THE WORLD BANK I BANK DUNIA t
Sharing Development Solutions
for an Emerging Indonesia
Rodrigo A. Chaves
Country Director, Indonesia
Letter No. CD-1 08/PNPM Peduli/V/2014                               May 16, 2014
Mr. Muhammad Hasyim
Director
Lembaga Kajian dan Pengembangan Sumberdaya
Nahdlatul Ulama (LAKPESDAM NU)
Jl. Ramli No. 20A
Menteng Dalam Tebet
Jakarta, Indonesia
Dear Mr. Hasyim:
Re: Amendment No. 4 to PSF Grant No. TF099535
PNPM Peduli Executing Organization: LAKPESDAM Project
We refer to the Grant Agreement ("Grant Agreement"), dated June 30, 2011, as amended,
between the Lembaga Kajian dan Pengembangan Sumberdaya Nahdlatul Ulama (LAKPESDAM NU)
("Recipient") and the International Bank for Reconstruction and Development ("World Bank"),
acting as administrator of grant funds provided by donors under the Support Facility for National
Program for Community Empowerment (TF070967) ("PSF") for the above-mentioned project (the
"Project").
We refer also to your letters dated January 15. 2014 and March 20, 2014 requesting an
amendment to the Grant Agreement. The World Bank is pleased to inform you that, after due
consideration, it has concurred with your request and accordingly agreed to: (i) amend the Grant
Agreement to reflect an increase of the Grant amount under Section A; and (ii) reallocate Grant
proceeds under Section B; and (iii) extend the Closing Date as stated in Section C below.
A.     Increase in the Amount of the Grant. The Grant amount is hereby increased from
US$1,844,500 to US$2,053,100 as follows (the amended language is italicized for ease of
reference):
"In response to the request for financial assistance made on behalf of the Lembaga K.ajian dan
Pengembangan Sumberdaya Nahdlatul Ulama (LAKPESDAM NU) ("Recipient"), I am
pleased to inform you that the International Bank for Reconstruction and Development
("World Bank"), acting as administrator of grant funds provided by donors under the Support
Facility for National Program for Community Empowerment (TF070967) ("PSF"), proposes
to extend to the Recipient for the benefit of the Republic of Indonesia ("Member Country"), a
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grant in an amount not to exceed two million fifty three thousand one hundred United States
Dollars (USS2,053,100) ("Grant") on the terms and conditions set forth or referred to in this
letter agreement ("Agreement"), which includes the attached Annex, to assist in the financing
of the project described in the Annex ("Project").  This Grant is funded out of the
abovementioned trust fund for which the World Bank receives periodic contributions. In
accordance with Section 3.02 of the Standard Conditions (as defined in the annex to this
Agreement), the Recipient may withdraw the Grant proceeds subject to the availability of such
funds."
B.     Reallocation of Grant Proceeds. The World Bank hereby reallocates the proceeds of the
Grant allocated in the table in Section 3.01 of the Annex to the Grant Agreement as set out
below:
Category               Amount of the Grant            Percentage of
Allocated               Expenditures to be
(expressed in US$)              Financed
(inclusive of Taxes)
(1) Goods                                  10,700                  100%
(2) Consultant services                    92,860                  100%
(3) Training and Workshops*               354,640                  100%
(4) Sub-Grants under Part 1 of           1,300,650                 100%
the Project
(5) Direct Operational Costs*             214,400                  100%
(6) Indirect Operational Costs*            79,850                  100%
TOTAL AMOUNT                             2,053,100
C.     Extension of Closing Date. The Bank has established November 30, 2014 as the later date
for the purpose of Section 3.03 of the Annex to the Grant Agreement.
Except as specifically provided in this Amendment, all other terms and conditions of the Grant
Agreement remain in full force and effect.
The World Bank will disclose this letter agreement and related information on this Grant in
accordance with the World Bank Policy on Access to Information. By entering into this agreement,
the Recipient consents to disclosure of this agreement and related information on this Grant.
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TF099535                                 3 of 3                            May 16, 2014
Please confirm your agreement to the amendment proposed under Sections A above by signing
and dating both enclosed copies of this letter in the space provided and returning one signed copy to us.
The above Amendment will become effective as of the date of the later date of countersignature of this
letter by the Recipient.
Very truly yours,
INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT
Rodrigo
C        irector, donesia
AGREED:
LEMBAGA KAJAN DAN PENGEMBANGAN SUMBERDAYA
NAHDLATUL ULAMA (LAKPESDAM NU)
By:
Name: MLAW1-Nbac.        kC      1
Title: ~tC&C           k ci  '    LI.q k pes-dav  JU
Date:    __
ISEB Tower 2, 121h Floor, JI. Jend- Sudirman Kay. 52-53, Jakarta 12190  a+6221 5299 3000  i+6221 5299 3111  Owww.wo-Idbank.org/id