ANNEX 2b - PHASE 2 TEMPLATE for FY21 RFA.docx

ANNEX 2b – PHASE 2 TECHNICAL APPLICATION - TEMPLATE

ANNEX 2 – PHASE 2 TECHNICAL APPLICATION TEMPLATE

Instructions: Applicants should reproduce and complete the "Annex 2 - Phase 2 Technical Application Template" and return to ASHA for review. All requested information should be submitted.

II. Table of Contents (1 page)

III. Management Approach (not to exceed 6 pages)

Please provide your response to the merit review criterion of Management Approach, in accordance with the instructions in Section E.2.b of this NOFO/RFA.

For the monitoring and evaluation factor, Applicants should note the following:

· "F" indicators can be found using this link: https://usaidlearninglab.org/library/standard-foreign-assistance-indicators

· ASHA's two mandatory custom indicators are:

ASHA PD Custom 1: Number of American best practices that improve organizational performance.

ASHA PD Custom 2: Number of American best practices formally disseminated, accepted, or adopted.

Additional information can be found on ASHA's PD Custom Indicators. Additionally, Applicants must use the following table (add rows as needed) as part of the response to monitoring and evaluation and should include both the "F" indicators and the ASHA PD Custom indicators:

[Example 1] Indicator DR.1.5-1 Number of USG-assisted courts with improved case management systems

[Example 2] Indicator 3.4.1(a) Neonatal mortality rate (number of deaths of infants during the first 28 days of life per 1,000 live births) in childbirth facilities in the southern region of East Tambou.

Improved child birth outcomes in the southern region of East Tambou.

MANDATORY INDICATOR:

ASHA PD Custom Indicator 1: Number of American best practices that improve organizational performance

Performance/ Custom

Reported quarterly.

MANDATORY INDICATOR:

ASHA PD Custom Indicator 2: Number of American best practices formally disseminated, accepted, or adopted

Performance/ Custom

Reported quarterly.

IV. Commodities and/or Construction Approach (not to exceed 6 pages for either and 9 pages for both[footnoteRef:1]) [1: If submitting for Commodity Only, 6 pages are allowed. If submitting for Construction/Renovation Only, 6 pages are allowed. If submitting for both Commodity and Construction/Renovation then 9 pages total are allowed.]

Please provide your response to the merit review criterion of Commodities and/or Construction under the appropriate headings below, in accordance with the instructions in Section E.2.b of this NOFO/RFA.

Durable Commodities Information (if applicable), including Procurement Plan

Construction/Renovation Information (if applicable), including Implementation Plan

Environmental Capability: By responding to Annex 3