1. Information on the Applicant

RISK ASSESSMENT & SCIENTIFIC ASSISTANCE DEPARTMENT

APPLICATION FORM

Call reference: GP/EFSA/BIOCONTAM/2017/01 Call title: Identifying organisations that can be entrusted by EFSA “Bioinformatic support for WGS data analyses of zoonotic microorganisms (capacity building)”

Restricted to the list of competent organisations established by the Authority’s Management Board in application of article 2 the Commission Regulation (EC) No 2230/2004 laying down detailed rules for the implementation of European Parliament and Council Regulation (EC) No 178/2002 with regard to the network of organisations operating in the fields within the Authority’s.

Before completing this Application form, please read carefully the related Call for proposals and guide for applicants with all the annexes.

Please note that this Application form has to be completed in all parts following these instructions:

 Text in blue background: only advice for applicants  Text in yellow background: text to be completed by the applicants  Text in white background must be kept in the final version of this Application form

The Application form has to be supported by the documents indicated in the final completeness checklist. Incomplete application forms will not be accepted. 1. INFORMATION ON THE APPLICANT

1.1 APPLICANT

Official name in full: XX Short name or acronym: XX Legal form: XX Address:  Street: XX  Number: XX  Post code: XX  City: XX  Country: XX

Organisation`s contact details:  Telephone: XX  Fax: XX  E-mail address: XX  Internet site: XX

Legal representative of the applicant (he/she will sign the grant agreement in case of award): XX

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Administrative contact point for project implementation in the case of grant award: XX  Position: XX  Telephone: XX  Fax: XX  E-mail address: XX

Contact person responsible for this application (if different from the above):  Position: XX  Telephone: XX  Fax: XX  E-mail address: XX

2. AWARD CRITERIA REQUIREMENTS

The applying organisation should attach to this application form a short report (max 20 pages) describing: 1. bioinformatics capacity of the organisation, including both the achievements regarding development of tools/pipelines for WGS analyses zoonotic bacteria/food- borne microorganisms (at least for Salmonella, L. monocytogenes and/or E. coli, but also for other microorganisms if available), as well as the implementation of these tools/pipelines in routine, i.e. for outbreak investigations, source attribution or surveillance; 2. list of scientific publications including impact factor, in which the bioinformatics capacity of the organisation is reflected; 3. team members and IT-structure available to perform the analyses; 4. list of training activities focusing on next generation sequencing methodologies and analysis organised/co-organised by the Institution/members of it should be included; 5. The CV of the bioinformatician expert proposed for the assignment.

In the report, for point 1 and 5 make very clear how the minimum selection criteria requirements in point 2.4 of the call for proposals are exceeded because this will be seen as an extra asset under the award criteria.

This report will be assessed by EFSA along these award criteria:

1a Years of experience on developing/implementing tools/pipelines for the WGS of zoonotic bacteria/food borne microorganisms, beyond the minimum requirements of selection criteria (Max 15 points); 1b Number of areas covered in implementation of WGS analyses in routine (e.g. Salmonella, E.coli and/or Listeria, others, indicating the use (outbreak investigation, surveillance, source attribution) (Max 15 points), beyond the minimum requirements of selection criteria; 2. Number and quality of scientific publications (Max 10 points); 3. Team members and IT-structure available to perform the analyses (Max 10 points); 4. Number and relevance of training activities on the subject of the call (Max 5 points); 5. Experience of the proposed bioinformatician expert, beyond the minimum requirements of selection criteria (Max 45 points); Under this award sub-criteria, this will be seen as assets: o Experience in data analyses (SQL and noSQL databases), o Experience in parallel programming, o Galaxy administration, o Experience with widely used commercial software for managing and analysing WGS data.

In order for an application to be awarded the grant, the proposal must score a minimum of 70 points out of maximum possible 100 points;

See more information in the Call for proposals.

3 3. APPLICATION SUBMISSION COMPLETENESS CHECKLIST

 The below checklist is designed to help the applicant to ensure that all requested documentation is provided to EFSA.  The application must be submitted in line with guidelines described in the Call for proposals and guide for applicants.  This checklist should be signed and included in the submitted application.  Please tick  in the boxes provided if the document is attached to the application.

The application submission must contain one original unbound paper version and one electronic version (CD Rom or USB key) of all the following documents:

 THIS CHECKLIST, completed.  THIS APPLICATION FORM, completed and signed  LEGAL ENTITY FORM (including requested supporting documents)  FINANCIAL IDENTIFICATION FORM  EXCLUSION CRITERIA: THE DECLARATION OF HONOUR ON EXCLUSION CRITERIA  SELECTION CRITERIA: SIMPLIFIED FINANCIAL STATEMENT (applicable only if an applicant is a private body).  SELECTION CRITERIA: LETTER OF COMMITMENT signed by other contributing public sector body (applicable only when the project involves sources of funding other than EFSA grant and contributions from applicant).  SELECTION CRITERIA: All other evidence requested for the applying organisation under part 2.4 of the Call for proposals.  AWARD CRITERIA: short report (max 20 pages), see above

The legal representative of the applicant confirms that it currently does not receive from the European Union budget an operating grant in line with EU Financial Regulation Article 121 1b (grant for the functioning of a body which pursues an aim of general Union interest or has an objective forming part of, and supporting, a Union policy). The applicant is aware that should it already receive an operating grant from the EU budget, indirect costs are not eligible under the present call.

Name of the legal representative of the applicant: ………………………………

Signature: ………………………

Place: ………………….………….

Date: ………………………………