OFFICIAL , THE WORLD BANK DOCUMENTS IBRD - IDA [ WORLD BANKGROUP 176/20 2020 H.E. Michel Patrick Boisvert Ministre de l'Economie et des Finances Minist&re de I'Economie et des Finances Palais des Minist&res 5, Avenue Charles Sumner/Turgeau Port-au-Prince Republique d'Hafti Re: IDA Grant IDA D601 -HT (Haiti COVID-19 Response Project) Additional Instructions: Disbursement and Financial Information Letter. Excellency: I refer to the Financing Agreement between REPUBLIC OF HAITI (the "Recipient") and the International Development Association (the "Association") for the above-referenced Project. The General Conditions, as defined in the Financing Agreement, provide that the Recipient may from time to time request withdrawals of Grant amounts from the Grant Account in accordance with the Disbursement and Financial Information Letter, and such additional instructions as the Association may specify from time to time by notice to the Recipient. The General Conditions also provide that the Disbursement and Financial Information Letter may set out Project specific financial reporting requirements. This letter constitutes such Disbursement and Financial Information Letter ("DFIL") and, may be revised from time to time. I. Disbursement Arrangements, Withdrawal of Grant' Funds, and Reporting of Uses of Grant Funds. The Disbursement Guidelines for Investment Project Financing, dated February 2017, ("Disbursement Guidelines") are available in the Association's public website at https:w or and its secure website "Client Connection" at hutps:.clienteennection,worlbank.ory. The Disbursement Guidelines are an integral part of the DFIL, and the manner in which the provisions in the guidelines apply to the Grant is specified below. (i) Disbursement Arrangements * (ii) General Provisions (Schedule 1). The table in Schedule I sets out the disbursement methods which may be used by the Recipient, and conditions, information on registration of authorized signatures, processing of withdrawal applications (including minimum value of applications and processing of advances), instructions on supporting documentation, and frequency of reporting on the Designated Account. * Special Provision. Projects in situations of urgent need of assistance or capacity constraints: Disbursements under contracts for goods, works, non-consulting services and consulting services procured or selected through international open or limited competition or Direct Selection, as set out in the procurement plan, shall be made only through Direct Payment and/or Special Commitment disbursement methods. THE WORLD BANK IBRD - IDA WORLDBANKGROUP (ii) Electronic Delivery. Section 11.01 (c) of the General Conditions. The Recipient shall deliver Withdrawal Applications (with supporting documents) electronically through the Association's web-based portal "Client Connection" at htps: lienzoonneerion. rIdbanLkre This option shall be effected after the officials designated in writing by the Recipient who are authorized to sign and deliver Withdrawal Applications have registered as users of "Client Connection". The designated officials shall deliver Applications electronically by completing the Form 2380, which is accessible through "Client Connection". By signing the Authorized Signatory Letter, the Recipient confirms that it is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Association by electronic means. The Recipient may exercise the option of preparing and delivering Withdrawal Applications in paper form on exceptional cases (including those where the Recipient encounters legal limitations), and which were previously agreed with the Association. By designating officials to use SIDC and deliver the Applications electronically, the Recipient confirms through the authorized signatory letter its agreement to: (a) abide by the Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation, available in the Association's public website at him. w o-Jbank l and "Client Connection"; and (b) to cause such official to abide by those terms and conditions. II. Financial Reports and Audits. 'i,) Financial Reports. The Recipient shall prepare and furnish to the Association not later than forty-five 145) days after the end of each calendar quarter, interim unaudited financial reports ("IFR") for the Project covering the quarter. (ii) Audits. Each audit of the Financial Statements shall cover the period of one fiscal year of the Recipient, ommekcing with the fiscal year in which the first withdrawal was made. The audited Financial S.itements for each such period shall be furnished to the Association not later than six (6) months after the end of such period. III. Other Information For additional information on disbursement arrangements, please refer to the Loan Handbook available on the Association's website (http:www.worldbanLorg and "Client Connection". The Association recommends that you register as a user of "Client Connection". From this website you will be able to prepare and deliver Applications, monitor the near real-time status of the Grant, and retrieve related policy, financial, and procurement information. For more information about the website and registration arrangements, or if you have any queries in relation to the above, please contact the Association by email at AskLoan i WorldBank.orI using the above reference. i\ er Suarez Authorized Representative for Haiti Latin Adverica and the Caribbean THE WORLD BANK I WORLDBMNKGROUP Attachments 1. Form of Authorized Signatory Letter 2. Statement of Expenditure (SOE) 3. Designated Account Reconciliation Statement With copies: H.E. Michel Patrick Boisvert Ministre de I'Economie et des Finances Ministere de I'Economie et des Finances Palais des Minist&res 5, Avenue Charles Sumner/Turgeau Port-au-Prince Republique d'HaYti Unite de Gestion des Projets 10, Delmas 81 Port-au-Prince, Haiti wedner.pierre@ugp.ht _ _ i , , ._ Г -� у � � У � У f� �-' � ` � � � ' �,� у . N �,л � о а `' �~' ` � 71 - j I�.. р �.Л ,";: ш М i '3J у � 7Л �',��.�� У �-'3 '�. О 1 С У С ч. �i ,б . у ;) 1- у � � �' у ш� Е L`о с ' 1 сб 4- � �w�� '� -° и у� Q� � у� ;� с . 4, F • ь-� сУб � л� � �.1 . и � О у у ;,_, и .У I • . У+ vJ' .` .. �, � �� � ч-. у О Q � .. О .., '� � р] Q � ;�, (`1 . � I •'--, О . ., L и � � � � � • о С ,, у � :л , � �-' � r""'.. с�б У ��* � '� � о � У� F'� ,_ л� у I. �.� ,� 'ui r{� � У О о J г'-- � С=' 'о л>' р J��� ь+ . О С. - уi , ? .� .у-. у у � Т' 1 � ;J •. у С� � � ��'П, �,'`�J 7J 7l�;� у .���'�1 ^' � и ii г�. с�. 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' о л ... ,� о С '/] � � I � � J С .: � _ � ' _б � I цif� = у � у у У 1'� г, ` ���'л I,�; � У �; .`-��с с ю�� � 3 � у у II'; Е J_ у._ ��j. ` о�С ''�' �� г .�..., � s s� `� �'у i� � V � , � л :С у 1�i ^ J � - � `� .з I�I - �. � у л ,, �����. N ц� г✓ � 3 � Q �_ � У с у � r - �:, у � -� Э �.., �` с " � � z �_л � � � � ,J 'ti , J 3а �. в л . � рр � >м.,� . \ � � :_ L � i. 'у�'б J �' .- •v � `у Z` у й i.� а�:.'� ` О у J V Ci '"..С � Q Q J� "* < Z I �L С/а i._ Е-� � Q f1, �- ,{- _ � Attachment I - Form of Authorized Signatory Letter [Letterhead] Ministry of Finance [Street address] [City] [Country] [DATE] International Development Association 1818 H Street, N.W. Washington, D.C. 20433 United States of America Re: [Grant] [Credit]' No. - ([Name of the project]) Attention: Country Director I refer to the [Grant] [Credit] Agreement ("Agreement") between the International Development Association (the "Association ')[, acting as implementing of the ]2 and [name of recipient] (the "Recipient"), dated , providing the above [Grant] [Creditl. For the purposes of Section 2.03 of the General Conditions as defined in the Agreement, any 3[one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Recipient to sign applications for withdrawal [and applications for a special commitment] under this [Grant] [Credit]. For the purpose of delivering Applications to the Association, including by electronic means, 4[each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient, acting 5[individually] 6[jointly], to deliver Applications, and evidence in support thereof on the terms and conditions specified by the Association. I Instruction to the Recipient: use "Credit" or "Grant" as applicable. Please delete thisfootnote infinal letter that is sent to the Associations. Instruction to the Recipient: add text in line with the Grant Agreement if applicable; if not applicable delete it. Please delete thisfootnote infinal letter that is sent to the Associations 3 Instruction to the Recipient: stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete thisfootnote infinal letter that is sent to the Association. ' Instruction to the Recipient: stipulate if more than one person needs tojointly sign Applications, if so, please irldicate the actual number. Please delete thisfootnote infinal letter that is sent to the Association. 5 Instruction to the Recipient: use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete. Please delete thisfootnote infinal letter that is sent to the Association. 6 Instruction to the Recipient: use this bracket paly if several individuals mustjointly sign each Application; if this is not applicable, please delete. Please delete thisfootnote infinal letter that is sent to theAssociation. This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Association by electronic means. In full recognition that the Association shall rely upon such representations and warranties, including without limitation, the representations and warranties contained in the Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation ("Terms and Conditions of Use of SIDC"), the Recipient represents and warrants to the Association that it will cause such persons to abide by those terms and conditions. This Authorization replaces and supersedes any Authorization currently in the Association records with respect to this Agreement. [Name], [position] Specimen Signature: [Name], [position] Specimen Signature: [Name], [position] Specimen Signature: Yours truly, / signed / , � i � J1 1 L � I - ;б i у � I � � � aCi � � I � С � у � х к >, � о 1 I ^, � � I � - °� Z z Z Z �' гд б��i С � L ггl ,1 � с��б л�+ L�� � О Х� i `� U ;, � ш са � J i �у+ д I I G � � � � � L р„ � � � 1 у J г"- � С оо г- � �.� о.и Q s`r � � � 7�j � U Q О Q Q �_ _ � 1 С у С � ,L1 ' j �С% I � �. �• 7D с'-�' с�С Х 1 С � ¢ Сг1 � 1 I � � I � � � ¢ � F �. �д°- I о �� � � �. � � � � ; � , � у -� ^ �У � м 7 ll д� I 1 О ,v � Т F р "� ;б v.� � ¢ > ai � i � - _ > п. с3 гi.., � Гу U � ° U ¢ i °-. I I � а � о � Е � � � -у :� � � � 0 ; .� � � � � � � �:�� О о с. °' � J � Л i О и � � � i � � �¢ L од о С . _ У � � С I I у � р Е-� О I F � � а Q 1 ' � � п � v О'�.. I 1 =' Е °°- гп Л � � � и м � L (, ai 511 О N� � � С � Qи �'� �L о ,� � 3 т , я 1 J� � � Л с � ^� I ,Yi ' р � 3 v' ' 7� � у = � •= ?� � Г 1 � �=� . у гу- '3" > as..+ й =�-' о�х �� � 1 z � � . i , _.i.. и I ^� F I - L1 сб й z � i Attachment 3 - Form of Designated Account Reconciliation Statement DESIGNATED ACCOUNT RJECONCILIATION STATEMENT LOAN/CREDIT/PPF/COFINANCIER NUMBER ACCOUNT NUMBER - - WITH (BANK) I TOTAL ADVANCED BY WORLD BANK (OR COFINANCIER) US$/EUR 2 LESS: TOTAL AMOUNT RECOVERED BY WORLD BANK US$/EUR 3. EQUALS PRESENT OUTSTANDING AMOUNT ADVANCED TO THE DESIGNATED ACCOUNT (NUMBER I LESS NUMBER 2) US$/EUR 4. BALANCE OF DESIGNATED ACCOUNT PER ATTACHED BANK STATEMENT AS OF DATE US$/EUR 5. PLUS: TOTAL AMOUNT CLAIMED IN THIS APPLICATION NO. + US$/EUR 6. PLUS: TOTAL AMOUNT WITHDRAWN AND NOT YET CLAIMED REASON: + US$/EUR 7. PLUS: AMOUNTS CLAIMED IN PREVIOUS APPLICATIONS NOT YET CREDITED AT DATE OF BANK STATEMENTS APPLICATION NO. AMOUNT SUBTOTAL OF PREVIOUS APPLICATIONS NOT YET CREDITED + US$/EUR 8. MINUS: INTER-EST EARNED - US$/EUR 9. TOTAL ADVANCE ACCOUNTED FOR (NO. 4 THROUGH NO. 9) - US$/EUR 10. EXPLANATION OF ANY DIFFERENCE BETWEEN THE TOTALS APPEARING ON LINES 3 AND 9: 11. DATE SIGNATURE: TITLE: