Attachment C - SOURCES SOUGHT NOTICE - USAID Small Grants for Biodiversity .docx

Attachment C - SOURCES SOUGHT NOTICE

REQUEST FOR INFORMATION FORM

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 & Assistance Strategy, taking into account the range of local capabilities. Please do not exceed five pages in your response.

A. ORGANIZATIONAL INFORMATION:

Name of Organization: ___________________________________________ Office Address: _________________________________________________ City: _________________________________________________________ Telephone Number: ____________________________________________ E-mail Address: ________________________________________________ Website address (if any): _________________________________________ Point of Contact (Name): ________________________ Contact Number: _______________________________________________ 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 organization registered in Nepal? 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.

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 for meeting the work detailed in Attachment A:

E. WORKWITHUSAID.ORG

WorkwithUSAID.org 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.org? Yes [ ] No [ ] If not, why not? Specify Reason: _______________________________________________

F. GENERAL INFORMATION

How did you hear about this RFI/SSN?

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]:_________________________________________________

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