Financial Statement on Income and Expenditures for Funds Received from the

1st Instalment Fixed date report 2nd Instalment 3rd Instalment Final report Expenditure
Balance available as of XX.XX.20XX $ 28,569.00 $ 753,879.20 (Pls move this column if $ 565,409.40 $ 565,409.40 $ 1,856,129.00
fixed date report falls
after the 2nd or 3rd
instalment)

For final report only

Interest Income $ -
Miscellaneous Income (if any) $ -

Current balance / final balance: $ 28,569.00

Approved 1st Instalment % Fixed date report % 2nd Instalment % 3rd Instalment % Final Report % Balance %
Budget expenditure expenditure expenditure

A. Staff and Other Personnel Costs $ 25,200.00 $ 11,000.00 43.7% $ 88,000.00 349.2% #REF! #REF! #REF! #REF! $ 24,000.00 95.2% $ 1,200.00 4.8%

B. Supplies, Commodities, Materials (Programme Inputs) $ 1,260,000.00 $ 520,000.00 41.3% $ 340,000.00 27.0% #REF! #REF! #REF! #REF! $ 1,240,000.00 98.4% $ 20,000.00 1.6%

C. Equipment $ 1,600.00 $ 1,000.00 62.5% $ 1,200.00 75.0% #REF! #REF! #REF! #REF! $ 1,600.00 100.0% $ - 0.0%

D. Contractual Services $ 42,000.00 $ 19,000.00 45.2% $ 24,000.00 57.1% #REF! #REF! #REF! #REF! $ 39,500.00 94.0% $ 2,500.00 6.0%

E. Travel $ 5,400.00 $ 2,000.00 37.0% $ 4,000.00 74.1% #REF! #REF! #REF! #REF! $ 5,400.00 100.0% $ - 0.0%

F. Transfers and Grants to Counterparts $ 423,000.00 $ 140,000.00 33.1% $ 180,000.00 42.6% #REF! #REF! #REF! #REF! $ 420,000.00 99.3% $ 3,000.00 0.7%

G. General Operating and Other Direct Costs $ 4,200.00 $ 1,500.00 35.7% $ 3,000.00 71.4% #REF! #REF! #REF! #REF! $ 4,200.00 100.0% $ - 0.0%

Subtotal Direct Project Costs $ 1,761,400.00 $ 694,500.00 $ 640,200.00 36.3% #REF! #REF! $ 1,734,700.00 $ 26,700.00 1.5%

Indirect Programme Support Costs (PSC) $ 123,298.00 $ 48,615.00 $ 44,814.00 36.3% #REF! #REF! $ 121,429.00 $ 1,869.00 1.5%
(max. 7%)
Total CBPF Project Cost $ 1,884,698.00 $ 743,115.00 39% $ 685,014.00 36.3% #REF! #REF! #REF! #REF! $ 1,856,129.00 98.5% $ 28,569.00 1.5%

Balance available as of [XX.XX.XXXX] $ 10,764.20 $ 68,865.20 #REF! #REF! $ 28,569.00 $ 28,569.00

Rate of cumulative expenditure versus total paid instalment 99% 91% #REF! #REF! 98.5%

Certification by Implementing Partner:

This is to certify that the above statement of income and expenditure (hereinafter referred to as "financial statement") has been generated through the Grants Management System (hereinafter referred to as "GMS"), and is a true representation of the income and expenditure for the corresponding
project and project budget.
Name:
Title:

Signature Date Stamp

With the submission of the financial report for the utilization of the advance, I am requesting the release of the subsequent instalment of US $XX,XXX.XX.

Name:
Title:

Signature Date Stamp

Approved by the OCHA

Name:
Title:

Signature Date
 Project title:
Project code:
Implementing partner:
Country:
Project period:

Country-based Pooled Funds (CBPFs) Project Budget Tool

· Please use the template without modifying the section headings, guidance and formula. Wherever possible and relevant, please provide sufficiently detailed breakdown of each line item. Where breakdown
of unit, quantity and unit cost is unavailable or unnecessary, please enter total amount of the item, along with sufficient description of cost content. Please add additional rows as needed, and ensure that the
formula is carried over and the subtotal of the budget category includes the added rows.
· All unit costs and total costs should be rounded to a maximum of 2 decimal places (e.g. 0.00).
· For further guidance on budget preparation, please refer to Chapter 6. Administration of CBPF Financial Resources of the CBPF Global Guidelines.

Budget Items Budget Narratives Unit Quantity Unit Cost (USD) Duration Duration Unit % Charged to Total (USD)
CBPF
I. Direct Project Costs
A. Staff and Other Personnel Costs (please itemize costs of staff, consultants and other personnel to be recruited directly by the implementing partner for project implementation. Please indicate
international
Example or national staff,
A1. Programme Officerlevel, title,One
number, unit
xx level cost, duration
programme and@percentage
officer $3,000 percharged to50%
month at CBPFcost
for each personnel
1 or each
$ group of same personnel.)
3,000.00 12 Months 50% $ 18,000.00
sharing for 12 months to monitor food distribution at location xxxx.

Example A2. Warehouse security 6 warehouse security guards at location xxx to undertake xxxx @ 6 $ 1,000.00 12 Months 10% $ 7,200.00
guards $1,000 per month at 10% cost sharing for 12 months
$ -
$ -
Sub-Total A: —— —— —— $ 25,200.00
B. Supplies, Commodities, Materials (Programme Inputs) (please itemize the costs of consumables to be purchased under the project, including associated transportation, freight, storage and distribution
costs) B1. Cereals
Example Procurement of 2,000 MT cereals at $300 per MT for xxx beneficiaries 2000 $ 300.00 1 n/a 100% $ 600,000.00
at xxx location
Example B2. Transportation costs - Transportation costs for the cereals at 10% of purchase value 2000 $ 30.00 1 n/a 100% $ 60,000.00
cereals
Example B3. Cash transfer One-time cash transfer directly implemented by [main IP name] to 500 500 $ 100.00 12 Months 100% $ 600,000.00
beneficiaries at location xxxx at $100 per beneficiary per month for 12
months

$ -
Sub-Total B: —— —— —— $ 1,260,000.00
C. Equipment (please itemize the costs of non-consumables to be purchased under the project)
Example C1. laptop Procurement of 2 Lenovo xxxx laptops at $800 each for IDP registration 2 $ 800.00 1 n/a 100% $ 1,600.00
at xxxx center
C2. xxxxx $ -
$ -
$ -
Sub-Total C: —— —— —— $ 1,600.00
D. Contractual Services (please list the works and services of commercial nature to be contracted under the project)
Example D1. Quality inspection service XXXX [name of contractor]'s quality inspection service at location xxx 800 $ 40.00 1 n/a 100% $ 32,000.00
(cereals) by xxxx [name of contractor] for 800 MT of cereals at $40 per MT
Example D2. Cash transfer process fee Contractual service fees to xxx financial service provider for processing 10000 $ 1.00 1 n/a 100% $ 10,000.00
by xxx [name of contractor] cash transfer to 10,000 beneficiaries at $1 per transaction

$ -
$ -
Sub-Total D: —— —— —— $ 42,000.00
E. Travel (please itemize the travel costs of staff, consultants and other personnel for project implementation)
Example E1. Airfare for food Airfare at $400 each for 3 staff to undertake 2 domestic trips each from 6 $ 400.00 1 n/a 100% $ 2,400.00
distribution monitoring trip location A to location B to monitor food distribution
Example E2. DSA for food distribution DSA at $100 per day and 5 days per trip for 3 staff to undertake 2 6 $ 100.00 5 Days 100% $ 3,000.00
monitoring trip domestic trips each from location xx to location xx to monitor food
distribution

$ -
$ -
Sub-Total E: —— —— —— $ 5,400.00
F. Transfers and Grants to Counterparts (please list transfers and sub-grants to project implementing partners)
Example F1. National NGO xxx mobile Deployment of 2 mobile health clinics at $10,000 per month for 6 2 $ 10,000.00 6 Months 100% $ 120,000.00
clinics months to location xxx (please see further cost breakdown attached)

Example F2. National NGO xxx: Cash
transfer
Cash transfer to 1,000 households in location A and B, including: (a) 1 $ 303,000.00 1 100% $ 303,000.00
cash transfer of $100 per household per month for 1,000 household
and 3 months, and (b) cash distribution costs at $1 per transaction for
3,000 transactions (1,000 households, with 1 transaction per
household per month for 3 months), $100*1,000 HH * 3 mos +
$1*3,000 transactions = $303,000

$ -
$ -
Sub-Total F: —— —— —— $ 423,000.00
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project implementation)
Example G1. Office rental Office rental at location xxx at $2,000 per month for 3 months, CBPF 1 $ 2,000.00 3 Months 50% $ 3,000.00
shares 50%
Example G2. Communication cost Communication cost of 2 mobile phones for programme officers @ 2 $ 100.00 12 Months 50% $ 1,200.00
$100 per month for 12 months, CBPF shares 50%
$ -
$ -
Sub-Total G: —— —— —— $ 4,200.00
Subtotal Direct Project Costs $ 1,761,400.00
II. Indirect Programme Support Costs (PSC)
PSC rate (insert a percentage not exceeding 7 per cent) 7.00%
PSC Amount $ 123,298.00
Total CBPF Project Costs (Direct Project Costs + PSC) $ 1,884,698.00
 Country-based Pooled Funds (CBPFs) Project Budget Tool

· Please use the template without modifying the section headings, guidance and formula. Wherever possible and relevant, please provide sufficiently detailed breakdown of each line item. Where
breakdown of unit, quantity and unit cost is unavailable or unnecessary, please enter total amount of the item, along with sufficient description of cost content. Please add additional rows as needed,
and ensure that the formula is carried over and the subtotal of the budget category includes the added rows.
· All unit costs and total costs should be rounded to a maximum of 2 decimal places (e.g. 0.00).
· For further guidance on budget preparation, please refer to Chapter 6. Administration of CBPF Financial Resources of the CBPF Global Guidelines.

Budget Items Budget Narratives Unit Quantity Unit Cost Duration Duration % Charged Total (USD)
(USD) Unit to CBPF
A. Staff and Other Personnel Costs (Please itemize costs of staff, consultants and other personnel to be recruited directly by the implementing partner for project implementation. Please indicate
international or national staff, level, title, number, unit cost, duration and percentage charged to CBPF for each personnel or each group of same personnel.)
Example A1. Programme Officer One xx level programme officer @ $3,000 per month at 50% cost 1 $ 3,000.00 12 Months 50% $ 18,000.00
sharing for 12 months to monitor food distribution at location xxxx.

Example A2. Warehouse security guards 6 warehouse security guards at location xxx to undertake xxxx @ 6 $ 1,000.00 12 Months 10% $ 7,200.00
$1,000 per month at 10% cost sharing for 12 months
$ -
$ -
Sub-Total A: —— —— —— $ 25,200.00
B. Supplies, Commodities, Materials (Please itemize the costs of consumables to be purchased under the project, including associated transportation, freight, storage and distribution costs)
Example B1. Cereals Procurement of 2,000 MT cereals at $300 per MT for xxx 2000 $ 300.00 1 n/a 100% $ 600,000.00
beneficiaries at xxx location
Example B2. Transportation costs - cereals Transportation costs for the cereals at 10% of purchase value 2000 $ 30.00 1 n/a 100% $ 60,000.00
Example B3. Cash transfer One-time cash transfer directly implemented by [main IP name] to 500 $ 100.00 12 Months 100% $ 600,000.00
500 beneficiaries at location xxxx at $100 per beneficiary per month
for 12 months

$ -
Sub-Total B: —— —— —— $ 1,260,000.00
C. Equipment (Please itemize the costs of non-consumables to be purchased under the project.)
Example C1. laptop Procurement of 2 Lenovo xxxx laptops at $800 each for IDP 2 $ 800.00 1 n/a 100% $ 1,600.00
registration at xxxx center
$ -
$ -
$ -
Sub-Total C: —— —— —— $ 1,600.00
D. Contractual Services (Please list the works and services of commercial nature to be contracted under the project.)
Example D1. Quality inspection service XXXX [name of contractor]'s quality inspection service at location 800 $ 40.00 1 n/a 100% $ 32,000.00
(cereals) by xxxx [name of contractor] xxx for 800 MT of cereals at $40 per MT
Example D2. Cash transfer process fee by Contractual service fees to xxx financial service provider for 10000 $ 1.00 1 n/a 100% $ 10,000.00
xxx [name of contractor] processing cash transfer to 10,000 beneficiaries at $1 per
transaction

$ -
$ -
 Sub-Total D: —— —— —— $ 42,000.00
E. Travel (Please itemize the travel costs of staff, consultants and other personnel for project implementation.)
Example E1. Airfare for food distribution Airfare at $400 each for 3 staff to undertake 2 domestic trips each 6 $ 400.00 1 n/a 100% $ 2,400.00
monitoring trip from location A to location B to monitor food distribution
Example E2. DSA for food distribution DSA at $100 per day and 5 days per trip for 3 staff to undertake 2 6 $ 100.00 5 Days 100% $ 3,000.00
monitoring trip domestic trips each from location xx to location xx to monitor food
distribution

$ -
$ -
Sub-Total E: —— —— —— $ 5,400.00
F. Transfers and Grants to Counterparts (Please list transfers and sub-grants to project implementing partners.)
$ -
$ -
$ -
$ -
Sub-Total F: —— —— —— $ -
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project implementation)
Example G1. Office rental Office rental at location xxx at $2,000 per month for 3 months, CBPF 1 $ 2,000.00 3 Months 50% $ 3,000.00
shares 50%
Example G2. Communication cost Communication cost of 2 mobile phones for programme officers @ 2 $ 100.00 12 Months 50% $ 1,200.00
$100 per month for 12 months, CBPF shares 50%
$ -
$ -
Sub-Total G: —— —— —— $ 4,200.00
Total Direct Costs of Sub-partner $ 1,338,400.00

* Sub-partner's programme support costs (PSC) shall be agreed between the main partner and the sub-partner, and be entered under the PSC segment of the overall CBPF project budget in GMS.
 Project Title:
Project Code:
Implementing partner:
Country:
Project period:
Reporting period: From (project start To dd/mmm/yyyy
date) dd/mm/yyyy
Reporting date

Financial Report on 1st

Installment
Original budget Expenditure report
Budget Items Unit Quantity Unit Cost (USD) Duration Duration % Charged to Total (USD) Cumulative expenditure Remaining balance % of Comments and budget
Unit CBPF since project start date (US$) expenditure variation explanation
(USD) as of budget

I. Direct Project Costs

A. Staff and Other Personnel Costs (please itemize costs of staff, consultants and other personnel to be recruited directly by the implementing partner
for project implementation)
Example A1. Programme Officer 1 $3,000.00 12 Months 50% $ 18,000 $ 8,000 $ 10,000 44%
Example A2. Warehouse security guards 6 $1,000.00 12 Months 10% $ 7,200 $ 3,000 $ 4,200 42%
0 0 $0.00 0 0 0% $ - $ - #DIV/0!
0 0 $0.00 0 0 0% $ - $ - #DIV/0!
Sub-Total A: —— —— —— $ 25,200 $ 11,000 $ 14,200 43.7%
B. Supplies, Commodities, Materials (Programme Inputs) (please itemize direct and indirect costs of consumables to be purchased under the project,
including associated transportation, freight, storage and distribution costs)
Example B1. Cereals 2000 $300.00 1 n/a 1 $ 600,000 $ 300,000 $ 300,000 50%
Example B2. Transportation costs - cereals 2000 $30.00 1 n/a 1 $ 60,000 $ 20,000 $ 40,000 33%
Example B3. Cash transfer 500 $100.00 12 Months 1 $ 600,000 $ 200,000 $ 400,000 33%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total B: —— —— —— $ 1,260,000 $ 520,000 $ 740,000 41.3%
C. Equipment (please itemize costs of non-consumables to be purchased under the project)
Example C1. laptop 2 $800.00 1 n/a 1 $ 1,600 $ 1,000 $ 600 63%
C2. xxxxx 0 $0.00 0 0 0 $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total C: —— —— —— $ 1,600 $ 1,000 $ 600 62.5%
D. Contractual Services (please list works and services of commercial nature to be contracted under the project)
Example D1. Quality inspection service (cereals) 800 $40.00 1 n/a 1 $ 32,000 $ 10,000 $ 22,000 31%
by xxxx [name of contractor]
Example D2. Cash transfer process fee by xxx 10000 $1.00 1 n/a 1 $ 10,000 $ 9,000 $ 1,000 90%
[name of contractor]
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total D: —— —— —— $ 42,000 $ 19,000 $ 23,000 45.2%
E. Travel (please itemize travel costs of staff, consultants and other personnel for project implementation)
Example E1. Airfare for food distribution 6 $400.00 1 n/a 1 $ 2,400 $ 1,000 $ 1,400 42%
monitoring trip
Example E2. DSA for food distribution 6 $100.00 5 Days 1 $ 3,000 $ 1,000 $ 2,000 33%
monitoring trip
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total E: —— —— —— $ 5,400 $ 2,000 $ 3,400 37.0%
F. Transfers and Grants to Counterparts (please list transfers and sub-grants to project implementing partners)
Example F1. National NGO xxx mobile clinics 2 $10,000.00 6 Months 1 $ 120,000 $ 40,000 $ 80,000 33%
Example F2. National NGO xxx: Cash transfer 1 $303,000.00 1 0 1 $ 303,000 $ 100,000 $ 203,000 33%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total F: —— —— —— $ 423,000 $ 140,000 $ 283,000 33.1%
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project implementation)
Example G1. Office rental 1 $2,000.00 3 Months 0.5 $ 3,000 $ 1,000 $ 2,000 33%
Example G2. Communication cost 2 $100.00 12 Months 0.5 $ 1,200 $ 500 $ 700 42%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total G: —— —— —— $ 4,200 $ 1,500 $ 2,700 35.7%
Subtotal Direct Project Costs $ 1,761,400 $ 694,500 $ 1,066,900 39.4%
II. Indirect Programme Support Costs (PSC)
PSC rate (insert a percentage not exceeding 7 per cent) 7% 7% 7%
PSC Amount $123,298 $48,615 $74,683
Total CBPF Project Costs (Direct Project Costs + PSC) $1,884,698 $743,115 $1,141,583

This is to certify that the above statement of income and expenditure is correct and that expenditures correspond to the approved project and project budget for which funds have been received.

Name:
Title:

Signature Date Stamp

 Project title:
Project code:
Implementing partner:
Country:
Project period:
From (project start
Reporting period: date) dd/mm/yyyy To dd/mmm/yyyy

Reporting date

Financial Report on the 1st

Installment
Original budget Expenditure report
Budget Items Unit Quantity Unit Cost (USD) Duration Duration Unit % Charged to Total (USD) Cumulative expenditure Remaining balance % of expenditure as Comments and budget
CBPF since project start date (US$) of budget variation explanation
(US$)

I. Direct Project Costs

A. Staff and Other Personnel Costs (please itemize costs of staff, consultants and other personnel to be recruited directly by the implementing partner for
project implementation)
Example A1. Programme Officer 1 $3,000.00 12 Months 50% $ 18,000 $ 9,000 $ 9,000 50%
Example A2. Warehouse security guards 6 $1,000.00 12 Months 10% $ 7,200 $ 6,000 $ 1,200 83%
0 0 $0.00 0 0 0% $ - $ 65,000 $ (65,000) #DIV/0!
0 0 $0.00 0 0 0% $ - $ 8,000 $ (8,000) #DIV/0!
Sub-Total A: —— —— —— $ 25,200 $ 88,000 $ (62,800) 349.2%
B. Supplies, Commodities, Materials (Programme Inputs) (please itemize direct and indirect costs of consumables to be purchased under the project,
including associated transportation, freight, storage and distribution costs)
Example B1. Cereals 2000 $300.00 1 n/a 1 $ 600,000 $ 300,000 $ 300,000 50%
Example B2. Transportation costs - cereals 2000 $30.00 1 n/a 1 $ 60,000 $ 40,000 $ 20,000 67%
Example B3. Cash transfer 500 $100.00 12 Months 1 $ 600,000 $ - $ 600,000 0%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total B: —— —— —— $ 1,260,000 $ 340,000 $ 920,000 27.0%
C. Equipment (please itemize costs of non-consumables to be purchased under the project)
Example C1. laptop 2 $800.00 1 n/a 1 $ 1,600 $ 1,200 $ 400 75%
C2. xxxxx 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total C: —— —— —— $ 1,600 $ 1,200 $ 400 75.0%
D. Contractual Services (please list works and services of commercial nature to be contracted under the project)
Example D1. Quality inspection service 800 $40.00 1 n/a 1 $ 32,000 $ 15,000 $ 17,000 47%
(cereals) by xxxx [name of contractor]
Example D2. Cash transfer process fee by xxx 10000 $1.00 1 n/a 1 $ 10,000 $ 9,000 $ 1,000 90%
[name of contractor]
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total D: —— —— —— $ 42,000 $ 24,000 $ 18,000 57.1%
E. Travel (please itemize travel costs of staff, consultants and other personnel for project implementation)
Example E1. Airfare for food distribution 6 $400.00 1 n/a 1 $ 2,400 $ 2,000 $ 400 83%
monitoring trip
Example E2. DSA for food distribution 6 $100.00 5 Days 1 $ 3,000 $ 2,000 $ 1,000 67%
monitoring trip
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total E: —— —— —— $ 5,400 $ 4,000 $ 1,400 74.1%
F. Transfers and Grants to Counterparts (please list transfers and sub-grants to project implementing partners)
Example F1. National NGO xxx mobile clinics 2 $10,000.00 6 Months 1 $ 120,000 $ 80,000 $ 40,000 67%

Example F2. National NGO xxx: Cash transfer 1 $303,000.00 1 0 1 $ 303,000 $ 100,000 $ 203,000 33%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total F: —— —— —— $ 423,000 $ 180,000 $ 243,000 42.6%
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project implementation)
Example G1. Office rental 1 $2,000.00 3 Months 0.5 $ 3,000 $ 2,000 $ 1,000 67%
Example G2. Communication cost 2 $100.00 12 Months 0.5 $ 1,200 $ 1,000 $ 200 83%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total G: —— —— —— $ 4,200 $ 3,000 $ 1,200 71.4%
Subtotal Direct Project Costs $ 1,761,400 $ 640,200 $ 1,121,200 36.3%
II. Indirect Programme Support Costs (PSC)
PSC rate (insert a percentage not exceeding 7 per cent) 7% 7% 7%
PSC Amount $123,298 $44,814 $78,484
Total CBPF Project Costs (Direct Project Costs + PSC) $1,884,698 $685,014 $1,199,684

This is to certify that the above statement of income and expenditure is correct and that expenditures correspond to the approved project and project budget for which funds have been received.

Name:
Title:

Signature Date Stamp

 Project Title:
Project Code:
Implementing partner:
Country:
Project period:
Reporting period: From (project start date) To dd/mmm/yyyy
dd/mm/yyyy
Reporting date

Final Financial Report

Original budget Expenditure report
Budget Items Unit Quantity Unit Cost Duration Duration % Charged to Total (USD) Cumulative expenditure Remaining balance Remaining Comments and budget variation
(USD) Unit CBPF since project start date (US$) balance (%) explanation
(US$)

A. Staff and Other Personnel Costs (please itemize costs of staff, consultants and other personnel to be recruited directly by the
implementing partner for project implementation)
Example A1. Programme Officer 1 $3,000.00 12 Months 50% $ 18,000 $ 17,000 $ 1,000 6%
Example A2. Warehouse security guards 6 $1,000.00 12 Months 10% $ 7,200 $ 7,000 $ 200 3%
0 0 $0.00 0 0 0% $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0% $ - $ - $ - #DIV/0!
Sub-Total A: —— —— —— $ 25,200 $ 24,000 $ 1,200 5%
B. Supplies, Commodities, Materials (Programme Inputs) (please itemize direct and indirect costs of consumables to be purchased
under the project, including associated transportation, freight, storage and distribution costs)
Example B1. Cereals 2000 $300.00 1 n/a 1 $ 600,000 $ 600,000 $ - 0%
Example B2. Transportation costs - cereals 2000 $30.00 1 n/a 1 $ 60,000 $ 40,000 $ 20,000 33%
Example B3. Cash transfer 500 $100.00 12 Months 1 $ 600,000 $ 600,000 $ - 0%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total B: —— —— —— $ 1,260,000 $ 1,240,000 $ 20,000 2%
C. Equipment (please itemize costs of non-consumables to be purchased under the project)
Example C1. laptop 2 $800.00 1 n/a 1 $ 1,600 $ 1,600 $ - 0%
C2. xxxxx 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total C: —— —— —— $ 1,600 $ 1,600 $ - 0%
D. Contractual Services (please list works and services of commercial nature to be contracted under the project)
Example D1. Quality inspection service 800 $40.00 1 n/a 1 $ 32,000 $ 30,000 $ 2,000 6%
(cereals) by xxxx [name of contractor]
Example D2. Cash transfer process fee by xxx 10000 $1.00 1 n/a 1 $ 10,000 $ 9,500 $ 500 5%
[name of contractor]
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total D: —— —— —— $ 42,000 $ 39,500 $ 2,500 6%
E. Travel (please itemize travel costs of staff, consultants and other personnel for project implementation)
Example E1. Airfare for food distribution 6 $400.00 1 n/a 1 $ 2,400 $ 2,400 $ - 0%
monitoring trip
Example E2. DSA for food distribution 6 $100.00 5 Days 1 $ 3,000 $ 3,000 $ - 0%
monitoring trip
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total E: —— —— —— $ 5,400 $ 5,400 $ - 0%
F. Transfers and Grants to Counterparts (please list transfers and sub-grants to project implementing partners)
Example F1. National NGO xxx mobile clinics 2 $10,000.00 6 Months 1 $ 120,000 $ 120,000 $ - 0%

Example F2. National NGO xxx: Cash transfer 1 $303,000.00 1 0 1 $ 303,000 $ 300,000 $ 3,000 1%

0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total F: —— —— —— $ 423,000 $ 420,000 $ 3,000 1%
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project
implementation)
Example G1. Office rental 1 $2,000.00 3 Months 0.5 $ 3,000 $ 3,000 $ - 0%
Example G2. Communication cost 2 $100.00 12 Months 0.5 $ 1,200 $ 1,200 $ - 0%
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
0 0 $0.00 0 0 0 $ - $ - $ - #DIV/0!
Sub-Total G: —— —— —— $ 4,200 $ 4,200 $ - 0%
Subtotal Direct Project Costs $ 1,761,400 $ 1,734,700 $ 26,700 2%
II. Indirect Programme Support Costs (PSC)
PSC rate (insert a percentage not exceeding 7 per cent) 7% 7% 7% 7%
PSC Amount $123,298 $121,429 $1,869 $0
Total CBPF Project Cost $1,884,698 $1,856,129 $28,569 2%

This is to certify that the above statement of income and expenditure is correct and that expenditures correspond to the approved project and project budget for which funds have been received.

Name:
Title:

Signature Date Stamp

 Project Title:
Project Code:
Implementing partner:
Country:
Project period:

· Please use the template without modifying the section headings, guidance and formula. Wherever possible and relevant, please provide sufficiently detailed breakdown of each line item. Where breakdown of unit, quantity and unit cost is unavailable or unnecessary, please enter total amount of the item, along with sufficient description of cost
content. Please add additional rows as needed, and ensure that the formula is carried over and the subtotal of the budget category includes the added rows.
· All unit costs and total costs should be rounded to a maximum of 2 decimal places (e.g. 0.00).
· For further guidance on budget preparation, please refer to Chapter 6. Administration of CBPF Financial Resources of the CBPF Global Guidelines.
Cumulative expenditure
Original budget from project start to Revised budget Budget variance
DD/MM/YYYY (US$)

Budget Items Unit Quantity Unit Cost (USD) Duration Duration Unit % Charged to Total (USD) Unit Quantity Unit Cost (USD) Duration Duration Unit % Charged to Total (USD) % budget variation Explanation for budget variation
CBPF CBPF
A. Staff and Other Personnel Costs (please itemize costs of staff, consultants and other personnel to be recruited directly by the implementing partner for project
implementation)
Example: Project manager 1 $2,000.00 12 Months 100% $ 24,000 $10,000.00 1 $1,900.00 10 100% $ 19,000 -21%
Example: Security guards 12 $1,000.00 12 Months 10% $ 14,400 $5,000.00 12 $1,200.00 13 10% $ 18,720 30%
Example: Nurse 8 $500.00 6 0 100% $ 24,000 $15,000.00 9 $500.00 7 100% $ 31,500 31%
0 $ - $ - #DIV/0!
Sub-Total A: —— —— —— $ 62,400 $ 30,000 —— —— —— $ 69,220 11%
B. Supplies, Commodities, Materials (Programme Inputs) (please itemize direct and indirect costs of consumables to be purchased under the project, including associated
transportation, freight, storage and distribution costs) n/a $ - $ - #DIV/0!
n/a $ - $ - #DIV/0!
Months $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total B: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
C. Equipment (please itemize costs of non-consumables to be purchased under the project)
n/a $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total C: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
D. Contractual Services (please list works and services to be contracted under the project)
n/a $ - $ - #DIV/0!
n/a $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total D: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
E. Travel (please itemize travel costs of staff, consultants and other personnel for project implementation)
n/a $ - $ - #DIV/0!
Days $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total E: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
F. Transfers and Grants to Counterparts (please list transfers and sub-grants to project implementing partners)
Months $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total F: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
G. General Operating and Other Direct Costs (please include general operating expenses and other direct costs for project implementation)
Months $ - $ - #DIV/0!
Months $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
0 $ - $ - #DIV/0!
Sub-Total G: —— —— —— $ - $ - —— —— —— $ - #DIV/0!
Subtotal Direct Project Costs $62,400 $30,000 $69,220 11%
Indirect Programme Support Costs (PSC) rate (insert percentage, not to exceed 7 per cent) 7.00% 7% 7% 7%
PSC Amount $4,368 $2,100 $4,845 11%
Total CBPF Project Cost $66,768 $32,100 $74,065 11%