SAROJ KUMAR JHA Country Director Iran, Iraq, Jordan, Lebanon, Syria Middle East and North Africa Region Date: Wednesday July 24, 2019 H.E. Mohammad Al-Ississ Minister of Planning and International Cooperation Ministry of Planning and International Cooperation Post office Box 555 Amman, 11118 The Hashemite Kingdom of Jordan Re: IBRD Loan 9000 – JO and GCFF TF0B0686 (Additional Financing Jordan Emergency Health Project) Additional Instructions: Disbursement and Financial Information Letter Excellency: I refer to the Loan Agreement between The Hashemite Kingdom of Jordan (the “Borrower”) and the International Bank for Reconstruction and Development (the “Bank”) for the above-referenced Project. The General Conditions, as defined in the Loan Agreement, provide that the Borrower may from time to time request withdrawals of Loan Amounts from the Loan Account in accordance with the Disbursement and Financial Information Letter, and such additional instructions as the Bank may specify from time to time by notice to the Borrower. The General Conditions also provide that the Disbursement and Financial Information Letter may set out Project specific financial reporting requirements. This letter constitutes such Disbursement and Financial Information Letter (“DFIL”) and may be revised from time to time. I. Disbursement Arrangements, Withdrawal of Loan Funds, and Reporting of Uses of Loan Funds The Disbursement Guidelines for Investment Project Financing, dated February 2017, (“Disbursement Guidelines”) are available in the Bank’s public website at https://www.worldbank.org and its secure website “Client Connection” at https://clientconnection.worldbank.org. The Disbursement Guidelines are an integral part of the DFIL, and the manner in which the provisions in the Disbursement Guidelines apply to the Loan is specified below. (i) Disbursement Arrangements The table in Schedule 1 sets out the disbursement methods which may be used by the Borrower, and conditions, information on registration of authorized signatures, processing of withdrawal applications (including minimum value of applications and processing of advances), instructions on supporting documentation, and frequency of reporting on the Designated Account. (ii) Electronic Delivery. Section 10.01 (c) of the General Conditions. The Borrower will deliver Withdrawal Applications (with supporting documents) electronically through the Bank’s web-based portal “Client Connection” at https://clientconnection.worldbank.org. This option will be affected after the officials designated in writing by the Borrower who are authorized to sign and deliver Withdrawal Applications have registered as users of “Client Connection”. The designated officials will deliver Applications electronically by completing the Form 2380, which is accessible through “Client Connection”. By signing the Authorized Signatory Letter, the Borrower confirms that it is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the Bank by electronic means. The Borrower may exercise the option of preparing and delivering Withdrawal Applications in paper form on exceptional cases (including those where the Borrower encounters legal limitations), and which were previously agreed with the Bank. By designating officials to use SIDC and by choosing to deliver the Applications electronically, the Borrower confirms through the authorized signatory letter its agreement to: (a) abide by the Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation, available in the World Bank's public website at https://worldbank.org and “Client Connection”; and (b) to cause such official to abide by those terms and conditions. II. Financial Reports and Audits (i) Financial Reports. The Borrower must prepare and furnish to the Bank IFRs not later than forty- five (45) days after the end of each calendar Semester (6 months), interim unaudited financial reports (“IFR”) for the Project covering the semester. (ii) Audits. Each audit of the Financial Statements must cover the period of one fiscal year of the Borrower, commencing with the fiscal year in which the first withdrawal was made, or first payment made in case of retroactive financing, or such other period as agreed to with the Bank. The audited Financial Statements for each such period must be furnished to the Bank not later than six (6) months after the end of such period. III. Other Information For additional information on disbursement arrangements, please refer to the Loan Handbook available on the Bank’s website (http://www.worldbank.org/) and “Client Connection”. The Bank recommends that you register as a user of “Client Connection”. From this website you will be able to prepare and deliver Applications, monitor the near real-time status of the Loan, and retrieve related policy, financial, and procurement information. For more information about the website and registration arrangements, or if you have any queries in relation to the above, please contact the World Bank by email at AskLoans@WorldBank.org using the above reference. Yours sincerely, ______________________________ Saroj Kumar Jha Country Director Iran, Iraq, Jordan, Lebanon, Syria Middle East and North Africa Region Attachments 1. Form of Authorized Signatory Letter 2. Interim Financial Reports (IFRs) Schedule 1 to DFIL Disbursement Arrangements-IPF with DLIs Basic Information Country The Hashemite Kingdom of Jordan Closing Date Section III of Schedule 2 to the Loan Financing Agreement Borrower /Beneficiary The Hashemite Kingdom of Jordan Number 9000- JO Name of the Project Jordan Emergency Health Additional Disbursement Four months after the closing date and GCFF Financing project Deadline Date TF0B0686 Subsection 3.7 ** Disbursement Methods and Supporting Documentation Disbursement Methods Methods Supporting Documentation Section 2 (**) Subsections 4.3 and 4.4 (**) Direct Payment Yes Copy of records Reimbursement Yes Withdrawal Applications with the IFRs in the format provided in Attachment 2 to the DFIL Designated Account/ Yes Withdrawal Applications with the IFRs in the format provided in Attachment 2 to the DFIL – Advance Except for category 2 under the Additional Financing (DLI Linked Category) which will only use reimbursement method. Special Commitments No N/A. Designated Account (Sections 5 and 6 **) The OF Two DAs will continue being used, and will be pooled together with the two AF sources in this DFIL: Flexible Type of Account Ceiling -DA A- for AF for category 1 and 2 (Output based and IPF linked categories) - Managed by MoPIC -DA B (Pure IPF) for AF category 3 – Managed by MoPIC Financial Institution - Name Central Bank of Jordan for both accounts Currency USD Amount Forecast for 6 months as per cleared Frequency Semi-annually IFRs Minimum Value of Applications (subsection 3.5) The minimum value of applications for Direct Payment is USD 100,000 equivalent Authorized Signatures (Subsection 3.1 and 3.2 **) The form for Authorized Signatories Letter is provided in Attachment 1 of this letter Withdrawal and Documentation Applications (Subsection 3.3 and 3.4 **) ASL and All Withdrawal Applications and its supporting documentation will be electronically sent via the Association’s system ClientConnection. Notes Under Category 1 (i.e. Output Based Disbursements), the following is required: 1. Expenditure Verification: a financial audit, to be provided by the Audit Bureau, of MOH total expenditures PAID for all primary and all secondary health care services provided , and, 4 2. Utilization Verification: a formal report, by an independent Utilization Verification Entity (UVE), on the total number of outpatient and inpatient services provided to the target population and, 3. Health Care Service Delivery Expenditure Report: a report prepared by MoPIC indicating amount to be claimed from the non-concessional and concessional portion of the loan showing unit cost multiplied by the number of eligible services to the target population. Under Category 2 under the Additional Financing (i.e. DLI linked category), the following is required:  Interim Financial Report (IFRs) in the form attached (Attachment 2) including the sheets (i) DLIs reconciliation Form, (ii) List of DLIs achieved and verified, (iii) Sources and Uses of Funds, (iv) Cash Forecast and (v) Bank Reconciliation.  Confirmation notice by task team leader that (i) one or more DLI(s) (as referred to in LA annex 2) have been achieved and verified according to the verification protocol set in the project’s operations manual and (ii) indicating amounts pertaining to such DLI(s).  DLIs reconciliation Form (on cumulative basis).  For financing eligible expenditures under said category: 1. Please refer to the withdrawal Condition(s) in the Financing Agreement. Section III.B. 2. For financing eligible expenditures under this category (ies), the Borrower has furnished evidence satisfactory to the Bank that (i) EEP payments have been made and verified in accordance with provisions of Loan Agreement Section III.B.1.b and that (ii) the relevant DLI(s) has/have been achieved and verified. 3. For Documentation expenditures category 2 EEPs, the Lesser of (i) EEP payments reported in the quarterly IFRs (as verified by the Auditor General ) or (ii) the amounts confirmed by TTL based on IVA verification report pertaining to DLIs which have been achieved and verified in accordance with the verification protocol set in project’s operations manual , will be documented, as presented in the DLIs reconciliation Form (on cumulative basis).  Advances method is available for AF category 1 and 3 only, Category 2 will use reimbursement method. Such advances may be made semiannually or as deemed necessary and as approved by the Bank’s Task Team based on submitted IFRs. ** Sections and subsections relate to the “Disbursement Guidelines for Investment Project Financing”, dated February 2017. Attachment 1 – Form of Authorized Signatory Letter [Letterhead] Ministry of Finance [Street address] [DATE] The World Bank 1818 H Street, N.W. Washington, D.C. 20433 United States of America Attention: [Country Director] Re: IBRD Loan 9000-JO and GCFF Grant TF0B0686 (Additional Financing Jordan Emergency Health Project) I refer to the Loan Agreement between the International Bank for Reconstruction and Development (the “World Bank”) and [name of borrower] (the “Borrower”), dated July 24, 2019, providing the above Loan. For the purposes of Section 2.03 of the General Conditions as defined in the Agreement, any 1[one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Borrower to sign applications for withdrawal under this Loan. For the purpose of delivering Applications to the World Bank, 2[each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Borrower, acting 3 [individually] 4[jointly], to deliver Applications, and evidence in support thereof on the terms and conditions specified by the World Bank. This confirms that the Borrower is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the World Bank by electronic means. In full recognition that the World Bank 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 1 Instruction to the Borrower: Stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete this footnote in final letter that is sent to the Bank. 2 Instruction to the Borrower: 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 Bank. 3 Instruction to the Borrower: 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 Bank. 4 Instruction to the Borrower: 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 Bank. 6 Conditions of Use of SIDC”), the Borrower represents and warrants to the World Bank that it will cause such persons to abide by those terms and conditions. This Authorization replaces and supersedes any Authorization currently in the World Bank records with respect to this Agreement. [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ Yours truly, / signed / ______________ [Position] 8 Attachment 2 – IFRs - To be provided by FMS FOR OFFICIAL USE ONLY Maiada Kassem - FO, WFACS Cleared with and cc: Natalia Robalino- Country Lawyer Fernando Montenegro Torres - Task Team Leader Cc: Jad Mazahreh - FMS 10