Part D
	Cost Statement Summary (National Currency/ECU)

for the period from ______________ to ______________    (reporting period no. _____)              Cost basis:  ______________

Project Title:
Contract No.:
Name of Contractor/Associated Contractor:			to
National Currency in which accounts kept:        Exchange rate used for conversion from national currency to ECU:

Categories of Cost		Amount for the period
National Currency			  ECU		
Direct Costs

	1.	Personnel
	2.	Equipment
	3.	Third party assistance
	4.	Travel and subsistence
	5.	Consumables and computing
	6.	Other significant specific Project costs

										Subtotal of direct costs	

		
 			
Indirect Costs

	7.	Overheads

Adjustments

	8.	Adjustments to costs previously reported

VAT

					Total:

			....% contribution of Commission:			

Contractor's Certificate

We certify that
‑ the above costs are derived from the resources employed which were necessary for the work under the contract, 
‑ such costs have been incurred and fall within the definition of allowable costs specified in the contract, 
‑ any necessary permissions of the Commission have been obtained and
‑ full supporting documentation to justify the costs is available for audit.

We certify that any necessary adjustments, for any reason, to costs reported in previous cost statements have been incorporated in the above statement.14

Date:										Date:

Name of Technical Manager:			Name of Financial Officer:

Signature of Technical Manager:			Signature of Financial Officer:

	COST STATEMENT: DETAILS BY CATEGORY (National Currency)

for the period from________________________________to_____________________________

Contract No.:				Name of Contractor/Associated Contractor:

Currency:

	PERSONNEL AND OVERHEADS

	Category
	A	
	No. of Man Hours
	B		Hourly
	Personnel Rate
	C		Hourly
	Overhead Rate
	D		Personnel
	Amount
	Col. (B) x (C)		Overheads
	Amount
	Col. (B) x (D)	

				

		
			
	Subtotals	

				Total
	(personnel + 	overheads)	

	EQUIPMENT

	Description		Date of Purchase		Cost		Depreciation period
	36/60 months		% Allocation
	to Project		Amount21	

						
			
	Total		

	OTHER SIGNIFICANT SPECIFIC Project COSTS

	Description		Amount	

		

	Total	

	SUMMARY COST STATEMENT FROM COORDINATOR/NOMINATED PERSON (ECU)

for the period from ______________________________to_____________________________

Project Title:

Contract No.:

	Name of Participant		Status		Total Costs
	(ECU)		EC Contribution (ECU)
		Cost Basis		Remarks	

						

				
	         TOTAL					

The signed original copy of each participant cost statement is attached.

Confirmed by Nominated Person(s) on behalf of the Contractors as reasonable for the work under the contract.

Name:28						Name:28

Status:						Status:

Signature:					Signature:

Date:							Date:

a.	Include if appropriate.
b.	Programme variable.
c.	Programme variable; if specified in Annex I, delete remainder of Article 6 which follows.
d.	Specific conditions are programme/project variable.