Business Plan for Non-Profit Organisation Funding Page 1
Provincial Administration: Western Cape
Department of Social Development (DSD)
APPLICATION FOR NON-PROFIT ORGANISATION FUNDING 2011
FOR ABOVE R 200 000 FUNDING
Please note the following:
This form has been developed to assist you with providing the appropriate information required by the DSD to assess your funding application. You are not restricted to the spaces provided.
Where you are required to provide an attachment it will be indicated in italics in the form. For guidance on the application process, please read the last page of this form.
NAME OF YOUR ORGANISATION
ORGANISATION’S DSD REFERENCE NUMBER (where applicable)
STREET ADDRESS
POSTAL ADDRESS
CONTACT DETAILS
Name
Position
Telephone No.
Facsimile No.
E-mail Address
Is this APPLICATION being submitted AS AN AFFILIATION? (Y/N) If yes, please provide the name of the affiliated organisation, the contact person’s name, telephone and email address.
Please indicate with a X in the appropriate box/es the DSD PROGAMME/S YOU ARE APPLYING FUNDING FOR:
Children and Families
Youth
Persons with Disabilities
Older Persons
Substance Abuse
HIV/AIDS
Sustainable Livelihoods
Institutional Capacity Building
REGION and/or LOCAL OFFICE and/or area/s of operation where you will be rendering services
PURPOSE OF THIS APPLICATION to the DSD (you may X multiple boxes)
To re-apply for funding for projects/services currently funded
To apply for additional funding to extend projects/services currently funded
To apply for scaled down funding of currently funded projects/services
To apply as a new organisation (not currently funded by the DSD) for funding of projects/services
TOTAL AMOUNT of funding you are applying for
NAME AND SIGNATURE OF DSD OFFICIAL receiving the proposal (include job title)
DATE RECEIVED (ddmmyyyy)
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TABLE OF CONTENTS
1 ORGANISATIONAL BACKGROUND 3
2 ORGANISATION AND CAPACITY PROFILES 4
3 PROJECT/PROGRAMME BACKGROUND 6
3.1 PLANNED SERVICE DELIVERY PER LEVEL OF INTERVENTION (PLANNING MATRIX) 7
4 BUDGET PLANNING OF ORGANISATIONAL EXPENDITURE AND INCOME 11
4.1 EXPENDITURE 11
4.2 INCOME 16
5 FINANCIAL CONTROLS 19
6 MONITORING AND EVALUATION 20
6.1 BALANCED SCORECARD 20
7 FINANCIAL SUSTAINABILITY AND TRANSFORMATION 21
8 APPLICATION DECLARATION 22
9 APPENDICES 23
9.1 WRITTEN ASSURANCE IN TERMS OF SECTION 38 0F THE PFMA 23
9.2 DECLARATION OF INTEREST 25
9.3 BAS FORM 26
9.4 APPLICATION PROCESS DESCRIPTION 27
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1 ORGANISATIONAL BACKGROUND
Please indicate with an X in the appropriate box
your organisation type
NPO
Section 21 company
Trust Affiliation to NPO
In process of NPO
registration
Please attach proof of registration, affiliation or NPO Registration Application. Attached? (Y/N)
Did your organisation receive government funding in the past? If so, when, how much and for what purpose:
If you are not currently funded by the DSD, please provide a summary of the major projects/services your organisation delivered in the past year.
Provide your organisation banking details below. Please complete the attached BAS Annexure only if you are not currently
funded by the DSD or if your banking particulars or signatories for financial transactions have changed.
Account name:
Account number:
Account type (e.g. current, saving,
cheque, transmission account):
Full name of the bank:
Name of the branch:
Branch code:
Branch address:
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2 ORGANISATION AND CAPACITY PROFILES
Please attach an organogram to your application to illustrate the structure of your organisation.
Please set out the functions of your Board / Trustees / Volunteer Management Committee:
Only complete the table below regarding your organisation’s governing members of the Board/ Trustees/Volunteer Management Committee, only if you are not currently
funded by the DSD or these particulars have changed from your previous application.
Name and surname Position ID Numbers Disabled/ not Disabled
Race Gender Telephone, Email Address &
Physical address
Chairperson
Deputy / Vice Chairperson
Treasurer
Secretary
Additional members
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Please complete this schedule of your registered professionals who will be involved in the implementation of your service/project proposed for funding:
1 2 3 4 5 6 7 8 9
Location of office /
service point /
satellite service /
facility
Occupation Race Gender Registration no. in
terms of relevant
Professional Act
Level of post if
applicable
Funding for post (X) Area(s)/place where staff
member is deployed
(indicate suburb/informal
settlement, etc.)
Salary per annum
R Funded by
Dept.
Not
funded
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3 PROJECT/PROGRAMME BACKGROUND
PLEASE COMPLETE THIS SECTION FOR EACH INDIVIDUAL DSD PROGRAMME (make copies of the matrix if you apply to more than one programme) The DSD has 8 Programmes, listed on the cover page, which are implemented across 4 levels of intervention. Please
indicate which DSD programme your proposal for funding will deliver to and indicate the level/s of intervention it
will deliver to.
1. Name of DSD programme: ………………………………………………………………
Levels of
intervention
Definition and examples of services within different levels of intervention X
Awareness To ensure that individuals and communities know their socio-economic rights and responsibilities, for example international and national awareness programs; commemoration of days/weeks/months/years for specific causes; and prevention programs
Early
Intervention
To identify vulnerable individuals and groups and ensure the provision of a range of developmental and therapeutic programmes and services, for example protective workshops; service centres etc.
Statutory To ensure the provision of statutory services and ensure compliance with statutory provisions, protocols and minimum standards, for example social work services; child abuse protocol; children’s court services; criminal court services etc.
Reintegration To ensure the provision of a range of aftercare and community based services that enhance positive life styles, self-reliance and optimal social functioning, for example reintegration programmes for offenders etc.
Describe the purpose of your project and provide details of the process followed to determine the needs to be addressed by
this project (e.g. Conducted research and community profiling)
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3.1 PLANNED SERVICE DELIVERY PER LEVEL OF INTERVENTION (PLANNING MATRIX)
Please complete the planning matrix below. It is structured according to the four levels of intervention and requires you to describe the type of service, target group,
outputs, outcomes, geographic area and major cost drivers of the project/service you are applying for funding for.
1. Awareness and Prevention
Type of Services
Target group Outputs (How the major goals will be
achieved)
Outcomes (major goals/ community
impacts)
Geographic area Cost ( Major Cost Drivers)
Staff R
Administration R
Special project cost
R
Staff R
Administration R
Special project cost
R
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2. Early Intervention
Type of Services
Target group Outputs (How the major goals will be
achieved
Outcomes (major goals / community
impacts)
Geographic area Cost ( Major Cost Drivers)
Staff R
Administration R
Special project cost
R
Administration R
Special project cost
R
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3. Statutory
Type of Services
Target group Outputs (How the major goals will be
achieved
Outcomes (major goals / community
impacts)
Geographic area Cost ( Major Cost Drivers)
Staff R
Administration R
Special project cost
R
Staff R
Administration R
Special project cost
R
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4. Re-integration
Type of Services
Target group Outputs (How the major goals will be
achieved
Outcomes (major goals /community
impacts)
Geographic area Cost ( Major Cost Drivers)
Staff R
Administration R
Special project cost
R
Staff R
Administration R
Special project cost
R
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4 BUDGET PLANNING OF ORGANISATIONAL EXPENDITURE AND INCOME
Please complete the table below on the expenditure and income of your organisation as per the Budget: Planning of Organisational Income and Expenditure below. Add rows as necessary.
For multi-year applications, complete column 4 too.
4.1 EXPENDITURE
Column 1 Column 2 Column 3 Column 4 Motivation / Remarks
Item of Expenditure Estimated Actual Expenditure
for financial year 2011/12
(01.04.2011-31.03.2012)
Budget for financial year 2012/13
Budget for financial year
2013/14
1 HUMAN RESOURCE EXPENDITURE
i Specify type of all occupational groups in the service plan
Current number of personnel employed in each occupational group
Salaries and wages for each occupational group
Salaries and wages for each occupational group
Salaries and wages for each occupational group
SUBTOTAL: ITEM 1
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Column 1 Column 2 Column 3 Column 4 Motivation/Remarks
Item of Expenditure Estimated Actual Expenditure for financial
year 2011/12 (01.04.2011-31.03.2012)
Budget for financial year 2012/13
Budget for financial year 2013/14
1 HUMAN RESOURCE EXPENDITURE (continued)
i. Bonus
ii. Personnel Training (Not Expenditure
Item 5)
iii. Honorarium (Paid to Volunteers)
iv. Contributions:
Medical Aid Fund
Pension Fund
Workmen's Compensation
UIF
other (specify)
v. Clothing/Uniform
SUBTOTAL: ITEM 1
2 TRANSPORT EXPENDITURE
i. Petrol (for managerial and/or administrative tasks)
ii. Maintenance of vehicles
iii. Insurance of vehicles
iv. Traveling & Accommodation (Conferences, workshops,
consultation/supervision, events, etc.)
v. Replacements (specify)
vi. Purchases (specify)
SUBTOTAL: ITEM 2
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Column 1 Column 2 Column 3 Column 4 Motivation/Remarks
Item of Expenditure Estimated Actual Expenditure
for financial year 2011/12 (01.04.2011-31.03.2012)
Budget for financial year 2012/13
Budget for financial year
2013/14
3 OFFICE/ADMINISTRATIVE EXPENDITURE
i. Municipal Services
ii. Post & Telecommunication Services
iii. Printed Matter & Stationery
iv. Advertisements
v. Books & Journals
vi. Levies/Registration & Affiliation fees
vii. Insurance
viii. Maintenance
ix. Replacements (specify):
x. Purchases (specify):
SUBTOTAL: ITEM 3
4 GROUNDS & BUILDINGS
i. Capital and Interest Redemption
(Private)
ii. Capital and Interest Redemption
(State)
iii. Maintenance
other (specify)
iv. Insurance
other (specify)
SUBTOTAL: ITEM 4
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Column 1 Column 2 Column 3 Column 4 Motivation/Remarks
Item of Expenditure Estimated Actual Expenditure
for financial year 2011/12
(01.04.2011-31.03.2012)
Budget for financial year
2012/13
Budget for financial year
2013/14
5 PROGRAMME/PROJECT EXPENDITURE
i. Fees in respect of training
ii. Cost of material/equipment needed for training
iii. Transport to implement program/activities
iv. Hiring of venues to implement program/activities
v. Equipment for activities
vi. Refreshments offered implementing program/activities
vii. Food and Groceries
viii. Consumable equipment to implement program/activities
ix. Accommodation
x. Education & Recreation
xi. Domestic fuel/laundry and cleaning services **
xii. Linen **
xiii. Toiletries **
xiv. Medical **
xv. Other (refer to activities in implementation plan)
xvi. Purchases (specify)
xvii. Replacements (specify)
SUBTOTAL: ITEM 5
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Column 1 Column 2 Column 3 Column 4
Motivation/Remarks
Item of Expenditure Estimated Actual Expenditure
for financial year 2011/12 (01.04.2011-31.03.2012)
Budget for financial year
2012/13
Budget for Financial year
2013/14
6 BANK AND OTHER COSTS
i. Audit Costs
ii. Bank Costs
iii. Fund-Raising
iv. Other (specify)
SUBTOTAL: ITEM 6
7 SUNDRIES
i. Research
ii. Public Relations and Marketing
iii. VAT
iv. other (specify)
SUBTOTAL: ITEM 7
8 EXPENDITURE: PROVISION FOR SPECIAL FUNDS
i.
ii.
iii.
iv.
SUBTOTAL: ITEM 8
GRAND TOTAL: ITEMS 1 – 8
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4.2 INCOME
Column 1 Column 2 Column 3 Column 4
Motivation/Remarks
Item of Income Estimated Actual Expenditure
for financial year 2011/12
(01.04.2011-31.03.2012)
Budget for financial year
2012/13
Budget for Financial year
2013/14
9 PROVISION FOR SPECIAL FUNDS
i.
ii.
iii.
iv.
SUBTOTAL: ITEM 9
10 FEES FOR SERVICES
i. Board and Lodging
ii. Community Services
iii. Consultation
iv. Counselling/Treatment
v. Fees for Day Care
vi. Membership
vii. Registration Fees
viii. Training
ix. other (specify)
SUBTOTAL: ITEM 10
11 OTHER FORMS OF INCOME
i. Bequests (cash)
ii. Donations
iii. Fund-raising
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Column 1 Column 2 Column 3 Column 4
Motivation/Remarks
Item of Income Estimated Actual Expenditure
for financial year 2011/12
(01.04.2011-31.03.2012)
Budget for financial year
2012/13
Budget for Financial year
2013/14
iv. Grants
v. Income from investments
vi. Income from fixed property bequeathed to organization
vii. Products sold
viii. Rent
ix. Social Relief
x. VAT (reclaimed)
xi. In natura (value of products etc. donated to organisation))
xii. Interest gained from investing pensions/grants of residents (optional)
xiii. Other (specify)
SUBTOTAL: ITEMS 11
12 STATE AND OTHER ALLOCATIONS
i. National Departments (specify)
ii. Provincial Departments
iii. Local Government (Municipality)
iv. Lotto
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Column 1 Column 2 Column 3 Column 4
Motivation/Remarks
Item of Income Estimated Actual Expenditure
for financial year 2011/12
(01.04.2011-31.03.2012)
Budget for financial year
2012/13
Budget for Financial year
2013/14
v. Community Chest
vi. International Funding
vii. Other funders/donors (specify)
SUBTOTAL: ITEMS 13
13 ALLOCATION DEPT SOCIAL DEVELOPMENT
i. Subsidy per annum
ii. Special Programme funding (specify)
SUBTOTAL: ITEMS 13
TOTAL EXPENDITURE (1-8)
TOTAL INCOME (9-13)
SURPLUS/SHORTAGE
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5 FINANCIAL CONTROLS
System of control Make an X where
appropriate
All funds received are promptly deposited into the organization’s bank account, properly recorded, reconciled and all records kept under adequate security
A central point of contact is designated for all incoming mail
Bank statements are reconciled to General Ledger on a monthly basis and reviewed by management
Segregation of duties within the account reconciliation, journal posting, and management review and approval processes
Funds are disbursed only upon authorisation of management for the purpose for which funds are granted and all disbursements are properly recorded
There is policy on minimum petty cash to be held on a daily basis and all petty cash is kept in a secure and safe place
Policies and procedures governing accounts payable and purchasing processes exist
Wire transfers are executed through a password-protected internet process
Expense reimbursements are only issued to employees with clearly defined needs
There are policies and procedures governing payroll processes detailing timelines, responsibilities, and actions.
There is up to date asset register with all fixed assets recorded/updated on a monthly basis
Managerial approval is required in advance for the acquisition, disposal, and write-off of assets.
Procedures and systems approved for the storage, use and maintenance of all its assets and equipment
Procedures and mechanisms exist to prevent abuse, theft and loss of assets and equipment.
Password protected accounting software system exists and access to information and editable fields are limited to appropriate personnel
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6 MONITORING AND EVALUATION
6.1 BALANCED SCORECARD
FINANCIAL PERSPECTIVE CUSTOMER PERSPECTIVE ORGANISATIONAL (INTERNAL BUSINESS PERSPECTIVE)
INNOVATION AND LEARNING PERSPECTIVE
Explain how your organization plans to monitor compliance with financial requirements as stipulated in the TPA/Written Contract with the DSD.
Explain how your organisation plans to get feedback from customers and ensure that they are satisfied with the services provided?
Explain which policies, legislation, procedures and guidelines your organisation will be adhering to ensuring excellence in provision of services
Explain how your organisation will keep pace with the latest developments and demand for service thus ensuring adaptation to change and improvements?
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7 FINANCIAL SUSTAINABILITY AND TRANSFORMATION
Describe the ways in which the organization plans to sustain itself financially after funding from the department stops.
Explain how the organization plans to share resources and transfer skills to emerging organisations
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8 APPLICATION DECLARATION
We, the undersigned, being the persons responsible in the application organisation for action, certify that the
information given in this application is correct and that, should we be awarded funding by the DSD, we will comply with
the DSD reporting requirements as set out in the TPA/contract.
Board/Trustees/Volunteer Management Committee chairperson’s name:
Signature:
Date:
Board/Trustees/Volunteer Management Committee treasurer’s name:
Signature:
Date:
OPTIONAL FEEDBACK SECTION
In seeking to improve service delivery to you, our NGO partners, and ultimately the beneficiaries of social welfare and
community development services, we would appreciate it if you could complete this short feedback form:
Please indicate with an X in the appropriate box whether your organisation found this form:
Very easy to complete Very useful in terms of presenting your organisation’s proposal to the DSD
Easy to complete Useful in terms of presenting your organisation’s proposal to the DSD
Difficult to complete Less useful in terms of presenting your organisation’s proposal to the DSD
Very difficult to complete Not useful in terms of presenting your organisation’s proposal to the DSD
If your organisation has previously applied for government funding, could you please indicate with an X in the appropriate block whether this form is:
Easier to complete More difficult to complete
More useful in terms of presenting your organisation’s proposal to the DSD
Less useful in terms of presenting your organisation’s proposal to the DSD
Please provide any suggestions you may have on how we could improve this form:
Thank you very much for your honest feedback.
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9 APPENDICES
9.1 WRITTEN ASSURANCE IN TERMS OF SECTION 38 0F THE PFMA
Written Assurance in terms of Section 38(1) (j) of the Public Finance Management Act, 1999
In terms of Section 38(1) (j) of the Public Finance Management Act, 1999 the Department of Social Development requires written
assurance that your organization implements effective, efficient and transparent financial management and internal control
systems.
Part 1: should be completed by those organisations that implement effective, efficient and transparent financial
management and internal control systems.
Part 2: should be completed by those organisations that do not implement effective, efficient and transparent financial
management and internal control systems.
Part 1:
I, the undersigned (print name)
in my capacity as (position)
of
hereby declare that (organization)
Implements effective, efficient and transparent financial management and internal control systems.
Signed at (place)
On this day of month year
signature
Confirmed by 2 witnesses:
signature print name of witness
signature print name of witness
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Part 2
Conditions and remedial measures to comply with Section 38(1)(j) of the Public Finance Management Act, 1999 (Act 1
of 1999 as amended by Act 29 of 1999)
In instances where written assurance cannot be obtained that effective, efficient and transparent financial management
and internal control systems are implemented, the following conditions and remedial measures will apply:
The management committee will arrange to attend and subject itself to training in business management and financial control systems.
The management committee will implement and adhere to the financial control system prescribed by the Department.
The management committee will subject itself to monitoring and inspection of financial records on a regular basis as conducted by officials of the Department or its representatives.
The management committee will submit audited as well as financial expenditure reports and progress reports on training and implementation of prescribed financial systems when requested by the Department.
I, the undersigned (print name)
in my capacity as (position)
of (organization)
hereby declare that (organization)
will adhere to the conditions as stipulated above in order to ensure effective, efficient and transparent financial
management and internal control systems.
Signed at (place)
on this day of month year
signature
Confirmed by 2 witnesses:
signature print name of witness
signature print name of witness
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9.2 DECLARATION OF INTEREST
This declaration is to be signed by all persons, management or staff involved in
approving or buying equipment, food, or any other items, signing cheques, accessing Internet banking, drawing cash for daily expenditure (petty cash), receiving donations, equipment, food or other items, handing out food or other items
The DSD wants to advise organizations that in terms of financial and auditing practices, it is advisable that persons
involved or responsible for any of the above should not be from the same family.
I, the undersigned, hereby make the following declaration:
initials & surname designation / post / involvement signature date
I will not use my discretion, official or non-official powers, or position within or outside the organization, to benefit
myself, or any other person known to me or the organization, or any legal person, to obtain an unlawful or unauthorized
advantage during the requisitioning, consideration, acceptance, or allocation of tenders, quotations or any other
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9.3 BAS FORM
I/We hereby request and authorise you to pay any amounts which any accrue to me/us to the credit of my/our account with the mentioned
bank.
I/We understand that the credit transfers hereby authorised will be processed by computer through a system know as the "ACB ELECTRONIC
BANK TRANSFER SERVICE", and I/We also understand that no additional advice of payment will be provided by my/our bank, but details of
each payment will be provided by my/our bank, but details of each payment will be printed on my/our ban statement or any accompanying
voucher. (This does not apply where it is not customary for banks to furnish statements)
I/We understand that a payment advice will be supplied by the Department in the normal way, and that it will indicate the date on which
funds will be available in my/our account. This authority may be cancelled by me/us by giving thirty days notice by prepaid registered post.
System User Only BAS Ref No.
Captured by
Date Captured
Authorised By
Date Authorised
FOR OFFICE USE ONLY
APPROVED BY HEAD OFFICE
Print Name
Signature
Date
PROVINCIAL ADMINSTRATION WESTERN CAPE
BAS ENTITY MAINTENANCE BANK DETAILS
Bank Details
Name
Address
Contact Persons
Contact No.
/ /
Initials and Surname Authorised Signature Date dd/mm/ccyy
Name of Bank
Name of Branch
Branch Code
Account Number
Type of Account Current Account Savings Account Transmission Account
Other (Specify)
DATE STAMP
OF BANK
BANK
ACCOUNT PARTICULARS
CERTIFIED AS
CORRECT
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9.4 APPLICATION PROCESS DESCRIPTION
9.4.1 STEP 1: Complete Application
From the time we call for proposals in the newspapers, you will have 6 weeks to submit your application. Complete this format,
including the written assurances. The BAS form only needs to be completed if you are not currently funded by the DSD or if your
banking details have changed and proof of affiliation, only if you are applying as an affiliation. Please also attach a copy of your NPO
certified registration or your NPO Registration Application, your organisation structure and submit your application form to the
relevant DSD Regional Office.
9.4.2 STEP 2: Application Evaluation
We will acknowledge receipt of your application within 15 working days. Your application will be assessed by the DSD
programme/programmes you have applied to from a compliance, a qualitative and a DSD strategic alignment perspective. We might
also request that we visit your organisation on site as part of the assessment process.
If your organisation is compliant, meets our minimum norms and standards, is strategically aligned to the DSD objectives and is in
terms of other applications received, one of the preferred organisations to deliver the services, subject to budget availability, the
programme/programmes will recommend to the Head of the DSD, that you be funded in accordance with the DSD guidelines for
funding. This process takes approximately 4 months to complete.
9.4.3 STEP 3: Application Contracting and Funding Disbursement
If your application has been successful we will contact you to agree on a Third Party Agreement, which will become the formal
contract between your organisation and the DSD for the delivery of the services as specified in the contract. The contract will also
specify the amount of funding the DSD is committing to your organisation, how and when that funding will be disbursed and set out
the obligations of your organisation and the DSD.
If your application is unsuccessful, we will advise you in writing, providing reasons for why your application has been unsuccessful
and informing you of your right to have your application Reviewed and the Review process.
Contracting takes approximately a month and no disbursements will be made until the DSD has received a signed copy of the
contract from your organisation. The DSD strives to fund approved organisations in terms of the contract signed, from 1 April 2012.
Due to volumes variability, this is however not always possible.
9.4.4 STEP 4: Performance Management of Service Delivery
Post the disbursement of the funds to your organisation as per the signed contract, we require regular feedback on the contracted
service/project (STEP 3). During this phase of the process we will call for reports in accordance with the contract and may visit your
organisation to observe and discus progress as well as recommend remedial action, where necessary.