convocatoria 2010 formulario de aplicación - parte a

8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A

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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK

A1

Proposal TENtec Nr.

Annual Call 2010 Priority 1Priority 2Priority 3

Multi-Annual Call 2010 RISMoS

G ENERAL I NFORMATION ON THE P ROPOSAL

Title of the proposed action

Priority/Horizontal project 00 Section (only for PP) 0000

Transport mode

Start date of the Action End date of the Action

Summary (up to 2000 characters)

Proposal type

Please select the proposal type:

StudyWork

For ERTMS proposals only:

Trackside equipmentOn board equipmentOther activities related toMoU implementation



2


A2.1

Proposal TENtec Nr. Applicant Nr

APPLICANT

Applicant's legal name

Administrative data

Legal address

Street name Number

Town / City

Postal Code / Cedex

Country

Legal status of the applicant

Please select the legal status of the applicant (see definitions in Annex 2 of the Guide for Applicants ).

Member State

Public sector body

European Economic Interest Grouping (EEIG)

Private undertaking or body




A2.2


Contact points

Person in charge (the person who will be contacted by the E U in the first instance)

Family Name First name(s)

Function

Is the address different from the legal address (of section A2.1)? YES NO

Street name Number

Town / City

Postal code / Cedex

Country

Phone

FaxE-mail

Representative authorized to sign this application

Family Name First name(s)

Function

Is the address different from the legal address (of section A2.1)? YES NO

Street name Number

Town / City

Postal code / Cedex

Country

Phone

Fax

E-mail

Date

Stamp + Signature




A2.3


F INANCIAL IDENTIFICATION

Bank Account holder

Family name (1) First name(s)

Street name Number

Town / City

Postal code / Cedex

Country

Contact person

Family name First name(s)

Phone

Fax

E-mail

Bank

Bank Name

Branch address

Street name Number

Town / City

Postal code / Cedex

Country

Account number

IBAN (2)

REMARKS:

BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE(Both Obligatory)(3)

DATE + SIGNATURE ACCOUNT HOLDER :(Obligatory)

Date:

(1) The name or title under which the account has been opened and not the name of the authorized agent(2) If the IBAN Code (International Bank account number) is applied in the country where your bank is situated(3) It is preferable to attach a copy of recent bank statement, in which event the stamp of the bank and thesignature of the bank's representative are not required. The signature of the account-holder is obligatory in allcases.




A2.4


I F THE APPLICANT IS A M EMBER S TATE , FILL IN THE BELOW SECTION ON THE P UBLIC OR PRIVATE UNDERTAKING OR BODY ( IES ) WHICH WILL IMPLEMENT THE ACTION

Implementing body's legalname

Administrative data

Legal address

Street name Number

Town / City

Postal code / Cedex

Country

(*) If there are more than one implementing body, indicate them all.

I F THE APPLICANT IS A P UBLIC OR P RIVATE UNDERTAKING OR BODY , FILL IN THE BELOW SECTION ON

THE MINISTRY APPROVING THIS PROPOSAL

Ministry's legal name

Administrative data

Legal address

Street name Number

Town / CityPostal code / Cedex

Country

Representative authorized to sign this proposal

Family name First name(s)

Function

Is the address different from the legal address? YES NO

Street name Number

Town / City

Postal code / Cedex

Country

Phone

Fax

E-mail

Date

Stamp (*) + Signature

(*) As foreseen by the Ministry concerned.




A2.5

Proposal TENtec Nr.

C OORDINATING APPLICANT ( ONLY FOR APPLICATIONS WITH MORE THAN ONE APPLICANT )

Please, select the Legal Entity that will act as Coordinating Applicant

Legal Entity (Applicant or Implement ing Body) CoordinatingApplicant




A3.1

Proposal TENtec Nr.

LOCATION OF THE ACTION

Member State(s)

Region(s) (1)

(1) NUTS 2 nomenclature will be used for the regions.

Geographical co-ordinates

DMS Format (2) DD Format (3)

Longitude Latitude Longitude Latitude

Start point: : : : Interim point 1 : : : :

« : : : :

Interim point n : : : :

End point : : : :

(2) DMS stands for Degrees, Minutes and Seconds.(3) DD stands for Decimal Degrees. In this case, longitude and latitude must be given in a seven digit number (+or - sign followed by three digits and four decimals).

ACTIVITIES OF THE ACTION

Activitynumber

ISICcode (3)

Activity name Startdate

Enddate

Verifyingmilestone

(3) For complete description and other codes, see: http://unstats.un.org/unsd/cr/registry/regcst.asp?Cl=17

M ILESTONES OF THE ACTION

Milestonenumber

Milestone name(including milestones at start and end date of the Action)

Expecteddate

Means of verification

C ONTRIBUTION OF THE ACTION TO THE TEN-T POLICY OBJECTIVES

If the Action is part of a Global Project previously supported under the TEN-T budget, please specify:

Decision number Title




A3.2

Proposal TENtec Nr.

F INANCIAL INFORMATION

Global project

SOURCES OF FINANCING * Financial Contribution (in euros)

1. State budget (-s)

2. Regional/local budget

3. Project promoter (Public or Private)

4. EIB loan

5. Other loans

6. TEN financing

7. Other EU funds (ERDF, CF, FPR)

8. Other sources

Total

For multi-beneficiary projects, please give only the total amounts per category.

Proposed Action

SOURCES OF FINANCING (*) Totalfinancial

contribution

2007 2008 2009 2010 2011 2012 2013

1. State budget(s)

2. Regional/local budget(s)

3. Applicant's self-financing

4. EIB loan5. Other loans

6. TEN financing

7. Other EU funds

8. Other sources

Total

(*) contribution to eligible costs only

For multi-beneficiary actions, please split state, regional budgets and applicant's self-financing by applicant.

All amounts must be in euros.




Proposal TENtec Nr.

I NDICATIVE BREAKDOWN OF ESTIMATED ELIGIBLE COSTS OF THE P ROPOSED ACTION BY AC

Activities 2007 2008 2009 2010 2011

1.DIRECT COST

1.1 Activity 1

1.2 Activity 2

1.3 Activity 3

1.4 Activity 4

1.5 Activity 51.6 Activity 6

«.

1.N Activity N

SUBTOTAL DIRECT COST

2. INDIRECT COSTS (*)

TOTAL ELIGIBLE COST

Please give an indicative breakdown of the estimated eligible costs of the proposed Action (i.e. the action for which a financial cis requested in this proposal) by activity (as defined in section A3.1) and year (all amounts must be in euros).

(*) Costs which are not identifiable as direct costs, but which have nevertheless been incurred in connection with the eligible direshall satisfy the general criteria specified at article III.3.7.1 of the General Conditions and may be eligible for flat rate funding fixedcosts.

Applicants will be asked to explain the methodology used in determining the percentage of flat rate (between 0 and 7%) before c




A3.4

Proposal TENtec Nr.

T ECHNICAL INFORMATION

Proposed Action

RailwaysCurrent Target

Year Value Year Value

Length of the section (km)

Number of tracks

Train length

Max speed (km/h)

Axle load

Inclination (deg)

Passenger capacity (persons)

Passenger traffic flow (pax per year)

Freight capacity (t per year)

Freight traffic flow (ton-km per year)

Rail voltage (V)

Clearance or structure gauge

Voice system radio

Control and command system

RoadsCurrent Target


Length of the section (km)Number of lanes per direction

Max speed (km/h)

Longitudinal gradient (deg)

Vehicles capacity per direction(vehicles/day)

Annual average daily traffic per lane(vehicles/day)



Percentage of heavy good vehicles (%)

Road toll (eur/km)

Number of fatal accidents

Electronic management system (Y/N)

AirportsCurrent Target


Number of runways

Max frequency (movements per hour)

Passenger capacity (persons)

Passenger traffic flow (pax per year)



Max size of aircraft

Electronic management system (Y/N)



11

Air Traffic ManagementFunctional Airspace Blocks (FABs)

Current Target


Number of FIRs in (proposed) FAB

Number ATM systems in use in(proposed) FAB

Number of ATCCs in (proposed) FABNumber of Sectors in (proposed) FAB

PortsCurrent Target


Master plans (num ports)

Master plans (ha)

Master plans (t)

Breakwaters (km)

Breakwaters (m depth at entrance)

Dredged fairways and basins (m length)

Dredged fairways and basins (m wide)

Dredged fairways and basins (m of depth)

Maritime chamber lock (m wide x mlong)

Waterway connection (UN class)

Waterway connection (t)

Rail connection (num tracks)

Rail connection (t)

Road connection (num lanes)

Road connection (t)

Port terminals (m draught)

Port terminals (m quays)

Port terminals (ha)

Combined terminals (num rail tracks)

Combined terminals (ha)Passenger or cruise terminal (m2)

Passenger or cruise terminal (pass)


Port traffic (num vessels)

Electronic management system (which)

Inland WaterwaysCurrent Target


Master plans (km)

Master plans (UN class)

Master plans (t)

Section (km)

Section (reaches)

Section (UN class)

Navigation reliability (draught)

Navigation reliability (days)

Navigation reliability (%)

IWW locks (num)

IWW chamber lock (m wide)

IWW chamber lock (m long)

Local bottleneck solved (num bridge or others)

Ports, transhipment or storage facilities(num)



12

Ports, transhipment or storage facilities(tons)


Freight capacity (ton x km)

IWW traffic (vessels)

IWW traffic (vessels x km)


Motorways of the Sea(Corresponding component parts relating to the other modes (road, ports, IWW, rail) should be alsobe filled out for MoS actions)

Current Target


Distance of maritime part of link (nm)

Vessels (type: cont or ro/ro)

Vessels (type: number)

Vessels (capacity: TEU or lm)

Traffic volume (t per year)

Frequency of departure (e.g.: 1/day)

Average vessel turn around time (hoursin ports per call)

Duration of action (number of years)

Total modal shift (ton/km)Total CO2 emissions




13


A4

Proposal TENtec Nr.

Will an English translation be provided?

Project summary-Application

N/A (i.e. proposal submitted in English)YesNo

Application Form Part B1

N/A (i.e. proposal submitted in English)

YesNo

Application Form Part B2

N/A (i.e. proposal submitted in English)Yes

No

Annexes

N/A (i.e. proposal submitted in English)

YesNo

Translation cost

If you will submit an English translation of theproposal, please give an estimate of the total of the cost of the translation.

¼

convocatoria 2010 formulario de aplicación - parte a

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