ORDIN   Nr. 370 din 30 noiembrie 2005

privind modificarea formularelor prevazute in anexa nr. 4 la Metodologia de control, inspectie si monitorizare, aplicabila in domeniul de competenta al Autoritatii Nationale pentru Persoanele cu Handicap, aprobata prin Ordinul presedintelui Autoritatii Nationale pentru Persoanele cu Handicap nr. 248/2005

ACT EMIS DE: MINISTERUL MUNCII, SOLIDARITATII SOCIALE SI FAMILIEI

              AUTORITATEA NATIONALA PENTRU PERSOANELE CU HANDICAP
ACT PUBLICAT IN: MONITORUL OFICIAL  NR. 1113 din  9 decembrie 2005

    Avand in vedere prevederile art. 1 alin. (3) din Ordonanta Guvernului nr. 14/2003 privind infiintarea, organizarea si functionarea Autoritatii Nationale pentru Persoanele cu Handicap, aprobata cu modificari si completari prin Legea nr. 239/2003, cu modificarile si completarile ulterioare,
    in temeiul art. 5 alin. (4) din Ordonanta Guvernului nr. 14/2003, aprobata cu modificari si completari prin Legea nr. 239/2003,

    presedintele Autoritatii Nationale pentru Persoanele cu Handicap emite urmatorul ordin:

    Art. 1
    Se modifica formularele prevazute in anexa nr. 4 la Metodologia de control, inspectie si monitorizare, aplicabila in domeniul de competenta al Autoritatii Nationale pentru Persoanele cu Handicap, aprobata prin Ordinul presedintelui Autoritatii Nationale pentru Persoanele cu Handicap nr. 248/2005, publicat in Monitorul Oficial al Romaniei, Partea I, nr. 912 din 12 octombrie 2005, conform anexei*).
------------
    *) Anexa este reprodusa in facsimil.

    Art. 2
    Anexa face parte integranta din prezentul ordin.
    Art. 3
    Directiile de specialitate din cadrul Autoritatii Nationale pentru Persoanele cu Handicap vor duce la indeplinire prevederile prezentului ordin.
    Art. 4
    Prezentul ordin se publica in Monitorul Oficial al Romaniei, Partea I.

                      Presedintele Autoritatii Nationale
                        pentru Persoanele cu Handicap,
                           Silviu George Didilescu

    ANEXA 1

                             RAPORT PE ACTIVITATE
                   PENTRU PERIOADA .........................

    Date de identificare a proiectului
 ______________________________________________________________________________
| Nr. de inregistrare in Registrul      |                                      |
| Comisiei de Evaluare                  |                                      |
|_______________________________________|______________________________________|
| Titlul proiectului                    |                                      |
|_______________________________________|______________________________________|
| Solicitant                            |                                      |
|_______________________________________|______________________________________|
| Adresa                                |                                      |
|_______________________________________|______________________________________|
| Telefon                               |                                      |
|_______________________________________|______________________________________|
| Fax                                   |                                      |
|_______________________________________|______________________________________|
| E-mail                                |                                      |
|_______________________________________|______________________________________|
| Responsabil institutie/organizatie    |                                      |
|_______________________________________|______________________________________|
| Coordonator                           |                                      |
|_______________________________________|______________________________________|
| Echipa de management a Proiectului    |                                      |
| (nume, functie in organizatie,        |                                      |
| functie in echipa)                    |                                      |
|_______________________________________|______________________________________|
| Localizarea proiectului               |                                      |
| (localitate, adresa)                  |                                      |
|_______________________________________|______________________________________|
| Contract de Finantare (nr./data)      |                                      |
|_______________________________________|______________________________________|
| Acte Aditionale la Acordul de         | (daca este cazul)                    |
| Finantare nr./data                    |                                      |
|_______________________________________|______________________________________|
| Durata proiectului                    |                                      |
|_______________________________________|______________________________________|
| Data efectiva a inceperii proiectului |                                      |
|_______________________________________|______________________________________|

 ______________________________________________________________________________
| Mediatizarea proiectului     | (daca s-a realizat in perioada de raportare)  |
| (mijloace/metode)            |                                               |
|______________________________|_______________________________________________|

    Obiective specifice
 ____________________________________________________________
|                                    |        Realizat       |
|                                    | (exprimat procentual) |
|____________________________________|_______________________|
| 1                                  |            %          |
|____________________________________|_______________________|
| 2                                  |            %          |
|____________________________________|_______________________|
| 3                                  |            %          |
|____________________________________|_______________________|

    Activitati
 ______________________________________________________________________________
| Luna | Activitati | Activitati | % | Abaterile de la | Evaluare | Observatii |
|      | planificate| realizate  |   | activitatile    | interna  |   (*)   |
|      |     (*)    |    (*)    |   | planificate;    |  (*)   |            |
|      |            |            |   | Justificari     |          |            |
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|
|______|____________|____________|___|_________________|__________|____________|

    Grupul tinta
 ______________________________________________________________________________
| Luna | Planificat          | Realizat       | % | Justificari abateri        |
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|

    Rezultate scontate
 ______________________________________________________________________________
| Luna | Planificat          | Realizat       | % | Justificari abateri        |
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|

    Indicatori de performanta
 ______________________________________________________________________________
| Luna | Planificat          | Realizat       | % | Justificari abateri        |
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|

    Impact
 ______________________________________________________________________________
| Luna | Planificat          | Realizat       | % | Justificari abateri        |
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|

    Parteneriat
 ______________________________________________________________________________
|   Partener    |  Angajament  |  Angajament  | % | Justificarea diferentelor  |
|               |  asumat in   |  realizat    |   |                            |
|               |  proiect     |  efectiv     |   |                            |
|_______________|______________|______________|___|____________________________|
|_______________|______________|______________|___|____________________________|
|_______________|______________|______________|___|____________________________|
|_______________|______________|______________|___|____________________________|

    Viabilitatea/Sustenabilitatea proiectului (Cum veti continua activitatile dupa incetarea finantarii?)
 ______________________________________________________________________________
| Surse de finantare,| Actiuni realizate | Rezultat       |   Rezultat     | % |
| parteneri sau      | pentru            | scontat al     |   obtinut      |   |
| donatori           | sensibilizarea    | actiunilor     |   efectiv      |   |
| identificati care  | donatorilor       | (pana la data) |   (la data)    |   |
| va vor sustine in  | (si data)         |                |                |   |
| viitor activitatile|                   |                |                |   |
|____________________|___________________|________________|________________|___|
|____________________|___________________|________________|________________|___|
|____________________|___________________|________________|________________|___|

    Voluntariat
 ______________________________________________________________________________
| Luna | Planificat          | Realizat       | % | Justificari abateri        |
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|
|______|_____________________|________________|___|____________________________|

    I. Anexati:
    - lista beneficiarilor (nume, semnatura, loc de munca - daca e cazul - si numar de telefon) cu semnatura si stampila organizatiei;
    - agende si liste de participanti pentru seminarii, mese rotunde; chestionare de evaluare;
    - materiale redactate in cadrul proiectului;
    - articole din presa referitoare la activitati din cadrul proiectului;
    - orice alt material relevant pentru modul de desfasurare al proiectului conform prevederilor ghidului solicitantului.

------------
    (*) Activitati planificate
    - precizati activitatile planificate asa cum au fost acestea formulate in cererea de finantare.
    (*) Activitati realizate
    - precizati numarul de participanti, locul de desfasurare si durata pentru fiecare activitate realizata.
    (*) Evaluare interna
    - evaluati rezultatele activitatilor desfasurate.
    (*) Observatii
    - daca in urma evaluarii remarcati modificari/imbunatatiri care trebuie aduse proiectului, mentionati-le.

    Semnatura si stampila beneficiar                        VIZE:
                                                            Inspector
    Judetean/Sector: ....................

                              RAPORT DE MONITORIZARE
                       PENTRU PERIOADA ....................

 ______________________________________________________________________________
| Echipa de monitorizare ANPH           | 1.                                   |
|                                       | 2.                                   |
|                                       | 3.                                   |
|_______________________________________|______________________________________|
| Nr. si data vizitei de monitorizare   |                                      |
|_______________________________________|______________________________________|
| Nr. de inregistrare in Registrul      |                                      |
| Comisiei de Evaluare                  |                                      |
|_______________________________________|______________________________________|
| Titlul proiectului                    |                                      |
|_______________________________________|______________________________________|
| Solicitant                            |                                      |
|_______________________________________|______________________________________|
| Adresa                                |                                      |
|_______________________________________|______________________________________|
| Telefon                               |                                      |
|_______________________________________|______________________________________|
| Fax                                   |                                      |
|_______________________________________|______________________________________|
| E-mail                                |                                      |
|_______________________________________|______________________________________|
| Responsabil institutie/organizatie    |                                      |
|_______________________________________|______________________________________|
| Coordonator proiect                   |                                      |
|_______________________________________|______________________________________|
| Echipa de management al proiectului   |                                      |
| (nume, functie in organizatie,        |                                      |
| functie in echipa)                    |                                      |
|_______________________________________|______________________________________|
| Localizarea proiectului               |                                      |
| (localitate, adresa)                  |                                      |
|_______________________________________|______________________________________|
| Contract de finantare                 |                                      |
| (nr./data)                            |                                      |
|_______________________________________|______________________________________|
| Acte Aditionale la Acordul de         | daca este cazul                      |
| Finantare (nr./data)                  |                                      |
|_______________________________________|______________________________________|
| Durata proiectului                    |                                      |
|_______________________________________|______________________________________|
| Data efectiva a inceperii proiectului |                                      |
|_______________________________________|______________________________________|

    Descrierea vizitelor: (se indica doar nr. si data Notei de vizita si se anexeaza Nota de vizita)
    Continut minim al Notei de vizita:
    1. Persoane contactate
    2. Vizite efectuate la: (locatia proiectului, alte institutii)
    3. Verificarea Raportului de activitate si financiar privind gradul de realizare si situatia financiara incepand cu lista de probleme consemnata in Raportul de monitorizare al Inspectorului de judet/sector. In urma verificarii Echipa de monitorizare din cadrul ANPH face observatiile cuvenite si atentioneaza pe beneficiarul de finantare cu privire la gradul de realizare, situatia financiara si recomandarile ce vor fi consemnate in Raportul sau de monitorizare.

    Observatii:
    Notele de vizita se intocmesc in cel putin doua exemplare originale un exemplar original revenind beneficiarului finantarii.
    Notele de vizita vor fi intocmite de echipa de monitorizare si vor fi semnate de membrii acesteia, de reprezentantul beneficiarului finantarii si de ceilalti participanti la discutii.
    Notele de vizita intocmite cu ocazia participarii la procedura de achizitii a bunurilor/serviciilor/lucrarilor necesare derularii proiectului vor mentiona pe langa prevederile generale ale unei note de vizita rezultatul procedurii si confirmarea legalitatii acesteia.
    Se vor anexa notelor de vizita documentele relevante preluate cu ocazia vizitei de monitorizare, in copie.

    CONCLUZII

    a. Realizari
 ______________________________________________________________________________
| Grad de realizare pentru: | % | Observatii                                   |
|___________________________|___|______________________________________________|
| Activitati                |   |                                              |
|___________________________|___|______________________________________________|
| Obiective specifice       |   |                                              |
|___________________________|___|______________________________________________|
| Grup tinta                |   |                                              |
|___________________________|___|______________________________________________|
| Rezultate                 |   |                                              |
|___________________________|___|______________________________________________|
| Indicatori                |   |                                              |
|___________________________|___|______________________________________________|
| Impact                    |   |                                              |
|___________________________|___|______________________________________________|
| Parteneriat               |   |                                              |
|___________________________|___|______________________________________________|
| Viabilitate               |   |                                              |
|___________________________|___|______________________________________________|
| Voluntariat               |   |                                              |
|___________________________|___|______________________________________________|

    b. Situatie financiara:                                             lei RON
 ______________________________________________________________________________
|Buget/Plati|     ANPH    |  Beneficiar  |     Altii    |   Sume nedecontate   |
|           |_____________|______________|______________|______________________|
|           |Buget| Decont| Buget| Decont| Buget| Decont| ANPH|Beneficiar|Altii|
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Total     |     |       |      |       |      |       |     |          |     |
| din care: |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 1  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 2  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 3  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|

    c. Recomandari
    In mod obligatoriu acest punct trebuie sa contina una din urmatoarele recomandari:
    - rezilierea contractului si returnarea sumelor achitate (cu motivarea corespunzatoare)
    - rezilierea contractului pentru restul sumei (cu motivarea corespunzatoare)
    - continuarea proiectului si eliberarea transei urmatoare conditionata de eliminarea deficientelor constatate (cu mentiunea expresa a acestora si a termenului de rezolvare)
    - continuarea proiectului si eliberarea transei urmatoare

    Echipa de monitorizare ANPH:
    1.
    2.
    3.

                             RAPORT DE MONITORIZARE
                   PENTRU PERIOADA ........................

 ______________________________________________________________________________
| Monitor: Inspector Judetean           |                                      |
|_______________________________________|______________________________________|
| Nr. si data vizitei de monitorizare   | 1.                                   |
|                                       | 2.                                   |
|                                       | 3.                                   |
|_______________________________________|______________________________________|
| Nr. de inregistrare in Registrul      |                                      |
| Comisiei de Evaluare                  |                                      |
|_______________________________________|______________________________________|
| Titlul proiectului                    |                                      |
|_______________________________________|______________________________________|
| Solicitant                            |                                      |
|_______________________________________|______________________________________|
| Adresa                                |                                      |
|_______________________________________|______________________________________|
| Telefon                               |                                      |
|_______________________________________|______________________________________|
| Fax                                   |                                      |
|_______________________________________|______________________________________|
| E-mail                                |                                      |
|_______________________________________|______________________________________|
| Responsabil institutie/organizatie    |                                      |
|_______________________________________|______________________________________|
| Coordonator proiect                   |                                      |
|_______________________________________|______________________________________|
| Echipa de management al proiectului   |                                      |
| (nume, functie in organizatie,        |                                      |
| functie in echipa)                    |                                      |
|_______________________________________|______________________________________|
| Localizarea proiectului               |                                      |
| (localitate, adresa)                  |                                      |
|_______________________________________|______________________________________|
| Contract de finantare                 |                                      |
| (nr./data)                            |                                      |
|_______________________________________|______________________________________|
| Acte Aditionale la Acordul de         | daca este cazul                      |
| Finantare (nr./data)                  |                                      |
|_______________________________________|______________________________________|
| Durata proiectului                    |                                      |
|_______________________________________|______________________________________|
| Data efectiva a inceperii proiectului |                                      |
|_______________________________________|______________________________________|

    Descrierea vizitelor: (se indica doar nr. si data Notei de vizita si se anexeaza Nota de vizita)

    a. vizite efectuate pana la intocmirea si semnarea rapoartelor, consemnate in Note de vizita cu urmatorul continut:
    1. Persoane contactate
    2. Vizite efectuate la: (locatia proiectului, alte institutii etc.)
    3. Constatari, documente solicitate beneficiarului, recomandari, probleme de rezolvat pana la urmatoarea vizita

    b. vizita efectuata cu ocazia solicitarii de obtinere a vizei pe Raportul de activitate si financiar, consemnata in Nota de vizita cu urmatorul continut:
    1. Persoane contactate
    2. Vizite efectuate la: (locatia proiectului, alte institutii etc.)
    3. Verificarea Raportului de activitate si a Raportului financiar privind gradul de realizare si situatia financiara. In urma verificarii Inspectorul de judet face observatiile cuvenite si atentioneaza pe beneficiarul de finantare cu privire la gradul de realizare, situatia financiara si recomandarile ce vor fi consemnate in Raportul sau de monitorizare.

    Observatii:
    Notele de vizita se intocmesc in cel putin doua exemplare originale, un exemplar original revenind beneficiarului finantarii.
    Notele de vizita vor fi intocmite de inspectorul de judet si vor fi semnate de acesta, de reprezentantul beneficiarului finantarii si de ceilalti participanti la discutii.
    Notele de vizita intocmite cu ocazia participarii inspectorului de judet ca observator la procedura de achizitii a bunurilor/serviciilor/lucrarilor necesare derularii proiectului vor mentiona pe langa prevederile generale ale unei note de vizita rezultatul procedurii si confirmarea legalitatii acesteia.
    Se vor anexa notelor de vizita documentele relevante preluate cu ocazia vizitei de monitorizare, in copie.

    CONCLUZII

    a. Realizari
 ______________________________________________________________________________
| Grad de realizare pentru: | % | Observatii                                   |
|___________________________|___|______________________________________________|
| Activitati                |   |                                              |
|___________________________|___|______________________________________________|
| Obiective specifice       |   |                                              |
|___________________________|___|______________________________________________|
| Grup tinta                |   |                                              |
|___________________________|___|______________________________________________|
| Rezultate                 |   |                                              |
|___________________________|___|______________________________________________|
| Indicatori                |   |                                              |
|___________________________|___|______________________________________________|
| Impact                    |   |                                              |
|___________________________|___|______________________________________________|
| Parteneriat               |   |                                              |
|___________________________|___|______________________________________________|
| Viabilitate               |   |                                              |
|___________________________|___|______________________________________________|
| Voluntariat               |   |                                              |
|___________________________|___|______________________________________________|

    b. Situatie financiara:                                             lei RON
 ______________________________________________________________________________
|Buget/Plati|     ANPH    |  Beneficiar  |     Altii    |   Sume nedecontate   |
|           |_____________|______________|______________|______________________|
|           |Buget| Decont| Buget| Decont| Buget| Decont| ANPH|Beneficiar|Altii|
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Total     |     |       |      |       |      |       |     |          |     |
| din care: |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 1  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 2  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|
| Transa 3  |     |       |      |       |      |       |     |          |     |
|___________|_____|_______|______|_______|______|_______|_____|__________|_____|

    c. Recomandari
    In mod obligatoriu acest punct trebuie sa contina una din urmatoarele recomandari:
    - rezilierea contractului si returnarea sumelor achitate (cu motivarea corespunzatoare)
    - rezilierea contractului pentru restul sumei (cu motivarea corespunzatoare)
    - continuarea proiectului si eliberarea transei urmatoare conditionata de eliminarea deficientelor constatate (cu mentiunea expresa a acestora si a termenului de rezolvare)
    - continuarea proiectului si eliberarea transei urmatoare

    d. lista de probleme pe care trebuie sa le aiba in vedere echipa de monitorizare din partea ANPH.

            Inspector Judetean ................................

                                                                Data:

                                 RAPORT FINANCIAR
                                 Transa .........

    1. Situatie financiara:                                             lei RON
 ______________________________________________________________________________
|Nr. | Buget/Plati|    ANPH    | Beneficiar |    Altii   |   Sume nedecontate  |
|crt.|            |____________|____________|____________|_____________________|
|    |            |Buget|Decont|Buget|Decont|Buget|Decont|ANPH|Beneficiar|Altii|
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I   |Cheltuieli  |     |      |     |      |     |      |    |          |     |
|    |referitoare |     |      |     |      |     |      |    |          |     |
|    |la proiect  |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.1 |Reparatii si|     |      |     |      |     |      |    |          |     |
|    |amenajari   |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.2 |Dotari      |     |      |     |      |     |      |    |          |     |
|    |tehnice si  |     |      |     |      |     |      |    |          |     |
|    |cheltuieli  |     |      |     |      |     |      |    |          |     |
|    |de instalare|     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.3 |Cheltuieli  |     |      |     |      |     |      |    |          |     |
|    |de          |     |      |     |      |     |      |    |          |     |
|    |intretinere |     |      |     |      |     |      |    |          |     |
|    |si          |     |      |     |      |     |      |    |          |     |
|    |service     |     |      |     |      |     |      |    |          |     |
|    |echipamente |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.4 |Software    |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.5 |Materiale si|     |      |     |      |     |      |    |          |     |
|    |servicii    |     |      |     |      |     |      |    |          |     |
|    |necesare in |     |      |     |      |     |      |    |          |     |
|    |procesul    |     |      |     |      |     |      |    |          |     |
|    |derularii   |     |      |     |      |     |      |    |          |     |
|    |proiectului |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.6 |Inchirieri  |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.7 |Consumabile |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.8 |Transport   |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.9 |Cazare      |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.10|Masa        |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|I.11|Mediatizare |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|II  |Cheltuieli  |     |      |     |      |     |      |    |          |     |
|    |referitoare |     |      |     |      |     |      |    |          |     |
|    |la          |     |      |     |      |     |      |    |          |     |
|    |implementare|     |      |     |      |     |      |    |          |     |
|    |proiect     |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|II.1|Cheltuieli  |     |      |     |      |     |      |    |          |     |
|    |administra- |     |      |     |      |     |      |    |          |     |
|    |tive        |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|II.2|Plata       |     |      |     |      |     |      |    |          |     |
|    |colaboratori|     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|II.3|Voluntariat |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|II.4|Alte        |     |      |     |      |     |      |    |          |     |
|    |cheltuieli  |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|
|III |TOTAL       |     |      |     |      |     |      |    |          |     |
|    |lei RON     |     |      |     |      |     |      |    |          |     |
|____|____________|_____|______|_____|______|_____|______|____|__________|_____|

    Observatii:
    - Structura bugetului nu poate fi modificata decat cu acordul ANPH;
    - Pentru fiecare pozitie bugetara se va face o anexa in care se insumeaza toate cheltuielile aferente acelei pozitii bugetare. In anexa se precizeaza emitentul, tipul (factura, chitanta, ordin de plata, stat de plata etc.), nr. si data documentului, valoarea si se anexeaza fotocopiile tuturor documentelor de decontare prevazute in prezentul ghid (factura, chitanta, ordin de plata, stat de plata, liste de participanti cu semnaturile de confirmare unde este cazul, precum si orice alt document pe baza caruia se deconteaza o suma);
    - Pentru achizitii de bunuri, servicii si lucrari necesare derularii proiectului se va anexa in copie dosarul de achizitie.

    Semnatura si stampila beneficiar: ...........

                                           Inspector judetean ................

                     FISA FINALA DE EVALUARE A PROIECTULUI

 ______________________________________________________________________________
| Nr.  |                                 |                                     |
| crt. |                                 |                                     |
|______|_________________________________|_____________________________________|
|   1  | Subcomisie:                     |                                     |
|______|_________________________________|_____________________________________|
|   2  | Nume proiect                    |                                     |
|______|_________________________________|_____________________________________|
|   3  | Punctaj subcomisie:             |                                     |
|______|_________________________________|_____________________________________|
|   4  | Obiective proiect:              |                                     |
|______|_________________________________|_____________________________________|
|   5  | Activitati proiect:             |                                     |
|______|_________________________________|_____________________________________|
|   6  | Buget solicitat: |                                     |
|______|_________________________________|_____________________________________|
|   7  | Buget alocat:                   |                                     |
|______|_________________________________|_____________________________________|
|   8  | Puncte tari proiect: |                                     |
|______|_________________________________|_____________________________________|
|   9  | Puncte slabe proiect:           |                                     |
|______|_________________________________|_____________________________________|
|  10  | Recomandari subcomisie:         |                                     |
|______|_________________________________|_____________________________________|

    Subcomisie

    Evaluator 1                     Evaluator 2:

    Nume                            Nume
    Semnatura                       Semnatura
    Data                            Data