CERTIFICATE AND STATEMENT OF EXPENDITURE AND APPLICATION FOR PAYMENT
ANNEX IXSupplementary provisions
ANNEX IX CERTIFICATE AND STATEMENT OF EXPENDITURE AND APPLICATION FOR PAYMENT PART A Certificate and statement of expenditure and application for interim payment Text of image EUROPEAN COMMISSION European Fisheries Fund Certificate and statement of expenditure and payment application Member State: … Commission Decision … of … Commission reference (CCI) No: … Convergence and non-convergence regions: … Text of image CERTIFICATE I, the undersigned, representing the certifying authority designated by (1): hereby certify that all expenditure included in the attached statement complies with the criteria for eligibility of expenditure set out in Article 55 of Regulation (EC) No 1198/2006 and has been paid by the beneficiaries on the implementation of the operations selected under the operational programme in accordance with the conditions for granting of public contributions under Article 78 of that Regulation. after (2) .. .. 20.. and amounts to: EUR (3) (exact figure to two decimal places) The attached statement of expenditure, broken down by priority axis, is based on accounts provisionally closed on .. .. 20 .. and forms an integral part of this certificate. I also certify that operations are progressing in pursuance with the objectives laid down in the Decision and in accordance with Regulation (EC) No 1198/2006, and in particular that: (1) the expenditure declared complies with the applicable Community and national rules and has been paid in respect of operations selected for funding in accordance with the criteria applicable to the operational programme and the applicable Community and national rules; (2) the statement of expenditure is accurate, results from reliable accounting systems and is based on verifiable supporting documents; (3) the underlying transactions are lawful and comply with the rules and the procedures have been followed satisfactorily; (4) the statement of expenditure and the payment application take account, where applicable, of any amounts recovered, any interest received and of revenue accruing from operations financed under the operational programme. (5) the breakdown of the underlying operations is recorded on computer files and is available to the relevant Commission departments on request. In accordance with Article 87 of Regulation (EC) No 1198/2006, the supporting documents are and will continue to be available for at least three years following the closure of the operational programme by the Commission (without prejudice to the special conditions laid down in Article 98(1) of that Regulation). Date: .. .. 20.. Name in capitals, stamp, position and signature of competent authority: … (1) Indicate the administrative instrument of designation in accordance with Article 58 of Regulation (EC) No 1198/2006 with any references and the date. (2) Reference date according to the Decision. (3) Total amount of eligible expenditure paid by beneficiaries. Text of image Statement of expenditure by priority axis: Interim payment Operational programme reference No (CCI No): … Member State: … Date of provisional closure of accounts: … Date of submission to the Commission: … Total certified eligible expenditure paid in regions eligible under the convergence objective: … Priority axis 2007-2015 Total amount of eligible expenditure paid by beneficiaries EFF contribution National contribution Priority axis 1 Priority axis 1: Total Priority axis 1: Total expenses relating to operations which have been subject to partial closure at 31/12/20 .. Priority axis 2 Priority axis 2: Total Priority axis 2: Total expenses relating to operations which have been subject to partial closure at 31/12/20 .. Priority axis 3 Priority axis 3: Total Priority axis 3: Total expenses relating to operations which have been subject to partial closure at 31/12/20 .. Priority axis 4 Priority axis 4: Total Priority axis 4: Total expenses relating to operations which have been subject to partial closure at 31/12/20 .. Priority axis 5 Priority axis 5: Total Priority axis 5: Total expenses relating to operations which have been subject to partial closure at 31/12/20 .. Grand total Grand total of expenses relating to operations which have been subject to partial closure (1) (1) Partial closure concerns operations completed as at 31 December of the year preceding the year of partial closure. The list of operations which have been subject to partial closure is made available to the Commission upon request. Text of image Total certified eligible expenditure paid in regions eligible under the non-convergence objective: … Priority axis 2007-2015 Total amount of eligible expenditure paid by beneficiaries EFF contribution National contribution Priority axis 1 Priority axis 1: Total Priority axis 1: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 2 Priority axis 2: Total Priority axis 2: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 3 Priority axis 3: Total Priority axis 3: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 4 Priority axis 4: Total Priority axis 4: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 5 Priority axis 5: Total Priority axis 5: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Grand total Grand total of expenses relating to operations which have been subject to partial closure at 31/12/20.. Text of image Breakdown by year of the total certified eligible expenditure paid in regions under the convergence objective (2): Amounts of expenditure (in euros) Grand total 2007-2015 2007 2008 2009 2010 2011 2012 2013 2014 2015 Breakdown by year of the total certified eligible expenditure paid in regions under the non-convergence objective (2): Amounts of expenditure (in euros) Grand total 2007-2015 2007 2008 2009 2010 2011 2012 2013 2014 2015 (2) By year: the breakdown mentioned in this table shall correspond to the payments made by the beneficiaries in the year concerned. Where it is not possible to establish this breakdown precisely, the best estimate of the breakdown must be given. Text of image APPLICATION FOR PAYMENT: Interim payment Member State: Operational programme reference No (CCI): Pursuant to Article 60 of Council Regulation (EC) No 1198/2006, I, the undersigned (name in capitals, stamp, position and signature of competent authority), hereby request that you pay by way of interim payment the sum of …: The amount requested has been calculated following the provisions of Article 76(1)/76(2) (1) of that Regulation. (EUR) Convergence objective Non-convergence objective EFF This application is admissible because: Delete as appropriate (a) no more than the maximum amount of assistance from the EFF as laid down in the decision of the Commission approving the operational programme has been paid by the Commission during the whole period for each priority axis; (b) the managing authority has submitted to the Commission the most recent annual report on implementation in accordance with Article 67 (1) and (3) of Regulation (EC) No 1198/2006. — has been submitted by the managing authority within the time limit laid down — is attached — is not due. (c) there is no reasoned opinion by the Commission in respect of an infringement under Article 226 of the Treaty, as regards the operation(s) for which the expenditure is declared in the application for payment. The payment shall be made by the Commission to the body designated by the Member State for the purposes of making payments Designated body Bank Bank account No Holder of account (where not the same as the designated body) Date .. .. 20 .. Name in capitals, stamp, position and signature of competent authority … (1) Delete as appropriate. If the Member State chooses the option provided for under Article 76(2) of Regulation (EC) No 1198/2006, it shall state the specific and proper reasons for this choice. PART B Certificate and statement of expenditure and application for final payment Text of image EUROPEAN COMMISSION European Fisheries Fund Certificate and statement of expenditure and payment application Member State: … Commission Decision … of … Commission reference (CCI) No: … Text of image CERTIFICATE I, the undersigned, representing the certifying authority designated by (1): hereby certify that all expenditure included in the attached statement complies with the criteria for eligibility of expenditure set out in Article 55 of Regulation (EC) No 1198/2006 and has been paid by the beneficiaries on the implementation of the operations selected under the operational programme in accordance with the conditions for granting of public contributions under Article 78 of that Regulation. after (2) .. .. 20.. and amounts to: EUR (3) (exact figure to two decimal places) The attached statement of expenditure, broken down by priority axis, is based on accounts provisionally closed on .. .. 20.. and forms an integral part of this certificate. I also certify that operations are progressing in pursuance with the objectives laid down in the Decision and in accordance with Regulation (EC) No 1198/2006, and in particular that: (1) the expenditure declared complies with the applicable Community and national rules and has been paid in respect of operations selected for funding in accordance with the criteria applicable to the operational programme and the applicable Community and national rules; (2) the statement of expenditure is accurate, results from reliable accounting systems and is based on verifiable supporting documents; (3) the underlying transactions are lawful and comply with the rules and the procedures have been followed satisfactorily; (4) the statement of expenditure and the payment application take account, where applicable, of any amounts recovered, any interest received and of revenue accruing from operations financed under the operational programme. (5) the breakdown of the underlying operations is recorded on computer files and is available to the relevant Commission departments on request. In accordance with Article 87 of Regulation (EC) No 1198/2006, the supporting documents are and will continue to be available for at least three years following the closure of the operational programme by the Commission (without prejudice to the special conditions laid down in Article 98(1) of that Regulation). Date: .. .. 20.. Name in capitals, stamp, position and signature of competent authority: … (1) Indicate the administrative instrument of designation in accordance with Article 58 of Regulation (EC) No 1198/2006 with any references and the date. (2) Reference date according to the Decision. (3) Total amount of eligible expenditure paid by beneficiaries. Text of image Statement of expenditure by priority axis: Payment of balance Operational programme reference No (CCI No): … Member State: … Date of final closure of accounts: … Date of submission to the Commission: … Total certified eligible expenditure paid in regions eligible under the convergence objective: … Priority axis 2007-2015 Total amount of eligible expenditure paid by beneficiaries EFF contribution National contribution Priority axis 1 Priority axis 1: Total Priority axis 1: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 2 Priority axis 2: Total Priority axis 2: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 3 Priority axis 3: Total Priority axis 3: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 4 Priority axis 4: Total Priority axis 4: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 5 Priority axis 5: Total Priority axis 5: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Grand total Grand total of expenses relating to operations which have been subject to partial closure (1) (1) Partial closure concerns operations completed as at 31 December of the year preceding the year of partial closure. The list of operations which have been subject to partial closure must be made available to the Commission upon request. Text of image Total certified eligible expenditure paid in regions eligible under the non-convergence objective: … Priority axis 2007-2015 Total eligible expenditure paid by beneficiaries EFF contribution National contribution Priority axis 1 Priority axis 1: Total Priority axis 1: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 2 Priority axis 2: Total Priority axis 2: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 3 Priority axis 3: Total Priority axis 3: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 4 Priority axis 4: Total Priority axis 4: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Priority axis 5 Priority axis 5: Total Priority axis 5: Total expenses relating to operations which have been subject to partial closure at 31/12/20.. Grand total Grand total of expenses relating to operations which have been subject to partial closure at 31/12/20.. (1) (1) Partial closure concerns operations completed as at 31 December of the year preceding the year of partial closure. The list of operations which have been subject to partial closure must be made available to the Commission upon request. Text of image Breakdown by year of the total certified eligible expenditure paid in regions eligible under the convergence objective (2): Amounts of expenditure (in EUR) Grand total 2007-2015. 2007 2008 2009 2010 2011 2012 2013 2014 2015 Breakdown by year of the total certified eligible expenditure paid in regions eligible under the Non-convergence objective (2): Amounts of expenditure (in EUR) Grand total 2007-2015. 2007 2008 2009 2010 2011 2012 2013 2014 2015 (2) By year: the breakdown mentioned in this table shall correspond to the payments paid by the beneficiaries in the year concerned. Where it is not possible to establish this breakdown precisely, the best estimate of the breakdown must be given. Text of image APPLICATION FOR PAYMENT: Payment of balance Member State: … Operational programme reference (CCI) No: … Pursuant to Article 60 of Regulation (EC) No 1198/2006, I, the undersigned (name in capitals, stamp, position and signature of competent authority), hereby request that you pay the sum of EUR … from EFF by way of final payment. (EUR) Convergence objective Non-convergence objective EFF This application is admissible because: Delete as appropriate (a) the final implementation report for the operational programmed under Article 67 of Regulation (EC) No 1198/2006 — has been submitted by the managing authority within the time limit laid down — is attached (b) a closure declaration referred to in Article 61(1)(f) of Regulation (EC) No 1198/2006. — has been submitted by the managing authority within the time limit laid down — is attached (c) there is no reasoned opinion by the Commission in respect of an infringement under Article 226 of the Treaty, as regards the operation(s) for which the expenditure is declared in the payment application in question The payment shall be made by the Commission to the body designated by the Member State for the purposes of making payments: Designated body Bank Bank account No Holder of account (where not the same as the designated body) Date .. .. 20.. Name in capitals, stamp, position and signature of competent authority: …