Application No. (Office Use Only) Submission Date Instructions: Israeli Companies Applying

India-Israel Initiative for Industrial R&D (i4RD) Application Form

Application No. (Office Use Only) Submission Date

Instructions: Israeli companies applying for funding under the i4RD program should fill out this form and submit it to MATIMOP (in Israel) via an online system (create an account and login to your account to submit forms). Indian companies should apply using the GITA online application form (www.gita.org.in).

Please include with this application an MOU/letter of intent noting the IP arrangements, as well as resumes/CVs of key personnel. Additional documents may be required for applicants - for detailed guidelines and instructions, refer to the Request for Proposal (RFP) document.

Applicant Contact Information (Lead Partners)

India: Company Name:

Last name of applicant First name of applicant

Telephone (Office) Telephone (Mobile)

Email Fax

Israel: Company Name:

Last name of applicant First name of applicant

Telephone (Office) Telephone (Mobile)

Email Fax

Project Title (Do not exceed 60 characters)

of 25 India-Israel Initiative for Industrial R&D (i4RD) Application Form

Executive Summary

Project Title (Do not exceed 60 characters)

Description of the Project (Up to 15 lines) Briefly describe the product, the technology, the technological innovation, the functional innovation, the essence of the development, what patents will be issued, & expected outcome by the end date of the project

Market & Commercial Potential (Up to 15 lines) General description of the market, market size and growth rate, estimated price per unit, estimated cost per unit, the competitor’s price per unit, the business model, sales forecast

General Description of Cooperation (Up to 15 lines) Describe the general synergies, advantages, complementarities, etc. in terms of the cooperation between the partners.

Focus Technology Sectors of Request for Proposals 2013 (Select main sector and subsector) Renewable Energy Off–Grid Micro Solar Large Scale Solar Biomass Based Power Smart Grids Systems Systems Other Subsector (please specify)

Water Management Water Treatment Water Supply & Other Subsector (please technologies: Water Reuse Distribution: Water Leak specify) & Recycling, Desalination Detection, Loss Reduction Affordable Healthcare Non–Invasive Diagnostic ICT Applications for Other Subsector (please Devices, particularly for Medicine / Healthcare specify) Women & Children Health (Anaemia, Nutrition) & Diabetes

Other Technology Sectors (Select main sector and subsector) Clean-Tech Agrobiotech Energy Environment Materials Water Technologies Communications Broadband Access Broadcast Enterprise Networking Home Networking Mobile Applications NGN & Convergence Optical Networking Telecom Applications VoIP & IP Telephony Wireless Applications Wireless Infrastructure Internet Content Delivery Content Management e-Commerce E-Learning Internet Applications Internet Infrastructure Online Advertising Online Entertainment Search Engines Social Networks IT & Enterprise Software Business Analytics Security Enterprise Applications Enterprise Infrastructure Miscellaneous Software Design and Development Tools

Life Sciences Agrobiotech Bioinformatics Biologicals Diagnostics Healthcare IT Industrial Medical Devices Telemedicine Therapeutics Semiconductors Fabrication and Testing Manufacturing Equipment Memory & Storage Miscellaneous & EDA Semiconductors Network Processors Processors & RFID Security Semiconductors Video, Image & Audio Miscellaneous Technologies Defense / Homeland Hardware Industrial Technologies Others (please specify) Security Nanotechnology

Project Funding & Budget Summary

TOTAL Project Budget* *Totals should be extracted from Part J – Project Budget Funding Source Role of Partner (%) Year 1 Year 2 Total Indian Sources (INR/Lakhs & USD) $ Israeli Sources (Nis & USD) $ Total Project Budget (Both Sides – 100% $ USD)

Project Start Date: End Date:

A. The Innovation (The Product & Technology)

A.1. Technological Description of the Product Provide a description of the technological aspects of the product to be developed within the framework of the project, as well as the corresponding R&D development plan. Describe the functions, applications, and performance/operation of the product. Use visual diagrams/images if necessary.

A.2 Product Characteristics What is the shelf-life of the product? Is it a general-use of tailor-made product? What is the length of usage? Is this a stand-alone product or does it integrate with other systems/products? If so, how?

A.3 What is the current state-of-the-art and limitations of current technologies? How are things done today and how does your product differ from what is already available?

A.4 Innovation of the Product What is the uniqueness and innovation of the developed product? How will the companies be capable of reaching the goal of creating a highly innovative product? This should be answered in reference both to the current activities and products of the companies, as well as compared to technology available worldwide. What are the technological barriers for competitors to develop the same product – how easy would it be for them to do the same (what is your advantage, uniqueness, in this sense?)

A.5 Restrictions & Standards Are there any restrictions or standards that this product/process needs to meet (environmental standards, restrictions) in either the partner countries or in countries where you intend to develop it? If relevant, what steps will you take to ensure the product/process meets these standards?

A.6 Proof of Concept Is there any proof of concept for this product? Is there theoretical or empirical evidence that the challenges in the development of the product can be overcome?

B. The Proposed R&D Program

B.1 Analysis of the Problem Please describe the basis for the proposed R&D program by identifying specific problem areas which this project aims to solve (eg: How to make an existing product more efficient, cost-effective, etc. How to streamline a process or decrease its environmental footprint, how to integrate a product for a local market, etc.)

B.2 Proposed Approach Describe the general approach being followed for the R&D project, including the achievements that will make it possible to realize the program’s objectives. What are the technical and economic constraints being faced? Discuss also alternate approaches to resolving problems as the basis for selecting the preferred solution.

C. The Program Plan

C.1. Work Plan for the First Year* Describe the main tasks of the work plan for the development of this product for the first year (for both partners). For each task, define clear milestones and deliverables needed in order to achieve the tasks. Do not describe the work in generic terms or in terms of general methodology (“design”, “planning”, “PR”, etc.). Deliverables should be clearly defined and include how much time and resources are needed to complete them.

Phase 1 – Technology Research & Development # Title of Task

Responsible Partner Start Date End Date Work Hours

Description of Task

Expected Milestones

Description of Deliverables

# Title of Task

Description of Task

Expected Milestones

Phase 2 – Technology Integration & Validation # Title of Task

Description of Task

Expected Milestones

# Title of Task

Description of Task

Expected Milestones

Phase 3 – Trials/Pilot Test Runds/Demonstration/Prototype/Pre-Commercialization (as applicable to your project) # Title of Task

Description of Task

Expected Milestones

# Title of Task

Description of Task

Expected Milestones

Phase 4 – Commercialization # Title of Task

Description of Task

Expected Milestones

# Title of Task

Description of Task

Expected Milestones

*You may include additional phases and additional tasks as needed (just copy/paste the tables above).

D. The Market

D.1. Market Opportunities What is the market need? For each product being developed within the framework of the project, describe the market opportunities in the home country and abroad. Define the target markets, potential customers, segmentation of the market on a geographical basis and the market dynamics.

D.2 Market Size Describe the size of the market in the world today, in terms of units and dollars. What is the potential for this product in the local market? In the global market? [Volume and total value ($) of the product market as of today and potentially; growth rate of the product-market and expected growth rate of the demand for the product]. What events could significantly alter this projection? Please indicate the sources used.

D.3 Competition Compare your product to that of competitors Vendor Name Name of Product Price per unit Percentage of Capabilities: Global Market Strengths & Weaknesses

D.4 Marketing Barriers Describe the potential barriers to marketing – such as standards, regulations, permissions and registration requirements, and how the companies intend to deal with these restrictions/barriers.

D.5 Marketing Plan How will you market this product? What are the marketing channels? Distribution companies? Offices Abroad? Daughter companies? What type of cooperation agreements – existing or potential – do you have for marketing through these channels? What is the marketing budget needed for these activities? What are the resources (including staff) you have dedicated to this task?

E. Commercialization – Plans & Prospects

E.1 Manufacturing Plan Describe how you will prepare for the manufacturing of the product. What are the physical and financial resources needed for the production? Where will production take place, and why?

E.2 Costs of Production Fill in the below table detailing the costs of production and the price for the end-customer ($)

The Product Price per Transfer Costs of Production Total Cost end- Price (if Subcontract Materials & Labor of customer relevant) ors Supplies Production

E.3 Sales Plan – Revenue & Market Share Forecast Define what the expected sales are for each target market over five years (for each product, if more than one) in dollars and what percentage of the market share is expected to be captured in each year.

Product Target Sales revenue ($) & Market Share (%) Market Year 1 Year 2 Year 3 Year 4 Year 5 Overall $ % $ % $ % $ % $ % $ %

$ % $ % $ % $ % $ % $ %

F. Cooperation and Benefits

F.1. Risk Sharing Summarize the projected mode and extent of cooperative activity between the Indian and Israeli partners in terms of risk-sharing by both companies during the product development stage and during commercialization. What extent will the companies share in the financial exposure of the product development and introduction to the marketplace?

F.2. Benefits of Commercialization What are the expected benefits to be derived by each company during product commercialization? The general nature of the planned revenue and profits-sharing arrangement between the two companies, from sales to the developed product.

F.3 Benefits to Countries What are the benefits to India and Israel in the form of new export markets, new employment opportunities, new capital formation, productivity improvements, etc.?

G. Organization & Management Plan

G.1. General Organization Plan Briefly summarize the proposed management procedures for the program, including the procedures to be implemented to maintain timely communications between lead participants in each country and an organization chart for staff working on the project.

H. The Participants and Project Personnel *If there are more than 2 partners, please copy/paste the relevant table and fill out for all project participants. Please also include the CVs of the main project personnel. H.1 Israeli Partner H.1.1 General Profile Full Name of Company Registration #

Prior name of Company

Type of Company HT R&D Research Institute University Other

Stage Seed R&D Initial Revenues Revenue Growth

Ownership Public Private Governmental Other

Year Established No. Employees

No. R&D Personnel

H.1.2 Company Contact Info Street Address

City P.O. Box

Country Zip Code

Telephone Fax

Website E-mail

H.1.3 Contact Person First Name Last Name

Title Function

Phone Mobile Phone

H.1.4 Organization Background General Business Description & Area of Expertise

Technology Description (Main Products/Services)

Targeted Customers

Sales (for last 3 years) Current year (i) i-1 i-2

H.1.5 Previous Experience Record of performance in similar/related undertakings

Description of previous or current projects for which the company received funding from the Government of India/State of Israel. Indicate the program scope, program duration, file number (if relevant), and outcome in commercial terms.

Description of relevant facilities, equipment, infrastructure, etc., which are expected to be utilized during the project and during project commercialization.

H.1.6 Company R&D Capabilities Describe the relevant R&D capabilities of the company and its R&D Team (ex: experience in similar R&D projects, relevant personnel and human resources)

Are there any gaps in the capabilities needed? If so, how do the companies plan to bridge these gaps (subcontractors, hiring other staff, etc.)

H.1.7 Technology Sector & Subsector of Company (Select 1 sector and 1 subsector) Clean-Tech Agrobiotech Energy Environment Materials Water Technologies Communications Broadband Access Broadcast Enterprise Networking Home Networking Mobile Applications NGN & Convergence Optical Networking Telecom Applications VoIP & IP Telephony Wireless Applications Wireless Infrastructure Internet Content Delivery Content Management e-Commerce E-Learning Internet Applications Internet Infrastructure Online Advertising Online Entertainment Search Engines Social Networks IT & Enterprise Software Business Analytics Security Enterprise Applications Enterprise Infrastructure Miscellaneous Software Design and Development Tools Life Sciences Agrobiotech Bioinformatics Biologicals Diagnostics Healthcare IT Industrial Medical Devices Telemedicine Therapeutics Miscellaneous Technologies Defense Hardware Industrial Technologies Miscellaneous Nanotechnology Semiconductors Fabrication and Testing Manufacturing Equipment Memory & Storage Miscellaneous & EDA Semiconductors

Network Processors Processors & RFID Security Semiconductors Video, Image & Audio

H.1.8 Company Settings (For Israeli Companies ONLY) Would you like your company profile to appear in the public, online MATIMOP Company Database? Would you like to receive emails from MATIMOP on news & events?

H.2. Indian Partner H.2.1 General Profile Full Name of Company Registration #

Prior name of Company

Type of Company HT R&D Research Institute University Other

Stage Seed R&D Initial Revenues Revenue Growth

Ownership Public Private Governmental Other

Year Established No. Employees

No. R&D Personnel

H.2.2 Company Contact Info Street Address

City P.O. Box

Country Zip Code

Telephone Fax

Website E-mail

H.2.3 Primary Company Contact Person First Name Last Name

Title Function

Phone Mobile Phone

H.2.4 Organization Background General Business Description & Area of Expertise

Technology Description (Main Products/Services)

Targeted Customers

Sales (for last 3 years) Current year (i) i-1 i-2

H.2.5 Previous Experience Record of performance in similar/related undertakings

Description of previous or current projects for which the company received funding from the Government of India/State of Israel. Indicate the program scope, program duration, file number (if relevant), and outcome in commercial terms.

Description of relevant facilities, equipment, infrastructure, etc., which are expected to be utilized during the project and during project commercialization.

H.2.6 Company R&D Capabilities Describe the relevant R&D capabilities of the company and its R&D Team (ex: experience in similar R&D projects, relevant personnel and human resources)

Are there any gaps in the capabilities needed? If so, how do the companies plan to bridge these gaps (subcontractors, hiring other staff, etc.)

H.2.7 Technology Sector & Subsector of Company (Select 1 sector and 1 subsector) Clean-Tech Agrobiotech Energy Environment Materials Water Technologies Communications Broadband Access Broadcast Enterprise Networking Home Networking Mobile Applications NGN & Convergence Optical Networking Telecom Applications VoIP & IP Telephony Wireless Applications Wireless Infrastructure Internet Content Delivery Content Management e-Commerce E-Learning Internet Applications Internet Infrastructure Online Advertising Online Entertainment Search Engines Social Networks IT & Enterprise Software Business Analytics Security Enterprise Applications Enterprise Infrastructure Miscellaneous Software Design and Development Tools Life Sciences Agrobiotech Bioinformatics Biologicals Diagnostics Healthcare IT Industrial Medical Devices Telemedicine Therapeutics Miscellaneous Technologies Defense Hardware Industrial Technologies Miscellaneous Nanotechnology

Semiconductors Fabrication and Testing Manufacturing Equipment Memory & Storage Miscellaneous & EDA Semiconductors Network Processors Processors & RFID Security Semiconductors Video, Image & Audio

H.2.8 Company Settings Would you like to receive emails from GITA on news & events?

I. Intellectual Property Treatment

I.1. Past IP Please provide a list of the background IP brought to the project by all the participants/partners.

3.2 New IP What new IP is expected to result from the project and how will the IP be treated? This includes the ownership of new IP and sharing of new IP between the participants. Please also attach an MOU noting the basic IP arrangement between the partners.

J. Project Budget

J.1. Israeli Partners Israeli Partners – Funding Sources (NIS Only) Funding Source Company/ Role & Year 1 Year 2 Total Organization Contribution of Name Partner (%) Israeli Project Lead (IsrPL)

Collaborator 1 (if relevant)

Collaborator 2 (if relevant) I4RD Contribution OCS to Project (requested) Other Sources Total Project Budget (Israeli 100% sources):

J.2. Indian Partners Indian Partners – Funding Sources (INR & Lakhs Only) Funding Source Company/ Role & Year 1 Year 2 Total Organization Contribution of Name Partner (%) Indian Project Lead (IPL)

Collaborator 1 (if relevant)

Collaborator 2 (if relevant) I4RD Contribution GITA/DST to Project (requested) Other Sources Total Project Budget (Indian 100% sources):

J.3 Total Budget TOTAL Project Budget* Funding Source Role of Partner (%) Year 1 Year 2 Total Indian Sources (INR/Lakhs & USD) $ Israeli Sources (Nis & USD) $ Total Project Budget (Both Sides – 100% $ USD)

Statement of Cooperation & Certification

The participants signing this form certify that the information in this application is correct at the time of submission. The participants confirm their intent to cooperate within the project as described in this form with the aim of realizing the technical developments as set forth in this application. In addition the participants have or intend to put in place, a formal collaboration agreement. Signature of Partner 1 (Israeli Project Lead) Company Name

First Name Last Name

Title Function

Signature

Signature of Partner 2 (Indian Project Lead) Company Name

First Name Last Name

Title Function

Signature