CIPICT PSP CALL 6 PILOT TYPE A 010212 [PROPOSAL

CIPICT PSP CALL 6 PILOT TYPE A 010212 [PROPOSAL






Form: Certification of National Authorised Representative

CIP-ICT PSP Call 6 Pilot Type A

01/02/12


[Proposal acronym]



Form: Certification of National Authorised Representative


The co-ordinator must collect and retain for each legal entity, acting in the proposal as authorised national representative, the "Certification of national authorised representative" form (see required text below), filled and signed by the responsible national administration.


This is an official written declaration from the national administration on administration letterhead paper, stamped, and signed by a legal representative.


Required text:



Certification of National Authorised Representative



I hereby declare that [full name of the legal entity receiving the authorisation] is authorised to represent and act on behalf of [name of the national authority giving the authorisation] in the project [project acronym and title].

This delegation is limited to the scope of the project, but enables the representative to engage the National Authority in the definition of common specifications, and its future possible endorsement at the national level.

Further specific conditions can be added.



[Signature]

[Name First name(s)]

[Full Legal Name of organisation]

[Date]




Stamp of organisation and Signature of the administrative official authorised to sign (legal representative).






Tags: [proposal, cipict, pilot, 010212