OFFICIAL i# 4 DOCUMENTS The World Bank 1818 H Street N. (202) 4731 000 INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Washington, D.C. 20433 Cable Addgess: INTBAFRAD INTERNATIONAL DEVELOPMENT ASSOCIATION U.S.A. Uabl.eiAddress: INDEVAS Honorable Amara Konneh Minister of Finance Ministry of Finance Broad Street Monrovia Republic of Liberia Excellency: Re: Multi-Donor Trust Fund for the Global Financing Facility GFF Grant Number TFOA1167 (Liberia Health Systems Strengthening Project) Additional Instructions: Disbursement I refer to the Grant Agreement ("Agreement") between the Republic of Liberia (the "Recipient") and the International Development Association ("Association"), acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child (GFF), for the above- referenced project, datedt? 11 I-.The Agreements provides that the Association may issue additional instructions regarding the withdrawal of the proceeds of GFF Grant TFOAl 167 ("Grant"). This letter ("Disbursement Letter"), as revised from time to time, constitutes the additional instructions. The attached World Bank Disbursement Guidelines for Projects, dated May 1, 2006, ("Disbursement Guidelines") (Attachment 1), are an integral part of the Disbursement Letter. The manner in which the provisions in the Disbursement Guidelines apply to the Financing are specified below. Sections and subsections in parentheses below refer to the relevant sections and subsections in the Disbursement Guidelines and, unless otherwise defined in this letter, the capitalized terms used have the meanings ascribed to them in the Disbursement Guidelines. I. Disbursement Arrangements (i) Disbursement Methods (section 2). The following Disbursement Methods may be used under the Grant: * Reimbursement * Advance * Direct Payment * Special Commitment (ii) Disbursement Deadline Date (subsection 3.7). The Disbursement Deadline Date is 4 months after the Closing Date. Any changes to this date will be notified by the Association. (iii) Disbursement Conditions (subsection 3.8). Please refer to the Disbursement Condition(s), if any, in the Agreement. II. Withdrawal of Grant Proceeds (i) Authorized Signatures (subsection 3.1). A letter in the Form attached (Attachment 2) should be furnished to the Association at the address indicated below providing the name(s) and specimen signature(s) of the official(s) authorized to sign Applications: The World Bank Office Bright Building UN Dhve, Mamba Point Monrovia, Liberia Attention: Henry G. R. Kerali Country Director for Liberia (ii) Applications (subsections 3.2 - 3.3). Please provide completed and signed (a) applications for withdrawal, together with supporting documents to the address indicated below: The World Bank Office Bright Building UN Drive, Mamba Point Monrovia, Liberia Attention: Henry G. R. Kerali Country Director for Liberia (iii) Electronic Delivery (subsection 3.4) The Association may permit the Recipient to electronically deliver to the Association Applications (with supporting documents) through the Association's Client Connection, web-based portal. The option to deliver Applications to the Association by electronic means may be effected if: (a) the Recipient has designated in writing, pursuant to the terms of subparagraph (i) of this Section, its officials who are authorized to sign and deliver Applications and to receive secure identification credentials ("SIDC") from the Association for the purpose of delivering such Applications by electronic means; and (b) all such officials designated by the Recipient have registered as users of Client Connection. If the Association agrees, the Association will provide the Recipient with SIDC for the designated officials. Following which, the designated officials may deliver Applications electronically by completing Form 2380, which is accessible through Client Connection (https://clientconnection.worldbank.org). The Recipient may continue to exercise the option of preparing and delivering Applications in paper form. The Association reserves the right and may, in its sole discretion, temporarily or permanently disallow the electronic delivery of Applications by the Recipient. (iv) Terms and Conditions of Use of SIDC to Process Applications. By designating officials to use SIDC and by choosing to deliver the Applications electronically, the Recipient confirms through the authorized signatory letter its agreement to: (a) abide by the Terms and Conditions of Use ofSecure Identification Credentials in connection with Use ofElectronic Means to Process Applications and Supporting Documentation ("Terms and Conditions of Use of Secure Identification Credentials") provided in Attachment [3]; and (b) to cause such official to abide by those terms and conditions. (v) Minimum Value of Applications (subsection 3.5). The Minimum Value of Applications for reimbursements, direct payments and special commitments in US dollars is 20% of the balance of the Designated Account. (vi) Advances (sections 5 and 6). * Type of Designated Account (subsection 5.3): Segregated * Currency of Designated Account (subsection 5.4): US Dollars * Financial Institution at which the Designated Accounts Will Be Opened (subsection 5.5): International Bank of Liberia Ltd * Ceiling (subsection 6.1): USD 100,000 III. Reporting on Use of Grant Proceeds (i) Supporting Documentation (section 4). Supporting documentation should be provided with each application for withdrawal as set out below: * For requests for Advances and Reimbursement and for reporting eligible expenditures paid from the Designated Account: o Records evidencing eligible expenditures (e.g., copies of receipts, supplier invoices and documentary evidence of delivery and the Recipient's acceptance of contracted goods or services) for payments against contracts valued more than US$ 200,000 or equivalent for goods and non-consulting services, more than $ 100,000 or equivalent for consulting services using firms and more than US $50,000 or equivalent for consulting services using individual consultants; o Statement of Expenditures (Attachment 4) for all other expenditures; and o Summary Sheet of payments against contracts that are subject to the World Bank's prior review, in the form attached (Attachment 5) * For requests for Direct Payment and Special Commitments: records evidencing eligible expenditures, e.g., copies of receipts, supplier invoices and documentary evidence of delivery and acceptance of contracted goods or service. (ii) Frequency of Reporting Eligible Expenditures Paid from the Designated Account (subsection 6.3): Monthly (iii) Other Supporting Documentation Instructions * Copies of the bank statements of the Designated Accounts and a reconciliation statement for this account should be submitted with each application of replenishment (Attachment 6) * For reporting expenditures under the Statement of Expenditure (Attachment 4) should include supplementary information, including the commercial bank branch processing the payments. IV. Other Important Information For additional information on disbursement arrangements, please refer to the Disbursement Handbook available on the World Bank's public website at http://www.worldbank.org and its secure website "Client Connection" at http://clientconnection.worldbank.org. Print copies are available upon request. If you have not already done so, the World Bank recommends that you register as a user of the Client Connection website (http://clientconnection.worldbank.org). From this website you will be able to download Applications, monitor the near real-time status of the Financing, and retrieve related policy, financial and procurement information. For more information about the website and registration arrangements, please contact the World Bank by email at . If you have any queries in relation to the above, please contact loa-afr@worldbank.org using the above reference. Yours sincerely, rHeny G. R. Kei Country Director for Liberia Africa Region Attachment II [Letterhead] Ministry of Finance Address [DATE] The World Bank Address Attention: Mr. Country Director Re: Multi-Donor Trust Fund for the Global Financing Facility GFF Grant Number -LR (Liberia Health System Strengthening Project) Additional Instructions: Disbursement I refer to the Grant Agreement ("Agreement") between the Republic of Liberia (the "Recipient") and the International Development Association ("Association"), acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child (GFF), for the above- referenced project, dated . For the purposes of Section 3.04 (b) of the Standard Conditions respectively, as defined in the Agreement, any ['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 Grant. For the purpose of delivering Applications to the Association, 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. 5[This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to 1 Instruction to the recipient when sending this letter to the World Bank: Stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. 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. I 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. I Instruction to the Recipient: Add this paragraph if the Recipient wishes to authorize the listed persons to accept Secure Identification Credentials and to deliver Applications by electronic means; if this is not applicable, please delete the paragraph. Please delete this footnote in final letter that is sent to the Association. Attachments: 1. World Bank Disbursement Guidelines for Projects, dated May 1, 2006 2. Form for Authorized Signatures 3. Terms and Conditions of Use ofSecure Identification Devices in connection with Use of Electronic Means to Process Applications and Supporting Documentation, dated January 20, 2010 4. Form of "Statement of Expenditure" 5. Form of Summary Sheet for Payments Against Contracts Subject to the World Bank's Prior Review 6. Form of Designated Account Activity Statement Luis Schwarz Cleared with and cc: Julie Rieger, LEGAM Shunsuke Mabuchi, co-TTL Rianna L. Mohammed, co - TTL Cc with copies: 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 / [Position] Attachment [31 Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation March 1, 2013 The World Bank (Bank)6 will provide secure identification credentials (SIDC) to permit the Borrower7 to deliver applications for withdrawal and applications for special commitments under the Agreement(s) and supporting documentation (such applications and supporting documentation together referred to in these Terms and Conditions of Use as Applications) to the Bank electronically, on the terms and conditions of use specified herein. SIDC can be either: (a) hardware-based (Physical Token), or (b) software-based (Soft Token). The Bank reserves the right to determine which type of SIDC is most appropriate. A. Identification of Users. 1. The Borrower will be required to identify in a completed Authorized Signatory Letter (ASL) duly delivered to and received by the Bank each person who will be authorized to deliver Applications. The Bank will provide SIDC to each person identified in the ASL (Signatory), as provided below. The Borrower shall also immediately notify the Bank if a Signatory is no longer authorized by the Borrower to act as a Signatory. 2. Each Signatory must register as a user on the Bank's Client Connection (CC) website (https://clientconnection.worldbank.org) prior to receipt of his/her SIDC. Registration on CC will require that the Signatory establish a CC password (CC Password). The Signatory shall not reveal his/her CC Password to anyone or store or record the CC Password in written or other form. Upon registration as a CC user, the Signatory will be assigned a unique identifying account name. B. Initialization of SIDC. 1. Prior to initialization of SIDC by a Signatory, the Signatory will acknowledge having read, understood and agreed to be bound by these Terms and Conditions of Use. 6"Bank" includes IBRD and IDA. I "Borrower" includes the borrower of an IBRD loan, IDA credit, or Project Preparation Facility advance and the recipient of a grant. 2. Where a Physical Token is to be used, promptly upon receipt of the Physical Token, the Signatory will access CC using his/her account name and CC Password and register his/her Physical Token and set a personal identification number (PIN) to be used in connection with the use of his/her Physical Token, after which the Physical Token will be initialized for use by the Signatory exclusively for purposes of delivering Applications. Where a Soft Token is to be used, the Signatory will access CC using his/her account name and CC Password and set a personal identification number (PIN) to be used in connection with the use of his/her Soft Token, after which the Soft Token will be initialized for use by the Signatory exclusively for purposes of delivering Applications. Upon initialization of the SIDC, the Signatory will be a "SIDC User". The Bank will maintain in its database a user account (Account) for each SIDC User for purposes of managing the SIDC of the SIDC User. Neither the Borrower nor the SIDC User will have any access to the Account. 3. Prior to first use of the SIDC by the SIDC User, the Borrower shall ensure that the SIDC User has received training materials provided by the Bank in use of the SIDC. C. Use of SIDC. Use of the SIDC is strictly limited to use in the delivery of Applications by the SIDC User in the manner prescribed by the Bank in the Agreement(s) and these Terms and Conditions. Any other use of the SIDC is prohibited. 2. The Bank assumes no responsibility or liability whatsoever for any misuse of the SIDC by the SIDC User, other representatives of the Borrower, or third parties. 3. The Borrower undertakes to ensure, and represents and warrants to the Bank (such representation and warranty being expressly relied upon by the Bank in granting SIDC) that each SIDC User understands and will abide by, these Terms and Conditions of Use, including without limitation the following: 4. Security 4.1. The SIDC User shall not reveal his/her PIN to anyone or store or record the PIN in written or other form. 4.2. The SIDC User shall not allow anyone else to utilize his/her SIDC to deliver an Application to the Bank. 4.3. The SIDC User shall always logout from CC when not using the system. Failure to logout properly can create a route into the system that is unprotected. 4.4. If the SIDC User believes a third party has learned his/her PIN or has lost his/her Physical Token he/she shall immediately notify clientconnection(gworldbank.org. 4.5. The Borrower shall immediately notify the Bank at clientconnection(worldbank.org of any lost, stolen or compromised SIDC, and take other reasonable steps to ensure such SIDC are disabled immediately. 5. Reservation of Right to Disable SIDC 5.1. The Borrower shall reserve the right to revoke the authorization of a SIDC User to use a SIDC for any reason. 5.2. The Bank reserves the right, in its sole discretion, to temporarily or permanently disable a SIDC, de-activate a SIDC User's Account or both. 6. Care of Physical Tokens 6.1. Physical Tokens will remain the property of the Bank. 6.2. The Bank will physically deliver a Physical Token to each Signatory designated to receive one in a manner to be determined by and satisfactory to the Bank. 6.3. Physical Tokens contain delicate and sophisticated instrumentation and therefore should be handled with due care, and should not be immersed in liquids, exposed to extreme temperatures, crushed or bent. Also, Physical Tokens should be kept more than five (5) cm from devices that generate electromagnetic radiation (EMR), such as mobile phones, phone-enabled PDAs, smart phones and other similar devices. Physical Tokens should be carried and stored separate from any EMR device. At close range (less than 5 cm), these devices can output high levels of EMR that can interfere with the proper operation of electronic equipment, including the Physical Token. 6.4. Without derogating from these Terms and Conditions of Use, other technical instructions on the proper use and care of Physical Tokens are available at http://www.rsa.com. 7. Replacement 7.1. Lost, damaged, compromised (in terms of 4.5, above) or destroyed Physical Tokens will be replaced at the expense of the Borrower. The Bank reserves the right, in its sole discretion, not to replace any Physical Token in the case of misuse, or not to reactivate a SIDC User's Account. RE from to Date: acts not subject to the Bank Prior Review Loan/Grant No: SOE No.: 4 5 6 7 8 9 10 ind Name of Currency Amount Amount Eligible % from Schedule 1 of Amount US$ Remarks it of Contractor / and Total financed by covered by Loan/ Grant Agreement Eligible for equivalent Payee Amount of Other this Financing Amount Paid Invoice Sources, if Application (7x 8) from any (5-6) Designated Account TOTALS iined at (insert location) -gory; or altematively, a separate SOE form may be used for each category i should be provided with each application for withdrawal as set out below: wrsement and for reporting eligible expenditures paid from the Designated Accounts: Records iditures (e.g., copies of receipts, supplier invoices and documentary evidence of delivery and the F contracted goods or services) for payments against contracts valued more than US$ 200,000 or non-consulting services, more than $ 100,000 or equivalent for consulting services using firms and equivalent for consulting services using individual consultants; 3 (Attachment 4) for all other expenditures; and nts against contracts that are subject to the World Bank's prior review, in the form attached Attachment 5 Project Name: SUMMARY SHEET for Payments made during the period from to Date: Application No.: For expenditures against the contracts subject to the Bank Prior Review Grant No. Credit No. Ref. No. 1 2 3 4 5 6 7 8 9 10 11 12 Item No. Category Currency Name of Ref. No. of Date of Invoice Currency and Eligible % Amount Currency Exchange No. & and Total Contractor Contract NOL from No. & date Total Amount from Eligible for and Amount Rate (Col. Description Amount of World of Invoice Schedule 1 Financing (8 Paid from 11 divided (") Contract Bank Covered by of Financing x 9) Designated by Col. 10) Application Agreement Account (if (Net of Applicable) Retention) TOTALS Remarks: Authorized Signatory Supporting documents for this Application retained at (insert location) (*) A separate form should be used for retroactive financing (") Items should be grouped by category; or alternatively, a separate form may be used for each category Attachment 6 Credit No.: Bank and Account No.: Part I 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) Part II 4. Opening DA balance at beginning of reporting period (per Bank statement attached, as of.....) 5. Add/Subtract: Cumulative adjustments, including interest earned and recoveries by WB, (if any) 6. Advances received from the World Bank during current reporting period 7. Closing DA balance at end of current reporting (per Bank statement attached, as of ....... 8. Outstanding amount of advances to be accounted for (4+5+6-7) 9. Total Expenditures reported for current reporting period, including this Application Applic No. Amount Total (9) 10. Difference (if any) 9-8 Remarks Approved by: