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RFA No. 2019/05/027

Feed the Future Hinga Weze Project

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Feed the Future Rwanda Hinga Weze Activity

Request for Applications (RFA) No. 2019/05/027

For

Small Scale Irrigation Technologies (SSIT) Grants

Issuance Date: May 14th 2019

Mandatory Site Visits: May 21 – May 23, 2019

Deadline for Questions: May 31st 2019

Deadline for Submissions: June 21st 2019

Dear Applicant,

The Feed the Future Rwanda Hinga Weze Activity is releasing a Request for Applications (RFA) to award grants in support

of its activities. Instructions for completing the application can be found in Annex A. The grants will be awarded and

implemented in accordance with the USAID and US Government regulations governing grants and Hinga Weze internal

grants management policies.

This solicitation will target private sector actors working in irrigation services who seek to expand their clientele amongst

smallholder farmers in vulnerable regions. Applicants must be able to provide sustainable small-scale irrigation technologies

(SSIT) and other water management measures for hillside agriculture on pre-selected sites.

Applicants will visit the various sites prior to submitting an application. It is required (compulsory) to visit the site in

order to submit an application. The site visits are an opportunity for applicants to ask for any additional information in

accordance with the Deadline for Questions provided above. Further information regarding the site visits is provided in this

RFA.

Hinga Weze investments in individual grant activities are anticipated to range from $50,000 to $500,000 depending on the

scope of the irrigation system. The period of performance is anticipated to be for up to one (1) year, from September 2019

to September 2020. Grant agreements will be implemented in 2 distinct phases:

Phase 1: five (5) months from September 2019–January 2020, for implementation of small-scale irrigation

technologies services

Phase 2: seven (7) months from February – August 2020, for required follow-up and technical assistance.

Please note that applications in response to this RFA are due by June 21, 2019, by 1:00pm. The application for this RFA

is attached as Annex A – Grant Application.

This RFA is composed of 6 separate lots. Applicants may submit an application for more than one lot; however, please note

that Phase 1 will commence at the same time for each lot. Applicants should take into consideration the required resources

(i.e. manpower, equipment, etc.) when applying for multiple lots.

For any questions during the grant application process, please contact [email protected].

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Section I. Program Description

A. ABOUT HINGA WEZE

Feed the Future Rwanda Hinga Weze is a five (5) year Activity of the United States Agency for International Development

(USAID) that started in June 2017. The activity is implemented by CNFA. The primary objective of the Feed the Future

Rwanda Hinga Weze activity is to sustainably increase smallholder farmers’ income, improve the nutritional status of

Rwandan women and children, and increase the resilience of the agriculture and food systems to the changing climate.

These outcomes will be achieved through combining capacity building with fixed amount awards, in-kind grants and

technical support to strengthen agricultural extension, improve agricultural infrastructure, and facilitate linkages among

value chain actors.

B. GRANT PROGRAM DESCRIPTION

Hinga Weze is seeking to establish strategic partnerships with private sector actors in small-scale irrigation technologies

(SSIT) services who seek to expand their clientele amongst smallholder farmers in vulnerable regions. Through these

partnerships, private sector actors will establish working relationships with Hinga Weze-selected smallholder farmers, to

provide innovative, climate-smart irrigation services during the year two of the project. Through these grants, Hinga Weze

seeks to increase and establish dialogue between private sector actors and smallholder farmers, to empower

smallholder farmers in understanding available services and resources for irrigation needs, and to sustainably

increase agricultural productivity on vulnerable land while fueling market demand of irrigation services within the

private sector.

Applicants must be able to provide sustainable SSIT and other water management measures for hillside agriculture on pre-

selected sites. These include but are not limited to:

Estimate the water needs for irrigating the pre-selected sites;

Propose an irrigation system based on the source of water and land topography using SSIT approach;

Comply with setting out of intakes, energy stations, pipes network, and water storage structures;

Propose a detailed design for a sustainable and environmentally friendly irrigation system for SSIT project;

Fulfil efficient pump power requirement including supplying and installing solar pumps, solar panels with

controllers; supplying and installing pipes and related fittings,

Prepare irrigation network layout maps and general layout maps indicating location of all proposed and established

irrigation structures;

Prepare detailed Bills of Quantities (BOQs);

Implement designed irrigation system; and

Stabilize water storage embankments with compaction and planting grasses, as well as provide drainage filters

where applicable, like in clay rip-raps reservoirs (see specification below).

Mobilize and supervise the required labor force and facilitate their timely payment through Savings and Credit

Cooperative Organizations (SACCOs) or any other microfinance institutions in the area, or using other digital

payment channels like Mobile Money.

Hinga Weze will award grant funds to private sector stakeholders to provide technical services to develop irrigation systems

on pre-selected sites on behalf of Hinga Weze smallholder farmer beneficiaries.

IC. AUTHORITY AND GOVERNING REGULATIONS

Hinga Weze grant awards are made under the authority of the US Foreign Affairs Act, Code of Federal Regulations (CFR)

(2 CFR 200), and USAID’s Automated Directive System (ADS) Chapter 303, “Grants and Cooperative Agreements to Non-

Governmental Organizations.” Grants administered under Hinga Weze will adhere to the terms of the applicable USAID

Standard and Required as Applicable Provisions, as well as Hinga Weze grants procedures.

Hinga Weze is required to ensure that all applicants receiving USAID grant funds comply with the requirements found in

these regulations, as applicable to the respective terms and conditions of individual grant awards. Under the Hinga Weze

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grants program, USAID retains the right, at all times, to terminate, in whole or in part, Hinga Weze grant-making authorities

or any grants in progress. Hinga Weze reserves the right to award part or multiple sites, as it deems fit for the smallholder

farmers on the pre-selected sites.

Section II. Eligibility

IIA. ELIGIBLE RECIPIENTS

Hinga Weze would like to emphasize that applicants that submit applications in response to this RFA must be legally

registered entities in Rwanda and must submit registration documents with the application.

Formal Hinga Weze grant support under this solicitation may be extended to local private sector/service providers.

IIB. ADDITIONAL CONDITIONS OF ELIGIBILITY

To be considered eligible for grant receipt, applicants must meet the following eligibility criteria:

● Must be an approved, current RAB-subsidy service provider (required to submit proof) OR be able to commit

substantial leverage.

● Demonstrate past experience working with target beneficiaries (i.e. smallholder farmers) within Hinga Weze’s targeted

Rwandan districts for irrigation activities (Bugesera, Ngoma, Kayonza, Gatsibo); ● Submit resumes for key individuals which, at minimum, meet qualifications listed in application

● Have organizational objectives which contribute to Hinga Weze’s objectives and results;

● Submit a completed application responding to Hinga Weze’s requirements and conditions;

● Be committed to adhering to high ethical business standards, including transparency in business dealings and record keeping;

● Be prepared to undertake an independent financial review or audit, as requested;

● Demonstrate ability and/or willingness to update/modify business, financial, and technical records, either manually or

electronically, to ensure compliance with Hinga Weze recording requirements, as requested;

● Ensure compliance with relevant environmental protection requirements;

● Present a current RAB subsidy contract certification (if this is the source of leverage);

● Certify that the organization/individual is not debarred, suspended, or proposed for debarment from receipt of USG funds.

If the application passes evaluation, applicants must meet the following eligibility criteria:

● Complete and pass a site-visit of previously completed assignments of similar scope (as requested) and pre-award assessment;

● Agree to and sign the applicable certifications, such as the Certification Regarding Lobbying; Certification Regarding

Terrorist Financing; Prohibition on Assistance to Drug Traffickers; and Certification of the Recipient;

● Agree to the terms and conditions of the Mandatory Standard Provisions and Required as Applicable Provisions for Fixed

Amount Awards, if applicable; and

While Hinga Weze will consider all applicants, priority will be given to projects that impact larger numbers of beneficiaries,

address under-served populations, including women and youth, the poor, and historically disadvantaged groups, and/or

create significant numbers of sustainable new jobs when selecting potential awardees.

IIIC. INELIGIBLE ACTIVITIES AND UNALLOWABLE COSTS

Applicants may NOT use grant funds for any of the following:

Private ceremonies, parties, celebrations, or “representation” expenses;

Purchases of restricted goods, which include agricultural commodities, motor vehicles, pharmaceuticals, pesticides,

used equipment, or fertilizers, without the prior waiver and approval provided by Hinga Weze. In accordance with

the Hinga Weze Initial Environmental Examination, procurement of seeds or seedlings of non-native or invasive

species will require additional approval from USAID/BEO.

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Ineligible goods under USAID regulations, including but not limited to: military equipment; surveillance

equipment; police or law enforcement equipment; abortion equipment and services; weather modification

equipment; luxury goods; and gambling equipment;

Any purchases or activities deemed unnecessary to accomplish grant purposes as determined by Hinga Weze,

including any applicant headquarters’ expenses that are not directly linked to the implementation of the proposed

project;

Previous obligations and/or bad debts;

Fines and/or penalties;

Creation of endowments;

Indirect costs that are NOT supported by documented proof of such rates through audits or USAID-issued NICRA;

and

Any other costs unallowable per 2 CFR 200 Subpart E – Uniform Administrative Requirements, Cost Principles,

for Federal Awards;

Fee or profit of any kind.

Section III. Application Submission Information

III.A MANDATORY SITE VISIT

This RFA is composed of 6 separate lots. Applicants are welcome to submit an application for more than one lot; however,

please note that all lots will commence at the same time. Applicants should take into consideration the required resources

when applying for multiple lots.

As part of this RFA, applicants will have the opportunity to visit the pre-selected irrigation sites. Applicants are required

(it is compulsory) to visit the site in order to submit an application for the site. Site visits are an opportunity for

applicants to ask for any additional information. The site visit calendar is provided in the below table:

Lot District Sector Cell Village Area (ha) Date Time

1 Bugesera Mayange

Kibenga Rwarusaku 10 May 24, 2019

Before

noon

2 Ngoma Rukumberi Gituza Mfune 10 May 24, 2019 Afternoon

3 Kayonza Rwinkwavu Mukoyoyo Busasamana 10 May 21, 2019 All day

4

Gatsibo

Gasange Kigabiro Munini 10 May 22, 2019 Before

noon

5 Kiramuruzi Nyabisindu Itaba 10 May 22, 2019 afternoon

Total 50

All interested applicants must respect the calendar above, as only one visit is planned for each site. Please email

[email protected] to confirm your intent on visiting the sites. The departure will be at the field office of Hinga Weze

in each district, the location of which will be communicated to applicants upon their notification of intent to participate in

the site visit.

IIIB. QUESTION AND APPLICATION SUBMISSION REQUIREMENTS

Any questions related to this RFA must be submitted to [email protected] no longer than 5:00pm, Kigali, on Friday

May 31, 2019. Grant applications will be accepted only in the application format given in Annex A, Grant Application.

Applications and any required supporting documentation should be submitted no later than 1:00pm, Kigali, on June 21,

2019. Electronic applications should be submitted to [email protected]. Hard-copy applications should be submitted

to CNFA’s offices located at KG 28 AV, 7, Kimihurura, Gasabo District, P Box 1270, Kigali, Rwanda. Applicants should

mailto:[email protected]

mailto:[email protected]

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be sure to request a confirmation of receipt from Hinga Weze when submitting email applications, to ensure their submission

was received.

Please reference the RFA number in any response to this RFA. Applicants must have the RFA number in the email

subject. Applications received after the specified time and date will be considered late and will be considered only at the

discretion of CNFA. Applicants must strictly follow the provided deadlines to be considered for award.

IV. Evaluation, Selection, and Award Information

Hinga Weze will evaluate applicants using the trade-off evaluation methodology to identify grant applications considered

to be of best value and quality when considering both technical and cost factors. Selection criteria include the following: Factor Description Weight

Technical Approach How well the applicant defines the technical assistance, and how the proposed technical

approach meets the current best practices in irrigation activity implementation;

To what extent the proposed technical assistance in irrigation will equally benefit women,

men, and youth;

How the applicant aligns the technical approach with environmental safeguards

The feasibility of the proposed monitoring and evaluation plan during the entire grant

implementation period.

30

Management

Personnel and

Resources

The relevant background of proposed management personnel

Feasibility and effectiveness of the proposed Labor Resources Mobilization Plan.

25

Past Performance The applicant’s experience in successfully conducting similar activities, specifically with

smallholder farmers;

The applicant’s demonstrated organizational and financial capacity to meet the demands of

implementing a grant.

20

Budget The applicant’s proposed budget for implementing the grant. 25

TOTAL 100

Evaluation Process:

Once applications have been submitted to CNFA, members of the Hinga Weze Grant Selection Committee will evaluate

applications in accordance with the above selection criteria. Only applicants whose applications were deemed acceptable

will be contacted by CNFA. If you are not contacted within 30 calendar days from the application due date, your

application did NOT move on to the next round.

A decision to engage in more in-depth and specific discussion following initial selection is not a commitment to funding;

it is simply a decision to gain further information on the application. If the in-depth and specific discussions do not result in

the identification and development of a grant activity worthy of further pursuit, then Hinga Weze will inform the applicant

that it is no longer interested in advancing the grant project. However, if the more in-depth discussions result in a promising

design and concept, Hinga Weze will inform the applicant of that determination.

Applicants considered successful will be subject to a site visit from Hinga Weze staff for a pre-award assessment to verify

the accuracy of their submission, perform an administrative and financial review, and conduct environmental due diligence.

If the site visit assessment uncovers no major issues, Hinga Weze will provide the necessary instructions, technical

requirements, and next steps of grant award. CNFA anticipates awarding fixed amount award grants as a result of this RFA.

V. Terms and Conditions

Applicants understand, by submitting a response to this RFA, that application submission does not constitute an award

or commitment on the part of Hinga Weze, nor does it commit Hinga Weze to pay for costs incurred in the preparation

and submission of an application. Further, Hinga Weze reserves the right to accept or reject any or all applications received,

as well as issue amendments revising the terms of this RFA before or after receipt of applications. In submitting an

application, Applicants understand that USAID is not a party to this solicitation and the Applicant agrees that any

communications regarding this solicitation will be conducted with Hinga Weze, and not USAID. Only successful applicants

will be contacted.

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ANNEX A – GRANT APPLICATION

1. Applicant Name:

2. Applicant Address:

3. Applicant Telephone:

Fax:

Email:

4. Key Contact person and title:

5. Briefly describe the organization, purpose, and past related experience:

6. Proposed Grant Activity title:

7. Describe your overarching approach to conducting the required irrigation system development

a. Define how you would assess the sites;

b. Define how you would approach the irrigation;

c. Describe the equipment to be used;

d. Describe how you will ensure the effective and efficient implementation of different irrigation technologies, as

per the respective technical specifications in Question 13, below, including any activities to ensure site-specific

readiness;

8. Describe your monitoring and evaluation plan during the grant implementation. How will you evaluate progress made,

and make corrections if necessary?

9. Describe your approach to management and personnel considerations, including:

a. List the team members who will participate in this grant activity and detail their experience and

qualifications (attach CVs);

b. Detail who will manage the team;

c. Describe how the activities will be monitored;

d. Describe what organization resources will be used, and any partner organizations you propose to work

with (if any).

10. Describe your plan to mobilize and supervise the required labor force and facilitate their timely payment through

Savings and Credit Cooperative Organizations (SACCOs) or any other microfinance institutions in the area, or using other

digital payment channels like Mobile Money.

11. The following are the sites for irrigation development:

Lot District Sector Cell Village Area (ha)

1 Bugesera Mayange Kibenga Rwarusaku 10

2 Ngoma Rukumberi Gituza Mfune 10

3 Kayonza Rwinkavu Mukoyoyo Busasamana 10

4 Gatsibo

Gasange Kigabiro Munini 10

5 Kiramuruzi Nyabisindu Itaba 10

Total 50

This Application is composed of 5 separate sites. Applicants can submit an application for more than one site,

however all sites will commence at the same time.

12. Which site(s) is the Applicant applying for? List here.

13. What are the proposed results to be achieved, and how do the proposed activities link to the grant objective?

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14. Identify beneficiaries, disaggregated by gender if possible, number, and how they will benefit from the grant and their

participation in the grant activities:

15. Site Activities:

(Part 1) Technical Specifications: Using the table provided below, propose a realistic deliverables schedule, per site.

(Part 2) Personnel Qualifications: Using the tables provided below, please provide CVs of individuals who will be

performing the listed job functions, per site. If you do not currently have a staff member, or identified individual, to

perform the listed job function, please include a short summary of your recruitment process and timeline.

Part 1: TECHINICAL SPECIFICATIONS (Bugesera,) – site #1

Irrigation system development

Milestones Description of activities X Response from Applicant

a. Water Resource

Demands for

Irrigation per

site

To estimate the water demand for irrigated areas

Analysis regarding cropped areas, evapotranspiration and precipitation

Environmental issues

b. Site description The distance from water sources to the irrigation scheme

The water intake proposal for capturing water from the water sources

The total dynamic head of the area to be irrigated

The size area to be considered of the SSIT development

The capacity of the farmers to be contributed in the development of the SSIT

The potential and productivity of the soil with proposed crop

The design parameters, including those obtained from the investigations of climatic conditions and environmental conditions

The hydraulic/hydrological information, river capacity, lakes potential; probable floods; head losses; including: friction estimation

b

c.

Feasible

Options

Establish several options for the irrigation project (hose irrigation, sprinkler, drip etc.)

Evaluate the costs, benefits of each option.

Grade each option according to expected costs, environmental impacts and other benefits

d. Physical

Planning and

design

Hydraulic design of intake facilities.

Hydraulic designs for the water conveyance system.

Hydraulic and structural design for the irrigation appurtenances.

Estimation of the project implementation cost based to the recommended option

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Part II: Personnel Qualifications for Bugesera Site (Site #1)

Profession Required

Professional

Discipline

Responsibilities Required Minimum Years of

Experience

Estimation of costs per year for support the farmers and annual operation and maintenance (O & M), requirements and inputs.

Finalization of the project draft designs and cost estimates

e. Preparation of

Bills of

Quantities

(BOQs)

The applicant will determine the quantities of the items in conformity with the design drawings.

The Applicant’s estimate of each quantity or item involved in the implementation of the irrigation system will be presented in a Bill of Quantities based to the unit rates of materials, labor and equipment.

The Applicant will separate contribution of the beneficiaries especially labor for excavation and other works which needs local labor including up load and off load of equipment.

f. Pump Power

Requirement

The applicant will design the pump capacity based to the source of power proposed, the preference is solar system in order to limit the expenses of farmers of paying the electricity or fuel.

The pump power requirement is determined by the following formula where the total dynamic head (TDH) and the required flow rate are known.

g. Preparation of

drawings and

calculation

result in

conformity with

local norms and

engineering

standards

Design of scheme layout;

Quantify the scheme water demand/water requirements;

The information of raising mainline (Pressure, size)

Main and secondary pipelines in the scheme (Pressure, size)

Intake drawing in details

Reservoir drawing in details

other Irrigation scheme structures;

Infield system drawing including details (hydrant, trenches, views of wetting areas including water application system

h. Implementation plan

Time frame for implementation

Personnel management (staff per site as the attachment)

Available equipment for the assignment

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Irrigation Engineer BSC in

Irrigation

Engineering

Determine water resources analysis with

hydrology and climate data available,

designing of alternative technologies for the

development of irrigated agriculture for the

respective sites, selection of alternative

irrigation & water delivery systems, and

performing preliminary design for possible

alternatives irrigation option, and perform

selection of technically, and agricultural

data. Perform hydraulic design for the

irrigation system proposed.

with proven experience of at

least 10 years, having at least

three (3) similar experiences as

irrigation engineer on the

planning, design and

implementation of irrigation

projects

Mechanical Engineer A1 or A2 Mechanical Engineering or related field

Design irrigation pumps units and pump

stations equipment, pumps installation and

its cabling

with proven experience of at 5 least years, having at least three (3) similar experiences as technician in mechanical parts

Surveyor Engineer A2 Surveying Engineering

Topographic surveying works for command area of the respective sites, development of base maps at an appropriate for:

Topographical surveys of the intended area of the sites

Topographical field surveys of the selected irrigable area and produce mapping to the scale the detailed design of the networks and structures (pumping stations and reservoirs).

with proven experience of at 5 least years, having at least three (3) similar experiences as technician in survey parts

Part 1: TECHINICAL SPECIFICATIONS (Ngoma) – site #2


Milestones Description of activities Response from Applicant

i. Water Resource

Demands for

Irrigation per

site




j. Site description The distance from water sources to the irrigation scheme





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b

k.

Feasible

Options




l. Physical

Planning and

design







m. Preparation of

Bills of

Quantities

(BOQs)




n. Pump Power

Requirement



o. Preparation of

drawings and

calculation

result in

conformity with

local norms and

engineering

standards









p. Implementation plan




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Part II: Personnel Qualifications for Ngoma Site (Site #2)

Profession Required

Professional

Discipline


Experience


Irrigation

Engineering


















projects




its cabling







Part 1: TECHINICAL SPECIFICATIONS (Kayonza,) – site #3



q. Water Resource

Demands for

Irrigation per

site




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r. Site description The distance from water sources to the irrigation scheme








b

s.

Feasible

Options




t. Physical

Planning and

design







u. Preparation of

Bills of

Quantities

(BOQs)




v. Pump Power

Requirement



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Part 2: Personnel Qualifications for Kayonza Site (Site #3)

Profession Required

Professional

Discipline


Experience


Irrigation

Engineering


















projects




its cabling





Topographical field surveys of the selected irrigable area and produce mapping to the scale the detailed


w. Preparation of

drawings and

calculation

result in

conformity with

local norms and

engineering

standards









x. Implementation plan




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design of the networks and structures (pumping stations and reservoirs).

Part 1: TECHINICAL SPECIFICATIONS (Gatsibo) – Gasange site (site #4); Kiramuruzi site (site #5)



y. Water Resource

Demands for

Irrigation per

site




z. Site description The distance from water sources to the irrigation scheme








b

aa.

Feasible

Options




bb. Physical

Planning and

design





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Part II: Personnel Qualifications for Gatsibo Sites (#4, #5)

Profession Required

Professional

Discipline


Experience



cc. Preparation of

Bills of

Quantities

(BOQs)




dd. Pump Power

Requirement



ee. Preparation of

drawings and

calculation

result in

conformity with

local norms and

engineering

standards









ff. Implementation plan




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Irrigation

Engineering


















projects




its cabling







14. Describe a training plan for the site farmers, specifically on irrigation operation and maintenance:

15. Describe how gender sensitivity will be addressed during the grant activities:

16. Please provide a detailed cost proposal per site (should the applicant choose to apply for more than one

site). A sample budget template is provided below. An excel spreadsheet template for this information is

available on request.

Lot _______________

District: ___________

Number of Hectares: _____________

Applicant Name:__________________

ITEM - LABOR Unit Rate Per Ha Number of

Hectare

Total Amount

LABOR TOTAL

ITEM- EQUIPMENT Unit Rate Per Ha Number of

Hectare

Total Amount

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EQUIPMENT TOTAL

ITEM- INPUTS Unit Rate Per Ha Number of

Hectare

Total Amount

INPUTS TOTAL

GRAND TOTAL

Attachment 1 – Grant Application Checklist

Attachment 2 – Applicant Cover Letter

ATTACHMENT 1. GRANT APPLICATION CHECKLIST

Grantees must ensure they submit the following documentation in order to be considered eligible for grant award:

Cover Letter (Attachment 2) on Company Letterhead, signed by an authorized representative of

the Applicant

Grant Application (Annex A) with all questions answered. The following may be included as

separate attachments if necessary:

CVs for proposed personnel;

Applicant timeframe and implementation plan for proposed lots;

Cost proposal.

Copy of Applicant’s registration or business license

Three (3) contacts for references from organizations or individuals for which the applicant has

successfully worked with/for before.

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ATTACHMENT 2. APPLICANT COVER LETTER

The following cover letter must be placed on letterhead and completed/signed/stamped by a representative authorized to

sign on behalf of the applicant:

To: Hinga Weze Activity

CNFA offices located at KG 28 AV, 7 Kimihurura

Gasabo District, PO Box 1270 Kigali.

Reference: RFA no. 2019/05/027

To Whom It May Concern:

We, the undersigned, hereby provide the attached application to perform all work required to complete the activities and

requirements as described in the above-referenced RFA. Please find our application attached.

We hereby acknowledge and agree to all terms, conditions, special provisions, and instructions included in the above-

referenced RFA. We further certify that the below-named firm—as well as the firm’s principal officers and all commodities

and services offered in response to this RFA—are eligible to participate in this procurement under the terms of this

solicitation and under USAID regulations.

Furthermore, we hereby certify that, to the best of our knowledge and belief:

We have no close, familial, or financial relationships with any CNFA or Hinga Weze project staff members;

We have no close, familial, or financial relationships with any other applicants submitting proposals in response to

the above-referenced RFA; and

The prices in our offer have been arrived at independently, without any consultation, communication, or agreement with

any other applicant or competitor for the purpose of restricting competition.

All information in our application and all supporting documentation is authentic and accurate.

We understand and agree to CNFA’s prohibitions against fraud, bribery, and kickbacks.

We understand and agree to CNFA’s prohibitions against funding or associating with individuals or organizations

engaged in terrorism or trafficking in persons activities.

We hereby certify that the enclosed representations, certifications, and other statements are accurate, current, and complete:

Authorized Signatory:

Name and Title of Signatory:

Date:

Company Registration or Taxpayer ID Number:

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