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8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A1
Proposal TENtec Nr.
Annual Call 2010 Priority 1Priority 2Priority 3
Multi-Annual Call 2010 RISMoS
G ENERAL I NFORMATION ON THE P ROPOSAL
Title of the proposed action
Priority/Horizontal project 00 Section (only for PP) 0000
Transport mode
Start date of the Action End date of the Action
Summary (up to 2000 characters)
Proposal type
Please select the proposal type:
StudyWork
For ERTMS proposals only:
Trackside equipmentOn board equipmentOther activities related toMoU implementation
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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2
Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A2.1
Proposal TENtec Nr. Applicant Nr
APPLICANT
Applicant's legal name
Administrative data
Legal address
Street name Number
Town / City
Postal Code / Cedex
Country
Legal status of the applicant
Please select the legal status of the applicant (see definitions in Annex 2 of the Guide for Applicants ).
Member State
Public sector body
European Economic Interest Grouping (EEIG)
Private undertaking or body
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A2.2
Proposal TENtec Nr. Applicant Nr
Contact points
Person in charge (the person who will be contacted by the E U in the first instance)
Family Name First name(s)
Function
Is the address different from the legal address (of section A2.1)? YES NO
Street name Number
Town / City
Postal code / Cedex
Country
Phone
FaxE-mail
Representative authorized to sign this application
Family Name First name(s)
Function
Is the address different from the legal address (of section A2.1)? YES NO
Street name Number
Town / City
Postal code / Cedex
Country
Phone
Fax
Date
Stamp + Signature
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A2.3
Proposal TENtec Nr. Applicant Nr
F INANCIAL IDENTIFICATION
Bank Account holder
Family name (1) First name(s)
Street name Number
Town / City
Postal code / Cedex
Country
Contact person
Family name First name(s)
Phone
Fax
Bank
Bank Name
Branch address
Street name Number
Town / City
Postal code / Cedex
Country
Account number
IBAN (2)
REMARKS:
BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE(Both Obligatory)(3)
DATE + SIGNATURE ACCOUNT HOLDER :(Obligatory)
Date:
(1) The name or title under which the account has been opened and not the name of the authorized agent(2) If the IBAN Code (International Bank account number) is applied in the country where your bank is situated(3) It is preferable to attach a copy of recent bank statement, in which event the stamp of the bank and thesignature of the bank's representative are not required. The signature of the account-holder is obligatory in allcases.
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A2.4
Proposal TENtec Nr. Applicant Nr
I F THE APPLICANT IS A M EMBER S TATE , FILL IN THE BELOW SECTION ON THE P UBLIC OR PRIVATE UNDERTAKING OR BODY ( IES ) WHICH WILL IMPLEMENT THE ACTION
Implementing body's legalname
Administrative data
Legal address
Street name Number
Town / City
Postal code / Cedex
Country
(*) If there are more than one implementing body, indicate them all.
I F THE APPLICANT IS A P UBLIC OR P RIVATE UNDERTAKING OR BODY , FILL IN THE BELOW SECTION ON
THE MINISTRY APPROVING THIS PROPOSAL
Ministry's legal name
Administrative data
Legal address
Street name Number
Town / CityPostal code / Cedex
Country
Representative authorized to sign this proposal
Family name First name(s)
Function
Is the address different from the legal address? YES NO
Street name Number
Town / City
Postal code / Cedex
Country
Phone
Fax
Date
Stamp (*) + Signature
(*) As foreseen by the Ministry concerned.
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A2.5
Proposal TENtec Nr.
C OORDINATING APPLICANT ( ONLY FOR APPLICATIONS WITH MORE THAN ONE APPLICANT )
Please, select the Legal Entity that will act as Coordinating Applicant
Legal Entity (Applicant or Implement ing Body) CoordinatingApplicant
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A3.1
Proposal TENtec Nr.
LOCATION OF THE ACTION
Member State(s)
Region(s) (1)
(1) NUTS 2 nomenclature will be used for the regions.
Geographical co-ordinates
DMS Format (2) DD Format (3)
Longitude Latitude Longitude Latitude
Start point: : : : Interim point 1 : : : :
« : : : :
Interim point n : : : :
End point : : : :
(2) DMS stands for Degrees, Minutes and Seconds.(3) DD stands for Decimal Degrees. In this case, longitude and latitude must be given in a seven digit number (+or - sign followed by three digits and four decimals).
ACTIVITIES OF THE ACTION
Activitynumber
ISICcode (3)
Activity name Startdate
Enddate
Verifyingmilestone
(3) For complete description and other codes, see: http://unstats.un.org/unsd/cr/registry/regcst.asp?Cl=17
M ILESTONES OF THE ACTION
Milestonenumber
Milestone name(including milestones at start and end date of the Action)
Expecteddate
Means of verification
C ONTRIBUTION OF THE ACTION TO THE TEN-T POLICY OBJECTIVES
If the Action is part of a Global Project previously supported under the TEN-T budget, please specify:
Decision number Title
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A3.2
Proposal TENtec Nr.
F INANCIAL INFORMATION
Global project
SOURCES OF FINANCING * Financial Contribution (in euros)
1. State budget (-s)
2. Regional/local budget
3. Project promoter (Public or Private)
4. EIB loan
5. Other loans
6. TEN financing
7. Other EU funds (ERDF, CF, FPR)
8. Other sources
Total
For multi-beneficiary projects, please give only the total amounts per category.
Proposed Action
SOURCES OF FINANCING (*) Totalfinancial
contribution
2007 2008 2009 2010 2011 2012 2013
1. State budget(s)
2. Regional/local budget(s)
3. Applicant's self-financing
4. EIB loan5. Other loans
6. TEN financing
7. Other EU funds
8. Other sources
Total
(*) contribution to eligible costs only
For multi-beneficiary actions, please split state, regional budgets and applicant's self-financing by applicant.
All amounts must be in euros.
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
Proposal TENtec Nr.
I NDICATIVE BREAKDOWN OF ESTIMATED ELIGIBLE COSTS OF THE P ROPOSED ACTION BY AC
Activities 2007 2008 2009 2010 2011
1.DIRECT COST
1.1 Activity 1
1.2 Activity 2
1.3 Activity 3
1.4 Activity 4
1.5 Activity 51.6 Activity 6
«.
1.N Activity N
SUBTOTAL DIRECT COST
2. INDIRECT COSTS (*)
TOTAL ELIGIBLE COST
Please give an indicative breakdown of the estimated eligible costs of the proposed Action (i.e. the action for which a financial cis requested in this proposal) by activity (as defined in section A3.1) and year (all amounts must be in euros).
(*) Costs which are not identifiable as direct costs, but which have nevertheless been incurred in connection with the eligible direshall satisfy the general criteria specified at article III.3.7.1 of the General Conditions and may be eligible for flat rate funding fixedcosts.
Applicants will be asked to explain the methodology used in determining the percentage of flat rate (between 0 and 7%) before c
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A3.4
Proposal TENtec Nr.
T ECHNICAL INFORMATION
Proposed Action
RailwaysCurrent Target
Year Value Year Value
Length of the section (km)
Number of tracks
Train length
Max speed (km/h)
Axle load
Inclination (deg)
Passenger capacity (persons)
Passenger traffic flow (pax per year)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Rail voltage (V)
Clearance or structure gauge
Voice system radio
Control and command system
RoadsCurrent Target
Year Value Year Value
Length of the section (km)Number of lanes per direction
Max speed (km/h)
Longitudinal gradient (deg)
Vehicles capacity per direction(vehicles/day)
Annual average daily traffic per lane(vehicles/day)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Percentage of heavy good vehicles (%)
Road toll (eur/km)
Number of fatal accidents
Electronic management system (Y/N)
AirportsCurrent Target
Year Value Year Value
Number of runways
Max frequency (movements per hour)
Passenger capacity (persons)
Passenger traffic flow (pax per year)
Freight capacity (t per year)
Freight traffic flow (ton-km per year)
Max size of aircraft
Electronic management system (Y/N)
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Air Traffic ManagementFunctional Airspace Blocks (FABs)
Current Target
Year Value Year Value
Number of FIRs in (proposed) FAB
Number ATM systems in use in(proposed) FAB
Number of ATCCs in (proposed) FABNumber of Sectors in (proposed) FAB
PortsCurrent Target
Year Value Year Value
Master plans (num ports)
Master plans (ha)
Master plans (t)
Breakwaters (km)
Breakwaters (m depth at entrance)
Dredged fairways and basins (m length)
Dredged fairways and basins (m wide)
Dredged fairways and basins (m of depth)
Maritime chamber lock (m wide x mlong)
Waterway connection (UN class)
Waterway connection (t)
Rail connection (num tracks)
Rail connection (t)
Road connection (num lanes)
Road connection (t)
Port terminals (m draught)
Port terminals (m quays)
Port terminals (ha)
Combined terminals (num rail tracks)
Combined terminals (ha)Passenger or cruise terminal (m2)
Passenger or cruise terminal (pass)
Freight capacity (t per year)
Port traffic (num vessels)
Electronic management system (which)
Inland WaterwaysCurrent Target
Year Value Year Value
Master plans (km)
Master plans (UN class)
Master plans (t)
Section (km)
Section (reaches)
Section (UN class)
Navigation reliability (draught)
Navigation reliability (days)
Navigation reliability (%)
IWW locks (num)
IWW chamber lock (m wide)
IWW chamber lock (m long)
Local bottleneck solved (num bridge or others)
Ports, transhipment or storage facilities(num)
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Ports, transhipment or storage facilities(tons)
Freight capacity (t per year)
Freight capacity (ton x km)
IWW traffic (vessels)
IWW traffic (vessels x km)
Electronic management system (which)
Motorways of the Sea(Corresponding component parts relating to the other modes (road, ports, IWW, rail) should be alsobe filled out for MoS actions)
Current Target
Year Value Year Value
Distance of maritime part of link (nm)
Vessels (type: cont or ro/ro)
Vessels (type: number)
Vessels (capacity: TEU or lm)
Traffic volume (t per year)
Frequency of departure (e.g.: 1/day)
Average vessel turn around time (hoursin ports per call)
Duration of action (number of years)
Total modal shift (ton/km)Total CO2 emissions
Electronic management system (which)
8/9/2019 Convocatoria 2010 Formulario de Aplicación - Parte A
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Application Form Part A EUROPEAN COMMISSION TRANS-EUROPEAN TRANSPORT NETWORK
A4
Proposal TENtec Nr.
Will an English translation be provided?
Project summary-Application
N/A (i.e. proposal submitted in English)YesNo
Application Form Part B1
N/A (i.e. proposal submitted in English)
YesNo
Application Form Part B2
N/A (i.e. proposal submitted in English)Yes
No
Annexes
N/A (i.e. proposal submitted in English)
YesNo
Translation cost
If you will submit an English translation of theproposal, please give an estimate of the total of the cost of the translation.
¼