Applicant-Organizational-Information-Form.docx

DOCX document 51 KB Posted

Attached to
American Spaces Grant Funding 2022
Opportunity number
PAS-MOROCCO-FY22-03
Issued by

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Applicant Organizational Information Form

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Other files

File Type Posted
SF424B-Assurances.pdf PDF
SF424A-Budget-Information.pdf PDF
SF424-Organizations.pdf PDF
SF424I-Individual.pdf PDF
Budget-Proposal-USD-1.xlsx XLSX spreadsheet
Project-Narrative-Form-NOFO.docx DOCX document
ASSF FY22 NOFO - FULL ANNOUNCEMENT.pdf PDF

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Applicant Organizational Information

GENERAL INFORMATION

1. Organization Name:

2. Type of Organization (check all that apply)

Non-U.S. Based:
|_|
Non-Profit:
|_|
Non-

Governmental:

U.S. Based:
|_|
For-Profit:

(Commercial)

|_|
Educational

Institution:

3. Is your Organization incorporated, registered, or licensed as a legal entity: |_| Yes |_| No (Please submit a copy of your final registration proof with your application)

If Yes:
Place of Incorporation or Registration (City/Country):

Incorporation or Registration Date (DD/MM/YYYY):

If No:
List parent company or organization name and address OR explain status below:

4. President of the organization:

Full Name:

Title:

Email Address:

Telephone Number:

Address:

5. Program Director (The person who will oversee the day to day activities of the grant):

Full Name:

Title:

Email Address:

Telephone Number

Address:

ORGANIZATION STRUCTURE

1. Is your organization governed by Board of Directors?
|_| Yes |_| No

2. How many employees are employed by your organization?

3. Is your organization fully registered with the System for Award Management (SAM)?
|_| Yes |_| No
If No, please explain:
4. Does your organization have a DUNs number (Dun and Bradstreet Universal Numbering system)?
|_| Yes |_| No
If yes, please list your DUNS #
5. Does your organization have the CAGE/NCAGE Code?
|_| Yes |_| No
If yes, please list your Code #

FINANCIAL BANKING INFORMATION

1. Does your organization have a valid bank account?
|_| Yes |_| No

If Yes, please provide the banking information below:

(Please submit a copy of your banking info/attestation de RIB with your application)

Bank name

Bank address

Bank account number (24 digits for Moroccan bank accounts)

BACKGROUND and PARTNER INFORMATION

1. Has your organization received or is it expected to receive other funding from the Unites States Government?

|_| Yes |_| No

2. Has your organization received or is it expected to receive financial assistance from other donors?

|_| Yes |_| No

If yes, please provide the information requested below on all awards or funding received in the last five years, or expected to be received in the future specifically note if funds are U.S. Government (USG) funds.

Name of Donor
Amount (USD)
Period
Place of Implementation
3. Do you have partner organizations working with you on this project?
|_| Yes |_| No

If yes, please list the name(s) of your partner organizations and how they will assist on this project:

4. Has your organization ever been convicted of a felony criminal violation under U.S. or Moroccan law or has it received a U.S. Government award that was canceled or terminated due to Mismanagement or Fraud?
|_| Yes |_| No

If yes, please explain:

5. Please include a brief description of your organization’s history, background, and mission as well as past work & experience in this area.

- 1 - PAS – Applicant Organizational Information

- 2 - PAS – Project Narrative Template

File details come from the government source that posted it. Updated .