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Designing and Conducting Formative Research on Determinants of Indoor Quality at the Community Level and Developing Behavioral Change Strategy to Improve Indoor Air Quality and Promote Healthy Housing Request for Proposals (RFP) Bid Reference RFP 094-2021 WHO /Environmental Health

Closing Date:

17 June 2021 at 16:00 hours Time

Doc. Ref: RFP_LV_V.03 2021_20210407

2 Indonesia/Environmental Heath

The World Health Organization (WHO) is seeking offers for designing and conducting formative research on determinants of indoor air quality at the community level and developing a behavioral change strategy to improve indoor air quality and promote healthy housing. Your Company / Institution is invited to submit a proposal for the services in response to this Request for Proposals (RFP).

WHO is a public international organization, consisting of 194 Member States, and a Specialized Agency of the with the mandate to act as the directing and coordinating authority on international health work. As such, WHO is dependent on the budgetary and extra-budgetary contributions it receives for the implementation of its activities. Bidders are, therefore, requested to propose the best and most cost-effective solution to meet WHO requirements, while ensuring a high level of service.

1. Requirements WHO requires the successful bidder, to carry out activities to design and conduct formative research on determinants of indoor air quality at the community level and to develop behavioural change strategy to improve indoor air quality and promote healthy housing, based on these results. . See detailed Terms of Reference in Annex 1 for complete information.

The successful bidder shall be a for profit / not for profit institution operating in the field of public health and/or environmental health with proven expertise in behavioural change and health promotion.

The successful bidder is expected to demonstrate experience and list relevant projects as follows: Mandatory experience: • Public Health • Environmental Health

Desirable experience: • Behavioural science • Air pollution/quality • Health promotion

The bidder is expected to follow the instructions set forth below in the submission of their proposal to WHO.

2. Proposal The proposal and all correspondence and documents relating thereto shall be prepared and submitted in the English language, apart from copies of legal documents or previous work if accomplished in Indonesian language.

The proposal shall be concisely presented and structured to include the following information:

• Confidentiality Undertaking (please complete Annex 2) • Presentation of your Company/Institution (please complete Annex 3) and justification of suitability of the work • Proposed Approach/Methodology to design and conduct a formative research on determinants of indoor air quality at the community level and to develop behavioural change strategy to improve indoor air quality and promote healthy housing, based on these results • Proposed time line for the completion of the project, with the key milestones • Composition of the team and CVs of the team members demonstrating required expertise for their designated roles.

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• Financial proposal must be submitted in IDR currency with clear breakdown of budget lines for each output with adherence to the 2021 standard government rate. A proposed budget template is enclosed in the RFP document. The technical and financial proposal both are subject to final revision and approval after awarding the bid.

Information which the bidder considers confidential, if any, should be clearly marked as such.

3. Instructions to Bidders The bidder must follow the instructions set forth in this RFP in the submission of their proposal to WHO.

A prospective bidder requiring clarification on technical, contractual or commercial matters may notify WHO via email at the following address no later than than 12 Jun 2021:

Email for submissions of all queries: [email protected] with copy to [email protected] (use Bid reference in subject line )

A consolidated document of WHO's responses to all questions (including an explanation of the query but without identifying the source of enquiry) will be sent to all prospective bidders who have received the RFP.

From the date of issue of this RFP to the final selection, contact with WHO officials concerning the RFP process shall not be permitted, other than through the submission of queries and/or through a possible presentation or meeting called for by WHO, in accordance with the terms of this RFP.

The bidder shall submit, in writing, the complete proposal to WHO, no later than 17 June 2021 at 16:00 hours Jakarta time (“the closing date”), as follows:

A technical and financial proposal should be submitted separately in 2 emails stating in the subject the following reference number: RFP 094-2021.

Due to the current situation of COVID-19, submission of proposal can only be done electronically by email to: [email protected] (including any other email address in the submission will automatically disqualify the bid)

. All information and documentation related to the technical proposal (including the attached Annex 2: “Information about Bidders” shall be submitted to [email protected] stating in the email subject “Technical Proposal - RFP 094-2021”

. All information and documentation related to the financial proposal shall be submitted to [email protected] stating in the email subject “Financial Proposal - RFP 094-2021 ”.

PLEASE NOTE THAT ANY SUBMISSION OF TECHNICAL AND FINANCIAL PROPOSALS TOGETHER IN 1 FILE WILL BE REJECTED.

Please make sure to include the following documents to ensure your submission is complete: − A technical proposal, as described under part 2 above and the Terms of Reference in Annex 1; − A financial proposal, as described under part 2 above and the budget template provided in Annex 5; − Annex 2 (Confidentiality Undertaking) and Annex 3 (Vendor Information Form), duly completed and signed by a person or persons duly authorized to represent the bidder, to submit a proposal and to bind the bidder to the terms of this RFP.

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− Self‐Declaration Form − Legal document for operation permit in Indonesia

Each proposal shall be marked Ref: RFP 094-2021 .

WHO may, at its own discretion, extend the closing date for the submission of proposals by notifying all bidders thereof in writing before the above closing date and time.

Any proposal received by WHO after the closing date for submission of proposals may be rejected. Bidders are therefore advised to ensure that they have taken all steps to submit their proposals in advance of the above closing date and time. The offer outlined in the proposal must be valid for a minimum period of 90 calendar days after the closing date. A proposal valid for a shorter period may be rejected by WHO. In exceptional circumstances, WHO may solicit the bidder’s consent to an extension of the period of validity. The request and the responses thereto shall be made in writing. Any bidder granting such an extension will not, however, be permitted to otherwise modify its proposal.

The bidder may withdraw its proposal any time after the proposal’s submission and before the above mentioned closing date, provided that written notice of the withdrawal is received by WHO at the email address indicated above, before the closing date for submission of proposals.

No proposal may be modified after its submission, unless WHO has issued an amendment to the RFP allowing such modifications.

No proposal may be withdrawn in the interval between the closing date and the expiration of the period of proposal validity specified by the bidder in the proposal (subject always to the minimum period of validity referred to above).

WHO may, at any time before the closing date, for any reason, whether on its own initiative or in response to a clarification requested by a (prospective) bidder, modify the RFP by written amendment. Amendments could, inter alia, include modification of the project scope or requirements, the project timeline expectations and/or extension of the closing date for submission.

All prospective bidders that have received the RFP will be notified in writing of all amendments to the RFP and will, where applicable, be invited to amend their proposal accordingly.

All bidders must adhere to the UN Supplier Code of Conduct, which is available on the WHO procurement website at http://www.who.int/about/finances-accountability/procurement/en/.

4. Evaluation Before conducting the technical and financial evaluation of the proposals received, WHO will perform a preliminary examination of these proposals to determine whether they are complete, whether any computational errors have been made, whether the documents have been properly signed, and whether the proposals are generally in order. Proposals which are not in order as aforesaid may be rejected.

The evaluation panel will evaluate the technical merits of all the proposals which have passed the preliminary examination of proposals based on the following weighting:

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Technical Weighting: 80 % of total evaluation Financial Weighting: 20 % of total evaluation

The technical evaluation of the proposals will include:

Quality of the overall proposal, including the timeframe and 50 quality assurance mechanisms Experience of the firm/institution in carrying out related 15 project Qualification and competence of the personal proposed for 15 the assignment X X TOTAL 80

The number of points which can be obtained for each evaluation criterion is specified above and indicates the relative significance or weight of the item in the overall evaluation process.

A minimum of [50] points is required to pass the technical evaluation.

Please note that WHO is not bound to select any bidder and may reject all proposals. Furthermore, since a contract would be awarded in respect of the proposal which is considered most responsive to the needs of the project concerned, due consideration being given to WHO’s general principles, including the principle of best value for money, WHO does not bind itself in any way to select the bidder offering the lowest price.

WHO may, at its discretion, ask any bidder for clarification of any part of its proposal. The request for clarification and the response shall be in writing. No change in price or substance of the proposal shall be sought, offered or permitted during this exchange.

NOTE: Individual contact between WHO and bidders is expressly prohibited both before and after the closing date for submission of proposals.

5. Award WHO reserves the right to: 1. Award the contract to a bidder of its choice, even if its bid is not the lowest; 2. Award separate contracts for parts of the work, components or items, to one or more bidders of its choice, even if their bids are not the lowest; 3. Accept or reject any proposal, and to annul the solicitation process and reject all proposals at any time prior to award of contract, without thereby incurring any liability to the affected bidder or bidders and without any obligation to inform the affected bidder or bidders of the grounds for WHO's action; 4. Award the contract on the basis of the Organization’s particular objectives to a bidder whose proposal is considered to be the most responsive to the needs of the Organization and the activity concerned; 5. Not award any contract at all.

WHO has the right to eliminate bids for technical or other reasons throughout the evaluation/selection process. WHO shall not in any way be obliged to reveal, or discuss with any bidder, how a proposal was assessed, or to provide any other information relating to the evaluation/selection process or to state the reasons for elimination to any bidder.

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NOTE: WHO is acting in good faith by issuing this RFP. However, this document does not oblige WHO to contract for the performance of any work, nor for the supply of any products or services.

At any time during the evaluation/selection process, WHO reserves the right to modify the scope of the work, services and/or goods called for under this RFP. WHO shall notify the change to only those bidders who have not been officially eliminated due to technical reasons at that point in time.

WHO reserves the right at the time of award of contract to extend, reduce or otherwise revise the scope of the work, services and/or goods called for under this RFP without any change in the base price or other terms and conditions offered by the selected bidder.

WHO also reserves the right to enter into negotiations with one or more bidders of its choice, including but not limited to negotiation of the terms of the proposal(s), the price quoted in such proposal(s) and/or the deletion of certain parts of the work, components or items called for under this RFP.

Within 30 days of receipt of the contract between WHO and the successful bidder (the “Contract”), the successful bidder shall sign and date the Contract and return it to WHO according to the instructions provided at that time. If the bidder does not accept the Contract terms without changes, then WHO has the right not to proceed with the selected bidder and instead contract with another bidder of its choice. The Contract will include, without limitation, the provisions set forth in Annex 3.

Any and all of the contractor's (general and/or special) conditions of contract are hereby explicitly excluded from the Contract, i.e., regardless of whether such conditions are included in the Contractor's offer, or printed or referred to on the Contractor's letterhead, invoices and/or other material, documentation or communications.

We look forward to receiving your response to this RFP.

Yours sincerely, WHO Indonesia Healthier Population Unit.

RFP 094-2021 Doc. Ref: RFP_LV_V.03 2021_20210407 pg. 6 7 Indonesia/Environmental Heath

Annexes

1. Detailed Terms of Reference 2. Confidentiality Undertaking 3. Vendor Information Form 4. Contractual provisions 5. Proposed budget template 6. Evaluation Criteria

Appendix 1. Government Standard Rate 2021 2. Self-Declaration Form

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Annex 1: Detailed Terms of Reference

See attached document.

1. Purpose of the APW The purpose of the APW is to design and conduct formative research on determinants of indoor air quality at the community level, and to develop a behavioral change strategy to improve indoor air quality and promote healthy housing, based on these results.

2. Background Action on household or indoor air pollution is a global health priority; indoor air pollution is linked to cardiac and respiratory diseases, as well as poor maternal and child health outcomes. Indoor air quality is affected by a number of aspects of the indoor and outdoor environment, including the ventilation system, structure of the dwelling, its situation, the cooking, lighting and heating devices used, the types of furnishing, adhesives and coatings, and outdoor pollution as well as tobacco smoking by occupants or infiltrations of tobacco smoke coming from neighbouring units. 1 In addition, solid fuel is also one of major causes to indoor air pollution which has been linked to diseases such as acute and chronic respiratory diseases, tuberculosis, asthma, cardiovascular disease and perinatal health.2 The Government of Indonesia has included air quality and climate chance in the National Mid-Term Planning (RPJMN) 2020-2024 as national priorities in the development agenda. The Ministry of Health, which focuses on indoor air pollution, has issued Decree No. 829/1999 on Housing Health Standards and Regulation No. 1077/2011 on Guidelines for Household Air Quality. There are regulations related to household indoor air quality to be reviewed by the Ministry of Health during the strategic planning period i.e. (1) MOH Regulation on Environmental Health Quality and Air Quality Standards and (2) Environmental Health and Healthy Housing Quality Standard. Review of these regulations by the Directorate of Environmental Health, Ministry of Health will enable establishment of strong policy and implementation. In 2020, WHO supported MOH for Compilation of the Technical Resource Materials Including Best Buys and Application Tools on Air Pollution Control and Health Promotion. This process identified one the option to develop Guidelines on Behavioral Change through Community Empowerment to Improve Indoor Air Quality. WHO will support MOH to develop the guidelines for community empowerment to create healthy households and environment. However, before developing the guideline, it is necessary to conduct formative research though better understanding of the determinants of healthy home environments. The results of this research will better inform a behavioral change strategy and the development of guideline’s content and mechanism of intervention to improve indoor air quality and promote healthy housing. As the Ministry of Health will be reviewing and evaluating the relevant regulations, particularly the implementation of Regulation No. 1077/2011 on Guidelines for Household Air Quality, this research will also contribute to this review. The aim of this proposal is to design and conduct formative research on determinants of air quality and housing at the community level, and to design a behavioral change strategy to improve indoor air quality and promote healthy housing.

3. Planned timelines (subject to confirmation) Contract Phase 1 (Output 1.1) Start date: 01/07/2021 End date: 30/09/2021

1 https://www.who.int/publications/i/item/9789241550376 2 https://www.who.int/airpollution/publications/indoor_air_national_burden_estimate_revised.pdf?ua=1

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Total duration: three months Contract Phase 2 (Output 1.2) Start date: 02/01/2022 End date: 31/03/2022 Total duration: three months

4. Requirements - Work to be performed Objective: to design and conduct formative research to identify the determinants of indoor air quality and healthy housing, specifically the enabling and hindering factors for behavior change related to indoor air quality and housing quality. Output 1.1: Report of the results of formative research detailing determinants of indoor air quality and housing at the community, family and individual level. Output 1.2: Behavioral change strategy to improve indoor air quality and housing, based on the results of the research.

5. Requirements - Planning Output 1.1: Report of the results of formative research detailing determinants of indoor air quality and housing at the community, family and individual level. In close collaboration with WHO and the Ministry of Health, the contractor will undertake the following phases: Phase 1: Design formative research • The contractor will conduct a desk review to identify key behaviors contributing to the indoor air pollution problem in Indonesia and factors (individual, sociocultural, and economic) that might influence these behaviors. In reference to the results of the desk review, the contractor will develop a concept note of the formative research which includes (but is not limited to) the following components: a. Data related to the knowledge, attitudes and practices at community levels contributing to indoor air pollution b. Identification of factors (individual, sociocultural, and economic) that might influence behaviors and practices related to indoor air quality at the community and household level; this should include factors related to gender inequality. c. Proposed methodology, tools, study areas, target respondents, and timeframe of the formative research to design a comprehensive behavioral change study. • The contractor will conduct consultations with MoH and WHO to refine and finalize for the formative research concept note before the implementation (in Phase-2). • The contractor is responsible for obtaining any ethics approvals as needed. Expected timeline for this phase is in July 2021 (indicative). Phase 2: Conduct a formative research The contractor will conduct a formative research based on agreed design of the research generated from Phase 1 and develop a report of the findings. Expected timeline for this phase is from August to September 2021 (indicative) Output 1.2: Behavioral change strategy to improve indoor air quality and housing, based on the results of the research. Phase 3: Develop behaviour change strategy • The contractor will develop a comprehensive behavioral change strategy based on the results of the formative research including the intervention options to improve indoor air quality and promote healthy housing • The contractor in consultation with WHO, MOH, and other relevant stakeholders (i.e. Ministry of Women Empowerment and Child Protection, Ministry of Home Affairs, Ministry of Planning/Bappenas, academia, professional associations, and CSOs) to gain insights from stakeholders and ideas on how to address some the findings, as inputs into the behavioral change strategy.

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• The meetings might cover the following topics but not limited to: (1) Purpose and outlines, (2) key component, and (4) dissemination of information of the result of formative research, and (5) behavioral change strategy • Regular meeting series with MOH and WHO will be conducted to compile the feedback and input from consultative meetings. • Due to the on-going pandemic, the meetings are preferably conducted online or hybrid to ensure safe physical distance among the target participants. Expected timeline for this phase is from January to March 2021 (indicative)

The bidder will provide detailed work breakdown structure showing how and when all key activities will be undertaken and when the deliverables mentioned in the scope of work will be completed. This plan must be laid out in an implementation timetable that is within the duration of this contract.

6. Inputs Directorate of Environmental Health, MOH as beneficiary will closely work with WHO and selected bidder in every steps of work and facilitate the discussions and related meetings. For sustainability, MOH will use this formative research result to enrich and contribute the development of the guideline for the community to improve indoor air quality and promote healthy housing. Additionally, WHO will be involved and monitor the overall process of the project. The selected bidder is expected to actively comunicate the process and/or the changes (if any) to WHO on a weekly basis through email as official communication for the record.

7. Activity Coordination & Reporting Administrative Mr. Piotr Jakubiec Email: [email protected] Officer: Administrative Officer For the purpose of: Contractual and financial management of the contract

8. Characteristics of the Provider The project team is expected to possess the following expertise. Their CVs and experience relevant to air quality and environmental health, public health, data analysis, and stakeholder consultation should be submitted with the proposal. Information about their roles/responsibilities and the proportionate time they will dedicate to the project should also be included in the submission and in the financial proposal. Please also see the budget plan template for further information. Require minimum competencies and experiences for the contactor as follows: a. Team leader - Post graduate degree in public health/environmental health or related field. - At least 5 years of experience in research preferably on behavior and community approach, as well as in formulating recommendations for health policy and programmes. - Experience in leading environmental/public health research or projects related to environment health or a related field. b. Public Health Specialist - Graduate degree in public health with competencies on behavior science, qualitative research and qualitative data analysis. - At least 3 years of experience in behavior research, qualitative data analysis as well as in formulating recommendations for health policy and programmes. c. Health Promotion or Behavioral Sciences Specialist - Graduate degree in health promotion, health communication, or behavioral sciences

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- At least 3 years of experience in health communication, health promotion, and behavioral sciences, preferably in the area of environmental or public health. *Please clearly specify the proportionate time in terms of percentage of work hours that every team member will dedicate to this project.

9. Place of assignment Considering the pandemic situation, the institution can be based anywhere in Indonesia and use online and electronic meeting platforms to conduct the work. It is expected that due consideration will be given to using online and electronic meeting platforms to conduct all phases of this work, due to the COVID-19 pandemic

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Annex 2: Confidentiality Undertaking

1. The World Health Organization (WHO), acting through its Department of Healthier Population, has access to certain information relating to Proposal which it considers to be proprietary to itself or to entities collaborating with it (hereinafter referred to as “the Information”).

2. WHO is willing to provide the Information to the Undersigned for the purpose of allowing the Undersigned to prepare a response to the Request for Proposal (RFP) for “Designing and Conducting Formative Research on Determinants of Indoor Air Quality at the Community Level and Developing Behavioral Change Strategy to Improve Indoor Air Quality and Promote Healthy Housing” ("the Purpose"), provided that the Undersigned undertakes to treat the Information as confidential and proprietary, to use the Information only for the aforesaid Purpose and to disclose it only to persons who have a need to know for the Purpose and are bound by like obligations of confidentiality and non-use as are contained in this Undertaking.

3. The Undersigned undertakes to regard the Information as confidential and proprietary to WHO or parties collaborating with WHO, and agrees to take all reasonable measures to ensure that the Information is not used, disclosed or copied, in whole or in part, other than as provided in paragraph 2 above, except that the Undersigned shall not be bound by any such obligations if the Undersigned is clearly able to demonstrate that the Information: 1. was known to the Undersigned prior to any disclosure by WHO to the Undersigned (as evidenced by written records or other competent proof); 2. was in the public domain at the time of disclosure by or for WHO to the Undersigned; 3. becomes part of the public domain through no fault of the Undersigned; or 4. becomes available to the Undersigned from a third party not in breach of any legal obligations of confidentiality (as evidenced by written records or other competent proof).

5. The Undersigned further undertakes not to use the Information for any benefit, gain or advantage, including but not limited to trading or having others trading in securities on the Undersigned’s behalf, giving trading advice or providing Information to third parties for trade in securities.

6. At WHO's request, the Undersigned shall promptly return any and all copies of the Information to WHO.

7. The obligations of the Undersigned shall be of indefinite duration and shall not cease on termination of the above mentioned RFP process.

8. Any dispute arising from or relating to this Undertaking, including its validity, interpretation, or application shall, unless amicably settled, be subject to conciliation. In the event of the dispute is not resolved by conciliation within thirty (30) days, the dispute shall be settled by arbitration. The arbitration shall be conducted in accordance with the modalities to be agreed upon by the Undersigned and WHO or, in the absence of agreement within thirty (30) days of written communication of the intent to commence arbitration, with the rules of arbitration of the International Chamber of Commerce. The Undersigned and WHO shall accept the arbitral award as final.

9. Nothing in this Undertaking, and no disclosure of Information to the Undersigned pursuant to its terms, shall constitute, or be deemed to constitute, a waiver of any of the privileges and immunities enjoyed by WHO under national or international law, or as submitting WHO to any national court jurisdiction.

Acknowledged and Agreed:

Entity Name: …………………………………………………………………………………………………

………………………………………………………………………………………………… Mailing Address: ………………………………………………………………………………………………… ………………………………………………………………………………………………… Name and Title of duly authorized representative: …………………………………………………………………………………………………

Signature: …………………………………………………………………………………………………

Date: …………………………………………………………………………………………………

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Annex 3: Vendor Information Form

Company Information to be provided by the Vendor submitting the proposal UNGM Vendor ID Number: If available – Refer to WHO website for registration process* Legal Company Name: (Not trade name or DBA name) Company Contact: Address: City: State: Country: Zip: Telephone Number: Fax Number: Email Address: Company Website: Corporate information: Company mission statement Service commitment to customers and measurements used (if available)

Organization structure (include description of those parts of your organization that would be involved in the performance of the work)

Relevant experience (how could your expertise contribute to WHO’s needs for the purpose of this RFP) – Please attach reference and contact details Staffing information

______* http://www.who.int/about/finances-accountability/procurement/en/

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Annex 4: Contractual Provisions

Within 30 days of receipt of the contract between WHO and the successful bidder (the “Contract”), the successful bidder shall sign and date the Contract and return it to WHO according to the instructions provided at that time. If the bidder does not accept the Contract terms without changes, then WHO has the right not to proceed with the selected bidder and instead contract with another bidder of its choice. The Contract will include, without limitation, the provisions set forth below (with the successful bidder referred to below as the “Contractor”):

1. Compliance with WHO Codes and Policies. By entering into the Contract, the Contractor acknowledges that it has read, and hereby accepts and agrees to comply with, the WHO Policies (as defined below).

In connection with the foregoing, the Contractor shall take appropriate measures to prevent and respond to any violations of the standards of conduct, as described in the WHO Policies, by its employees and any other persons engaged by the Contractor to perform any services under the Contract.

Without limiting the foregoing, the Contractor shall promptly report to WHO, in accordance with the terms of the applicable WHO Policies, any actual or suspected violations of any WHO Policies of which the Contractor becomes aware.

For purposes of the Contract, the term “WHO Policies” means collectively: (i) the WHO Code of Ethics and Professional Conduct; (ii) the WHO Policy on Sexual Exploitation and Abuse Prevention and Response; (iii) the WHO policy on Preventing and Addressing Abusive Conduct; (iv) the WHO Code of Conduct for responsible Research; (v) the WHO Policy on Whistleblowing and Protection Against Retaliation; and (vi) the UN Supplier Code of Conduct, in each case, as amended from time to time and which are publicly available on the WHO website at the following links: http://www.who.int/about/finances-accountability/procurement/en/ for the UN Supplier Code of Conduct and at http://www.who.int/about/ethics/en/ for the other WHO Policies.

2. Zero tolerance for sexual exploitation and abuse. WHO has zero tolerance towards sexual exploitation and abuse. In this regard, and without limiting any other provisions contained herein:

(i) each legal entity Contractor warrants that it will: (i) take all reasonable and appropriate measures to prevent sexual exploitation or abuse as described in the WHO Policy on Sexual Exploitation and Abuse Prevention and Response by any of its employees and any other persons engaged by it to perform any services under the Contract; and (ii) promptly report to WHO and respond to, in accordance with the terms of the Policy, any actual or suspected violations of the Policy of which the contractor becomes aware; and

(ii) each individual Contractor warrants that he/she will (i) not engage in any conduct that would constitute sexual exploitation or abuse as described in the WHO Policy on Sexual Exploitation and Abuse Prevention and Response; and (ii) promptly report to WHO, in accordance with the terms of the Policy, any actual or suspected violations of the Policy of which the Contractor becomes aware.

3. Tobacco/Arms Related Disclosure Statement. The Contractor may be required to disclose relationships it may have with the tobacco and/or arms industry through completion of the WHO Tobacco/Arms Disclosure Statement. In the event WHO requires completion of this Statement, the Contractor undertakes not to permit work on the Contract to commence, until WHO has assessed the disclosed information and confirmed to the Contractor in writing that the work can commence.

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4. Anti-Terrorism and UN Sanctions; Fraud and Corruption. The Contractor warrants for the entire duration of the Contract that:

i. it is not and will not be involved in, or associated with, any person or entity associated with terrorism, as designated by any UN Security Council sanctions regime, that it will not make any payment or provide any other support to any such person or entity and that it will not enter into any employment or subcontracting relationship with any such person or entity;

ii. it shall not engage in any illegal, corrupt, fraudulent, collusive or coercive practices (including bribery, theft and other misuse of funds) in connection with the execution of the Contract; and

iii. the Contractor shall take all necessary precautions to prevent the financing of terrorism and/or any illegal corrupt, fraudulent, collusive or coercive practices (including bribery, theft and other misuse of funds) in connection with the execution of the Contract.

Any payments used by the Contractor for the promotion of any terrorist activity or any illegal, corrupt, fraudulent, collusive or coercive practice shall be repaid to WHO without delay.

5. Breach of essential terms. The Contractor acknowledges and agrees that each of the provisions of paragraphs 1, 2, 3 and 4 above constitutes an essential term of the Contract, and that in case of breach of any of these provisions, WHO may, in its sole discretion, decide to:

i. terminate the Contract, and/or any other contract concluded by WHO with the Contractor, immediately upon written notice to the Contractor, without any liability for termination charges or any other liability of any kind; and/or

ii. exclude the Contractor from participating in any ongoing or future tenders and/or entering into any future contractual or collaborative relationships with WHO.

WHO shall be entitled to report any violation of such provisions to WHO’s governing bodies, other UN agencies, and/or donors.

6. Use of WHO Name and Emblem. Without WHO’s prior written approval, the Contractor shall not, in any statement or material of an advertising or promotional nature, refer to the Contract or the Contractor’s relationship with WHO, or otherwise use the name (or any abbreviation thereof) and/or emblem of the World Health Organization.

7. Assurances regarding procurement. If the option for payment of a maximum amount applies, to the extent the Contractor is required to purchase any goods and/or services in connection with its performance of the Contract, the Contractor shall ensure that such goods and/or services shall be procured in accordance with the principle of best value for money. "Best value for money" means the responsive offer that is the best combination of technical specifications, quality and price.

8. Audit. WHO may request a financial and operational review or audit of the work performed under the Contract, to be conducted by WHO and/or parties authorized by WHO, and the Contractor undertakes to facilitate such review or audit. This review or audit may be carried out at any time during the implementation of the work performed under the Contract, or within five years of completion of the work. In order to facilitate such financial and operational review or audit, the Contractor shall keep accurate and systematic accounts and records in respect of the work performed under the Contract.

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The Contractor shall make available, without restriction, to WHO and/or parties authorized by WHO:

i. the Contractor’s books, records and systems (including all relevant financial and operational information) relating to the Contract; and ii. reasonable access to the Contractor’s premises and personnel.

The Contractor shall provide satisfactory explanations to all queries arising in connection with the aforementioned audit and access rights.

WHO may request the Contractor to provide complementary information about the work performed under the Contract that is reasonably available, including the findings and results of an audit (internal or external) conducted by the Contractor and related to the work performed under the Contract.

9. Publication of Contract. Subject to considerations of confidentiality, WHO may acknowledge the existence of the Contract to the public and publish and/or otherwise publicly disclose the Contractor’s name and country of incorporation, general information with respect to the work described herein and the Contract value. Such disclosure will be made in accordance with WHO’s Information Disclosure Policy and shall be consistent with the terms of the Contract.

RFP 094-2021 Doc. Ref: RFP_LV_V.03 2021_20210407 pg. 16 Annex. 5 Proposed Budget Template RFP 094-2021

Designing and Conducting Formative Research on Determinants of Indoor Air Quality at the Community Level and Developing Behavioral Change Strategy to Project title: Improve Indoor Air Quality and Promote Healthy Housing Name of institution Duration July - Sept 2021 and Jan - Mar 2022

No Activities Quantity Unit Duration Unit Frequency Unit Unit cost % of time Total (IDR)

1 Renumeration Team Leader Team member Admin Support and Finance Output 1.1

2 Phase 1 Consultative Meeting Honorarium for resource person Internet fee for meetings (virtual)

etc Workshop etc Sub Total 1 3 Phase 2 Conducting Formative research Honorarium for resource person Internet fee for meetings (virtual)

etc Sub Total 2 Output 1.2 4 Phase 3 Consultative Meeting Honorarium for resource person Internet fee for meetings (virtual)

etc Sub Total 3 5 Micellaneous Transportation Communication etc Sub Total 5

Total

Institutional Fee

Grand Total Annex 6 Designing and Conducting Formative Research on Determinants of Indoor Air Quality at the Community Level and Developing Behavioral Change Strategy to Improve Indoor Air Quality and Promote Healthy Housing EVALUATION CRITERIA

Max Min. Pass No. Category Points Points QUALITY OF THE TECHNICAL PROPOSAL 50 The proposal provides sufficient detail of a technically sound 1 methodology to design and conduct formative research on determinant 1.1 20 of indoor air qaulity at the community level, with key consultation and stakeholders identified (Phase 1) The proposal provides sufficient detail of a technically sound approach to develop behavioral change strategy to improve indoor air quality and 1.2 15 promote healthy housing, with key consultation and stakeholders identified (Phase 2) The proposal identifies key stakeholders to be involved at each stage 1.2 5 Implementation timeline The activity Gantt chart with implementation timeline is realistic and 1.3 includes specific tasks for each deliverable along with the person 5 responsible The proposal describes the anticipated projects risks and mitigation 1.4 measures, as well as quality assurance mechanisms including address the 5 need for ethics approval TEAM COMPOSITION 15 Overall team composition is in alignment with the skills and experience 2.1 7 required to fulfill the terms of reference 2 Structure of the team, including the role, responsibilities and time 2.2 3 dedicated to the project for each team member is specified CVs of each team member demonstrate required expertise to fulfill their 2.3 5 designated role EXPERIENCE OF THE INSTITUTION/COMPANY 15 Institution/company profile indicates previous major work related to 3.1 reseract or study and/or development of policy intervention, preferably 7 related to the environmental health and behavioural change References/links to previous relevant work provided and indicate high 3 3.2 3 quality of work List of clients in the last five years, including contact details (name, email 3.3 2 address, and phone numbers that can be used as reference) The institution/organization has demonstrated experience of working 3.4 3 with government counterparts TECHNICAL PROPOSAL 80 50 FINANCIAL PROPOSAL 20 TOTAL MARKS 100 Based onPMK No. 119/PMK.02/2020

HOTEL Daily Allowance Meeting Package KONSUMSI RAPAT Total Daily Allowance SEWA (the same city) for NO PROV IBU KOTA Daily Allowance KENDARAAN TAXI more than 8 hours PEJABAT (RODA 4) FULLBOARD FULLBOARD Meals & FULLDAY/ HALFDAY FULLDAY FULLBOARD MAKAN SNACK (incl travel) ES.IV/ GOL. III LUAR KOTA DALAM KOTA Refreshment HALFDAY DALAM KOTA 1 ACEH 360,000 140,000 556,000 930,000 123,000 120,000 120,000 85,000 300,000 370,000 772,000 51,000 19,000 70,000 2 SUMUT 370,000 150,000 530,000 975,000 232,000 130,000 130,000 95,000 178,000 275,000 764,000 47,000 17,000 64,000 3 RIAU 370,000 150,000 699,080 978,000 94,000 130,000 130,000 85,000 185,000 255,000 655,000 42,000 17,000 59,000 4 KEPRI Tj. Pinang 370,000 150,000 699,080 901,000 137,000 130,000 130,000 95,000 227,000 297,000 697,000 41,000 25,000 66,000 5 Jambi 370,000 150,000 580,000 804,000 147,000 130,000 130,000 95,000 215,000 301,000 840,000 42,000 17,000 59,000 6 SUMBAR 380,000 150,000 650,000 800,000 190,000 120,000 120,000 85,000 178,000 248,000 663,000 45,000 17,000 62,000 7 SUMSEL 380,000 150,000 679,080 1,375,000 128,000 120,000 120,000 85,000 218,000 293,000 745,000 46,000 17,000 63,000 8 LAMPUNG Bdr. Lampung 380,000 150,000 580,000 846,000 167,000 130,000 130,000 95,000 220,000 290,000 768,000 42,000 20,000 62,000 9 Bengkulu 380,000 150,000 630,000 777,000 109,000 130,000 130,000 95,000 214,000 284,000 912,000 45,000 16,000 61,000 10 BABEL 410,000 160,000 619,080 1,258,000 90,000 130,000 130,000 95,000 299,000 385,000 965,000 42,000 18,000 60,000 11 BANTEN 370,000 150,000 699,080 777,000 446,000 120,000 120,000 85,000 330,000 425,000 1,005,000 54,000 19,000 73,000 12 JABAR 430,000 170,000 570,000 932,000 166,000 150,000 150,000 105,000 331,000 401,000 822,000 46,000 20,000 66,000 13 DKI JAKARTA Jakarta 530,000 210,000 730,000 911,000 256,000 180,000 180,000 130,000 354,000 433,000 1,197,000 48,000 22,000 70,000 14 JATENG 370,000 150,000 600,000 1,016,000 90,000 130,000 130,000 95,000 191,000 263,000 675,000 44,000 15,000 59,000 15 DIY 420,000 170,000 845,000 905,000 135,000 140,000 140,000 100,000 210,000 310,000 750,000 39,000 16,000 55,000 16 JATIM 410,000 160,000 664,000 966,000 194,000 140,000 140,000 100,000 338,000 408,000 1,352,000 45,000 23,000 68,000 17 BALI 480,000 190,000 888,240 925,000 159,000 160,000 160,000 115,000 330,000 441,000 1,419,000 48,000 20,000 68,000 18 NTB 440,000 180,000 559,080 882,000 231,000 150,000 150,000 105,000 317,000 420,000 820,000 43,000 19,000 62,000 19 NTT 430,000 170,000 550,000 857,000 108,000 140,000 140,000 100,000 271,000 377,000 825,000 43,000 21,000 64,000 20 KALBAR 380,000 150,000 538,000 868,000 140,000 130,000 130,000 95,000 250,000 331,000 744,000 44,000 16,000 60,000 21 KALTENG Palangkaraya 360,000 140,000 659,000 1,177,000 111,000 120,000 120,000 85,000 242,000 340,000 1,170,000 42,000 15,000 57,000 22 KALSEL 380,000 150,000 648,000 778,000 150,000 130,000 130,000 95,000 200,000 295,000 800,000 51,000 16,000 67,000 23 KALTIM 430,000 170,000 579,080 1,100,000 450,000 150,000 150,000 105,000 207,000 302,000 900,000 44,000 24,000 68,000 24 KALTARA Tanjung Selor 430,000 170,000 579,080 1,100,000 218,000 150,000 150,000 105,000 207,000 302,000 750,000 44,000 21,000 65,000 25 SULUT Manado 370,000 150,000 782,000 956,000 138,000 130,000 130,000 95,000 189,000 270,000 737,000 55,000 25,000 80,000 26 Gorontalo 370,000 150,000 699,080 792,000 240,000 130,000 130,000 95,000 175,000 250,000 1,179,080 45,000 14,000 59,000 27 SULBAR 410,000 160,000 619,080 772,000 313,000 120,000 120,000 85,000 235,000 323,000 951,000 51,000 20,000 71,000 28 SULSEL 430,000 170,000 732,000 796,000 145,000 150,000 150,000 105,000 206,000 320,000 1,127,000 56,000 24,000 80,000 29 SULTENG 370,000 150,000 951,000 824,000 165,000 130,000 130,000 95,000 260,000 385,000 886,000 46,000 17,000 63,000 30 SULTRA 380,000 150,000 679,080 839,000 171,000 130,000 130,000 95,000 225,000 295,000 695,000 45,000 20,000 65,000 31 Ambon 380,000 150,000 667,000 947,000 240,000 120,000 120,000 85,000 265,000 346,000 746,000 59,000 22,000 81,000 32 MALUT Sofii 430,000 170,000 579,080 965,000 215,000 130,000 130,000 95,000 203,000 354,000 803,000 63,000 23,000 86,000 33 580,000 230,000 546,839 1,107,000 431,000 200,000 200,000 140,000 293,000 478,000 990,000 61,000 31,000 92,000 34 PAPUA BARAT 480,000 190,000 479,080 1,059,000 182,000 160,000 160,000 115,000 310,000 421,000 1,119,080 62,000 25,000 87,000

Average 406,765 161,765 648,974 938,088 191,500 137,059 137,059 98,088 246,265 337,882 889,505 47,676 19,735 67,412

Meeting in the hotel is allowed only if involves participation from other Ministry

*) Based on UN DSA rate for March 2020 SBU TAHUN 2017

TIKET PESAWAT PP JKT NO PROV IBU KOTA Kota Tujuan Ekonomi 1 ACEH Banda Aceh Banda Aceh 4,492,000 2 SUMUT Medan Medan 3,808,000 3 RIAU Pekanbaru Pekanbaru 3,016,000 4 KEPRI Tj. Pinang 2,888,000 5 JAMBI Jambi Jambi 2,460,000 6 SUMBAR Padang Padang 2,952,000 7 SUMSEL Palembang Palembang 2,268,000 8 LAMPUNG Bdr. Lampung Bdr. Lampung 1,583,000 9 BENGKULU Bengkulu Bengkulu 2,621,000 10 BABEL Pangkal Pinang Pangkal Pinang 2,139,000 11 BANTEN Serang - 12 JABAR Bandung - 13 DKI JAKARTA Jakarta - 14 JATENG Semarang Semarang 2,182,000 Solo 2,342,000 15 DI YOGYAKARTA Yogyakarta Jogyakarta 2,268,000 16 JATIM Surabaya Surabaya 2,674,000 2,695,000 17 BALI Denpasar Denpasar 3,262,000 18 NTB Mataram Mataram 3,230,000 19 NTT Kupang Kupang 5,081,000 20 KALBAR Pontianak Pontianak 2,781,000 21 KALTENG Palangkaraya Palangkaraya 2,984,000 22 KALSEL Banjarmasin Banjarmasin 2,995,000 23 KALTIM Samarinda 3,797,000 24 KALTARA Tanjung Selor Tarakan 3,797,000 25 SULUT Manado Manado 5,102,000 26 GORONTALO Gorontalo Gorontalo 4,824,000 27 SULBAR Mamuju Mamuju 4,867,000 28 SULSEL Makassar Makassar 3,829,000 29 SULTENG Palu Palu 5,113,000 30 SULTRA Kendari Kendari 4,182,000 31 MALUKU Ambon Ambon 7,081,000 32 MALUT Sofii 6,664,000 33 PAPUA Jayapura Jayapura 8,193,000 Biak 7,519,000 7,487,000 34 PAPUA BARAT Manokwari Manokwari 10,824,000

Papua, Papbar, Maluku 8,699,333 Taxi 474,000 Taxi Jakarta 340,000 9,513,333 Resource Person Fee

Level Rate per hour (IDR) Minister 1,700,000 per hour for max of 3 hours Escelon I 1,400,000 per hour for max of 3 hours Escelon II 1,000,000 per hour for max of 3 hours Escelon III and below 900,000 per hour for max of 3 hours Moderator 700,000 per times

Resource person (including moderator) fee is payable when he/she comes from other Ministry/Institution (K/L) than the organizing Ministry/Institution(K/L) SELF DECLARATION FOR M Applicable to private and public companies ______(the “Company”) hereby declares to the World Health Organization (WHO) that: a. it is not bankrupt or being wound up, having its affairs administered by the courts, has not entered into an arrangement with creditors, has not suspended business activities, is not the subject of proceedings concerning the foregoing matters, and is not in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b. it is solvent and in a position to continue doing business for the period stipulated in the contract after contract signature, if awarded a contract by WHO; c. it or persons having powers of representation, decision making or control over the Company have not been convicted of an offence concerning their professional conduct by a final judgment; d. it or persons having powers of representation, decision making or control over the Company have not been the subject of a final judgment or of a final administrative decision for fraud, corruption, involvement in a criminal organization, money laundering, terrorist-related offences, child labour, human trafficking or any other illegal activity; e. it is in compliance with all its obligations relating to the payment of social security contributions and the payment of taxes in accordance with the national legislation or regulations of the country in which the Company is established; f. it is not subject to an administrative penalty for misrepresenting any information required as a condition of participation in a procurement procedure or failing to supply such information; g. it has declared to WHO any circumstances that could give rise to a conflict of interest or potential conflict of interest in relation to the current procurement action; h. it has not granted and will not grant, has not sought and will not seek, has not attempted and will not attempt to obtain, and has not accepted and will not accept any direct or indirect benefit (finanical or otherwise) arising from a procurement contract or the award thereof; i. it adheres to the UN Supplier Code of Conduct; and j. it has zero tolerance for sexual exploitation and abuse and has appropriate procedures in place to prevent and respond to sexual exploitation and abuse. The Company understands that a false statement or failure to disclose any relevant information which may impact upon WHO's decision to award a contract may result in the disqualification of the Company from the bidding exercise and/or the withdrawal of any offer of a contract with WHO. Furthermore, in case a contract has already been awarded, WHO shall be entitled to rescind the contract with immediate effect, in addition to any other remedies which WHO may have by contract or by law.

Entity Name: …………………………………………………………………………………………………

………………………………………………………………………………………………… Mailing Address: ………………………………………………………………………………………………… …………………………………………………………………………………………………

Name and Title of duly authorized representative: …………………………………………………………………………………………………

Date: …………………………………………………………………………………………………

Signature: …………………………………………………………………………………………………