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Project Evaluation Forms for PPP as of 06 April 2015
ICC evaluation forms for PPP
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Project Evaluation Forms for Public-Private Partnership
PPP-PE Form No. 1
General Information
1. Project Title
2. Description of Project
3. Sectoral Linkages
4. Project linkages with the national and regional development thrusts, goals, gender and development
and the environment
5. Project Location
6. Proposed scheme and length of concession/cooperation period
As of 6 April 2015
7. Total Project Costs
P_______________
a. Foreign Exchange Cost
b. Local Component
P_______________
P_______________
8. Implementation Schedule/Processing Schedule
Processing
Project Approval
Contract Award
Phase/Stage
Exchange Rate______________
Target Date
Start of Construction (Month/Year)
I
____________________________
II
____________________________
III
Target Date for Completion of
Construction (Month/Year)
____________________________
9. Estimated Economic Life of Project: ____________________years
10. Sponsoring National Government Agency(ies)/ Government-Owned or- Controlled Corporation(s)/
Local Government Unit(s)
a.
b.
c.
11. Project Proponent (Composition)1
a.
b.
c.
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
________________________
________________________
________________________
________________________
1
The proposed contractual structure should be attached to guide the ICC of the relationship between and among the financier ,
operator, contractor, supplier and other members of the project consortium.
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP- PE Form No. 2
Estimated Project Cost
The costs should be expressed in constant and current costs. Likewise, the assumptions for said costs, i.e.
base year, inflation rate etc. must be indicated.
Year 0
Year 1
Year 2
Year N Total
1. Development Costs
2. Detailed Engineering Design Costs
3. Financing Costs
4. Civil Works
a. Equipment/Machineries
Foreign Exchange Costs
Local Costs
b. Materials/Supplies
Foreign Exchange Costs
Local Costs
c. Labor Costs
c.1 Supervision and Consultancy Fees
Foreign Exchange Costs
Local Costs
c.2 Laborers
Local Costs (skilled)
(unskilled)
d.
Machinery/Equipment
Foreign Exchange Costs
Local Costs
5. Land Acquisition Costs
6. Other Investment Phase Costs
(Specify)
Foreign Exchange Costs
Local Costs
7. Total Costs (1-6)
8. Total Foreign Exchange Costs
9. Total Local Costs
10. Subsidies
What are the subsidized items?
Working capital (accounts receivables/payables, cash balances)
Depreciation (economic life, depreciation rate)
Taxes and subsidies
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
________________________
________________________
________________________
________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP-PE Forms No. 3
Project Revenue
Project revenues/tariffs
a.
b.
c.
Year
Revenue/
Tariff1
Revenue/
Tariff 2
Revenue/
Tariff N
Total Revenues
1
2
3
4
5
N
Assumptions:
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP- PE Form No. 4a
Estimated Financial Revenues and Costs
I.
Project revenues
Year
Revenue1
1
2
3
4
…
N
II.
Year
1
2
3
4
…
N
Revenue2
RevenueN
Total Revenue
Cost2
CostN
Total Cost
Project costs
Cost1
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP- PE Form No. 4b
Estimated Economic Benefits and Costs
I.
Year
1
2
3
4
…
N
Project benefits
Benefits1
II.
Year
1
2
3
4
…
N
Project costs
Cost1
Benefits2
BenefitsN
Total Benefit
Cost2
CostN
Total Cost
1. Assumptions:
2. Indicate other benefits that may not be translated into monetary term, e.g. benefits that can only be
expressed in terms of quantity or percentage. Likewise, identify and enumerate unquantifiable project
benefits.
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP-PE Form No. 5
Risk Allocation Matrix
Nature of Risk
Government
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
Private Sector
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP-PE Form No. 6
Logical Framework
Project Title:
_____________________________________________________________________________________
Indicator/Targets
Means of Verification
Key Assumptions/Risks
1. Goal
2. Purpose
3. Outputs
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP-PE Form No. 7
Project and Financing Milestones
Project Title: ___________________________
Agency: ______________________________
A. Pre-Investment Phase
Activity
1. Project concept/identification
2. Inclusion in PIP/CIIP
3. Project definition or preparation
4. Project Approval
GOP Approval
a. Submission of requirements by Implementing Agency
(including respective mother agency/department level
endorsement or bureaus/attached agencies)
i. Feasibility Study
ii. Project Proposal
iii. Accomplished ICC Project Evaluation Forms (1-8)
iv. ICC Project Evaluation Matrix
v. Project context in the Department’s overall national
strategy and programs2
vi. DBM-certified budget strategy
vii. RDC endorsements
viii. Environmental Compliance Certificate/Certificate
of Non-Coverage
ix. ROW acquisition and resettlement action plan with
budget cover
x. DOF-CAG review (for GOCC and GFI projects)
xi. Information on job creation/employment impact of
the project
xii. Endorsements from other concerned agencies
xiii. Location Map
xiv. Advance Procurement Activities3
Consulting Services
Preparation of TOR and cost-estimates
Advertising
Completion of the consultant short-list and RFP
Issuance of RFP
Receipt of proposals
Evaluation of technical and financial proposals
Target Schedule
Yes/No
Yes/No
Consulting Services
Contract 1 Contract 2
Contract 3
Contract 4
Contract 5
Goods/Civil Works
2
Refers to the overview of the concerned Department’s national strategy and programs, including overall development outcomes,
timelines and investment requirements; and the specific link of the proposed project outputs, timelines and investment
requirements to achieve the Department’s national strategy and programs.
3
Advance procurement is the conduct of procurement activities starting from procurement planning up conduct of bidding (short
of notice of award), prior to effectiveness of the project financing agreement. APAs for ODA-assisted projects may be initiated
immediately after project appraisal by the development partner in accordance with the procedures agreed between the
development partner and the government. Per DBM Circular Letter No. 2010-9 (dated 30 December 2010, paragraph 5.5),
“procuring entities, even without the receipt of allotment issued by DBM should proceed with the procurement processes, starting
from procurement planning up to the conduct of bidding”.
As of 6 April 2015
Preparation of technical specifications and bidding
documents
Advertising
Pre-qualification of bidders
Issuance of Bidding documents
Bid opening
Evaluation of technical and financial proposals
Goods/Civil Works
Contract 1 Contract 2
Contract 3
Contract 4
Contract 5
b. ICC Technical Working Group review
c. ICC Cabinet Committee review
d. NEDA Board confirmation of ICC approval
Development Partner Activities (for hybrid ODA and PPP
projects)
a. Development Partner review of proposals
b. Appraisal Mission
c. Development Partner review of Appraisal Mission
report
d. Development Partner issuance of pledge
e. Acceptance by Philippine Government of pledge
f. Development Partner Approval of the Project Financing
Project Financing
a. Monetary Board Approval in Principle
b. DBM Issuance of Forward Obligational Authority
c. Technical Discussion/Loan Negotiations (DOFIFG/BSP-ID/DOJ)
d. Issuance of Full Powers
e. Signing of Loan Agreement and Exchange of Notes
f. Monetary Board Final Approval (DOF-IFG/BSP-ID)
g. DOJ Legal Opinion
5.
6.
B. Investment Phase
Activity
Detailed engineering/design
Procurement Milestones
Consulting Services
Target Schedule
Consulting Services
Contract 1
Contract 2
Contract 3
Contract 4
Contract 5
Goods/Civil Works
Contract 1
Contract 2
Contract 3
Contract 4
Contract 5
Preparation of TOR and cost-estimates
Advertising
Completion of the consultant short-list and RFP
Issuance of RFP
Receipt of proposals
Evaluation of technical and financial proposals
Contract award
Issuance of Notice to Proceed
Goods/Civil Works
Preparation of technical specifications and bidding
documents
Advertising
Pre-qualification of bidders
Issuance of Bidding documents
Bid opening
Evaluation of technical and financial proposals
Contract award
As of 6 April 2015
7.
Issuance of the Notice to Proceed
Project implementation
a. Loan/Grant
Effectivity Date
Closing Date
b. Physical Implementation
Start Date
Closing Date
C. Post-Investment Phase
Activity
8. Preparation of Project Completion Report
9. Start of O&M
10. Conduct of Ex-Post Evaluation
Target Schedule
Prepared by: __________________________ Date: _________
(Signature over printed name)
Approved by: __________________________ Date: _________
(Signature over printed name)
As of 6 April 2015
Project Evaluation Forms for Public-Private Partnership
PPP-PE Form No. 8
Maximum Government Exposure
Proposed Government Undertaking and Contingent Liabilities
Proposed
Government Undertaking
ROW
Resettlement
Tariff Subsidy
National Taxes, Duties and
Charges
Local Taxes, Fees and Charges
Government Supported
Enhancements
Costs Sharing
Contingent Liability
Prepared by:
Telephone Number:
Office Address:
Date Prepared:
__________________________
__________________________
__________________________
__________________________
As of 6 April 2015
