Annex I
Grant Application Form
The application form must be filled up duly in reference to the applicants existing system requirement.
The application submitted beyond the specified time will not be considered in the industry selection
process. The applicant has to submit both electronic as well as hard copy of the application form.
1.0 General Information
Project Title:
Project Type Piloting of new and innovative technologies/ideas
Technology Focus Solar Thermal
Broad Objectives:
Problem statement(s):
Research Question(s): (if applicable)
Hypothesis: (if applicable)
Summary:
Max: One Paragraph
Total Estimated Cost for the project (NPR):
Individual/Organizational or any third party contributions (attach budgetary details)
Name Contact Details Contributions in NPR
Total Cost requested (NPR)
Project Duration:
Implementing Agency:
Name of Lead applicant/Organization
1.2 Date of establishment
1.3 Complete postal address
VDC/Municipality Phone number
District Email
Zone Fax Number
Website
1.4 Name of the Team Members (with CVs)
Expected outcome & project Beneficiary (s)
2. Detail Information
2.1 Objectives (Objectives Briefly outline your organization's objectives or Individual Long term
Goals)
2.2 Major achievements (Outline any major achievements accomplished during the past 3 years)
3. Detailed Information on Project Proposal
3.1 Project justification (Attach separate sheet(s) if required)
3.2 Background of beneficiary (ies) (Attach separate sheet(s) if required)
3.3 General objectives (Attach separate sheet(s) if required)
3.4 Specific objectives (Attach separate sheet(s) if required)
3.5 Envisaged Work/Business Plan and timeline for activities to be carried out (Attach separate
sheet(s) if required)
3.6 NRREP Alignment (Please describe direct/indirect benefits that your project will contribute to
NRREP’s objectives)
3.7 Implementation and Reporting Timeline
3. Detailed Information on Technology promotion
Industry/Service scale (Small/Medium/Large)
Requirement of application (process heat/ laundry/
any other)
Heat requirement for application in the form (Steam,
Hot Air, Pressurized hot water, any other)
Required temperature and pressure of useful heat
Existing arrangement for such application
(Boiler/LPG/Biomass/Any others)
Fuel being used in existing system
Present fuel consumption per year
Expected fuel saving from the CSP installation
Available shadow free area during 9 A.M. to 4 P.M.
for solar system (sq. m.) installation
Distance of utility point from solar site
Whether solar system proposed, will be integrated
with existing boiler/heating arrangement or it will be
a standalone system
Is the CSP feasibility study done before for the
industry?
Name, address and contact number of supplier identified for installation of the system
Details of the Project Report (DPR) prepared by the identified supplier (Report will include the
technical specifications of various components and their life period)
Expected outcome from proposed installation in
terms of fuel savings & heat delivery with detailed
energy calculations (Attach separate sheet(s) if
required)
Proposed means of balance financing (Attach
separate sheet(s) if required)
Commitments from the beneficiary
i) We will bear the remaining cost apart from the AEPC
ii) We will not dismantle the system at any stage without prior written permission of AEPC
iii) We will regularly use and properly maintain the system and submit quarterly performance report for
a minimum period of one year from the date of installation through implementing agency.
iv) We will take Annual Maintenance contract for a period of at least 2-5 years after completion of the
warranty period from manufacturers or get our people trained for successful functioning of the system.
(v) We will make the installed system available for any time visit from AEPC in future for the purpose
of study tours, exposure visits or any other research and development activities.
_________________________________
Authorized Signature
Name:
Designation:
Stamp:
N.B.: The application must be submitted with the signature of authorized person along with
office seal and documents mentioned in RFP in 5.4.
