Attachment 4. APPLICANT ORGANIZATIONAL INFORMATION.pdf

Applicant Organizational Information

Instructitlns: "j'lre App|icant Organizatiorlal lrrtbrmatiort ternplate should Ье filled ottt in its епtiгеtу. Please поtс that the геslэiltlsе "Nоt Applicable." 0г "N/А." is gеrrегаllу not acceptable, Insteacl. а sr"rfficierrt cxplatlation should Ье provided to explairl why ап itenr is rrclt applicable.

l. Oгganizatiotr Name: NGO CENTER ОF,АGRО INF,ORMATION INNOVATION ОF

UZBEKSITAN

2. Assessment Completed Ву: Oybek Mukhammadiev I Title: Сооrdiпаtоr project

3. 'l'ype of Огgапizаtiоп (check all that apply)

Non-U.S.

Based: п Non-Profit: й

Non- Governmental: W

U.S.

Based: п

For-Profit:

(Commercial) п

Educational Institution: п

4. Is уоLtг огgапizаtiоп iпсоrрогаtеd, геgistеrеd, оr licensed as а legal entity: ЙУ", П Тlо

If )'es.

Place of Incorporation оr Registration (State/County): uzbekistan

Incorporation оr Registration Date (MM/DD/YYYY): 12 June 2010 уеаr

If No, List раrепt соmрапу оr organization паmе and address OR explain status below:

5. Ргоgгаm Diгесtог (The реrsоп yyho y,ill оvеrsее the day lo day ctctivilie,y o/'the cll,t,ctrd);

Рrоgrаm Director Name:

Mirzohid yuldashev Рrоgrаm Director Title: Project mапаgеr

Email Address: у_rтiгzоhid@mаil,ru Telephone Number:

+99899871 1000

Address: Tashkent, 3/41 X.Samadova, district Yunusabad

6. lrinancial оr Business Of{'icial (The реrsоп who is respoп.sibl,e./br thе.fiпапсiаlсопlроtлеlll,s o./'the ay,arcl);

Budget Оffiсеr Name: umid xalilov Budget Оffiсеr

Title: Accountant

Email Address: muslim.пr@Ьk.ru Telephone Number:

+99В90З31 0909

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l. What is the ending datc оf уоLrг organization's fiscal уеаг (MM/DD/YYYY)? з1.12.2о22

2. Does уоuг oгgatrizatiotr have ап autot-nated accottt,ttitig systenl?

2.1: If Yes, respond to the questions below:

2,1а Does the ассоuпtiпg system ассоuпtfоr costs Ьу iпdividual pro.iects? [l'v., П ТЧо

If' lxIo, please ецэla iп :

2.1Ь СаП the ассоuпtiпg system gепеrаtе reports that show costs iпсurrеdfоr iпdividaal awards? VУ* П ыо

Address: Tashkent, str. 2а l.Karimov, district МirаЬаd l . Is уоuг огgапizаtiоп goveгtred Ьу Воаrd оf Dirесtоrs? ! ves Йr" {/ Yes.

Has уоur Воагd authorized уоur organization to епtег into tlris gгапt/соореrаtiче аgrееmепt? ! ves П тчо

I./ Yеs;

РгоviсJе docltmentation indicatirrg Воагd арргочаl. 'Гhе dccision o1'thc diгесtог of the сепtеr is enouglr 1Ьг r,rs to гесеiче gгапts

2. Ilow matry employees аге employed Ьу уоuг organization? 8

З. Is уоLtг огgапizаtiоп геgistегеd with the SysterT Гоr Аwагd Management (SAM)? ffv", П ыо

I|'No, please ехрlаiп:

4. List all individr"rals autlroгized to sigrr аwагd and аmепdtпепt documerrts оп behalf оf уоuг oгganizatiotl:

Name: Mirzohid yuldashev Title: Dirесtоr of сепtеr

Name: Oybek Mukhammadiev Title: Сооrdiпаtоr ргоjесt

Name: umid xalilov TitIe: Accountant

Name: Title:

ffv", П ТЧо

I/' No, plea,se ехрlаiп :

2.1с Does the ассоuпtiпg system allow for reportiпg of Cash апd Iп-kiпd сопtriЬutiопs (from поп-fеdеrаl sources) i.e., cost share? Йу", П tчо

If' IVo, plea,se ехрlаiп :

З. Which оf tlre following best dеsсгiЬеs уоuг огgапizаtiоп's accounting system? (check the cl ppropri а le rеsропsе)

Мапuаl: п Automated: d combination: п Other: п

4. IIow fi,equently do you post to the gепегаl lеdgег?

(с h е с k l h е а 7эр rop r i al,e rel,1эo п s, е)

Daily: п Weeklv: п Monthly: d Other: п

5. Does уоuг accounting systetT ассurаtеIу and cornpletely tracl< гесеiрt and disbuгserTent оf funds Ьу eacll gгапt апd/оr funding sоurсе? ffv"" П тчо

I.f Nrl, plea,se ехрlаiп:

6. Does уоur accounting system рrочidе fЬг гесоrdirlg oГactr"ral expenditttгes fоr each gгаrltiсоIltгасt Ьу budget cost саtеgогiеs геflесtеd in the арргочеd budget? [[ ves П tЧо

I/' }V о, ple ase expl а i п ;

1, Does уоur organization have а NlСRд Qrlegotiated Iпdiгесt Cost Rate дgгееrтепt)? Щvеs П шо

8. l-ist all individLrals ar-rthoгized to sign payrTent геquеsts and flIlancial героrtiпg оп belialГof уоLtг oгganizatiotl:

Name: Mirzohid yuldashev Title: Dirесtоr of сепtег

Name: Oybek Mukhammadiev TitIe: Сооrdiпаtоr рrоjесt

Name: Title:

Name: Title:

Applicant Organizational Information

|. I Ias уоuг огgапizаtiоп Ьееп convicted of а 1'е[опу сгirтiпаl violatioIl uпdег а Ilеdегаl law within the рrесеdiIlg 24 rTonths? ! ves ИХо

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2. Does уоur огgапizаtiоп lrave апу unpaid Fеdегаl tax liability that has been assessed [Ьr which all.iudicial and adrriinistrative rеmеdiеs liave Ьееп exhausted ог hаче lapsed, and tlrat is not being paid in а tirTely mаппег рuгsuапt to ап аgгееmепt with thc autlroгity responsib|e 1'ог collecting the tax liability?

I ves Йтчо

I. Does the oгgarrizatioll llave а wогl<iпg knowledge of the following U.S. Gочеrпtтеrtt, Оffiсе оf Managemerrt and Budget (ОМВ) Rеquiгеmепts? (check lhe appropl,iclle re,spotl.se)

2 CFR 200 Uniform Administrative Requirementso Costs Principles, and Audit Requirements for Federal Awards:

d У", П тчо ! Not SLrге

2. Does уоur oгganization have wгittеп policies atld ргосеduгеs {'ог the busilless mапаgеmепt агеаs below?

(chec k the appropri ale re,s1:loп.se) реrsоппеl policies and procedures: Й У", П ТЧо ! Not Surе рrосurеmепt policies апсl procedures: ffi Ves П Шо ! Not SLrге

Cash Management Policies and Рrосеdurеs: ffi ves П tЧо ! Not Surе

Sub-Grant Monitoring and Management: fi ves П tчо ! Not Suге

Рrореrф Policies and Рrосеdurеs: й У.. П шо ! Not Sure тrачеl policies and procedures: ffi ves П тхо ! Not Suге

Anti-Nepotism Policy ffi ves П Ыо ! Not Suге

!/ 1,1o (to апу above), please cx;llctiп:

з. Аге time and activity гесогds nraintaitred Ьу funding sоuгсе and ргоjесt Гоr each errrployee to accollllt fЬг total level of еffогt (l00%) devoted to each рго.jесt?

ffives П ыо

I/'No, please ецllаiп:

4. Does уоuг огgапizаtiоп lrave а wгittеп Ьudgеtагу ргосеss and сопtгоls to ргечепt iпсr-tггirrg obligations itl excess of tlre grапt atnourrt Гог irrdividual cost саtеgогiеs?

VУ." П Х"

I./' Nо, рlectsе ехрlct iп :

5. Аге арргоргiаtе duties separated to еrrsuге one individual (i.e., рrо.iесt ог financial) is not controlling all aspects of а transactiori/process? й у", П тхо

I/' 1,Io, plaase ехрlаiп :

6. Ilas уоuг oгganizatioll еvеr utrdегgопе ап audit? V"", П ixo

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If I'es. Give the date of уоur last audit: 20.05.2021

What type oI'audit was it? (check lhe appropt^iale rеsропsе) ffProgr.a,т-specific ALrdit - an auclit of а Fсdеrаl аwагd ргоgгаm

I Single Audit * an audit that includes both the oгganization's financial statenrents and the Federal Аwагds to Ье cor'ducted

П IГ it was апоthег type оf audit, please explain:

I Not SLrrе

Has уоur organization received апу adverse findings in any audit in the past thrее уеаrs?

П yes Еrыо

I/ 7'es, please ех1llаiп:

7 . Has уоur оrgапizаtiоп гесеiчеd gгапt funds Ьеfоге? Р| ves П тчо

I/ I'es:

Did уоuг orgatlizatiolr expend $750,000 ог I1,1оге iп LJ.S.

Gочегпmеtlt {trrlds in the ргечiоus уеаг?

! ves Иtчо

7.1 Please provide the iпfоrmаtiоп requested below оп all awards or fuпdiпg rесеiчеd iп tloe last tive years, specifically поtе dfuпds are U.S. Gоvеrпmепt (USG) fuпds.

Nоmе of Dопоr Аmоuпt Period pl асе о f Imр l еmе пtаt io п

l. U.S. Embassy l'ashkent 2з,720 USD 2017-2018 у Tashkent and Sirdarya rеgiоп;

2. Public Fund fоr Support of Non-

Governmental Organizations under the Oliy Majlis of the Republic of Uzbekistan

400 mlп sum (41.500

USD)

20\9-2020 у Samarkand region

3. USAID 55 000 USD 20rЗ-20I5 у Al1 rеgiопs of the rерuЬliс

4. Public Fund for Support of Non- Gочеrпmепtаl Organizations uпdеr the Oliy Majlis of the Republic of Uzbekistan

5 000 USD

2016 у Al1 regions of the republic

5. Ministry of supporting neighborhood and fami 1у

3 000 USD 2022 у Tashl<ent and Fеrgапа regions

6. (iЕF Small Grants Рrоgrаlпm

IJNDP

36 000 USD 2022-202З у Tashkent region

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7. "Enhance livelihoods оf rural srnal lholder-women through linking then with agricultural value chains led Ьу lead women-farmers"

48480 USD 2022-202З у Karalpaksistan, Khorezm, Surkhandarya and Kashakadarya

*Ву signing this application, I certify that the statements herein аrе trueo complete and accurate to the best of mу knowledge.

Name of Authorized tatbo* М irzohid yu ldashev аturе:

Date: 05/|212023 лGRG лхм аN :у\ l 1-1:

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