Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized

- 4 -

Schedule 1 : Disbursement Provisions

Basic Information Country Federal Democratic Republic of Closing Date Section III.B.2. of Schedule 2 to the Financing Agreement. Grant No. D745-ET Recipient Federal Democratic Republic of and and Ethiopia Credit No. 6798-ET Name of the Project Strengthen Ethiopia’s Adaptive Safety Disbursement Four months after the closing date. Net Project Deadline Date Subsection 3.7 ** Disbursement Methods and Supporting Documentation Disbursement Methods Methods Supporting Documentation Section 2 (**) Subsections 4.3 and 4.4 (**) Direct Payment Yes Copy of records Reimbursement Yes Interim unaudited Financial Report (IFR) in the format provided in Attachment 2 of the DFIL- IPF Interim unaudited Financial Report (IFR) in the format provided in Attachment 3 of the DFIL-PBC Advance (into a Designated Yes Interim unaudited Financial Report (IFR) in the format provided in Attachment 2 of the DFIL-IPF Account) Interim unaudited Financial Report (IFR) in the format provided in Attachment 3 of the DFIL-PBC Special Commitments Yes Copy of Letter of Credit Designated Account (Sections 5 and 6 **) Segregated Variable- category 2 & 3 Type DA A- IPF- category 2 & 3 Ceiling Fixed – category 4 DA-B- linked to category 4-CERC component Financial Institution – National Bank of Ethiopia (NBE) USD Currency Name Quarterly DA A- Based on up to 6 months cash forecast as per detail provided in the IFR Frequency of Reporting Amount DA B- Up to the amount allocated to Subsection 6.3 (**) category 4

Minimum Value of Applications (subsection 3.5) The minimum value of applications for, Direct Payment and Special Commitment is USD200,000 equivalent. Authorized Signatures (Subsection 3.1 and 3.2 **) The form for Authorized Signatories Letter is provided in Attachment 1 of this letter Withdrawal and Documentation Applications (Subsection 3.3 and 3.4 **) (i) Authorized Signatures A letter in the Form attached (Attachment 1) should be furnished to the World Bank at the address indicated below providing the name(s) and specimen signature(s) of the official(s) authorized to sign Applications: (ii) Applications. Please provide completed and signed (a) applications for withdrawal, together with supporting documents, to the address indicated below:

- 5 -

The World Bank, Loan Department, Delta Center, 13th Floor, Upper Hill, Menengai Road, Nairobi, Kenya. Tel: 254 20 2936 000 Attention: Loan Department Additional Instructions

Other

** Sections and subsections relate to the “Disbursement Guidelines for Investment Project Financing”, dated February 2017 .

- 6 -

Attachment 1

Form of Authorized Signatory Letter

[Letterhead] Ministry of Finance [Street address] [City] [Country]

[DATE] International Development Association 1818 H Street, N.W. Washington, D.C. 20433 United States of America

Re: Grant No. D745-ET and Credit No. 6798-ET (Strengthen Ethiopia’s Adaptive Safety Net Project)

Attention: ______, Country Director

I refer to the Financing Agreement (“Agreement”) between the International Development Association (the “Association”), and Federal Democratic Republic of Ethiopia (the “Recipient”), dated ______, providing the above Credit. For the purposes of Section 2.03 of the General Conditions as defined in the Agreement, any 1[one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Recipient to sign applications for withdrawal [and applications for a special commitment] under this Credit.

For the purpose of delivering Applications to the Association, including by electronic means, 2[each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient, acting 3[individually] 4[jointly], to deliver Applications, and evidence in support thereof on the terms and conditions specified by the Association.

1 Instruction to the Recipient: stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete this footnote in final letter that is sent to the Association.

2 Instruction to the Recipient: stipulate if more than one person needs to jointly sign Applications, if so, please indicate the actual number. Please delete this footnote in final letter that is sent to the Association.

3 Instruction to the Recipient: use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association.

4 Instruction to the Recipient: use this bracket only if several individuals must jointly sign each Application; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association.

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This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Association by electronic means. In full recognition that the Association shall rely upon such representations and warranties, including without limitation, the representations and warranties contained in the Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation (“Terms and Conditions of Use of SIDC”), the Recipient represents and warrants to the Association that it will cause such persons to abide by those terms and conditions.

This Authorization replaces and supersedes any Authorization currently in the Association records with respect to this Agreement.

[Name], [position] Specimen Signature: ______

[Name], [position] Specimen Signature: ______

[Name], [position] Specimen Signature: ______

Yours truly,

/ signed /

______

- 8 -

Attachment 2

Interim unaudited Financial Statements

Strengthen Ethiopia's Adaptive Safety Net Project Interim Unaudited Financial Report

Content

1 Discussion of Financial performance, Notes & Explanations

2 Consolidated Statement of Sources and Uses of Fund

3 Consolidated Expenditure summary

4 Expenditure summary by Category

5 Expenditure summary Project Life 6 Expenditure Apportionment sheet 7 PBC Tracking Sheet 8 PBC eligible expenditure documentation sheet 9 Expenditure documentation reconciliation 10 Fund flow statements 11 Designated account reconciliation 12 Statement of cash movement for implementers 13 Regional fund utilization report 14 Expenditure forecast and cash requirement 15 Other supporting schedules

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Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Sources & Uses of Funds (in ) For The Quarter Ended ------Brought Forward (Pr Current Current Year Cumulative- Particulars evious Quarter Cumulative Project life Cumulative) Opening Balance Designated Account Designated USD Acct - IDA Designated USD Acct. - CERC Trust Funds DFID Irish Aid Pooled Birr Account at Federal - Core activities Pooled Birr Account at Federal - Shock Responsiveness +CERC Bank Balance at Implementing Entities MoF FSCD MOLSA NDRMC Region ( Birr Acct. ) ( Birr Acct. ) SNNP Region ( Birr Acct. ) ( Birr Acct. ) ( Birr Acct. ) ( Birr Acct. ) ( Birr Acct. ) Sidama Region (Birr Acct.) Dire Dewa CA ( Birr Acct. ) Cash On Hand Balance at Federal and Regional Advance at Federal and Regional Payables at Federal and Regional Total Opening Balance Add: Sources IDA

- 10 -

CERC Trust Funds DFID Irish Aid Other DPs Government Contribution Total Source For the Period Total Available Fund For The Period Less : Program Expenditures Total Expenditures Total Available Fund Less Total Expenditures Foreign currency difference Net Fund Available Ending Balance Designated Account Designated USD Account - IDA Designated CERC Account Trust Funds DFID Irish Aid Other DPs Pooled Birr Account at Federal - Core activities Pooled Birr Account at Federal - Shock Responsiveness +CERC Bank Balance at IEs MoF FSCD MOLSA NDRMC Oromia Region ( Birr Acct. ) Amhara Region ( Birr Acct. ) SNNP Region ( Birr Acct. ) Tigray Region ( Birr Acct. ) Afar region (Birr Acct) Somali region (Birr Acct.) Harari Region ( Birr Acct. )

- 11 -

Sidama Region ( Birr Acct. ) Dire Dewa CA ( Birr Acct. ) Cash On Hand Balance at Federal and Regional Advance at Federal and Regional Payables at Federal and Regional

Total Ending Balance - - - -

NOTES: I - The amounts are drawn from the ledger accounts of the program

Approved By Prepared By ______

Signature Signature ______Date

- 12 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Sources & Uses of Funds (in USD/ETB) For The Quarter Ended ------Brought Forward (Prev Current Cumulative Cumulative- Particulars ious Quarter (Year to date) Project life Cumulative) Opening Balance Designated Account /III Designated USD Acct - IDA Designated USD Acct. - CERC Trust Funds DFID Irish Aid Pooled Birr Account at Federal - Core activities Pooled Birr Account at Federal - Shock Responsiveness +CERC Bank Balance at Implementing Entities MoF FSCD MOLSA NDRMC Oromia Region ( Birr Acct. ) Amhara Region ( Birr Acct. ) SNNP Region ( Birr Acct. ) Tigray Region ( Birr Acct. ) Afar Region ( Birr Acct. ) Somali Region ( Birr Acct. ) Harari Region ( Birr Acct. ) Sidama Region (Birr Acct.) Dire Dewa CA ( Birr Acct. ) Cash On Hand Balance at Federal and Regional Advance at Federal and Regional Payables at Federal and Regional Total Opening Balance Add: Sources IDA CERC Trust Funds DFID Irish Aid Other DPs Government Contribution Total Source For the Period Total Available Fund For The Period

- 13 -

Less : Program Expenditures Total Expenditures Total Available Fund less Total Expenditures Foreign Exchange Difference/IV Net Fund Available Ending Balance Designated Account Designated USD Account - IDA Designated CERC Account Trust Funds DFID Irish Aid Other DPs Pooled Birr Account at Federal - Core activities Pooled Birr Account at Federal - Shock responsiveness and CERC Balance at Implementing Entities MoF FSCD MOLSA NDRMC Oromia Region ( Birr Acct. ) Amhara Region ( Birr Acct. ) SNNP Region ( Birr Acct. ) Tigray Region ( Birr Acct. ) Afar region (Birr Acct) Somali region (Birr Acct.) Harari Region ( Birr Acct. ) Sidama Region ( Birr Acct. ) Dire Dewa CA ( Birr Acct. ) Cash On Hand Balance at Federal and Regional Advance at Federal and Regional Payables at Federal and Regional

Total Ending Balance - - - -

Approved By Prepared By ______

Signature Signature ______

- 14 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Consolidated Expenditures Summary (in Ethiopia Birr) For The Quarter Ended ------Variance Total 1st Appr 2nd 3rd 4th expendi Curr Quar Quarte Bud oved quarter quarter quarter ture ent Particula ter r get Budg expend expend expend for the Quar rs Plan Expend year et iture iture iture year ter % % (2) iture (9) (1) (4) (5) (6) (7)=3+4 (8)= (3) = 1- +5+6 2-5 8 Expendit ures Compone nt 1: Adaptive Producti ve Safety Net 1.1 Public works 1.2 Mother and Child Package 1.3 Safety Net Transfers 1.4 Livelihoo d support Sub Total Compone nt 1 Compone nt 2: Improve d shock responsi veness 2.1 Geographi c expansion 2.2 Shock Responsiv e Systems 2.3 Contingen t early response

- 15 -

Sub Total compone nt 2 Compone nt 3: Systems, capacity develop ment and Program Managem ent support 3.1 Systems Developm ent 3.2 Capacity Building, Managem ent and Administr ation Sub Total compone nt 3 Grand Total of the Project

- 16 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Consolidated Expenditures Summary (in US Dollar) For The Quarter Ended ------Variance Total 1st 2nd 3rd 4th Approv Quart expenditu Curre Quarter quarter quarter quarter ed er re for the nt Budg Particulars Expendit expendit expendit expendit Budget Plan year Quart et ure ure ure ure (1) (2) (7)=3+4+ er year (3) (4) (5) (6) 5+6 (8)= (9) = 2-5 1-8 Expenditur es Component 1: Adaptive Productive Safety Net 1.1 Public works 1.2 Mother and Child Package 1.3 Safety Net Transfers 1.4 Livelihood support Sub Total Component 1 Component 2: Improved shock responsive ness 2.1 Geographic expansion 2.2 Shock responsive Systems 2.3 Contingent early response Sub Total component 2 Component 3: Systems, capacity developme

- 17 - nt and Program Manageme nt support 3.1 Systems Developmen t 3.2 Capacity Building, Managemen t and Administrati on Sub Total component 3 Grand Total of the Project

Actual Actual expenditures Expenditures Financiers of the quarter of the quarter Birr USD equivalent

IDA CERC DFID Irish Aid Trust Funds Other DPs Government Grand Total

Analysis of Total Expenditure by Irish Other Disbursement Method for IDA CERC DFID TFs Government Aid DPs current quarter Designated Account payments Direct Payment Special Commitment Total

- 18 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Expenditures Summary by Expenditure Category (IN ETB) For The Quarter Ended ------

Total Annual 1st Quarter 2nd quarter 3rd quarter 4th quarter expenditure Budget Expenditure expenditure expenditure expenditure Particulars for the year

1 2 3 4 5 (6)=(2+3+4+5) Expenditures : Category 1: Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Safety Net Transfers under Parts 1.3 and 3.2 of the Project and subject to PBCs Goods Works Consulting services Non consulting Services Training Operating Cost Safety Net transfers Total Category1 Category 2 :Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Safety Net Transfers under Parts 1.3 and 3.2 of the Project and not subject to PBCs

- 19 -

Goods Works Consulting services Non consulting Services Training Operating Cost Safety Net transfers Total Category 2 Category 3:Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Livelihood Grants under parts 1.1, 1.2, 1.4, 2, and 3.1

Goods

Works Consulting services Non consulting Services

Training

Operating Cost

Livelihood grants Total Category 3

Category 4: Early Response expenditures Grand Total

- 20 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Expenditures Summary by Expenditure Category (IN USD) For The Quarter Ended ------

Total Annual 1st Quarter 2nd quarter 3rd quarter 4th quarter expenditure for Budget Expenditure expenditure expenditure expenditure Particulars the year

1 2 3 4 5 (6)=(2+3+4+5+4) Expenditures : Category 1: Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Safety Net Transfers under Parts 1.3 and 3.2 of the Project and subject to PBCs Goods Works Consulting services Non consulting Services Training Operating Cost Safety Net transfers Total Category1 Category 2 :Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Safety Net Transfers under Parts 1.3 and 3.2 of the Project and not subject to PBCs Goods Works Consulting services Non consulting Services Training Operating Cost

- 21 -

Safety Net transfers Total Category 2 Category 3:Goods, works, non-consulting services, consulting services, Operating Cost, Training, and Livelihood Grants under parts 1.1, 1.2, 1.4, 2, and 3.1 Goods Works Consulting services Non consulting Services Training Operating Cost Livelihood grants Total Category 3

Category 4: Early Response expenditures Grand Total

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Consolidated Expenditure Summary - Project Life (IN ETB) For The Quarter Ended ------Previous Years Current Quarter Current Year Project Life to date Cumulative Previous Previous Years Particulars Years Cumulati Expendit Pla Expendit Pla Expendit Pla % % Cumulat ve % ure % n ure n ure n ive Plan Expendit ure Expenditur es

Component 1: Adaptive Productive Safety Net 1.1 Public works

- 22 -

1.2 Mother and Child Package 1.3 Safety Net Transfers 1.4 Livelihood support Sub Total Component 1 Component 2: Improved shock responsive ness

2.1 Geographic expansion 2.2 Shock Responsive Systems 2.3 Contingent early response Sub Total component 2 Component 3: Systems, capacity developme nt and Program Managemen t support

3.1 Systems 3.2 Capacity Building, Management and Administrati on Sub Total component 3 Grand Total

- 23 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Consolidated Expenditure Summary - Project Life ( IN USD ) For The Quarter Ended ------Previous Years Current Project Life to Current Year Cumulative Quarter date Previous Previous Years Particulars Years Cumulativ Expenditu Pla Expenditu Pla Expenditu Pla Cumulati e re n re n re n ve Plan Expenditu re Expenditure s Component 1: Adaptive Productive Safety Net 1.1 Public works 1.2 Mother and Child Package 1.3 Safety Net Transfers 1.4 Livelihood support Sub Total Component 1 Component 2: Improved shock responsivene ss 2.1 Geographic expansion

2.2 Systems 2.3 Contingent early response Sub Total component 2 Component 3: Systems, capacity development and Program

- 24 -

Management support 3.1 Systems development 3.2 Capacity Building, Management and Administratio n Sub Total component 3 Grand Total

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Expenditure Apportionment Worksheet ( IN USD) For The Quarter Ended ------Current Total Remaining quarter Total Category Allocation Documented undocumented expenditure Documented so far balance allocated IDA Credit

Category 1

Category 2

Category 3

Category 4

Total

IDA Grant

Category 1

Category 2

Category 3

Category 4

- 25 -

Total

Total

Trust Funds DFID

Irish Aid Government Contribution

Total

Grand Total

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Performance Based Conditions Tracking Worksheet ( IN USD) For The Quarter Ended ------Achieve Remaining Total d and Disburse undisburse Disburse Disburse Category Allocation (A) verified d in this d balance d so far d (D)= PBC quarter (E )= (A)- (B) (B)+(C) amount (C) (D) Performanc e Based Conditions PBC 1 - Share of GOE Contribution to Core PSNP Financing 24.00 PBC 2 - Share of payments made to core beneficiaries according to program’s performance standards for timeliness 54.00 PBC 3 - No. of core beneficiary households 15.00

- 26 - receiving their benefits in electronic accounts PBC 4 - Preparation and adoption of a Geographic Expansion and Caseload Allocation Plan 2.00 PBC 5 - Number of new woredas, in accordance with the agreed plan, in which PSNP systems have been established and are being used for core PSNP payments 21.00 PBC 6 - Establishmen t of key shock- responsive systems PBC 6.1 - GoE develops and adopts scalability manual 1.50 PBC 6.2 Early warning dashboard published 4.00 PBC 6.3 FSCD prepares an Annual 2.00

- 27 -

Drought Response Plan PBC 6.4 FSCD prepares Quarterly Drought Response Plan 1.50 PBC 7 - MIS Number of woredas using MIS for key program functions and are connected to the federal MIS server 25.00

Total 150.00

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Eligible Expenditure Tracking Worksheet for Performance Based Conditions ( IN USD) For The Quarter Ended ------

Expenditu Eligible Eligible res expenditu expendit Expenditu document res ures res ed against Expendit available docume available Expendit Advances PBC ures for nted for ures received Category allocat incurred document against document incurred (i.e. not ion in this ation disburse ation so far available quarter against d PBCs against (A) for (B) achieved in this achieved document PBCs D = quarter PBCs (F) = ation (A+B-C) (E) (D-E) against PBCs) (C) Eligible expenditu res for Performa nce Based

- 28 -

Condition s

Transfers (Compone nt 1.3) - for PBCs 1, 2, 3, and 7 118 Administa rative and manageme nt (Compone nt 3.2) - for PBCs 4, 5, and 6 32

Total 150

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Expenditure Documentation Reconciliation (for Advance and PBCs) ( IN USD)

Total expenditure Total expenditure Total expenditure reported for the for the year for project life quarter (1)

Documented for advance to the project (2) Documented for PBC

(3) Total amount

1. Amount must be the same as shown on the statement of source and uses of fund for the quarter. If there are any direct payments or special commitments, these should be clearly indicated in the footnote. 2. This amount must be the same as shown on the expenditure apportionment sheet 3. This must be similar to the amount shown on the PBC tracking worksheet (your word document)

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Strengthen Ethiopia's Adaptive Safety Net Project (SEASN)

Statement oF Fund Flow ( IDA Grant and credit )

Special USD Account No. ------

FOR THE PERIOD, FROM ---- to ------Exchange Particulars USD BIRR Rate

OPENING BALANCE

Add :Receipt

Fund Received as at

Fund Available for use

Less: Transfer and Expenditure

Transfer to pool birr account as at

Expenditures

Bank services Charges

Total transfer & expenditure

Closing balance

USD Actual exchange rate as at

Closing balance /Leger birr account/

Add gain or (Loss) on Foreign exchange

Balance After Gain of foreign exchange

- 30 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN)

Statement of Fund Flow (CERC Designated Account )

Special Account No. -----

FOR THE PERIOD, FROM ---- to ------

Particulars Exchange Rate USD BIRR

OPENING BALANCE

Add :Receipt

Fund Received as at

Fund Available for use

Less :Transfer and Expenditure

Transfer to pool birr account as at

Expenditures

Type of expenditures

Bank services Charges

Total transfer & expenditure

Closing balance

Actual exchange rate as of

Closing balance /Leger birr account/

Add gain or (Loss) on Foreign exchange

Balance After Gain/Loss of foreign exchange

- 31 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Statement of Fund Flow (Trust Fund no. ) Account No. ----- FOR THE PERIOD, FROM ---- to ------

Particulars Exchange Rate USD BIRR

OPENING BALANCE

Add :Receipt

Fund Received as at

Fund Available for use

Less :Transfer and Expenditure

Transfer to pool birr account as at

Expenditures

Type of expenditures

Bank services Charges

Total transfer & expenditure

Closing balance

Actual exchange rate as of

Closing balance /Leger birr account/

Add gain or (Loss) on Foreign exchange

Balance After Gain/Loss of foreign exchange

- 32 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN)

Statement of Fund Flow (DFID Designated Account )

Special Account No. -----

FOR THE PERIOD, FROM ---- to ------

Particulars Exchange Rate GBP BIRR

OPENING BALANCE

Add :Receipt

Fund Received as at

Fund Available for use

Less :Transfer and Expenditure

Transfer to pool birr account as at

Expenditures

Type of expenditures

Bank services Charges

Total transfer & expenditure

Closing balance

Actual exchange rate as of

Closing balance /Leger birr account/

Add gain or (Loss) on Foreign exchange

Balance After Gain/Loss of foreign exchange

- 33 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN)

Designated Account Activity Statement

FOR THE PERIOD, FROM ---- to ------

IDA and IDA-CERC Parts IDA CERC Total

Part I: Advances to be accounted (Cumulative) 1. Cumulative advances to end of current reporting period 2. Cumulative expenditures to end of last reporting period

3. Outstanding advances to be accounted (1-2)

Total ( 3 )

Part II: Movements in Designated Account in current period

1. Opening balance at beginning of reporting period (as of …..)

1.1. Designated Account

1.2. Project Bank accounts

Total ( 1.1+1.2)

- 34 -

4. a Advances received from the World Bank during reporting period (IDA)

Application No. Amount.

4.b Advances received from other Donor Partners

Deposit after reporting period

Total (4 a + 4 b+4c) 5 a. Subtract: Recoveries of Advances, if any/Adjustment

5 b. Add/Subtract: Other Cumulative adjustments, including interest earned, (if any)

6. Net advances to be accounted for (1+4+5)

7. Closing balance at end of current reporting period

(Designated Account Bank statement attached)

7.1 Designated Account

7.2 Project Bank accounts

Total (7.1 + 7.2)

- 35 -

8. Expenditures reported for current reporting period (only expenditures paid from Designated Account & project bank account)

9. Total Advances Accounted for ( 7+8 )

10. Applications submitted but not yet credited to DA during reporting period

12. Difference (if any) 6-9-10

Total (9+10 +11)

Part III

15. Total Expenditure Forecasted amount

Component 1

Component 2

Component 3

Sub total

16. Less: Closing DA balance after adjustment 17. Less: Direct payments/ SC payments expected (if any)

18. Add 16+17

Applications submitted but not yet credited

Deposit after reporting period

- 36 -

19. Cash requirement from DPs for next six months (15-18)

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Statement of Cash Movement (in ETB) FOR THE PERIOD, FROM ---- to ------

At At Particulars MoF FSCD MoLSA NDRMC woreda Regional TOTAL level level

Opening Balance Add :Cash transfers

Transfer From DPs/MOF/Rgions

Transfer To IAs/Regions/Cities Current Quarter Forign currency difference

Adjustment Total fund Available for use

Less :Expenditure

Component 1: Adaptive Productive Safety Net

1.1 Public works

1.2 Mother and Child Package

- 37 -

1.3 Safety Net Transfers

1.4 Livelihood Services

Sub Total Component 1 Component 2: Improved shock responsiveness

2.1 Shock Responsive Transfers

2.2 Shock Responsive Systems Sub Total component 2

Component 3: Program Management

3.1 Systems Development

3.2 Management and admin 3.3 Capacity development and woreda performance incentives Sub Total component 3 Total Expenditure

Closing balance Breakdown of closing balance

Cash at Bank Cash in safe Receivables Less: Payables

- 38 -

Total Closing Balances

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Summary of Fund Utilization Report (In ETB) For the period from -- to --- Begin. Balance Name Total Transfer During From previous Current of the Period (IFR) Gain/L Direct Feder Total Openni Gain/L oss Payme Total N al/ Beginni ng oss from nt Availa o Regio ng From To Balance from Foreign Made Oth ble nal Balance DPs/M regio from Foreign currenc By WB er Burea oF ns Operati currenc y u on y (f) = (a) (b) ( c ) (d) (e) (b)+(c )+(d)+€

1 MoF

2 FSCD MoLS 3 A NDRM 4 C Orom ia Regio 5 n Amha ra Regio 6 n SNNP 7 R Tigra y Regio 8 n Afar regio 9 n Somal i 1 regio 0 n 1 Harar 1 i

- 39 -

regio n Sidam a 1 regio 2 n Dire 1 Dewa 3 CA Grand Total

Compo Advan nent 3: ces Compon System /receiv Comp Nam ent 2: s, End End ables onent e of Improve Capacit ing ing 1: Fede Shock y Endi Cas cash Adapti Total Total N ral/ Responsi Develo ng h at bala Paya ve Expen ending o Regi veness of pment, Bala Ban nce bles Produ diture balance onal the and nce k on ctive Bure Rural Progra bala han Safety au Safety m nce d Net Net Manage ment Support (l) = (k) (p)=(l)+(m) (M)+(N) = (f ) ( l) (m) (n) (o) (g) (h) (i) +(n)+(o) +(O - (j)

1 MoF FSC 2 D MoL 3 SA NDR 4 MC Oro mia Regi 5 on Am hara Regi 6 on SNN 7 PR

- 40 -

Tigr ay Regi 8 on Afar regi 9 on Som ali 1 regi 0 on Har ari 1 regi 1 on Sida ma 1 regi 2 on

Dire 1 Dew 3 a CA Grand Total

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Cash Forecast for the Next Six Month For The Quarter Ended ------Description Quarter 1 Quarter 2 Quarter 1 Quarter 2 Total

Expenditures for the Next Six ETB ETB USD USD ETB USD Months Expenditures Component 1: Adaptive Productive Safety Net

1.1 Public works

1.2 Mother and Child Package

1.3 Safety Net Transfers

1.4 Livelihood support

- 41 -

Sub Total Component 1 Component 2: Improved shock responsiveness

2.1 Shock Responsive Transfers

2.2 Systems

Sub Total component 2 Component 3: Program Management

3.1 Systems

3.2 Management and admin 3.3 Capacity development and woreda performance incentives

Sub Total component 3

Total Cash Requirement

Ending Balance

IDA

IDA-CERC

Trust Funds

DFID

Irish Aid Add: Deposit after reporting period Cash Requirements for next Six months

IDA

CERC

Trust Funds

DFID

Irish Aid

Government

Total Contribution

- 42 -

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Receivable Aging Schedule Date-- Aging Sr. More Particulars 3-6 6 Month -1 NO. 1-3 Months than 1 Total Months year Year

1

2

3

4

5

Total

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Payable Aging Schedule Date-- Aging Sr. More Particulars 3-6 6 Month - NO. 1-3 Months than 1 Total Months 1 year Year

1

2

3

4

Total

- 43 -

Attachment 3 – (PBC supporting document)

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Performance Based Conditions Tracking Worksheet ( IN USD) For The Quarter Ended ------Achieve Remaining Total d and Disburse undisburse Disburse Disburse Category Allocation (A) verified d in this d balance d so far d (D)= PBC quarter (E )= (A)- (B) (B)+(C) amount (C) (D) Performanc e Based Conditions PBC 1 - Share of GOE Contribution to Core PSNP Financing 24.00 PBC 2 - Share of payments made to core beneficiaries according to program’s performance standards for timeliness 54.00 PBC 3 - No. of core beneficiary households receiving their benefits in electronic accounts 15.00 PBC 4 - Preparation and adoption of a Geographic Expansion and Caseload Allocation Plan 2.00

- 44 -

PBC 5 - Number of new woredas, in accordance with the agreed plan, in which PSNP systems have been established and are being used for core PSNP payments 21.00 PBC 6 - Establishmen t of key shock- responsive systems PBC 6.1 - GoE develops and adopts scalability manual 1.50 PBC 6.2 Early warning dashboard published 4.00 PBC 6.3 FSCD prepares an Annual Drought Response Plan 2.00 PBC 6.4 FSCD prepares Quarterly Drought Response Plan 1.50 PBC 7 - MIS Number of woredas 25.00

- 45 - using MIS for key program functions and are connected to the federal MIS server

Total 150.00

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Eligible Expenditure Tracking Worksheet for Performance Based Conditions (IN USD) For The Quarter Ended ------

Expenditu Eligible Eligible res expenditu expendit Expenditu document res ures res ed against Expendit available docume available Expendit Advances PBC ures for nted for ures received Category allocat incurred document against document incurred (i.e. not ion in this ation disburse ation so far available quarter against d PBCs against (A) for (B) achieved in this achieved document PBCs D = quarter PBCs (F) = ation (A+B-C) (E) (D-E) against PBCs) (C) Eligible expendit ures for Performa

nce Based Conditio ns Transfers (Compon ent 1.3) - for PBCs 1, 2, 3, and 7 118 Administr ative and managem ent 32

- 46 -

(Compon ent 3.2) - for PBCs 4, 5, and 6

Total 150

Strengthen Ethiopia's Adaptive Safety Net Project (SEASN) Expenditure Documentation Reconciliation (for Advance and PBCs) (IN USD)

Total expenditure Total expenditure Total expenditure reported for the for the year for project life quarter (1)

Documented for advance to the project (2) Documented for PBC

(3) Total amount

1. Amount must be the same as shown on the statement of source and uses of fund for the quarter. If there are any direct payments or special commitments, these should be clearly indicated in the footnote. 2. This amount must be the same as shown on the expenditure apportionment sheet 3. This must be similar to the amount shown on the PBC tracking worksheet (your word document)