Project information. Project number Innovation Fund Proposal. Project leader. Project funding. Disciplines. Areas of application.

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1 Project number Innovation Fund Project information Project title: Language of proposal: Applicant institution: Project leader Name: Title/position: Project funding Total project cost: Amount requested from the CFI ($): Percentage of the total project cost requested from the CFI (maximum 40%): Disciplines Primary discipline: Primary sub-discipline: Secondary discipline: Secondary sub-discipline: Tertiary discipline: Tertiary sub-discipline: Areas of application Primary: Secondary: Keywords Research or technology development infrastructure Specific

2 Canada Foundation for Innovation Project number Plain language summary This summary will not be used in the review process. Should the project be funded, the CFI may use it in its communication products. Project summary

3 Lead institution Project summary Project number Project summary attachment (maximum three pages) In language appropriate for a multidisciplinary assessment committee (MAC), provide a general description of the research or technology development to be undertaken and a general overview of the infrastructure being requested. This summary must concisely address the extent to which the proposal meets the competition objectives. The objectives of the 2015 Innovation Fund are to enable institutions and their best researchers to: Strive for global leadership by conducting world-class transformative research and technology development in areas of institutional strategic priority; Forge and foster productive, value-added partnerships within and among institutions, sectors and disciplines that will nurture creativity and innovation which will result in the effective and sustainable use of the research infrastructure and facilities; Identify and develop plans and potential pathways to social, health, environmental and economic benefits for Canada, including better training and improved skills for highly qualified personnel. For projects recommended for funding by the MAC, the project summary is the only section of the proposal that will be provided to the special multidisciplinary assessment committee (S-MAC) to assist in its deliberations. This section of the proposal may be translated by the CFI for the S-MAC s use. In such cases, institutions will be provided a copy of the translated text for the opportunity to comment and/or correct the translation prior to review by the S- MAC.

4 Canada Foundation for Innovation Project number Principal users Name Institution Department Key participants

5 Canada Foundation for Innovation Project number Other users Name and title/position data Institution and department data Other users

6 Lead institution Assessment criteria and budget justification Project number Assessment criteria and budget justification (maximum 40 pages) For this section of the online form, upload a PDF document that contains key information on how the proposal meets the objectives and established assessment criteria for this competition as well as a budget justification for the infrastructure items requested. Refer to the Guidelines for completing a notice of intent and a proposal for the 2015 Innovation Fund for detailed instructions.

7 Canada Foundation for Innovation Project number Financial resources for operation and maintenance These tables outline annual costs and sources of support committed to ensuring effective operation and maintenance of the infrastructure for the first five years after it becomes operational. They do not include costs related to research and/or technology development. When applicable, funding from CFI's Infrastructure Operating fund (IOF) is included in the institutional contributions category. Operation and maintenance budget summary Costs Year 1 Year 2 Year 3 Year 4 Year 5 Total Personnel Supplies Maintenance and repairs Services Other (specify) Total $0 $0 $0 $0 $0 $0 Funding sources Funding sources Year 1 Year 2 Year 3 Year 4 Year 5 Total Institutional contributions Other organizations User fees Other (specify) Total $0 $0 $0 $0 $0 $0 Financial resources for operation and maintenance

8 Project number Innovation Fund Infrastructure project funding This table provides a summary of total contributions and eligible costs for the project. costs Individual item costs are detailed in the Cost of individual items section. empty Total eligible costs Contributions from eligible partners Amount requested from the CFI Percentage of the total eligible cost requested from the CFI (may not exceed 40%) Summary of eligible costs This table provides a summary of the total eligible costs for each type of expenditure. Individual items are listed in the 'Cost of individual items' section. Expenditure type 13. Purchase of equipment (including shipping, taxes and installation) 14. Lease of equipment or facility 15. Personnel (for infrastructure acquisition & development) 16. Components 17. Travel (infrastructure related) 18. Software 19. Extended warranties / Service contracts 20. Construction/renovation costs essential to house and use the infrastructure 21. Initial training of infrastructure personnel 22. Other Total eligible Total.00% Total

9 Project number Innovation Fund Cost of individual items This table provides the details of eligible infrastructure acquisition and development costs. It shows the full costs of each item, including taxes (net of credits received), shipping and installation. For infrastructure that will be used for multiple purposes, the table includes prorated research (or technology development) costs only. The lead institution was instructed to follow its existing institutional policies and procedures for the preparation of budget estimates. The CFI expects that costs included in this budget are close estimates of fair value. Item # Type Item description Total eligible costs Eligible costs Number of items Cash In-kind Total Date acquired or to be acquired

10 Lead institution Floor plans Project number Floor plans (if applicable) - attachment For proposals that include construction or renovation involving multiple rooms, please provide floor plans of the proposed area(s), showing the location of the infrastructure and the scale of the plans. The floor plans must be legible when printed in black and white on standard letter size paper (8.5" x 11").

11 Project number Innovation Fund Contributions from eligible partners The following table provides details of funding from eligible partners. It does not include the amount requested from the CFI Partner name Partner type Cash In-kind Total Total contributions from eligible partners Secured or expected

12 Project number Innovation Fund Infrastructure utilization Category This table outlines the percentage utilization of the requested infrastructure by category. Research/technology development and associated training Education, excluding research / technology development training (not eligible for CFI support) Administration Clinical or other service function Other (specify) Total This section provides a breakdown of eligible costs included in each of the above categories. If the infrastructure will be used for non CFI-eligible purposes, the lead institution was instructed to explain the methodology used to estimate the percentage of utilization for each category and how the budget was pro-rated. Percentage data data data data

13 Curriculum vitae Identification Family name: First name and initials: Position: Institution: Department/Division: Mailing address Contact information Telephone: Fax: address: Web Address: Academic background Year Degree type received or expected Discipline/Field/Speciality Extension: Institution and country CV

14 Name: Area(s) of expertise Position/Organization Keywords: Discipline: Subdiscipline: Work experience Department/Division Start date Period End date CV

15 Name: Research/Technology development contributions in the last five years This section provides details on research or technology development contributions over the past five years. It should include: the most significant contributions to research/technology development (refereed articles, monographs, books, patents, copyright, products, services, technology transfer, other forms of research output), the significance in terms of influence and impact on the target community for the most important contributions; and other activities that show the impact of the work, such as research training, awards, consulting, contributions to professional practice or public policy, and membership on committees, boards, or policy-making bodies. CV

16 Name: List of published contributions This section provides a list of the most significant published contributions (e.g. submitted and/or published articles, patents, technical reports) over the past five years. CV

17 Name: Research or technology development funding This table lists support held over the past five years as an applicant or co-applicant for grants and contracts from all sources, including industry and academic/research institutions. Support can be either under review (R) or awarded (W). Title of proposal Name of Principal Applicant / Project Leader Funding source Program name Time commitment (hours per month) R, W Average amount per year Support Period From To CV

18 Canada Foundation for Innovation Project number Suggested reviewers The decision whether or not to use the suggestions remains with the CFI. Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Suggested reviewers

19 Canada Foundation for Innovation Project number Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Name: Institution/Organization: Country: Telephone: Fax: Online CV or biography: Area(s) of expertise (keywords): Suggested reviewers