Special authorization of a pre-approved template

to conclude contracts/agreements without further LEG review

as per paragraph 4, subparagraph c) of IN/99/Rev.2

4 May 2018
o Original Request made by Adela POUDRATCHI, Grants Manager, IOM Sudan on 18 March
2017 for RRF Implementation Agreements funded by USAID
o Special authorization issued by LEG (Contact person: P. Henson) on 4 May 2018

1.Conditions to be met
i) Use the attached template without any change except for changing
relevant information regarding the name of the Implementing Partner,
amounts, addresses, etc.;
ii) Maximum grant amount may not be higher than USD 250,000
iii) ensure that any Annex does not contain any additional conditions
imposed on IOM
iii) send scanned copies of all signed agreements and standard B.1
checklists as per IN/99 Rev. 2 for assignment of checklist codes from
LEG Contract Review
iv) ensure follow up with Implementing Partners and verify all
expenses with original documents

2. Authorized COM Sudan or OiC

Director/Chief/Heads
3. Authorized period From 24 March 2017 to 30 June 2018

4. Types of Contracts Rapid Response Fund Implementation Agreements in Sudan

5. Name of Project (* indicate OFDA - USAID
whether it is under an
emergency response project) or
Name of Donor (in case of a
framework agreement with a
donor using an agreed template)
6. Other notes, if any (e.g. 5-15 per year
expected no. of contracts signed
under this arrangement)

 The present special authorization form is issued as per Paragraph 10 of IN/99 Rev.2. Please
follow all relevant requirements stated in IN/99/Rev.2
 All other contracts/agreements, including any deviation from the pre-approved template
attached, will be subject to review by LEG and the contracts approval procedure as stated in
IN/99/Rev.2.
 The present special authorization form shall be filed in the archive of the Country/Regional
office or Department concerned together with all contracts/agreements signed under the
authorization.

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For LEG use

*Coordinate with Legal Counsel before issuing this form. Once issued, file in a designated file at LEG
EFS together with the agreed template and all relevant emails. The pre-approved template will not be
given LEG approval code but each contract/agreements sent by Director/Chief/Head together with the
signed checklists will be given Checklist Code.

LEG Ref. No. for Special EXC1006/2015 (ext.2)

Authorization of a pre-
approved template
 CHECKLIST-SDN/IMPL/SDN/MM/March2017 (EXC1006/2015 ext.2)
Checklist Codes issued
under this Special
Authorization form

Any other
notes