Template − Settlement Sheet for Local Contributions (to be submitted to GIZ)
| Contract no. (contractor): | Contractor’s reference for the local contribution contract: | Date: | |||
| PN (GIZ): | Recipient of local contribution: | ||||
| Brief description of GIZ project: | Value of local contribution contract: | ||||
| Country: | Currency: | ||||
| Term of local contribution: |
| Currency (Contract Currency) | ||||
| Serial no. | Date | No. call for funds/ settlement by recipient | Type 1) | |
| 1 | ||||
| 2 | ||||
| 3 | ||||
| Totals | ||||
| 1) Please enter: | V = advance payment D = direct payment E = reimbursement T = interim invoice S = final invoice |
We hereby confirm that the above entries are complete and correct:
.............................................
(Contractor)