PDF Assistance Application Form Nature of Assistance Project Development Funding for Rs. ______ Project Name : Sector : Sponsoring Authority : Location (District/Town) : Implementing agency (if : different from above as in case of SPV)) Need for the Project : Brief Project Description : PPP structure for Project : BOOT/BOT (its variants)/Concession /Lease Implementation Management/Service/EPC along with Performance based O&M Contract Project Implementation : List key milestones Milestones Likely impact(s) of the : Project Cost Benefit Analysis : Project Financial Structure : A) Details of Project Cost as estimated Item Rs. Lakhs Land Building Equipments Any other (Specify) Total Project Cost B) Proposed means of financing Source Rs. Lakhs Private Sector State Government Sponsoring Authority Govt. of India (VGF) Any Other (Specify) Total IRR Estimations (as applicable) : Economic IRR Project IRR Equity IRR Estimated Project Development Expenses Item Rs. Lakhs Surveys and Investigations Consultancy fees: Technical Environmental & Social Legal Financial Any other Total Consultancy Fees Transaction Advisory Fees Marketing and Procurement Related Expenses Any other Total Estimated Project Development Expenses PDF Assistance Sought (Rs Lakhs) Enclosures :
