3. Attachment C MS Word Version.docx

Attachment C - SOURCES SOUGHT NOTICE

USAID/Nepal is interested in the following information related to organizational capability.

Your responses to the information requested will assist USAID/Nepal to plan its Acquisition and Assistance Strategy, taking into account the range of local capabilities. Please do not exceed three pages in your response.

SOURCES SOUGHT NOTICE FORM

A. ORGANIZATIONAL INFORMATION

Name of Organization: ___________________________________________ Office Address: _________________________________________________ City: _________________________________________________________ Telephone Number: ____________________________________________ E-mail Address: ________________________________________________ Website address (if any): _________________________________________ Primary Point of Contact Name and Title : ________________________

B. REGISTRATION INFORMATION

a. Type of Organization:

Profit: ____________ Not-for-profit: _________________

b. Category of Organization:

College or University: _____________ Research Institute/Think tank : _____________ Diaspora: _____________ Foundation: _____________ Private Sector Entity: _______________ Non-governmental Organization:____________________ Other (fill in):___________________

c. Number of Employees: _____________________

d. Are you a “local entity” in Nepal? (see definition below) Yes [ ] No [ ]

USAID defines local entity as an individual or organization that:

1. Is legally organized under the laws of a country that is receiving assistance from USAID;

2. Has its principal place of business or operations in a country receiving assistance from USAID;

3. Is majority-owned by individuals who are citizens or lawful permanent residents of a country receiving assistance from USAID; and

4. Is managed by a governing body, the majority of whom are citizens or lawful permanent residents of the country receiving assistance from USAID.

More information is available at: https://www.usaid.gov/npi/npi-key-definitions

e. Mission Statement and/or summary description of your organization:

C. GEOGRAPHICAL LOCATION

Geographical Location of Organizational Head Office: _____________________

Geographical Location of Field Offices (if any): _____________________

Please list all the locations where your organization works: _____________________

D. CAPABILITIES OF THE ORGANIZATION

Please provide the capabilities of your organization as organized in the following questions:

1. What approach does your organization take to implementing earthquake and landslide risk reduction programs?

2. What unique skills and capabilities does your organization bring to a risk reduction activity?

3. What kinds of partnerships with private or public organizations has your organization entered into to complement its own skills and capabilities? What has been the success record of such partnerships?

4. What additional resources does your organization require to effectively plan and implement a risk reduction activity in the Karnali and Sudurpaschim Provinces (e.g., staff, technology, or capacity development)?

5. What experience does your organization have with performance-based grants or contracts in which payment is only made after achievement of certain programmatic objectives?

E. WORKWITHUSAID.GOV

WorkwithUSAID.gov is a resource hub designed for new, current, and future local and international partners to navigate how to work with USAID.

Have you established your organizational account at WorkwithUSAID.gov? Yes [ ] No [ ]

If not, why not? Specify Reason: _______________________________________________

F. GENERAL INFORMATION

How did you hear about this SSN/RFI (please mark your answer below)?

a. USAID/Nepal Facebook [ ]

b. US Embassy Kathmandu | Nepal Facebook [ ]

c. USAID Colleagues [ ]

e. SAM.gov [ ]

f. Grants.gov [ ]

g. Local Newspaper [ ]

h. Other [Please Specify]:_________________________________________________

Responses will be reviewed only by USAID Personnel and will be held in a confidential manner.

[End of Attachment C]