ANNEX 3 - PHASE 2 ENVIRONMENTAL for FY20 RFA (12.4.2019).pdf

ANNEX 3 – ENVIRONMENTAL CAPABILITY STATEMENT TEMPLATE1

Applicants must complete all questions below and submit to ASHA with the application.

USO/OSI Pair Name:

Commodities Only Construction with Commodities without Commodities

NOTE: Applicants are advised to review guidance for each question as in the ASHA Initial Environmental Examination (IEE) of ASHA environmental policies and procedures globally.

1. Institutional Arrangements: Is staffing in place to complete IEE and CRM analysis and implementation? (Yes/No): _______. Please describe:

2. Site Selection: Will the project be located in or near sensitive ecosystems and-or hazard-prone areas? (Yes/No): _______ Please describe corrective actions:________

3. Toxics: Will toxic construction materials be involved (e.g., asbestos)? (Yes/No/Not Applicable): __________________

4. Pesticides: Will the project need to address pest control and (if relevant) procure and or use pesticides? (Yes/No): _______ Are any pesticides that are needed already described in the USAID ASHA Construction Pesticide Evaluation and Safe Use Action Plan or PERSUAP?

(Yes/No): _______

5. Water Supply: Will the project ensure adequate water quality assurance (e.g., fecal coliforms, arsenic) to meet projected demand, and considering climate projections?

(Yes/No): _______. Please describe:

6. Solid Waste: How will the project dispose of solid waste (construction waste, electronic waste etc.) generated by its activities?

7. Sanitary Waste: How will the project dispose of sanitary waste streams generated by its activities?

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8. Medical Waste: Will medical waste be generated? (Yes/No/Not Applicable):

_________________Please describe the disposal mechanisms for medical waste generated.

9. Energy: Will the project employ energy efficiency measures and/or non-fossil fuel energy sources (e.g., hydropower, wind and solar panels)? (Yes/No): _______ Please describe:

10. Climate Risks and Opportunities: Will climate risk and /or vulnerability assessments be used to inform project design in all issues listed above, particularly site selection, location of procured commodities (e.g., consideration of flood risk in basements), water supply, and construction materials? (Yes/No): _______ Please describe:

1This statement of capability is developed by the applicant at the pre-award stage only. Following award, successful awardees are required to submit additional environmental and climate analyses as described in the ASHA IEE.