and availability of condoms nor their demand and use among those most vulnerable to reduce the transmission and acquisition of HIV. Goal The goal of the project is to reduce the transmission and acquisition of HIV in the highest prevalence regions of Côte d’Ivoire among vulnerable populations through the consistent and correct use of condoms. Intermediate Results (IR) USAID/West Africa - RFA-624-15-000003 PAGE 11 OF 59 IR1: Strengthen sustainable systems for condom and lubricant forecasting, procurement, distribution, pricing policies, and promotion This project will work closely with the GoCI on the condom and lubricant strategic planning and programming. There will be a heavy focus on building the GoCI’s capacity on forecasting, procurement, distribution, pricing policies, and promotion. USAID will support the GoCI by providing TA to develop sustainable systems to increase collaboration among donors, stakeholders, and the private and public sectors. The capacity of the GoCI will be strengthened to assume a leadership role in guiding the adoption of a TMA to condom and lubricant programing in Côte d’Ivoire. The project will adopt an active role in advocacy for condom and lubricant programming, seeking opportunities to increase the profile and importance of condom and lubricant programming within the national AIDS response, including the adoption of policies to support its goals. The SCSP and other USG staff will also actively participate in commodity security working groups (including condoms, lubricants, and contraceptives) which ensure continuity of condom and lubricant supplies and will advocate for regular meetings of these groups. USAID and the SCSP will work with the GoCI to build capacity and long-term expectations to support the full range of condom programming for HIV prevention and family planning to be part of the NPSP package of essential services. In addition, a transition plan in the course of the life of the project will be developed and integrated once project activities have been implemented and the capacity of the GoCI is better known. Project coordination will include the MOH and other donors. Illustrative Activities:  Support the MOH by providing TA in improving national coordination among various donors and stakeholders in condom and lubricant forecasting, procurement, distribution, pricing policies, and promotion;  Support the completion of a national strategic plan for condom and lubricant programming, which is integrated into the National commodities storage and distribution system, in Côte d’Ivoire which is gender-sensitive and includes the needs of key populations;  Participate in and support a national condom and lubricant TWG within the Contraceptive Security Committee;  Support the capacity within the GoCI to collect the data needed, disaggregated by sex and key population as relevant, to monitor evolution of the TMA; and,  Build capacity of the GoCI to budget nationally for condom and lubricant procurements for the public sector. IR2: Increase availability and accessibility of condoms and lubricants in areas most at risk to those most vulnerable to HIV There is a need to increase the availability and accessibility of condoms and lubricants to priority and key populations. In order to grow the overall market distribution of condoms and lubricants within the PEPFAR focus regions, it will be essential to expand availability in all three condom and lubricant sectors: public, private, and social marketing sectors. The SCSP will expand the availability of condoms and lubricants through the current PEPFAR IPs and the USAID/West Africa - RFA-624-15-000003 PAGE 12 OF 59 social marketing activity. The SCSP will review current condom activities implemented by PEPFAR partners and make recommendations on how to strengthen those activities. The PEPFAR IPs will be responsible for implementing those changes. The SCSP does not have direct control over the work plans or budgets of other IPs; therefore, it will be the responsibility of the USG, working with each IP, to ensure that these recommendations are acted upon. The project will simultaneously distribute partially subsidized condoms through vendors established in line with a targeted social marketing approach, which will incorporate gender considerations. One component of the SCSP is to implement a condom and lubricant socially marketed activity to expand their availability and up-take. The condom and lubricant social marketing activity will respond to key gaps in condom and lubricant availability such as in ‘hotspots’ where high-risk behaviors take place (e.g. bars, local restaurants) and in non-traditional outlets (e.g. kiosks). The goal of the social marketing activity will be to make socially marketed condoms and lubricants pervasively available in venues and locations frequented by middle income segments of priority and key populations who can afford to purchase high-quality, subsidized condoms. The private sector will be encouraged to target higher income consumers with their condoms. The project will also use a gender aware approach when determining the venues for social marketing of condoms. The SCSP will determine the most appropriate mix of no-logo and socially marketed condoms to support future activities. The SCSP will work with the private sector through the National Condom and Lubricant TWG (Result 1) to support the growth of the commercial condom and lubricant market. Often, social marketing programs ‘crowd out’ the private sector by providing highly subsidized products to the majority of the population. USG’s condom and lubricant project will work to develop the market for commercial condoms and lubricants in Côte d’Ivoire by carefully segmenting the populations that will receive a subsidized product and determining distribution, pricing and promotional plans based upon that segmentation. The project will also actively collaborate with private sector condom suppliers to encourage their market growth or entrance into the market. The project will provide TA to other IPs to better integrate condom distribution into their ongoing activities. USAID anticipates that the majority of this distribution via PEPFAR partners will be of fully-subsidized condoms, but a full analysis of the market will take place once the awardee is contracted. The project will also ensure that PEPFAR partners’ activities are gender-sensitive to guarantee the most effective distribution of condoms (using a gender-aware methodology at each stage of the project). Illustrative Activities:  Map condom and lubricant outlets within the PEPFAR focus regions in areas at greatest need to determine availability and accessibility;  Perform a market analysis to determine the most appropriate mix of no-logo and socially marketed condoms in specific venues;  Build partnerships with the commercial, private, and public sectors to support a TMA to condom and lubricant programming;  Distribute socially-marketed condoms and lubricants to partners and distribution outlets to increase their availability and accessibility;  Assess and improve upon the current condom and lubricant supply cascade within existing PEPFAR programs by determining opportunities and gaps in the system; USAID/West Africa - RFA-624-15-000003 PAGE 13 OF 59  Provide TA to PEPFAR partners to improve their ability to provide condoms and lubricants to their beneficiaries;  Provide TA to PEPFAR partners to improve their ability to store, distribute, and track condom and lubricant supplies;  Develop, in partnership with PEPFAR, Standard Operational Procedures for condom and lubricant programming;  Develop a pricing policy for socially-marketed condoms and lubricants to increase cost-recovery and sustainability of activities; and  Conduct rigorous monitoring and evaluations to determine effectiveness of the project to increase condom and lubricant accessibility and availability. IR3: Build demand for, and correct and consistent use of, condoms and lubricants through high-quality and rigorous condom advocacy and promotion In addition to the need to increase availability and accessibility of condoms and lubricants, there is also a need to intensify efforts to create demand for the correct and consistent use of condoms and lubricants. Condom and lubricant demand creation efforts will be developed based upon the population’s risk profile, socio-economic status, and determinants of behavior change. A critical component of the SCSP will be to build the sustained demand for the correct and consistent use of condoms and lubricants. Relevant condom indicators demonstrate that condom use during high-risk sex among the general population has decreased from 2005 to 2012. Condom use by CSW and MSM are also driven by type of partner and the amount of money exchanged for transactional sex. There are large decreases in condom use among CSWs with non-paying partners and when clients pay a larger amount. The target populations that PEPFAR/CI’s prevention strategy is focusing on are priority (especially clients of CSWs, young women 15-24 years, and higher risk segments of adult men) and key populations. Condom promotion among youth, especially young women aged 15-24 years, is important as evidence demonstrates the link between condom use at first sex and condom use at last sex as well as the link between condom use at first sex and HIV acquisition. Consistent and correct condom use among KPs with each partner is vital in controlling the epidemic as KPs have a much higher HIV/AIDS prevalence rate compared to the general population. To increase sustained demand among priority and key populations, the SCSP will need to build an enabling environment that specifically addresses supportive norms, poverty, power dynamics, cultural norms, and gender inequalities. SCSP will also focus on the use of motivators that are strong enough to overcome the barrier(s) to sustained condom and lubricant use. Behavior change is dynamic and influenced by outside factors (environment, communitylevel and interpersonal) as well as those at the individual-level; therefore, the SCSP will need to continually monitor the context and modify program activities as needs and gaps emerge. There is a strong body of literature, evidence, and experience in how to change behaviors including how to increase condom use. Typically, there are a series of steps that are followed to create high-quality behavior change communication (BCC) programming that is then evaluated in a relatively short time frame to see if it is effectively creating demand for condoms and lubricants and their correct and consistent use. The steps include formative research, audience analysis, communication strategy design, development of communication products, pre-testing with audiences, implementation of communications strategies, and evaluation of the strategy. SCSP will partner with the GoCI and other stakeholders in its promotion efforts so sustaining USAID/West Africa - RFA-624-15-000003 PAGE 14 OF 59 demand will not be dependent upon one entity. Innovative approaches to demand creation and correct and consistent use of condoms and lubricants, and sustaining that demand and use will be a primary objective of the project. Whether behavior change is sustained depends upon the overall environment. Often, continual work needs to be done to sustain behavior change. SCSP, through funding social marketing organizations and partnering with the GOCI and others, can build sustainability marketing campaigns that change behaviors. This is due to the cost-recovery elements of the Socially Marketed Organizations (SMO): essentially, they can reinvest their profits from sales to carry out BCC and marketing campaigns on a continual base. This, in turn, will drive sustainable demand for the products and sustainable behavior change. Illustrative Activities:  Conduct a “Willingness to Pay” survey to determine the proper market segmentation of various condom and lubricant types;  Determine the structural, cognitive and behavioral determinants as well as the motivators and barriers for the consistent and correct use of condoms and lubricants among key and priority populations to increase their demand and use;  Implement a strategic and tailored social marketing approach to condoms and lubricants within the 14 PEPFAR focus regions to better target specific products to unique segments of the population;  Work with the private, public and other sectors to mobilize investments in essential condom and lubricant promotion to increase demand across all market segments;  Provide targeted condom and lubricant programming TA to PEPFAR IPs on condom and lubricant promotion activities and provide recommendations on areas of improvement;  Promote favorable social norms supporting communication between casual, commercial and intimate partners on condom and lubricant use;  Involve the private sector in the development and implementation of evidence-based campaigns to increase demand for and utilization of condoms and lubricants;  Use innovative and novel use of communication technologies to promote demand (i.e. mobile phones, internet, social networks);  Engage key populations in demand creation activities;  Develop a cost-recovery plan for the social marketing component; and  Conduct rigorous monitoring and evaluations to determine effectiveness in the SCSP’s ability to increase condom and lubricant demand and use. USAID/West Africa - RFA-624-15-000003 PAGE 15 OF 59 Anticipated Results and Indicators The SCSP implementing partner will be expected to build a results framework; appropriate PEPFAR Monitoring, Evaluating, and Reporting (MER) indicators; and custom indicators that demonstrate impact. The Implementing Partner is expected to collect baseline data for all approved indicators during project start-up, in order for USAID to more effectively measure the impact of this proposed activity. The following illustrative indicators are tied to the activity’s goals and intermediate results. IR1: Strengthen sustainable systems for condom and lubricant forecasting, procurement, distribution, pricing policies, and promotion Indicator 1. Increase of the condom budget of the MOH 2. GoCI Staff/LOE increased 3. Development, finalization and validation of a National Condom and Lubricant Strategic Plan 4. # of technical working group meetings held IR2: Increase availability and accessibility of condoms and lubricants in areas most at risk to those most vulnerable to HIV Indicator 1. # of condoms and lubricants distributed RDCS Development Objective 3: Utilization of Quality Health Services Increased through West African Partners RDCS Development hypothesis: “… if the utilization of quality health services is increased, then social and economic well-being will be advanced… Purpose: Reduce the transmission and acquisition of HIV in the highest prevalence regions of Cote d’Ivoire among the most vulnerable populations through the consistent and correct use of condoms Result 2: Increase availability and accessibility of condoms and lubricants in areas of greatest need to those most vulnerable to HIV Result 3: Build demand for, and correct and consistent use of, condoms and lubricants through high-quality and rigorous condom advocacy and promotion Result 1: Strengthen sustainable systems for condom and lubricant forecasting, procurement, distribution, pricing policies, and promotion Illustrative Activities  Support the MOH in improving National coordination among various donors and stakeholders in condom and lubricant forecasting, procurement, distribution, pricing policies, and promotion  Support the completion of a national strategic plan for condom and lubricant programming in Cote d’Ivoire  Support the capacity of the MOH and stakeholders to collect data needed to monitor the evolution of the total condom market  Map condom and lubricant outlets in areas at greatest need to determine availability and accessibility  Assess and improve upon the current condom and lubricant supply cascade within existing PEPFAR programs by determining opportunities and gaps in the system  Perform a market analysis to determine the most appropriate mix of no-logo and socially marketed condoms in specific venues  Build partnerships with the private and public sectors to support a TMA to condom and lubricant programming  Distribute socially-marketed condoms and lubricants to partners and distribution outlets to increase their availability and accessibility  Determine the structural, cognitive, and behavioral determinants as well as the motivators and barriers for the consistent and correct use of condoms and lubricants among key and priority populations to increase their demand and use  Review current condom promotion activities within the PEPFAR portfolio and determine areas of improvement and modification  Improve communication activities within the PEPFAR portfolio to better address the motivators and barriers to condoms and lubricants to increase use  Implement a strategic and tailored social marketing approach to condoms and lubricants to better target specific products to unique segments of the population USAID/West Africa - RFA-624-15-000003 PAGE 16 OF 59 2. # of condom outlets reporting stock outs in the last 6 months 3. # and % of beneficiaries reporting that they can obtain a condom when they need one (disaggregated by KP, risk factors, sex, and age) 4. Map of condom and lubricant outlets 5. # of condom outlets established 6. # of T.A. visits/sessions completed 7. % of relevant IPs which have developed and use a monitoring system to track condoms and lubricants from distribution point to user/end sales point 8. # of condoms distributed in conjunction with SCMS 9. Pricing policy developed IR3: Build demand for, and correct and consistent use of, condoms and lubricants through high-quality and rigorous condom advocacy and promotion 1. # and % of men reporting the use of a condom during their last paid sexual intercourse (disaggregated by sex and age) 2. # and % of beneficiaries reporting more than one partner during the last 12 months that also reported the use of a condom during their last sexual intercourse (disaggregated by sex and age) 3. # and % of FSW reporting the use of a condom during their last sexual intercourse with a regular client (disaggregated by age) 4. # and % of FSW reporting the use of a condom during their last sexual intercourse with a non-paying partner (disaggregated by age) 5. # and % of MSM reporting the use of a condom during their last anal sex (disaggregated by age) 6. # and % of MSM reporting always using a condom with a man during sexual intercourse in the last 12 months (disaggregated by age) 7. # of campaigns/activities developed to increase demand for condom and lubricant 8. # of T.A. visits/sessions completed Internal Evaluations Project activities will be evaluated through an internal mid-term and end-term performance evaluation. The project team will ensure that evaluations are conducted using appropriate methodological and subject matter experts, and that data is disaggregated by sex and by different key populations, that is collected wherever appropriate and feasible. Evaluation results will be utilized to inform decisions related to implementation, continuation, replication, sustainability, and cost efficiency and effectiveness in future projects. 5. FUNDING PRIORITY FACTORS TO DEMONSTRATE IN PROPOSED INTERVENTIONS: Evidence-based: Interventions that have been proven effective through outcome evaluation and research are likely to be effective in reducing transmission and acquisition among key and priority populations. USAID/West Africa - RFA-624-15-000003 PAGE 17 OF 59 Efficiencies: It is important to maximize the impact of resources by targeting effective interventions for key and priority populations. In order to use funds efficiently and effectively it is increasingly important to use approaches that are not only evidence based but also the most likely to create efficiencies in implementation. Innovation: For the purpose of this RFA, innovation is a new or advanced intervention or approach that contributes to the achievement of the objectives and expected results and outcomes of the RFA. It is the introduction of a new approach or practice; substantial transformation of an existing approach or practice; and/or adaptation of a successful approach or practice to the context of this RFA. Sustainable Approaches: This award is intended to be for a five-year period; therefore, programs that demonstrate concrete sustainability plans with a high degree of probability for continuation of interventions beyond that period and that leverage other resources particularly from businesses or the private sector are encouraged. All applicants must describe their plans for sustainability of their activities. Sustainability includes the development of technical competence, human capacity, management systems, infrastructure, relationships with government programs and financial independence. In situations where after exhausting all reasonable efforts to sustain a program intervention or it is not warranted or feasible to do so, it is expected that funded applicants will develop and implement an exit plan that would successfully mitigate any adverse consequences on priority and key populations. Applicants are expected to develop and implement a sustainability plan to be reviewed on an annual basis. Public-Private Partnerships: The formation of public-private partnerships to address the objectives of this RFA is encouraged. A public-private partnership occurs when the application includes a commitment of material and significant non-USG resources that will allow the program to more fully address the challenges outlined in this solicitation. An example of this would be an application that included in its budget plan at least a one-to-one matching of USG resources with non-governmental resources. Resources may be defined as cash or in-kind, and applicants submitting applications are encouraged to be innovative. Such partnerships are expected to bring together partners who will jointly define the problem, strategy and solution to capitalize on combined knowledge, skills, expertise and resources of the partners. Additional information on can be found at: http://www.usaid.gov/our_work/global_partnerships/gda/. Gender Considerations: Gender influences an individual’s status within society as well as the roles, norms, and behaviors that in turn shape opportunities to access and utilize health services – all of which influence dynamics of the HIV and AIDS epidemic and the success of programs to prevent and/or respond to HIV and AIDS. In Cote d’Ivoire, women are disproportionally affected by the HIV epidemic, with prevalence rates several times those of their male peers, especially among adolescent girls. Applicants must fully subscribe to USAID’s Gender Equality and Female Empowerment Policy, which requires that all policies, programs, implementation, monitoring plans, and budgets analyze and address the element of gender in pursuit of sustainable economic growth, job creation, household security, and poverty reduction. PEPFAR-specific gender requirements, especially those concerning equity in services between men and women, women’s access to productive resources, and prevention and care for gender-based violence should be highlighted in proposed approaches. USAID/West Africa - RFA-624-15-000003 PAGE 18 OF 59 Applicants should demonstrate how gender will be integrated at all levels of the project planning cycle, as required by ADS 201. Evaluation plans should reference gender goals. Applicants should also describe how internal management structures, systems, and personnel processes will ensure that sufficient attention is paid to gender issues. Special emphasis should be given to addressing underlying gender issues that might affect participation and access by beneficiaries to the different services of the program as well as gender empowerment. Community Mobilization and Engagement for Increased Impact: Supportive and enabling community environments and platforms are critical components of successful approaches to increase the demand for and use of condoms and lubricants. Engaging communities to take ownership of the HIV response and to make necessary social changes that increase healthy behaviors will be a priority for the implementation of this project. Applicants should describe how proposed activities will address the need for strengthened community environments and platforms. USAID/West Africa - RFA-624-15-000003 PAGE 19 OF 59 SECTION II - AWARD INFORMATION (1) Available Funding and Awards The anticipated total federal funding amount is approximately $4,970,000.00. The Government may issue one or more awards resulting from this RFA to the responsible applicant(s) whose application(s) conforming to this RFA are the most responsive to the objectives set forth in this RFA. The Government may (a) reject any or all applications, (b) accept other than the lowest cost application, (c) accept more than one application, (d) accept alternate applications, and (e) waive informalities and minor irregularities in applications received. (2) Period of performance The period of performance is five years with an anticipated start date of o/a October 1, 2015 and end o/a September 30, 2020. USAID reserves the right to determine the resulting level of funding for the cooperative Agreement. (3) Type of award USAID intends to award a cooperative agreement involving substantial involvement in the following ways: In accordance with ADS 303.3.11, USAID will be substantially involved in the cooperative agreement award in the following ways:  Approval of annual work plans and modifications that describe the specific activities to be carried out under the Agreement;  Approval of and any changes to specified key personnel;  Approval of sub-grants and sub-grantees;  Approval of USAID-specific plans e.g. Performance Management, Branding and Marking, Environmental Assessment. The resulting award will be administered in accordance with Chapter 303 of USAID’s Automated Directives System (ADS 303), 2 CFR 200 Uniform Administrative Requirements, 2 CFR 700 applicable Cost Principles, and Audit Requirements for Federal Awards, OMB Circulars (i.e., A- 21 for Universities or A-122 for Non-Profit Organizations, and A-133), and Standard Provisions for Non-Governmental Organizations. For non-U.S. organizations, the Standard Provisions for Non-U.S., Nongovernmental Recipients will apply. While 2 CFR 200 does not directly apply to non-U.S. applicants, the Agreement Officer will use the standards of 2 CFR 200 in the administration of the award. For Public International Organizations (PIOs), the Standard Provisions for Grants to Public International Organizations, along selected provisions from the Standard Provisions for NonU.S., Nongovernmental Recipients and other negotiated provisions, will be used. All provisions of 2 CFR 200 and all Standard Provisions are applicable to the recipient and to USAID/West Africa - RFA-624-15-000003 PAGE 20 OF 59 sub-recipients which meet the definition of “Recipient” in Part 226. For any sub-award made with Non-US Sub-recipients the Recipient shall include the applicable “Standard Provisions for Non-US Nongovernmental” ADS 303 is available at: http://www.usaid.gov/ads/policy/300/303 Standard Provisions for US Non-governmental Recipients are available at http://www.usaid.gov/policy/ads/300/303maa.pdf Standard Provisions for Non-US Non-governmental Recipients are available at http://www.usaid.gov/policy/ads/300/303mab.pdf 2 CFR 200 is available at: http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tp 2 CFR 700 is available at: http://www.ecfr.gov/cgi-bin/textidx?SID=18fce4045d211e74d460016792650587&node=20141219y1.358 Applicable OMB Circular can be found at: http://www.whitehouse.gov/omb/circulars_default Deviations from Standard Provisions Currently USAID does not anticipate any deviations from the mandatory or applicable standard provisions for non-governmental organizations (see ADS 303). USAID/West Africa - RFA-624-15-000003 PAGE 21 OF 59 SECTION III - ELIGIBILITY INFORMATION (1) Eligible Applicants Any qualified US or non-US non-governmental organization (including, but not limited to, Private Voluntary Organizations (PVOs) and for-profit entities) or Public International Organization (PIOs) is eligible to apply under this RFA. To be eligible for award, the applicant must provide all required information in its application, including the requirements found in any attachments to the www.grants.gov opportunity. (2) New partners USAID encourages applications from potential new partners. (3) Cost Sharing or Matching There is no cost share requirement for this RFA. However, any non-federal funds contribution from own, private or local sources for the implementation of this program will be considered cost-share. Contributions can be either cash or in-kind and can include contributions from the U.S.NGO, local counterpart organizations, project clients, and other donors (not other USG funding sources). Contributions of host country support including in-kind contributions such as staff time can be used to meet cost share, but all such contributions must be tracked and reported in a way that is objectively verifiable. USAID/West Africa - RFA-624-15-000003 PAGE 22 OF 59 SECTION IV - APPLICATION AND SUBMISSION INFORMATION (1) Point of Contact Any questions concerning this RFA shall be submitted in writing via email to Sabine Gabriel at sgabriel@usaid.gov, with copy to accracontract@usaid.gov, and reference the RFA number in the subject line. Answers to all questions received by the time specified will be issued as an amendment to the RFA. For all inquiries and questions, please provide a contact person’s name, phone number and email address. To allow adequate response time, questions must be received by the clarification questions due date indicated on the cover letter of this solicitation. Oral explanations or instructions given before award of a Cooperative Agreement will not be binding. Any information given to a prospective applicant concerning this RFA will be furnished promptly to all other prospective applicants as an amendment of this RFA, if that information is necessary in submitting applications or if the lack of it would be prejudicial to any other prospective applicants. (2) Application forms Applicant must submit application using the SF-424 series, which includes the - SF-424, Application for Federal Assistance, - SF-424A, Budget Information – Non-construction Programs, and - SF-424B, Assurances – Non-construction Programs. The forms can be found at http://www.epa.gov/ogd/AppKit/form/SF424.pdf (3) Required certifications a. The applicant must submit signed copy of Certifications and Assurances in accordance with ADS 303.3.8, which includes: 1. Assurance of Compliance with Laws and Regulations Governing Nondiscrimination in Federally Assisted Programs (This assurance applies to Non-U.S. organizations, if any part of the program will be undertaken in the U.S.); 2. Certification on Lobbying (22 CFR 227); 3. Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206); 4. Certification Regarding Terrorist Financing; and 5. Certification of Recipient b. Other certifications and statements found in Certifications, Assurances, and Other Statements of the Recipient and Solicitation Standard Provisions: 1. A signed copy of Key Individual Certification Narcotics Offenses and Drug Trafficking, (ADS 206.3.10) when applicable; USAID/West Africa - RFA-624-15-000003 PAGE 23 OF 59 2. A signed copy of Participant Certification Narcotics Offenses and Drug Trafficking (ADS 206.3.10) when applicable; 3. The Survey on Ensuring Equal Opportunity for Applicants; 4. Other Statements of Recipients. Certifications, Assurances, Other Statements of the Recipient can be found in Annex D or at http://transition.usaid.gov/policy/ads/300/303mav.pdf (4) Required Application format To facilitate the competitive review of the applications, USAID will consider only applications conforming to the format prescribed below. TECHNICAL APPLICATION FORMAT Technical applications should be specific, complete and presented concisely. The applications should demonstrate the applicant's capabilities and expertise with respect to achieving the goals of this project. Technical applications should take into account requirements of the project and evaluation criteria found in this RFA. The technical application will be the most important part of consideration in selection for award of the proposed activity. It shall demonstrate the applicant’s capabilities and expertise with respect to achieving the goals of this project. It shall be specific, complete and presented concisely. The application shall take into account and be arranged in the order of the technical evaluation criteria found in Section V. Application Contents: THE TECHNICAL APPLICATION HAS A STRICT TWENTY FIVE (25) PAGE LIMIT. This page limit excludes the Cover Page, table of contents, and Annexes. The technical application should include a Cover Page; a table of contents, an Executive Summary; a Program Description; and Annexes. Applications must be in English. The following requirements apply to documents submitted for this RFA, with the exception of Government-issued forms:  Page layout of 8.5”x11” with 1” margins, single spaced.  12-point Times New Roman font for all narrative and tables.  Graphics/charts may use 10-point Times New Roman font.  Submitted via Microsoft Word or PDF formats, except budget files which must be submitted in Microsoft Excel. The technical application should clearly and concisely outline how the Applicant proposes to meet the critical needs identified in the Program Description and how the Applicant will achieve its expected results. The application must include a detailed description of the management approach for implementing the proposed project, which includes specifying the composition and organizational structure of the entire implementation team (including home office support); and describing each team member's role and level of effort.  Suggested Format for Technical Application USAID/West Africa - RFA-624-15-000003 PAGE 24 OF 59 - Cover Page: Title, name of organization(s) submitting application, contact person, telephone and fax numbers, address, and e-mail. - Table of contents - Executive Summary (maximum two pages): Briefly describe the proposed activities, goals, purposes, and anticipated results. Briefly describe technical and managerial resources of your organization. Describe how the overall project will be managed. - Body of the Technical Application (not to exceed 25 pages): Succinctly describe the causal model that underlies the Applicant’s technical approach and how the activities, outputs and outcomes will lead to expected results. Briefly describe technical and managerial resources of your organization. Describe how the overall project will be managed. The Application's structure should reflect the evaluation criteria listed in Section V. Pages exceeding the 25 page limit will not be read or evaluated. Applicants shall not include application material by referencing the annexes in an attempt to circumvent the 25 page limit. 1. Technical Approach This subsection should describe in detail the proposed technical strategy and approach and comprehensively address how the applicant will achieve the objectives outlined in the Program Description over the five-year life of the project. Details on how the applicant will implement the proposed technical interventions and corresponding activities should be specified. The implementation plan should clearly outline links between the conceptual approach, planned activities, proposed results, and performance indicators. Applicants should include a realistic timeline for achieving the program results over the life of the project. 2. Organization Capability and Management Approach In this section, Applicants should demonstrate institutional capabilities including experience of proposed staff and organizational experience implementing similar programs. Applicants should clearly describe the composition and organizational structure of the entire project team, including sub-partners. This section should also describe how these arrangements will achieve objectives against set targets and outcomes, within the proposed timeframe. This section should describe what the established lines of authorities will be within the Cooperative Agreement and the approach to addressing any potential problems. 3. Staffing The successful applicant will have ultimate responsibility for managing the program and for achieving the desired results and impacts. The application should present a comprehensive staffing plan and organizational chart defining clear roles and responsibilities of staff that demonstrates that it has the full range of technical expertise and experience in the major technical components of the program. USAID/West Africa - RFA-624-15-000003 PAGE 25 OF 59 Key Personnel: The Applicant must propose Key Personnel with qualifications and skills commensurate with the expectations, results and objectives of this RFA. USAID has designated the following positions as key personnel:  Chief of Party  Senior Condom Advisor  Financial Manager  Monitoring and Evaluation Specialist The Applicant must delineate roles and responsibilities for each Key Personnel proposed. The Applicant must include in the Annexes a resume, not to exceed five pages, for each proposed Key Personnel. Resumes should demonstrate that the proposed key personnel possess the skills and knowledge to function as proposed on the project team. Each resume must include three (3) references with telephone numbers and email addresses and must be accompanied by a signed letter of commitment from each candidate indicating his/her availability to serve in the stated position. 4. Past performance The Applicant is required to submit five past performance information on grants, cooperative agreements, contracts or subcontracts, performed over the previous three years that are similar in scope to the work covered by the Program Description. The information supplied must include the name and current address of the organization for which services were performed, a description of the work performed, the duration of the work and size (in dollars) of the grants, cooperative agreements, contracts, or subcontracts, and the current telephone number of the responsible technical representative of the organization. USAID will use this information to assess the following:  Quality of service, including consistency in meeting goals and targets.  Cost control, including forecasting costs as well as accuracy in financial reporting.  Timeliness of performance, including adherence to agreement schedules and other time sensitive project conditions and effectiveness of home and field office management to make prompt decisions and ensure efficient completion of tasks.  Customer satisfaction with performance including responsiveness to client needs and requests and to host country partners (Government, private sector) in implementation.  Effectiveness of key personnel, including appropriateness of personnel for the job and prompt and satisfactory changes in personnel when problems with clients where identified. 5. Authorized Attachments The above page limitations of the body of the application exclude the cover page, the executive summary and the authorized attachments. Applicants should retain for their records one copy of the Application and all enclosures that accompany their Application. Erasures or other changes must be initialed by the person signing the Application. The authorized attachments specified below shall not be counted towards the technical application page limit; however, any attachments other than those specified below shall not be USAID/West Africa - RFA-624-15-000003 PAGE 26 OF 59 read. LIST OF ANNEXES The applicant must submit the following annexes only. ANNEX I. CVS of Key Personnel ANNEX II. Monitoring and Evaluation Plan ANNEX III. Past Performance References and Information ANNEX IV: Staffing Plan and Organizational Charts with Position Descriptions ANNEX V: Letters of Commitment for Key Staff and partners. COST APPLICATION FORMAT The Cost or Business Application is to be submitted as separate document/package from the technical application. Certain documents are required to be submitted by an applicant in order for an Agreement Officer to make a determination of responsibility. However, it is USAID policy not to burden applicants with undue reporting requirements if that information is readily available through other sources. A. A copy of the applicant’s business/cost application formatted in Excel. B. Present the summary budget by year for proposed activity including uses of USAID funds and any other cost share. Clearly indicate the applicant’s commitment to match funds separate from other donor support. The portion of this matching fund which will qualify as cost-share under 2 CFR 200 shall be clearly identified. C. Include a budget, in US Dollars, with an accompanying budget narrative in MS Word to facilitate USAID’s determination that costs are allowable, allocable, and reasonable. Detailed budget notes and supporting justification of all proposed budget line items which provide in detail the total costs for implementation of the program your organization is proposing should be included. In addition, a summary of the budget must be submitted using Standard Form 424 and 424A which can be downloaded from the web site: http://www.grants.gov/agencies/approved_standard_forms.jsp The budget shall include: 1. The breakdown of all costs associated with the program according to costs of, if applicable, headquarters, regional and/or country offices; 2. The breakdown of all costs according to each partner organization or subcontractor/subgrantee involved in the program; 3. The costs associated with external, expatriate technical assistance and those associated with local in-country technical assistance; 4. The breakdown of the financial and in-kind contributions of all organizations involved in implementing this Cooperative Agreement; 5. Potential contributions of non-USAID or private commercial donors to this Cooperative Agreement; 6. A procurement plan for commodities. C. A copy of the latest Negotiated Indirect Cost Rate Agreement if your organization has such an agreement with the US Government; USAID/West Africa - RFA-624-15-000003 PAGE 27 OF 59 D. Applicants which do not currently have a Negotiated Indirect Cost Rate Agreement (NICRA) from their cognizant agency shall also submit the following information: 1. Copies of the applicant's financial reports for the previous 3-year period, which have been audited by a certified public accountant or other auditor satisfactory to USAID; 2. Projected budget, cash flow and organizational chart; and 3. A copy of the organization's accounting manual. E. Applicants should submit additional evidence of responsibility they deem necessary for the Agreement Officer to make a positive determination of responsibility. The information submitted should substantiate that the Applicant: 1. Has adequate financial resources or the ability to obtain such resources as required during the performance of the award. 2. Has the ability to comply with the award conditions, taking into account all existing and currently prospective commitments of the applicant, nongovernmental and governmental. 3. Has a satisfactory record of performance. Past relevant unsatisfactory performance is ordinarily sufficient to justify a finding of non-responsibility, unless there is clear evidence of subsequent satisfactory performance. 4. Has a satisfactory record of integrity and business ethics; and 5. Is otherwise qualified and eligible to receive a cooperative agreement under applicable laws and regulations (e.g., EEO). F. Required certifications, assurances, and other statements for the prime and subrecipients. G.Applicants that have never received a cooperative agreement, grant or contract from the U.S. Government are required to submit a copy of their accounting manual. If a copy has already been submitted to the U.S. Government, the applicant should advise which Federal Office has a copy. H. If applicable, please provide the date of your most recent A-133 or similar audit, including findings and results of such audits. (5) Branding Implementation Strategy and Marking Plan The “Apparently Successful Applicant(s)” will be requested to submit a Branding Strategy and Marking Plan per 2 CFR 700.16. Apparently Successful Applicant means the applicant(s) for USAID recommended for an award after evaluation, but who has not yet been awarded a Cooperative Agreement award by the Agreement Officer. Apparently Successful Applicant status confers no right and constitutes no USAID commitment to an award. The Apparently Successful Applicant, upon request of the Agreement Officer, will submit and negotiate a Branding Strategy and Marking Plan. The Branding Strategy and Marking Plan will be included in and made a part of the resulting grant or cooperative agreement. The Branding Strategy and Marking Plan will be negotiated within the time that the Agreement Officer specifies. Failure to submit and negotiate a Branding Strategy and marking plan will make the USAID/West Africa - RFA-624-15-000003 PAGE 28 OF 59 applicant ineligible for award of a grant or cooperative agreement. The Apparently Successful Applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events and materials, and the like. The Agreement Officer will review the Branding Strategy and Marking Plan for adequacy and reasonableness, ensuring that it contains sufficient detail and information concerning public communications, commodities, and program materials that will visibly bear the USAID Identity. The Agreement Officer will evaluate the plan to ensure that it is consistent with the stated objectives of the award; with the applicant’s cost data submissions; with the applicant’s actual project, activity, or program performance plan; and with the regulatory requirements of 2 C.F.R. 700.16. The Agreement Officer will approve or disapprove any requested Presumptive Exceptions on the basis of adequacy and reasonableness. The Agreement Officer may obtain advice and recommendations from technical experts while performing the evaluation. (6) Pre-award costs The Agreement Officer is the only individual who may legally commit the Government to the expenditure of public funds. No costs chargeable to the proposed award may be incurred before receipt of either a fully executed cooperative agreement or a specific, written authorization from the Agreement Officer. (7) Submission Requirements Electronic Applications are due to USAID by the closing date and time specified on the cover letter of this RFA. Applications which are submitted late or are incomplete run the risk of not being considered in the review process. "Late applications will not be considered for award" or "Late applications will be considered for award if the Agreement Officer determines it is in the Government's interest." The applicant must submit applications in electronic format as described below. Applications shall be submitted in two separate volumes: (a) Technical application; and (b) Cost or business application. The applicant must sign the application and print or type its name on the Cover Page of the technical and cost applications. Erasures or other changes must be initialed by the person signing the application. Send Application by email to accracontract@usaid.gov and request for acknowledgement without application to Sabine Gabriel at sgabriel@usaid.gov. 1. Before sending your documents to USAID as email attachments, convert them into Microsoft Word (for narrative text), Excel (for tables) version 2010, or PDF format. Documents requiring signature may be sent as scanned documents. The file size should be limited to 5MB per e-mail. Because of our system restrictions, please do not send zipped files. Applications and modifications thereof must be submitted with the name and address of the applicant and the RFA number (referenced above) inscribed thereon, via email, to accracontract@usaid.gov USAID/West Africa - RFA-624-15-000003 PAGE 29 OF 59 Technical application should be combined in one file (inclusive of annex) if does not exceed 5MB. Otherwise, please put the program description in one file and all annexes in one file. 2. Once sent, check your own emails to confirm that your attachments were indeed sent. If you discover an error in your transmission, re-send the material again and note in the subject line of the email that it is a "corrected" submission. Do not send the same email more than one time unless there has been a change, and if so, note that it is a corrected email. Do not wait for USAID to advise you that certain documents intended to be sent were not sent, or that certain documents contained errors in formatting, missing sections, etc. Each applicant is responsible for its submissions. To avoid confusion, duplication, and congestion problems with our email system, only one authorized person from your organization should send in the email submissions. 3. If you send your application by multiple emails, indicate in the subject line of the email whether the email relates to the technical or cost application, and the desired sequence of multiple emails (if more than one is sent) and sequence of attachments (e.g. Organization X, Cost Application, Part 1 of 4, etc.). However, you are requested to consolidate, as much as possible, the various parts of your technical application into one technical application document and the various parts of your cost application into one cost application document. Special Consideration: 1. Unnecessarily Elaborate Applications – Unnecessarily elaborate brochures or other presentations beyond those sufficient to present a complete and effective application in response to this RFA are not desired and may be construed as an indication of the applicant's lack of cost consciousness. Elaborate art work, expensive paper and bindings, and expensive visual and other presentation aids are neither necessary nor wanted. 2. Acknowledgement of Amendments to the RFA - Applicants shall acknowledge receipt of any amendment to this RFA by signing and returning the amendment. The Government must receive the acknowledgement by the time specified for receipt of applications. 3. Proprietary Information – Applicants which include data that they do not want disclosed to the public for any purpose or used by the U.S. Government except for evaluation purposes, should: a. Mark the title page with the following legend: "This application includes data that shall not be disclosed outside the U.S. Government and shall not be duplicated, used, or disclosed - in whole or in part - for any purpose other than to evaluate this application. If, however, a cooperative agreement is awarded to this applicant as a result of - or in connection with - the submission of this data, the U.S. Government shall have the right to duplicate, use, or disclose the data to the extent provided in the resulting agreement. This restriction does not limit the U.S. Government's right to use information contained in this data if it is obtained from another source without USAID/West Africa - RFA-624-15-000003 PAGE 30 OF 59 restriction. The data subject to this restriction are contained in pages ___; and” b. Mark each sheet of data it wishes to restrict with the following legend: "Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this application." 4. Telegraphic or Faxed Applications – Telegraphic or faxed applications will not be considered; however, applications may be modified by written or telegraphic notice, if that notice is received by the time specified for receipt of applications. 5. Language – All applications must be in English. USAID/West Africa - RFA-624-15-000003 PAGE 31 OF 59 SECTION V - APPLICATION REVIEW INFORMATION (1) Evaluation Criteria A. TECHNICAL EVALUATION CRITERIA Applications will be evaluated based on the following criteria: 1. Technical Approach: 45 points USAID will review the extent to which the proposed technical strategy and approach is likely to achieve the stated objectives outlined in the Program Description. USAID will review the extent to which the conceptual approach, planned activities, expected program results, and proposed indicators align to the goals of the RFA. USAID will evaluate the appropriateness of proposed mid-term milestones/benchmarks and end-ofproject results and evaluate whether the proposed timeline is achievable in the context in which the program will be carried out. Applications will be scored on the completeness, technical soundness, integration of priority factors for funding and plans for sustainability of approaches. Applications will be scored based on demonstrated expertise related to the programmatic context of HIV/AIDS and condom and lubricant programs. 2. Organizational Capability, Management Approach, and Staffing: 25 points USAID will review organizational capabilities, including experience of proposed staff and organizational experience implementing similar programs. USAID will review the organization‘s management composition and organizational structure, including any sub –recipient arrangements, and their proposed approach to carry out and track the proposed activities against set targets and outcomes and within the proposed timeframe. Demonstrated knowledge of Côte d’Ivoire’s programmatic context, plans for involvement of local authorities, and coordination plans will be scored favorably. Key personnel will be assessed on the appropriateness of their academic background, expertise and years of experience working on project activities similar to their designated duties and responsibilities for this project. They will be assessed on their success in managing similar activities and tasks. Staffing plans that demonstrate a commitment to gender balance will be scored favorably. 3. Past Performance: 15 points Applications will be scored based on demonstrated successful performance in implementing similar or related programs. Also reviewed will be success in program innovations, management and administration of similar programs The quality of the recipient’s past performance on relevant previous project agreements will be assessed on the following:  Quality of service, including consistency in meeting goals and targets and managing programs of similar size and scope.  Cost control, including forecasting costs as well as accuracy in financial reporting. USAID/West Africa - RFA-624-15-000003 PAGE 32 OF 59  Timeliness of performance, including adherence to agreement schedules and other time sensitive project conditions and effectiveness of home and field office management to make prompt decisions and ensure efficient completion of tasks.  Customer satisfaction with performance including responsiveness to client needs and requests and to host country partners (Government, private sector) in implementation.  Past performance in successfully retaining key personnel  Effectiveness of key personnel, including appropriateness of personnel for the job and prompt and satisfactory changes in personnel when problems with clients where identified. 4. Local Solutions: 10 Points The Applicant is encouraged to draw as much as possible on regional, sub-regional, national, and local technical expertise. Local solutions are often the most sustainable; therefore, this project will score applicants favorably for presentation of partnerships and innovations that are locally-driven. Local solutions also help in controlling costs and developing local capacity to increase the likelihood of the continuation of activities after the life of the project. 5. Gender Approach: 5 Points USAID will review the proposal’s planned approach to address concerns related to gender in the RFA. The technical proposal should clearly demonstrate how gender will be taken into consideration in the design, implementation, and evaluation of the project. Demonstrated adherence to PEPFAR’s Gender Strategy and USAID’s Gender Equality and Female Empowerment strategy will be scored favorably. Staffing and management plans should reference gender, including whether key personnel and technical staff have gender-related technical expertise B. COST EVALUATION CRITERIA Cost has not been assigned a weight but will be evaluated for realism, reasonableness, allowability, allocability, and cost effectiveness. Applications that have more efficient operational systems that reduce operation costs will be more favorably considered. As technical scores converge, applications that maximize direct activity costs including cost sharing and that minimize administrative costs will be more favorably considered. Other considerations are the completeness of the application, adequacy of budget detail and consistency with elements of the technical application. In addition, the organization must demonstrate adequate financial management capability, to be measured by a responsibility determination. (2) Cost-share Cost-share will not be an evaluation factor for this RFA. (3) Application review and selection process A technical evaluation committee will evaluate applications based on the evaluation criteria USAID/West Africa - RFA-624-15-000003 PAGE 33 OF 59 provided in this RFA. The criteria have been tailored to the requirements and expected results of this particular RFA. Applicants should note that these criteria serve to: (a) identify the significant matters which applicants should address in their applications and (b) set the standard against which all applications will be evaluated. The technical applications will be evaluated in accordance with the Technical Evaluation Criteria. Thereafter, the cost application of all applicants submitting a technically acceptable application will be opened and costs will be evaluated for general reasonableness, allowability, and allocability to the extent that they are necessary. A Cooperative Agreement may be awarded to the responsible applicant or applicants whose applications offer the greatest value, cost reasonableness, and other factors. Awards will be made based on the ranking of applications according to the selection criteria identified in this RFA. To make an objective evaluation possible, applications must clearly demonstrate how the organization and the application meet these criteria. USAID/West Africa - RFA-624-15-000003 PAGE 34 OF 59 SECTION VI - AWARD AND ADMINISTRATION INFORMATION (1) Award Notices Following selection of an awardee, USAID will inform the successful applicant concerning the award. A notice of award signed by the Agreement Officer is the official authorizing document, which USAID will provide either electronically or in hard copy to the successful applicant’s main point of contact. USAID also will notify unsuccessful applicants concerning their status after selection has been made. (2) A description of any deviations from standard provisions There is no standard provision deviation contemplated under this award. (3) Reporting The following programmatic reporting requirements shall be made part of any award issued under this RFA: a) Activity Mobilization Plan The Recipient will develop a detailed draft Activity Mobilization Plan for the first 90 calendar days of activity implementation, beginning on the effective date of award. This one-time plan must include a Gantt chart or similar tool and concise narrative that describes the Recipient’s plan to rapidly and effectively mobilize staff and resources to commence activities. This Activity Mobilization Plan is due no later than 3 business days after the effective date of award. The AOR will review the draft Mobilization Plan and provide comments within 2 business days of receipt. The Recipient should consider incorporating these comments as appropriate and provide a final Activity Mobilization Plan by 2 business days of receiving USAID’s comments. A final Activity Mobilization Plan should be in place within 14 calendar days of the beginning of the activity. b) Annual Work Plan The Recipient is required to prepare and submit an annual work plan on a schedule established by the USAID/West Africa office of Acquisition and Assistance following the award. A first draft of the Year One work plan will be due within forty five (45) days of the award of the Cooperative Agreement. This work plan will be reviewed and USAID written comments forwarded to the Recipient within one month of submission, and then finalized by the Recipient no later than two (2) weeks after Recipient’s receipt of USAID’s written comments. USAID will collaborate closely with the Recipient as USAID funding, technical, and policy guidelines evolve to ensure necessary degrees of flexibility are built into all Work plans and strategies over the course of the Cooperative Agreement. The Recipient will be encouraged to ensure that its work plans and budgets are (i) wellcoordinated and mutually reinforcing with those of other USG and other donor partners working in the targeted health zones and provinces; (ii) explicitly linked to achievement of the USAID funded project; and (iii) prepared in a timely manner. USAID/West Africa - RFA-624-15-000003 PAGE 35 OF 59 The Recipient should ensure that all research or data collection activities under the program are undertaken in collaboration and/or consultation with host countries’ Governments. Recipients should collaborate closely with USAID and other partners to avoid possible redundancies. The work plan will outline the: a. Proposed accomplishments and expected progress towards achieving planned results and performance targets tied to the Monitoring and Evaluation (M&E) plan and approved Country Operational Plan (COP) targets; b. Timeline for implementation of the year’s proposed activities, including target completion dates; c. Information on how activities will be implemented and supervised; d. Personnel requirements to achieve expected outcomes; e. Major commodities and equipment to be procured when applicable; f. Details of collaboration with other major partners; a. Detailed budget. b. Planned short term technical assistance c) Performance Monitoring Plan The Recipient must provide a comprehensive plan for project monitoring, evaluation, and reporting on achievements and impact. Specific data required are of two types: (i) those that report on progress toward Recipient-proposed milestones and targets under the Cooperative Agreement (CA); (ii) those to measure USAID/PEPFAR required indicators as established by PEPFRA’s Country Operational Plan. The plan will also describe the established quality assurance system. The Performance Monitoring Plan (PMP) is expected within 60 days of the award and is subject to approval by USAID Cote D’Ivoire and W/A. d) Quarterly and Annual Status Reports On a quarterly basis, thirty (30) days following the close of each three month period (based on the USG fiscal year), the Recipient shall prepare and submit to USAID Cote D’Ivoire and USAID/ West Africa written status reports (Quarterly Reports) that:  Identify and relate the benchmarks to the achievements, as identified in the applicant’s annual monitoring and evaluation implementation plan, of the three month period of the approved implementation plan;  Provide status on relevant indicators identified in the performance monitoring plan;  Identify key problems or issues encountered, how they were or will be resolved, and, if/as required, recommended Mission-level intervention to facilitate their timely resolution;  Include a brief summary of achievements during the concluding quarter towards planned targets; and  Submit success stories The final quarterly status report of the fiscal year will serve as the annual status report for the concluding year, and shall be submitted within thirty (30) days following the close of the fourth quarter (July-September). In addition to meeting the above requirements, the annual report shall include a discussion, supported with quantitative and qualitative evidence, (which evidence shall remain auditable under the terms of the agreement and USAID program implementation procedures), of impacts achieved to-date. This shall include clear USAID/West Africa - RFA-624-15-000003 PAGE 36 OF 59 identification of which impacts achieved were within the manageable interests of the Recipient and which were likely catalyzed by Recipient-supported initiatives, leading to substantial, sustained achievement of results. This discussion will be instrumental in helping the Mission to complete Annual Reports to USAID/Washington. e) Quarterly Financial Reports The Recipient must present a quarterly financial status report to the AOR and USAID/West Africa Agreement Officer on actual and accrued expenditures for the concluding period and planned expenditures for the subsequent quarter using SF 425 standard forms found at http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/operations/Fiscal/Standard%20Forms/ f) Consultant Reports The Recipient shall additionally provide USAID Cote D’Ivoire and USAID/ West Africa with hard and electronic copies of the products studies, trip reports, materials developed of all short-term consultants under the CA within 30 days of completion of the consultancy. Reports shall be in English. Where a report or document is more appropriately developed in another language including local languages – e.g. a training manual for local leaders – USAID may at its option request an English-language abstract. g) Environmental compliance and management 1a) The Foreign Assistance Act of 1961, as amended, Section 117 requires that the impact of USAID’s activities on the environment be considered and that USAID include environmental sustainability as a central consideration in designing and carrying out its development programs. This mandate is codified in Federal Regulations (22 CFR 216) and in USAID’s Automated Directives System (ADS) Parts 201.5.10g and 204 (http://www.usaid.gov/policy/ADS/200/), which, in part, require that the potential environmental impacts of USAID-financed activities are identified prior to a final decision to proceed and that appropriate environmental safeguards are adopted for all activities. Respondents environmental compliance obligations under these regulations and procedures are specified in the following paragraphs. 1b) In addition, the recipient must comply with host country environmental regulations unless otherwise directed in writing by USAID. In case of conflict between host country and USAID regulations, the latter shall govern. 1c) No activity funded under this Cooperative Agreement will be implemented unless an environmental threshold determination, as defined by 22 CFR 216, has been reached for that activity, as documented in an Initial Environmental Examination (IEE), or Environmental Assessment (EA) duly signed by the Bureau Environmental Officer (BEO). (Hereinafter, such documents are described as “approved Regulation 216 environmental documentation.”). 2) The IEE [http://gemini.info.usaid.gov/egat/envcomp/document.php] has been approved by the Africa Bureau Environmental Officer on 01/12/2015 for the Sustainable Condom Program funding this cooperative agreement. The IEE covers activities expected to be implemented under this cooperative agreement. USAID has determined that a Negative Determination with USAID/West Africa - RFA-624-15-000003 PAGE 37 OF 59 conditions applies to one or more of the proposed activities. This indicates that if these activities are implemented subject to the specified conditions, they are expected to have no significant adverse effect on the environment. 3a) As part of its initial Work Plan, and all Annual Work Plans thereafter, the Recipient, in collaboration with the USAID Cognizant Technical Officer and Mission Environmental Officer or Bureau Environmental Officer, as appropriate, shall review all ongoing and planned activities under this Cooperative Agreement to determine if they are within the scope of the approved Regulation 216 environmental documentation. 3b) If the Cooperative Agreement plans any new activities outside the scope of the approved Regulation 216 environmental documentation, it shall prepare an amendment to the documentation for USAID review and approval. No such new activities shall be undertaken prior to receiving written USAID approval of environmental documentation amendments. 3c) Any ongoing activities found to be outside the scope of the approved Regulation 216 environmental documentation shall be halted until an amendment to the documentation is submitted and written approval is received from USAID. 4a) The Recipient shall prepare an EMMP or M&M Plan describing how the Recipient will, in specific terms, implement all IEE and/or EA conditions that apply to proposed project activities within the scope of the award. The EMMP or M&M Plan shall include monitoring the implementation of the conditions and their effectiveness. 4b) Integrate a completed EMMP or M&M Plan into the initial work plan. 4c) Integrate an EMMP or M&M Plan into subsequent Annual Work Plans, making any necessary adjustments to activity implementation in order to minimize adverse impacts to the environment. 5a) A provision for sub-grants is included under this award; therefore, the Recipient will be required to use an Environmental Review Form (ERF) or Environmental Review (ER) checklist using impact assessment tools to screen grant applications to ensure the funded applications will result in no adverse environmental impact, to develop mitigation measures, as necessary, and to specify monitoring and reporting. Use of the ERF or ER checklist is called for when the nature of the grant applications to be funded is not well enough known to make an informed decision about their potential environmental impacts, yet due to the type and extent of activities to be funded, any adverse impacts are expected to be easily mitigated. Implementation of sub-grant activities cannot go forward until the ERF or ER checklist is completed and approved by USAID. Recipient is responsible for ensuring that mitigation measures specified by the ERF or ER checklist process are implemented. 5b) The Recipient will be responsible for periodic reporting to the USAID Cognizant Technical Officer, as specified in the Schedule/Program Description of this solicitation/award. USAID/West Africa - RFA-624-15-000003 PAGE 38 OF 59 SECTION VII - AGENCY CONTACT The Agreement Officer of this Solicitation is Yves B. Kore, Supervisory Agreement Officer, USAID/West Africa E-mail: YKore@usaid.gov Tel: (233) (302) 741-434 The Negotiator of this solicitation is Sabine Gabriel, Senior Acquisition and Assistance Specialist E-mail: sgabriel@usaid.gov Tel: (233) (302) 741-1273 USAID/West Africa - RFA-624-15-000003 PAGE 39 OF 59 SECTION VIII - OTHER INFORMATION (1) USAID reserves the right to fund any or none of the applications submitted. (2) List of Annexes: - Annex A – Budget Preparation guidance - Annex B – Solicitation Standard Provision - Annex C – past performance information - Annex D – Certifications, Assurances, Other Statements of the Recipient - Annex E – Grants.gov Registration Process - Annex F – Data Triangulation Document CDI FR 2013 - Annex G – 2012_PLS-PHV_Etude sur le VIH et les facteurs de risques associés chez les HSH à Abidjan, CI (SHARM) - Annex H – Rapport-IBBS-FM-PNLS-Enda-JHU (1) USAID/West Africa - RFA-624-15-000003 PAGE 40 OF 59 ANNEX A – BUDGET PREPARATION GUIDANCE The following object class categories are those required on USAID Form 424A (Section B – Budget Categories): Personnel The category includes the salary of each long-term and short-term, paid position for the total estimated life-of-project, except consultants, and the projected cost-of-living or bonus/merit increase for each position. Fringe Benefits & Allowances This category includes the amount and percentage of fringe benefits for each headquarters and field personnel identified above. Include here all allowances such as housing, schooling, leave benefits and other items. Travel & Per Diem This category includes all projected travel, per diem and other related costs for personnel except consultants. Include the method by which airfare costs were determined; i.e. quotes for coach and if per diems are based on established policies. Equipment & Supplies In accordance with 2 CFR 200, ‘equipment’ means tangible non-expendable personal property, including exempt property charged directly to the award having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. Information should be included in the application on how pricing was determined for each piece of the equipment. There are statutory constraints relating to the purchase of agricultural commodities, motor vehicles, pharmaceuticals, pesticides, rubber compounding chemicals and plasticizers, used equipment and fertilizer with USAID project funds. Applicants may obtain specific information on these regulations on USAID Web Site at http://www.usaid.gov/pubs/ads. In accordance with 2 CFR 200, ‘supplies’ means all personal property excluding equipment, intangible property, debt instruments and interventions. Contractual Services This category is for all subcontracts with organizations, which will provide services to the project and any short- or long-term consultant cost including fees, travel and per diem. This category is not to be used for sub-grant, which should be included in other direct costs. Construction N/A Other Direct Costs Applicants are to identify all costs associated with training of project personnel. Applicants planning to use USAID funds to send project staff or local counterparts for training in the U.S. or USAID/West Africa - RFA-624-15-000003 PAGE 41 OF 59 a country other than the host country, will be required to follow the guidance on USAID Participant Training Regulations, which may be found on the USAID Web Site http://www.usaid.gov/pubs/ads. The Applicant should provide information on any costs attributed to the project not associated above; i.e., communications, facilitate, fuel vehicles, repair, maintenance and insurance. Sub-agreements Include in this budget class category all subgrants. Indirect Costs/Charges Include a copy of the Applicant’s most recent negotiated indirect cost rate agreement (NICRA) from the cognizant audit agency showing the overhead and/or general administrative rate. In the absence of a NICRA all costs must be charged as direct costs. USAID Form 424A, Section C should reflect the Applicant’s and other sources’ cash contribution to this program, if applicable. A cash match means that funds are used to support the budget elements discussed above. The cash value of donated equipment or supplies must be documental. A narrative that justifies the costs as appropriate and necessary for the successful completion of the program should be attached to USAID Form 424. The narrative must provide clear explanations for cost reasonableness, particularly when proposed costs exceed market rates. The Cooperative Agreement Budget generally has four (4) different categories called Budget Cost Elements: Program, Training, Procurement, and Indirect Costs. A sample Agreement Budget is included below. On Standard Form 424A, Section B-Budget Categories, all eleven Object Class Categories have a footnote number next to them. The footnote numbers next to the Object Class Categories correspond to one of the four Cost Elements of the Cooperative Agreement Budget. The 11 Object Class Categories fit within the four Cost Elements of the Cooperative Agreement Budget. For this application, submit only the Standard Form 424 and 424A, with the corresponding eleven (11) Object Class Categories, supported by a detailed narrative. SAMPLE COOPERATIVE AGREEMENT BUDGET SF 424, Sec. B, Item 6 Budget Cost Element Object Class Category Budget Amount Program Line a, b, c, & h $ __________ Procurement Line d, e and f $ __________ Training Line h $ __________ Indirect Costs Line j $ __________ Program’s Total Budget $ __________ Funding arrangement: Total USAID Amount $ __________ Recipient’s Cost Share, if applicable $ __________ Total Program Funding $ __________ USAID/West Africa - RFA-624-15-000003 PAGE 42 OF 59 ANNEX B – SOLICITATION STANDARD PROVISION 1. Branding Strategy - Assistance (June 2012) a. Applicants recommended for an assistance award must submit and negotiate a "Branding Strategy," describing how the program, project, or activity is named and positioned, and how it is promoted and communicated to beneficiaries and host country citizens. b. The request for a Branding Strategy, by the Agreement Officer from the applicant, confers no rights to the applicant and constitutes no USAID commitment to an award. c. Failure to submit and negotiate a Branding Strategy within the time frame specified by the Agreement Officer will make the applicant ineligible for an award. d. The applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument. e. The Branding Strategy must include, at a minimum, all of the following: (1) All estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth. (2) The intended name of the program, project, or activity. (i) USAID prefers to have the “USAID Identity,” comprised of the USAID logo and brandmark, with the tagline “from the American people” as found on the USAID Web site at transition.usaid.gov/branding, included as part of the program or project name. (ii) USAID prefers local language translations of the phrase “made possible by (or with) the generous support of the American People” next to the USAID Identity when acknowledging contributions. (iii) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (iv) If branding in the above manner is inappropriate or not possible, the applicant must explain how USAID's involvement will be showcased during publicity for the program or project. (v) USAID prefers to fund projects that do not have a separate logo or identity that competes with the USAID Identity. If there is a plan to develop a separate logo to consistently identify this program, the applicant must attach a copy of the proposed logos. (3) The intended primary and secondary audiences for this project or program, including direct beneficiaries and any special target segments. USAID/West Africa - RFA-624-15-000003 PAGE 43 OF 59 (4) Planned communication or program materials used to explain or market the program to beneficiaries. (i) Describe the main program message. (ii) Provide plans for training materials, posters, pamphlets, public service announcement, billboards, Web sites, and so forth, as appropriate. (iii) Provide any plans to announce and promote publicly this program or project to host country citizens, such as media releases, press conferences, public events, and so forth. Applicant must incorporate the USAID Identity and the message, “USAID is from the American People.” (iv) Provide any additional ideas to increase awareness that the American people support this project or program. (5) Information on any direct involvement from host-country government or ministry, including any planned acknowledgement of the host-country government. (6) Any other groups whose logo or identity the applicant will use on program materials and related materials. Indicate if they are a donor or why they will be visibly acknowledged, and if they will receive the same prominence as USAID. e. The Agreement Officer will consider the Branding Strategy's adequacy in the award criteria. The Branding Strategy will be reviewed to ensure the above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan. f. If the applicant receives an assistance award, the Branding Strategy will be included in and made part of the resulting grant or cooperative agreement (END OF PROVISION) 2. Marking Plan – Assistance (June 2012) a. Applicants recommended for an assistance award must submit and negotiate a “Marking Plan,” detailing the public communications, commodities, and program materials, and other items that will visibly bear the “USAID Identity,” which comprises of the USAID logo and brandmark, with the tagline “from the American people.” The USAID Identity is the official marking for the Agency, and is found on the USAID Web site at http://transition.usaid.gov/branding. b. The request for a Marking Plan, by the Agreement Officer from the applicant, confers no rights to the applicant and constitutes no USAID commitment to an award. c. Failure to submit and negotiate a Marking Plan within the time frame specified by the Agreement Officer will make the applicant ineligible for an award. d. The applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument. e. The Marking Plan must include all of the following: USAID/West Africa - RFA-624-15-000003 PAGE 44 OF 59 (1) A description of the public communications, commodities, and program materials that the applicant plans to produce and which will bear the USAID Identity as part of the award, including: (i) Program, project, or activity sites funded by USAID, including visible infrastructure projects or other sites physical in nature; (ii) Technical assistance, studies, reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet activities, promotional, informational, media, or communications products funded by USAID; (iii) Commodities, equipment, supplies, and other materials funded by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs; and (iv) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (v) Events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities. If the USAID Identity cannot be displayed, the recipient is encouraged to otherwise acknowledge USAID and the support of the American people. (2) A table on the program deliverables with the following details: (i) The program deliverables that the applicant plans to mark with the USAID Identity; (ii) The type of marking and what materials the applicant will use to mark the program deliverables; (iii) When in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking; (iv) What program deliverables the applicant does not plan to mark with the USAID Identity , and (v) The rationale for not marking program deliverables. (3) Any requests for an exemption from USAID marking requirements, and an explanation of why the exemption would apply. The applicant may request an exemption if USAID marking requirements would: (i) Compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials. The applicant must identify the USAID Strategic Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why an aspect of the award is presumptively neutral. Identify by category or deliverable item, examples of material for which an exemption is sought. (ii) Diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent. The applicant must explain why each particular deliverable must be seen as credible. USAID/West Africa - RFA-624-15-000003 PAGE 45 OF 59 (iii) Undercut host-country government “ownership” of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications. The applicant must explain why each particular item or product is better positioned as host-country government item or product. (iv) Impair the functionality of an item. The applicant must explain how marking the item or commodity would impair its functionality. (v) Incur substantial costs or be impractical. The applicant must explain why marking would not be cost beneficial or practical. (vi) Offend local cultural or social norms, or be considered inappropriate. The applicant must identify the relevant norm, and explain why marking would violate that norm or otherwise be inappropriate. (vii) Conflict with international law. The applicant must identify the applicable international law violated by the marking. f. The Agreement Officer will consider the Marking Plan's adequacy and reasonableness in the award criteria, and will approve and disapprove any exemption requests. The Marking Plan will be reviewed to ensure the above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan. g. If the applicant receives an assistance award, the Marking Plan, including any approved exemptions, will be included in and made part of the resulting grant or cooperative agreement, and will apply for the term of the award unless provided otherwise. (END OF PROVISION) USAID/West Africa - RFA-624-15-000003 PAGE 46 OF 59 ANNEX C – PAST PERFORMANCE INFORMATION. PERFORMANCE REPORT - SHORT FORM PART I: Award Information (to be completed by Prime) 1. Name of Awarding Entity: 2. Award Number: 3. Award Type: 4. Award Value (TEC): (if sub-agreement, sub-agreement value) 5. Problems: (if problems encountered on this award, explain corrective action taken) 6. Contacts: (Name, Telephone Number and E-mail address) 6.a. Agreement Officer: 6.b. Contracting Officer Representative (COR): 6.c. Other: 7. Recipient: 8. Title/Brief Description of Product/Service Provided: 9. Information Provided in Response to RFP No. : PART II: Performance Assessment (to be completed by Agency) 1. Quality of product or service, including consistency in meeting goals and targets, and cooperation and effectiveness of the Prime in fixing problems. Comment: 2. Cost control, including forecasting costs as well as accuracy in financial reporting. Comment: 3. Timeliness of performance, including adherence to contract schedules and other timesensitive project conditions, and effectiveness of home and field office management to make prompt decisions and ensure efficient operation of tasks. Comment: 4. Customer satisfaction, including satisfactory business relationship to clients, initiation and management of several complex activities simultaneously, coordination among subcontractors and developing country partners, prompt and satisfactory correction of problems, and cooperative attitude in fixing problems. Comment: 5. Effectiveness of key personnel including: effectiveness and appropriateness of personnel for the job; and prompt and satisfactory changes in personnel when problems with clients where identified. Comment: USAID/West Africa - RFA-624-15-000003 PAGE 47 OF 59 ANNEX D – CERTIFICATIONS, ASSURANCES, OTHER STATEMENTS OF THE RECIPIENT NOTE: When these Certifications, Assurances, and Other Statements of Recipient are used for cooperative agreements, the term “Grant” means “Cooperative Agreement.” Part I – Certifications and Assurances 1. Assurance of Compliance with Laws and Regulations Governing NonDiscrimination in Federally Assisted Programs Note: This certification applies to Non-U.S. organizations if any part of the program will be undertaken in the United States. (a) The recipient hereby assures that no person in the United States will, on the bases set forth below, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program or activity receiving financial assistance from USAID, and that with respect to the Cooperative Agreement for which application is being made, it will comply with the requirements of: (1) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which prohibits discrimination on the basis of race, color or national origin, in programs and activities receiving Federal financial assistance; (2) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance; (3) The Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits discrimination based on age in the delivery of services and benefits supported with Federal funds; (4) Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving Federal financial assistance (whether or not the programs or activities are offered or sponsored by an educational institution); and (5) USAID regulations implementing the above nondiscrimination laws, set forth in Chapter II of Title 22 of the Code of Federal Regulations. (b) If the recipient is an institution of higher education, the Assurances given herein extend to admission practices and to all other practices relating to the treatment of students or clients of the institution, or relating to the opportunity to participate in the provision of services or other benefits to such individuals, and must be applicable to the entire institution unless the recipient establishes to the satisfaction of the USAID Administrator that the institution's practices in designated parts or programs of the institution will in no way affect its practices in the program of the institution for which financial assistance is sought, or the beneficiaries of, or participants in, such programs. USAID/West Africa - RFA-624-15-000003 PAGE 48 OF 59 2. Certification Regarding Lobbying The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal Cooperative Agreement, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned must complete and submit Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions. (3) The undersigned must require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients must certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification will be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Statement for Loan Guarantees and Loan Insurance “The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned must complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement will be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.” USAID/West Africa - RFA-624-15-000003 PAGE 49 OF 59 3. Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206) USAID reserves the right to terminate this Agreement, to demand a refund or take other appropriate measures if the Grantee is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140. The undersigned must review USAID ADS 206 to determine if any certifications are required for Key Individuals or Covered Participants. If there are COVERED PARTICIPANTS: USAID reserves the right to terminate assistance to or take other appropriate measures with respect to, any participant approved by USAID who is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140. 4. Certification Regarding Terrorist Financing, Implementing Executive Order 13224 By signing and submitting this application, the prospective recipient provides the certification set out below: 1. The Recipient, to the best of its current knowledge, did not provide, within the previous ten years, and will take all reasonable steps to ensure that it does not and will not knowingly provide, material support or resources to any individual or entity that commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in paragraph 3. 2. The following steps may enable the Recipient to comply with its obligations under paragraph 1: a. Before providing any material support or resources to an individual or entity, the Recipient will verify that the individual or entity does not (i) appear on the master list of Specially Designated Nationals and Blocked Persons, which is maintained by the U.S. Treasury’s Office of Foreign Assets Control (OFAC), or (ii) is not included in any supplementary information concerning prohibited individuals or entities that may be provided by USAID to the Recipient. b. Before providing any material support or resources to an individual or entity, the Recipient also will verify that the individual or entity has not been designated by the United Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999) (the “1267 Committee”) [individuals and entities linked to the Taliban, Usama bin Laden, or the AlQaida Organization]. To determine whether there has been a published designation of an individual or entity by the 1267 Committee, the Recipient should refer to the consolidated list available online at the Committee’s Web site: http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm. c. Before providing any material support or resources to an individual or entity, the Recipient will consider all information about that individual or entity of which it is aware and all public information that is reasonably available to it or of which it should be aware. d. The Recipient also will implement reasonable monitoring and oversight procedures to safeguard against assistance being diverted to support terrorist activity. 3. For purposes of this Certification - USAID/West Africa - RFA-624-15-000003 PAGE 50 OF 59 a. “Material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safehouses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.” b. “Terrorist act” means - (i) an act prohibited pursuant to one of the 12 United Nations Conventions and Protocols related to terrorism (see UN terrorism conventions Internet site: http://untreaty.un.org/English/Terrorism.asp); or (ii) an act of premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents; or (iii) any other act intended to cause death or serious bodily injury to a civilian, or to any other person not taking an active part in hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a government or an international organization to do or to abstain from doing any act. c. “Entity” means a partnership, association, corporation, or other organization, group or subgroup. d. References in this Certification to the provision of material support and resources must not be deemed to include the furnishing of USAID funds or USAID-financed commodities to the ultimate beneficiaries of USAID assistance, such as recipients of food, medical care, microenterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts. e. The Recipient’s obligations under paragraph 1 are not applicable to the procurement of goods and/or services by the Recipient that are acquired in the ordinary course of business through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the Recipient has reason to believe that a vendor or supplier of such goods and services commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts. This Certification is an express term and condition of any agreement issued as a result of this application, and any violation of it will be grounds for unilateral termination of the agreement by USAID prior to the end of its term. USAID/West Africa - RFA-624-15-000003 PAGE 51 OF 59 5. Certification of Recipient By signing below the recipient provides certifications and assurances for (1) the Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs, (2) the Certification Regarding Lobbying, (3) the Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206) and (4) the Certification Regarding Terrorist Financing Implementing Executive Order 13224 above. These certifications and assurances are given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts, or other Federal financial assistance extended after the date hereof to the recipient by the Agency, including installment payments after such date on account of applications for Federal financial assistance which was approved before such date. The recipient recognizes and agrees that such Federal financial assistance will be extended in reliance on the representations and agreements made in these assurances, and that the United States will have the right to seek judicial enforcement of these assurances. These assurances are binding on the recipient, its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign these assurances on behalf of the recipient. Request for Application or Annual Program Statement No. ________________________________ Application No. ________________________________ Date of Application ________________________________ Name of Recipient ________________________________ Typed Name and Title ________________________________ Signature ________________________________ Date ________________________________ USAID/West Africa - RFA-624-15-000003 PAGE 52 OF 59 Part II – Key Individual Certification Narcotics Offenses and Drug Trafficking I hereby certify that within the last ten years: 1. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. 2. I am not and have not been an illicit trafficker in any such drug or controlled substance. 3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. Signature: ____________________________ Date: ____________________________ Name: ____________________________ Title/Position: ____________________________ Organization: ____________________________ Address: ____________________________ ____________________________ Date of Birth: ____________________________ NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain key individuals of organizations must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001. USAID/West Africa - RFA-624-15-000003 PAGE 53 OF 59 Part III – Participant Certification Narcotics Offenses and Drug Trafficking 1. I hereby certify that within the last ten years: a. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. b. I am not and have not been an illicit trafficker in any such drug or controlled substance. c. I am not or have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. 2. I understand that USAID may terminate my training if it is determined that I engaged in the above conduct during the last ten years or during my USAID training. Signature: ___________________________________ Name: ___________________________________ Date: ___________________________________ Address: ___________________________________ ___________________________________ Date of Birth: ___________________________________ NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain participants must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001. USAID/West Africa - RFA-624-15-000003 PAGE 54 OF 59 Part IV – Survey on Ensuring Equal Opportunity for Applicants http://transition.usaid.gov/forms/surveyeo.doc Part V – Other Statements of Recipient 1. Authorized Individuals The recipient represents that the following persons are authorized to negotiate on its behalf with the Government and to bind the recipient in connection with this application or grant: Name Title Telephone No. Facsimile No. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 2. Taxpayer Identification Number (TIN) If the recipient is a U.S. organization, or a foreign organization which has income effectively connected with the conduct of activities in the U.S. or has an office or a place of business or a fiscal paying agent in the U.S., please indicate the recipient’s TIN: TIN: ________________________________ 3. Data Universal Numbering System (DUNS) Number (a) Unless otherwise specified in the solicitation using an applicable exemption, in the space provided at the end of this provision, the recipient should supply the Data Universal Numbering System (DUNS) number applicable to that name and address. Recipients should take care to report the number that identifies the recipient's name and address exactly as stated in the application. (b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the recipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to the recipient. The recipient should be prepared to provide the following information: (1) Recipient’s name. (2) Recipient’s address. (3) Recipient's telephone number. (4) Line of business. (5) Chief executive officer/key manager. (6) Date the organization was started. (7) Number of people employed by the recipient. (8) Company affiliation. (c) Recipients located outside the United States may e-mail Dun and Bradstreet at globalinfo@dbisma.com to obtain the location and phone number of the local Dun and Bradstreet Information Services office. The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system. DUNS: ________________________________________ 4. Letter of Credit (LOC) Number If the recipient has an existing Letter of Credit (LOC) with USAID, please indicate the LOC number: LOC: _________________________________________ USAID/West Africa - RFA-624-15-000003 PAGE 55 OF 59 5. Procurement Information (a) Applicability. This applies to the procurement of goods and services planned by the recipient (i.e., contracts, purchase orders, etc.) from a supplier of goods or services for the direct use or benefit of the recipient in conducting the program supported by the grant, and not to assistance provided by the recipient (i.e., a subgrant or subagreement) to a subgrantee or subrecipient in support of the subgrantee’s or subrecipient's program. Provision by the recipient of the requested information does not, in and of itself, constitute USAID approval. (b) Amount of Procurement. Please indicate the total estimated dollar amount of goods and services which the recipient plans to purchase under the grant: $__________________________ (c) Nonexpendable Property. If the recipient plans to purchase nonexpendable equipment which would require the approval of the Agreement Officer, indicate below (using a continuation page, as necessary) the types, quantities of each, and estimated unit costs. Nonexpendable equipment for which the Agreement Officer's approval to purchase is required is any article of nonexpendable tangible personal property charged directly to the grant, having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. TYPE/DESCRIPTION (Generic) ____________________________ QUANTITY ____________________________ ESTIMATED UNIT COST ____________________________ (d) Source If the recipient plans to purchase any goods/commodities which are not in accordance with the Standard Provision “USAID Eligibility Rules for Procurement of Commodities and Services,” indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, and probable source. “Source” means the country from which a commodity is shipped to the cooperating country or the cooperating country itself if the commodity is located in the cooperating country at the time of purchase. However, where a commodity is shipped from a free port or bonded warehouse in the form in which received, “source” means the country from which the commodity was shipped to the free port or bonded warehouse. Additionally, “available for purchase” includes “offered for sale at the time of purchase” if the commodity is listed in a vendor’s catalog or other statement of inventory, kept as part of the vendor’s customary business practices and regularly offered for sale, even if the commodities are not physically on the vendors’ shelves or even in the source country at the time of the order. In such cases, the recipient must document that the commodity was listed in the vendor’s catalog or other statement of inventory; that the vendor has a regular and customary business practice of selling the commodity through “just in time” or other similar inventory practices; and the recipient did not engage the vendor to list the commodity in its catalog or other statement of inventory just to fulfill the recipient’s request for the commodity. TYPE/DESCRIPTION _____________________________ QUANTITY _____________________________ ESTIMATED GOODS _____________________________ PROBABLE GOODS _____________________________ USAID/West Africa - RFA-624-15-000003 PAGE 56 OF 59 PROBABLE (Generic) _____________________________ UNIT COST _____________________________ SOURCE _____________________________ (e) Restricted Goods. If the recipient plans to purchase any restricted goods, indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, intended use, and probable source. Restricted goods are Agricultural Commodities, Motor Vehicles, Pharmaceuticals, Pesticides, Used Equipment, U.S. Government-Owned Excess Property, and Fertilizer. TYPE/DESCRIPTION ______________________________ QUANTITY ______________________________ ESTIMATED ______________________________ PROBABLE ______________________________ INTENDED USE (Generic) ______________________________ UNIT COST ______________________________ SOURCE ______________________________ (f) Supplier Nationality. If the recipient plans to purchase any goods or services from suppliers of goods and services whose nationality is not in accordance with the Standard Provision “USAID Eligibility Rules for Procurement of Commodities and Services,” indicate below (using a continuation page, as necessary) the types and quantities of each good or service, estimated costs of each, probable nationality of each non-U.S. supplier of each good or service, and the rationale for purchasing from a non-U.S. supplier. USAID/West Africa - RFA-624-15-000003 PAGE 57 OF 59 TYPE/DESCRIPTION _____________________________ QUANTITY _____________________________ ESTIMATED _____________________________ PROBABLE SUPPLIER _____________________________ NATIONALITY _____________________________ RATIONALE (Generic) _____________________________ UNIT COST (Non-US Only) _____________________________ FOR NON-US _____________________________ 6. Past Performance References On a continuation page, please provide past performance information requested in the RFA. 7. Type of Organization The recipient, by checking the applicable box, represents that - (a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of the State of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a state or local governmental organization, [ ] a private college or university, [ ] a public college or university, [ ] an international organization, or [ ] a joint venture; or (b) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of _____________________________ (country), [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a nongovernmental educational institution, [ ] a governmental organization, [ ] an international organization, or [ ] a joint venture. 8. Estimated Costs of Communications Products The following are the estimate(s) of the cost of each separate communications product (i.e., any printed material [other than non-color photocopy material], photographic services, or video production services) which is anticipated under the grant. Each estimate must include all the costs associated with preparation and execution of the product. Use a continuation page as necessary USAID/West Africa - RFA-624-15-000003 PAGE 58 OF 59 ANNEX E – GRANTS.GOV REGISTRATION PROCESS Appendix A – Grants.gov Registration Process Before submitting an application under this RFA, it is highly recommended that applicants read the entire Section IV, Application and Submission Information in this RFA. Reviewing these sections thoroughly will assist an Applicant in submitting a complete, full application. Register Online at Grants.gov New Applicants Applying to Grants.gov: It is strongly encouraged that new organizations immediately begin the 5-step Grants.gov registration process (listed below), while simultaneously completing the application package. The registration process may take up to two weeks to complete. USAID understands that delays in the registration process may be beyond your control. If an organization has begun the registration process but experiences delays that make it difficult for to meet the application deadline, contact the RFA POC(s) who will work with you to find a solution. If an organization is having difficulties, contact the Agency POC(s) listed in the RFA as soon as possible. Register as an organization on Grants.gov if you are not already registered. All organizations must register. See below for a brief overview of the registration steps. Grants.gov is also available to lead you through the process. STEP 1: Obtain a Data Universal Number (DUNS) The Data Universal Number System (DUNS) number is a unique nine-character number that identifies your organization. It is a tool of the federal government to track how federal money is distributed. Most large organizations, libraries, colleges and research universities already have DUNS numbers. Ask your grant administrator or chief financial officer to provide your organization’s DUNS number or search online by using the DUNS search. If your organization does not have an existing DUNS number, you will need to request one. You can request a DUNS Number here. STEP 2: Register Your Organization with the System for Awards Management (SAM) You must also register with SAM. SAM is the primary registrant database for the U.S. Federal Government. SAM collects, validates, stores and disseminates data about the federal government's trading partners in support of the contract award, grants and the electronic payment processes. STEP 3: Username and Password If your organization's E-Business Point of Contact (E-Biz POC) has assigned you AOR rights, you are authorized to submit grant applications on behalf of your organization. AORs must create on behalf of their organization. To register as an AOR and create a username and password, go to: https://apply07.grants.gov/apply/OrcRegister STEP 4: AOR Authorization USAID/West Africa - RFA-624-15-000003 PAGE 59 OF 59 Your E-Biz POC must then login to Grants.gov (using the organization’s DUNS number for the username and the "MPIN" password obtained in Step 2) and approve the AOR, thereby giving permission to submit applications. When an E-Biz POC approves an AOR, Grants.gov will send the AOR a confirmation email that includes the requesting AOR's name, e-mail address and phone number. In some cases the E-Biz POC can also be the AOR for an organization. If the EBiz POC wishes to submit applications on behalf of their organization, he or she must also complete a separate AOR profile with username and password (Step 3 of the registration process) using a different email than the one used for their E-Biz POC registration. STEP 5: Track AOR Status To verify that your organization’s E-Biz POC has approved you as an AOR, please track your status. You cannot apply for grants without E-Biz POC approval. For questions, please consult: • Organization Registration User Guide • Organization Registration Checklist • Grants.gov Contact Center: 1-800-518-4726 or support@grants.gov. Hours of Operation: 24 hours a day, 7 days a week. If you are concerned that you will not finish your SAM registration in time to meet the overall application deadline, contact the USAID POC(s) listed in Section VII who will work with you to find a solution. If an organization is having difficulties, contact the Agency POC(s) listed in Section VII above as soon as possible.