RES Form Instructions:

Similar documents
Quincy University Grants Development & Management Guide

THE FOX THEATRE INSTITUTE

2019 IGP Faculty Research Initiation Grant

Instructions. Important Dates. Application Deadline: May 15, 2013 at 5:00 p.m. Grant Awards Announced: July 15, 2013

Denver Public Schools. Financial Services. Financial Services Manual. Grants

SC Launch Grant Programs Qualifications and Processing Procedures Effective August 1, 2017

LSU HEALTH SHREVEPORT NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

GRANT APPLICATION. Sustainable Agricultural Land Strategy Grants SUSTAINABLE AGRICULTURAL LANDS CONSERVATION PROGRAM

EMPLOYEE INNOVATION GRANTS (EIG)

2017 TOURISM DEVELOPMENT MATCHING GRANT PROGRAM PROGRAM GUIDELINES

SAMPLE- Visit FirehouseSubsFoundation.org to apply online. Firehouse Subs Public Safety Foundation Grant Application

For purposes of this Security Agreement, the use of the terms you and your includes both the Oil and Gas Operator and the EFA when appropriate.

Tourism Events Grants. FY 2019 (July 1, 2018 June 30, 2019)

CITY OF MELBOURNE APPLICATION FOR OLDE EAU GALLIE RIVERFRONT CRA FAÇADE IMPROVEMENT PROGRAM

Annual South Carolina School Health LPN of the Year Award ( )

2018 HBS New Venture Competition Student Social Enterprise Track

Conference Grants Program

Champions for Healthy Kids Grants

Secomb Conference and Travel Fund

Practice Improvement Network (PIN) Project Application

REGIONAL ARTS FUND Quick Response Grant

REGIONAL ARTS FUND Step Out

EXPLANATORY NOTES. (applicable from 1 July 2015) STAGE 1 DESKTOP ASSESSMENT. for the RECOGNITION OF OVERSEAS OCCUPATIONAL THERAPY QUALIFICATIONS

State of Florida Department of Children and Families

Community Development Small Grants Fund. Guidelines 2018

USF GME - Moonlighting Privileges Request July1, 2018 June 30, 2019

DOCUMENT TITLE: Clarification of Bureau of Primary Health Care Credentialing and Privileging Policy outlined in Policy Information Notice

Loyola University Health System NURSING DEPARTMENT EDUCATION STIPEND GUIDELINES

Key Points for Approving Officers Regarding Electronic Filing

Original Date: January 27, 2010 Reviewed/Last Modified Date: September 15, 2015

AOTF Health Services Research Grant Request For Application

Directions & Instructions for Filing an Application to the Radiologic Technology Program

Archive and Destruction of Patient Records

NOTE: The first appearance of terms in bold in the body of this document (except titles) are defined terms please refer to the Definitions section.

Environment, Health and Safety Policy Appendix B: Environment, Health and Safety Responsibilities

Medicaid EHR Incentive Program Eligible Professionals

Guidelines for Analysis of Credentials to be Included on COOL

GRANT GUIDELINES FOR ORGANIZATIONS 2017 CYCLE

Down Payment Online Manual

Work Instruction Patient Visits

2016 Community Waste Reduction and Recycling Grants

South Lake Community Futures Development Corporation

Bursary Guidelines for Employed

Yolo County Homeless and Poverty Action Coalition (HPAC)

Financial Officer 18 Applicant Inventory

CITY OF MELBOURNE APPLICATION FOR DOWNTOWN MELBOURNE CRA RETAIL CORE COMMERCIAL LIGHTING PROGRAM

BEHAVIORAL HEALTH STAFF COVERAGE PROTOCOL. Psychiatrist and Psychologist Coverage Plan...4. Telemedicine.7

Fulton-Montgomery Arts Grants - Project Grants 2015 Guidelines Letter of Intent Deadline: October 31, 2014 Application Deadline: November 28, 2014

AOTF Intervention Research Grant Request For Application

Working Location: Science Council office in Farringdon, London. With some London and UKtravel

Guide to Complete the Steps for Foreign-Trained Nurses to Obtain the Maryland Registered Nurse (RN) License

APA Title Program. Information Booklet

Closing Date for Applications - no applications accepted after midnight (UK Time) on closing date First review of applications begins

Mellon Mays Undergraduate Fellows Dissertation Grants Program

APPLICATION FOR REGISTERED NURSING PROGRAM FALL 2017 (Filing deadline: February 10, 2017, 4:00 PM) PLEASE TYPE OR PRINT NEATLY

FLORIDA CHILD CARE DIRECTOR CREDENTIAL AND RENEWAL APPLICATION

NOTE: The first appearance of terms in bold in the body of this document (except titles) are defined terms please refer to the Definitions section.

Academic Health Center Mayo Mail Code Delaware Street SE, Minneapolis, MN nexusipe.

Community Arts and Arts Education DEC Grant 2019 Guidelines New York State Council on the Arts Decentralization Program

Valdez Beautification 2017 Matching Grant Program

SUMMER 2018 BACCALAUREATE TO ASSOCIATE DEGREE NURSE ACCELERATED PATHWAY APPLICATION

CANADIAN FOUNDATION FOR DIETETIC RESEARCH LA FONDATION CANADIENNE DE LA RECHERCHE EN DIETETIQUE

Obtain an official copy of your PN transcript to submit with this packet.

SECTION A: Patient s name: Last: First: MI: Date of birth: Phone number: Medical Record Number:

Application. Community Health Excellence (CHE) Grant Program

MEDI-CAL (MC051) ERA ENROLLMENT INSTRUCTIONS

Medical Assistance in Dying: Update Stakeholder Presentation

Smart Energy GB in Communities Fund Small grants. Grant Guidelines May 2016

Resident Assistant Application

Accelerated Bachelor of Science in Nursing. Fall 2018 Application Packet

CANADA-LUXEMBOURG CO-DEVELOPMENT AND CO-PRODUCTION INCENTIVE FOR AUDIOVISUAL PROJECTS GUIDELINES

MANUAL SURGE CAPACITY PROTOCOL

The information and instructions below are for College of Business Administration [Departmental] Scholarships only.

PLACEMENT POLICIES FOR WORK & TRAVEL AND TRAINEE/INTERN PROGRAMS

p so January 16, 2014

Love My Neighbor! Grant Application

CALL FOR ABSTRACTS. Overview of Summit Themes. Skills-Based Workshops

Oregon Registry. Infant Toddler Professional Credential. Overview. Oregon Center for Career Development in Childhood Care and Education

YOUTH What is Heads Up Football? What are the benefits of a youth football organization adopting Heads Up Football?

A Grant Program for Neighborhood Residents

Medical Assistant Program Western Technical College. Supplemental Information

Conference Grants Program

WebEX Time: 8:30am. Background. List Attached TOPIC Introductions. Facilitator: Holly Reeves; Edna Vallecillo Garcia. s Analyst.

SEQOHS Accreditation Assessor Job Description

ANU SPORT INTERNATIONAL TRAVEL GRANT GUIDELINES ANU SPORT

H-1B PETITION EMPLOYEE QUESTIONNAIRE

PRIVACY IMPACT ASSESSMENT (PIA) For the

Small Business. Big Recognition.

FOCUS AREA 1: Creative use of Existing Infrastructure for Future Transportation Needs:

Institutional Policy Manual

DoD Plain Writing Act Compliance Report April 13, 2018

About this guide 5 Section 1: Meeting VET sector requirements 7

IHSS In Home Support Services

Fulton-Montgomery Arts Grants-Arts Education 2015 Guidelines Letter of Intent Deadline: October 31, 2014 Application Deadline: November 28, 2014

Bulletin. Required Activity: Admission to Medicaid-Certified Nursing Facilities and 90-day Redetermination TOPIC PURPOSE CONTACT SIGNED

2018 FLAS Application Questions

Terminating the Provider- Patient Relationship. Provided by Coverys Risk Management

Patient Instructions for Home Medical Equipment

Patient Instructions for Home Medical Equipment

MUNICIPAL EMPLOYMENT INCENTIVE PROGRAM (MEIP)

Transcription:

Overview: The Request fr Extramural Supprt (RES) frm is an internal UCSD frm that must accmpany each prpsal. This standard frm assists each f the UCSD prpsal review ffices at OCGA, HSSPPO, and SIO, review the prpsal in an efficient manner by prviding a summary f infrmatin regarding the prpsal and the apprpriate required signatures and apprvals. Please Nte: A new RES frm is required each time a New, Cntinuatin, Renewal, r Supplement prpsal is submitted t a funding agency r basically when new r additinal funding is anticipated. Hwever, a new RES frm will nt be required fr esnaps submitted by the PI r fr Revisins r revised Budgets t current prpsals that have nt yet been funded. Sectin 1 General Department Cntact Infrmatin: Lead Department/ORU: List the Department/ORU the prpsal is being submitted frm. This is the Department/ORU that will administer the prject. Lead Department/ORU Cntact: Identify the individual that shuld be called if there are questins regarding the prpsal applicatin and budget. Email: List the email address f the individual listed as the Department/ORU cntact. Fax #: List the fax number f the individual listed as the Department/ORU cntact. Phne #: List the phne # f the individual listed as the Department/ORU cntact. Mail Cde: List the Department/ORU mail cde f the individual listed as the Department/ORU cntact. UCSD #: The UCSD # uniquely identifies a prpsal. The UCSD # stays with the prpsal until it is awarded. The UCSD # is issued by any f the UCSD campus prpsal review ffices: Fr prpsals submitted by General Campus and Health Sciences departments, call the Office f Cntract and Grant Administratin (OCGA) at 858-534-3330. Fr prpsals submitted by Scripps Institutin f Oceangraphy (SIO) Departments, call the SIO Cntract and Grant Office at 858-534-4570. Fr NIH Grant Prpsals nly, submitted by Health Sciences Department/ORUs, call the Health Sciences Spnsred Prjects Pre-Award Office (HSSPPO) at 858-822-4109. Prject Organizatin #: List the Prject Organizatin # fr the Department/ORU that will be administering the prject. This is a six digit # assigned by the UCSD Accunting Office that is part f the IFOPAL that uniquely identifies yur Department/ORU at UCSD. If yu are nt certain what the Prject Organizatin # is, cntact yur Department /ORU Business Officer. Mailing Index #: List the Mailing Index #, designated by yur Department/ORU Business Office, used fr mailing csts charged in transmitting the prpsal t the agency. Fr SIO prpsals, ensure that the SIO Cntract and Grant Office has yur current FedEx accunt number. Cpying Index #: List the Cpying Index #, designated by yur Department/ORU Business Office, used fr csts charged in making cpies related t the prpsal. Office f Cntract and Grant Administratin 8/2011 1

Sectin 2 Principal Investigatr and C-Principal Investigatr Infrmatin: PI Last Name: List the Last Name f the Principal Investigatr. PI First Name: List the First Name f the Principal Investigatr. Title: List the fficial Payrll Title f the Principal Investigatr. If yu are nt certain what the title is, either cntact yur Department/ORU Business Office r the University s Payrll Department. Department/ORU: List the Department r ORU in which the Principal Investigatr has their academic appintment. Mail Cde: List the Mail Cde fr the Principal Investigatr. Phne #: List the Phne # fr the Principal Investigatr. Email: List the Email address fr the Principal Investigatr. Will a PI Exceptin be Required? (Reference PPM 150-10): In rder t submit a prpsal as a Principal Investigatr, the researcher must have a qualified title. If the researcher des have a qualified title, check the N bx. If the researcher des nt have a qualified title, check the Yes bx. An exceptin can be apprved under certain cnditins. Refer t Summary f Eligibility Status; PPM 150-10. C-Principal Investigatr Last Name: List the Last Name f the C-Principal Investigatr. Please Nte: Shuld there be mre than ne C-Principal Investigatr, use the RES frm 2 Page Frmat, which was designed and created slely fr that purpse. NIH, NASA, and sme Nn Prfit Agencies d nt allw C-Principal Investigatrs. C-Principal Investigatr First Name: List the First Name f the C-Principal Investigatr. C-PI Title: List the fficial Payrll Title f the C-Principal Investigatr. If yu are nt certain what the title is, either cntact yur Department/ORU Business Office r the University s Payrll Department. C-PI Department/ORU: List the Department r ORU in which the C-Principal Investigatr has their academic appintment. This may r may nt be the same as that f the Principal Investigatr. Office f Cntract and Grant Administratin 8/2011 2

Sectin 2 - Cntinued Principal Investigatr and C-Principal Investigatr Infrmatin: C-Principal Investigatr Mail Cde: List the Mail Cde fr the C-Principal Investigatr C-PI Phne #: List the Phne # fr the C-Principal Investigatr. C-PI Email: List the Email address fr the C-Principal Investigatr. Will a PI Exceptin be Required? (Reference PPM 150-10): In rder t submit a prpsal as a C-Principal Investigatr, the researcher must have a qualified title. If the researcher des have a qualified title, check the N bx. If the researcher des nt have a qualified title, check the Yes bx. An exceptin can be apprved under certain cnditins. Refer t Summary f Eligibility Status; PPM 150-10. Sectin 3 Type f Award: Grant: A simple funding mechanism used by agencies t allcate extramural (utside) supprt. A grant prvides maximum flexibility in the expenditure f funds and perfrmance f the prpsed wrk. There is little agency invlvement and grant terms and cnditins are usually referenced rather than included in the grant agreement. Cntract: A cntract is the mst restrictive funding mechanism. Once the research scpe f wrk budget and terms and cnditins have been negtiated and a cntract dcument fully executed, mst changes require a re-negtiatin and a frmal cntract mdificatin. Agency persnnel may interact frequently with the PI with regard t prgress f the research and expenditure f the funds. The cntract terms and cnditins are generally a specific part f the cntract dcument. Cperative Agreement: A cperative agreement is nly used when the spnsr, generally the federal gvernment, plans t have a mre active management rle in the prject. The terms and cnditins generally have mre restrictins than a grant but less restrictins than a cntract. Office f Cntract and Grant Administratin 8/2011 3

Sectin 3 Cntinued Type f Award: Subaward Cntract: A subaward cntract is similar t a cntract except that, rather than UCSD receiving an award directly frm a funding agency, it is awarded via anther entity. Fr example, UCSD may receive funding frm anther University wh received their funding frm an Air Frce cntract. Subaward Grant: A subaward grant is similar t a grant except that, rather than UCSD receiving an award directly frm a funding agency, it is awarded via anther entity. Fr example, UCSD may receive funding frm anther University wh received their funding frm an NIH grant. Sectin 4 Type f Prpsal: New: A cmpetitive prpsal fr supprt f a prject that is being submitted fr funding the first time. Cntinuatin: A nn-cmpetitive prpsal fr the next funding increment f a current prject usually submitted annually, if required by the agency. Renewal: A prpsal t renew an expiring prject, which will be reviewed cmpetitively with ther prpsals and fr which funding is nt assured. Supplement: A prpsal requesting supplemental funds fr a current prject and which may r may nt cmpete with ther prpsals fr available funding. Revisin: A prpsal that is being funded but needs t be revised t incrprate changes requested by the funding agency. Resubmissin: A cmpetitive prpsal that was previusly submitted but was nt funded and is being amended fr resubmissin. Minrity Supplement: A nn-cmpetitive prpsal requesting supplemental funds fr a current prject t supprt minrity students. Please Nte: These prpsal types als apply t "internal" prpsals. Fr example; prpsals that are nt frmally submitted t the agency in advance f the receipt f an award. Office f Cntract and Grant Administratin 8/2011 4

Sectin 5 Type f Prject/Activity: Basic Research: Research which is directed tward increase f knwledge in science wherein the primary aim f the investigatr is fuller knwledge r understanding f the subject under study, rather than a clear r direct practical applicatin theref. Applied Research: Research which cnsists f the effrt which, (1) nrmally fllws basic research, (2) attempts t determine and expand the ptentiality f new scientific /imprvements in technlgy, materials, prcesses, methds, devices, and techniques, and (3) attempts t advance the state f the art. Develpmental Research: Research which invlves the systematic use and practical applicatin f investigative findings and theries f a scientific r technical nature tward the prductin f r imprvements in useful prducts t meet specific perfrmance requirements but exclusive f manufacturing and prductin engineering. Other Research: Research which cannt be categrized as either basic, applied, r develpmental. Training: Prjects that invlve the schlarly, prfessinal, r ccupatinal instructin fr matriculated students r University emplyees in frms such as classes, seminars, wrkshps, cnferences, etc. This als includes agency spnsrship f students r emplyees wh are in training primarily, but nt exclusively, at the graduate and pstgraduate levels. The scpe f this als includes spnsred training awards made t the University which prvide fr selectin f student recipients by academic departments and the institutinal supprt which is either included in the training grant r is applied fr and awarded separately. Public Service: Prjects, including cnferences, where the agency, usually the Federal r State gvernment, desires t have the University prvide the benefits f schlarly r prfessinal training r services t individuals r agency-designated recipient grups which are external t the University. Other Service: Services which the University prvides r makes available which d nt fit within the categries f training r public service, such as the use f University facilities. Equipment: Research which is restricted by the agency fr the sle purpse f either the upgrade f an investigatr s present equipment r the purchase f new state-f-the-art equipment t aid in their research endeavrs. Marine Facilities/Other: Scripps Institutin f Oceangraphy ship and ship technician use. Office f Cntract and Grant Administratin 8/2011 5

Sectin 6 Prpsal Title: Prpsal Title: List the title fr the prpsal. Be as brief and cncise as pssible. The Principal Investigatr will usually furnish this infrmatin. Be sure t check the funding agency guidelines fr any pssible requirements n length and cntent, as sme agencies are very specific abut this infrmatin. Sectin 7 Prpsal Infrmatin: Award # (if applicable): If this is ther than a New prpsal, list the current award number. Fr prpsals t agencies that d nt prvide an actual award number, list the riginal UCSD # assciated with the prject. Duplicate Prpsal #s (if applicable): If the Principal Investigatr has submitted r plans t submit the exact same prpsal t anther funding agency, list the UCSD # that is assciated with the duplicate prpsal. PA/RFA/RFP/etc. # (if applicable): These are sme examples f acrnyms fr the names f written annuncements that agencies publish fr submissin f prpsals. List the applicable number that is assciated with the annuncement. There may be ther acrnyms based n the particular agency. Fr example; BAA Brad Agency Annuncement r RFQ Request fr Qutatin. They generally cntain infrmatin abut the type f prjects they will fund, have detailed infrmatin/guidelines abut preparatin f the prpsal, and the deadline date by which the prpsal must be submitted. PA is an acrnym fr Prgram Annuncement, which describes a research pprtunity which may be either new r an expanded interest in a particular extramural prgram. Prpsals submitted in respnse t a PA and which are selected fr funding will generally be awarded as grants. RFA is an acrnym fr a Request fr Applicatin, which describes the availability f funds fr a tpic f specific interest t a funding agency. Prpsals submitted in respnse t an RFA and which are selected fr funding will generally be awarded as grants r cperative agreements. RFP is an acrnym fr a Request fr Prpsal, which describes the availability f funds fr a very specific tpic f research. Prpsals submitted in respnse t an RFP and which are selected fr funding will be awarded as cntracts. Office f Cntract and Grant Administratin 8/2011 6

Sectin 7 Cntinued Prpsal Infrmatin: Prject Begin Date (mm/dd/yy): List the anticipated starting date fr the prject. This is the date that shuld be used t estimate prject expenses fr the budget. Agency guidelines may determine the earliest start date that can be selected. Prject End Date (mm/dd/yy): List the anticipated ending date fr the prject. This is the date that wuld be at the end f the entire prject. Fr NIH annual Cntinuatins, use the dates f the ne year budget perid instead f the multi-year prject perid. Direct Csts: List the anticipated ttal Direct Csts fr the entire prject/budget perid. This als applies t NIH grant prpsals, even thugh the guidance fr the agency Face Page excludes cnsrtium/subaward Indirect Csts. The entire prject perid is frm the begin date thrugh the end date. Indirect Csts: List the anticipated Indirect Csts fr the entire prject/budget perid, which is frm the begin date thrugh the end date. IDC Rate(s) %: List the Indirect Cst Rate(s) percentage(s). Indirect cst rates can vary based n the type f prject, whether it will ccur in n r ff-campus lcatins and n funding agency guidelines. If yu are nt certain f the crrect rate, cntact yur prpsal review ffice analyst. Fr SIO, list all applicable rates if research and ship time r MPL is invlved. Ttal Csts Requested: This field will add autmatically, which will be the sum f the ttal direct csts plus the ttal indirect csts. Office f Cntract and Grant Administratin 8/2011 7

Sectin 8 Agency Infrmatin: Agency Due Date (mm/dd/yy): List the agency required due date fr the prpsal, as funding agencies will nt accept prpsals which miss a deadline. This date is extremely imprtant! If the agency des nt have a frmal due date and the Principal Investigatr is requesting a specific due date, indicate this by crssing ut Agency and hand-writing PI Due Date nce yu have printed a cpy f the RES. If there is n actual firm deadline, indicate "ASAP". If the prpsal will nt be submitted frmally t the agency, indicate internal in this space. Agency Name: List the name f the funding agency that the prpsal will be submitted t. Agency Cntact: List the name f a cntact persn at the agency t which the prpsal is being submitted. This is very imprtant fr bth mailing purpses and fr any clarificatin regarding the prpsal. Email: List the Email address f the cntact persn at the agency. Phne #: List the Phne # f the cntact persn at the agency. Fax #: List the Fax # f the cntact persn at the agency. Street: List the cmplete physical street address where the agency is lcated. D nt use P.O. Bxes since curier delivery services, such as UPS and FedEx will nly deliver t a street address. City: List the City where the agency is lcated. State: List the State where the agency is lcated. Zip: List the Zip Cde where the agency is lcated. # f Cpies Requested by the Agency: Indicate the number f cpies f the prpsal that are required by the funding agency. This usually cnsists f the riginal plus a specific number f cpies. If nly the riginal is required, indicate "riginal nly" in this space. If yu are nt certain f the crrect number, cntact yur prpsal review ffice analyst. Office f Cntract and Grant Administratin 8/2011 8

Sectin 8 Cntinued Agency Infrmatin: Will this prpsal result in UCSD receiving a subaward?: If the anticipated type f award is a subaward cntract r subaward grant, check the "Yes" bx. Fr example, fr example; rather than UCSD receiving an award directly frm a funding agency, it is awarded via anther entity. UCSD may receive funding frm anther University wh received their funding frm a Federal, Nn Prfit, Fr Prfit, State, r Freign agency. If nt, check the "N" bx. If Yes, list the "Prime" funding agency name: List the name f the funding agency, referred t here as the "Prime", actually prviding the dllars. Fr example, the name f the Federal, Nn Prfit, Fr Prfit, State, r Freign agency, nt the name f the entity the prpsal is being submitted t. Sectin 9 Yes r N Questins: Questin A: Will n-campus space be used?: On campus space is that which is wned by UCSD. If the respnse is Yes, check the Yes bx and cmplete the infrmatin regarding buildings, rms, labs, and ffices. If nt, check the N bx. Please Nte: Space being listed n the RES frm is nt in and f itself a guarantee. Fr frmal prcesses f apprval f space, cntact yur Department/ORU Business ffice. If Yes, list Building(s): If space fr the prject is wned by UCSD, list building numbers that will be used fr the prject. Rm/Lab/Office #(s): If space fr the prject is wned by UCSD, list all applicable rm, labratry and ffice # s that will be used fr the prject. Please Nte: Fr purpses f determining the apprpriate indirect cst rate, if space t be used fr the prject is ccurring in bth n-campus and ff-campus lcatins, the verall prject is defined as either being n-campus r ff-campus cnsistent with where the majrity f the wrk is t be perfrmed. Majrity is defined as ver 50% f the salary dllars paid t persnnel wrking n the prject. Office f Cntract and Grant Administratin 8/2011 9

Sectin 9 - Cntinued Yes r N Questins: RES Frm Questin B: Will ff-campus space be used?: Off campus space is that which is either leased by UCSD r is nt wned by UCSD. If the respnse is Yes, check the Yes bx. If nt, check the N bx. Please Nte: Space being listed n the RES frm is nt in and f itself a guarantee. Fr frmal prcesses f apprval f space, cntact yur Department/ORU Business ffice. Please Nte: This des nt include space fr any Subaward sites invlved in the UCSD prject. If Yes, list Building(s): If space fr the prject is leased r nt wned by UCSD, list all applicable building numbers r addresses that will be used fr the prject. Will rent be included in this prpsal?: If the space t be used fr the prject is leased by UCSD, rent may need t be included in the prpsal budget, depending upn the plicy f the applicable Dean r Vice Chancellr. All prpsals frm Health Sciences Departments/ORUs must include rent csts fr the prtin f the space which is used fr a particular prject. Check the Yes r N bx, as applicable. Please Nte: Fr purpses f determining the apprpriate indirect cst rate, if space t be used fr the prject is ccurring in bth n-campus and ff-campus lcatins, the verall prject is defined as either being n-campus r ff-campus cnsistent with where the majrity f the wrk is t be perfrmed. Majrity is defined as ver 50% f the salary dllars paid t persnnel wrking n the prject. Questin C: Will VA space be used? Will space at the Veterans Administratin Medical Center be used fr this prject? If Yes, list Building(s): List all applicable building(s) that will be used fr the prject. Rm #(s): List all applicable rm(s) that will be used fr the prject. Will mre than 50% f the prject be in VA space?: Determine if VA space will be used in the prject. If s, further determine if mre than 50% f the persns, determined by salary dllars, will be perfrming the prject in VA space. Check either the Yes r N bx, depending upn yur determinatin. Have dcumentatin available t supprt this determinatin if requested. If the Yes bx is checked, cntact yur prpsal review ffice analyst immediately fr infrmatin abut the Veteran s Medical Research Fundatin (VMRF) and guidance n VA/VMRF requirements fr such prjects. Questin D: Will animal subjects be used?: Determine if animals will be used fr the prject. If s check the Yes bx and cmplete the sectins fr date(s) apprved, Prtcl #(s), Species, and Pending. If yes, list date(s) apprved: List the mst recent date that the Principal Investigatrs s animal subject s prtcl was apprved by the UCSD Institutinal Animal Care and Use Cmmittee (IACUC). If n prtcl has been submitted r if the prtcl has expired, cntact the Animal Welfare Prgram ffice fr assistance. Prtcl #(s): Be careful t identify and list the crrect animal subject s prtcl number(s) that is/are in effect fr the specific prject. The apprved prtcl date(s) must cver at least the begin date f the prject. The dates f the prject and the prtcl may nt match exactly; as such, it may be necessary t renew the prtcl during the term f the prject. Species: Name all f the animal species that will be used n the prject. Fr example, rats, mice, etc. Pending: If the animal subject s prtcl fr the prject has either been submitted t the UCSD Institutinal Animal Care and Use Cmmittee (IACUC), but has nt been apprved yet r has nt yet been submitted, check this bx. Office f Cntract and Grant Administratin 8/2011 10

Sectin 9 - Cntinued Yes r N Questins: RES Frm Questin E: Will human subjects be used?: Determine if human subjects will be used fr the prject. If s, check the Yes bx and cmplete the sectins fr date(s) apprved, Prtcl #(s), and Pending. If yes, list date(s) apprved: List the mst recent date that the Principal Investigatr s human subject s prtcl was apprved by the UCSD Institutinal Review Bard. If n prtcl has been submitted r if the prtcl has expired, cntact the Human Research Prtectin Prgram Office fr assistance. Prtcl #(s): List the human subject s prtcl number(s) that is/are in effect fr the prject. The apprved prtcl date(s) must cver at least the begin date f the prject. The dates f the prject and the prtcl may nt match exactly; as such, it may be necessary t renew the prtcl during the term f the prject. Pending: If the human subject s prtcl fr the prject has either been submitted t the UCSD Institutinal Review Bard but has nt been apprved yet r has nt yet been submitted, check the bx. Questin F: Will human embrynic cells (any type) be used, r will ther cell types r prcedures be used that require ESCRO review? See Determine if Embrynic Stem Cell Research Oversight (ESCRO) cmmittee review and apprval is required fr the prject. A prpsal is subject t ESCRO review and apprval if the prject requires derivatin f human embrynic cell lines r the use f human embrynic cells derived frm: Blastcysts riginally created fr reprductive purpses which are n lnger required fr such purpses and are later btained fr research frm an in vitr fertilizatin clinic r Blastcysts made specifically fr research using in vitr fertilizatin r Smatic cell nuclear transfer int cytes If s, check the Yes bx and cmplete the sectins fr date(s) apprved by ESCRO, ESCRO prtcl #, and Pending. If Yes, list date(s) apprved by ESCRO: List the mst recent date that the Principal Investigatr s prtcl was apprved by the UCSD ESCRO cmmittee. If n prtcl has been submitted r if the prtcl has expired, cntact Dr. Michael Kalichman f the ESCRO cmmittee at kalichman@ucsd.edu fr assistance. ESCRO Prtcl #(s): List the prtcl number that is in effect fr the prject. The apprved prtcl date must cver at least the begin date f the prject. The dates f the prject and the prtcl may nt match exactly; as such, it may be necessary t renew the prtcl during the term f the prject. Pending: If the ESCRO prtcl fr the prject has either been submitted t the ESCRO cmmittee but has nt been apprved yet r has nt yet been submitted, check this bx. Questin G: Will Cnflict f Interest frms 9510 r 700-U be required? If Yes, include signed frm(s): Since this is nt a requirement fr all funding agencies, refer t the Cnflict f Interest sectin f the OCGA Web site t determine when and if either frm 9510 r 700-U is required. Office f Cntract and Grant Administratin 8/2011 11

Sectin 9 - Cntinued Yes r N Questins: Questin H: Will UCSD equipment cst sharing be included? If yes, include Equipment Matching frm r letter with apprval signature(s): If yur Department/ORU des nt make use f the referenced Equipment Matching frm, dcumentatin culd be in the frm f a letter which reflects the detail f the cst sharing and which has been signed by the individual wh has the authrity t cmmit the funds. Departments which utilize the Equipment Matching frm are Biengineering, Cmputer Science and Engineering, Electrical and Cmputer Engineering, Mechanical and Aerspace Engineering, Structural Engineering, Chemistry and Bichemistry, Mathematics, and Physics. Questin I: Will UCSD expenditure cst sharing be included? Fr example; salary, benefits, supplies, fellwships, and applicable indirect csts: This is when UCSD expenditure cst sharing is prvided frm internal UCSD nn-federal, unrestricted funding surces. This includes fellwship funding prvided by the Vice Chancellr. Fellwships frm ther entities, fr example; utside f UCSD, which are cntributed t a prject are cnsidered t be Nn-UCSD Cst Sharing. If Yes, list ttal $: List the ttal dllar amunt f the UCSD expenditure cst sharing fr the entire prject in this space. Fund#(s) f surce: List the fund number(s) assciated with the surces fr this UCSD expenditure cst sharing. Keep in mind that these must be nn-federal, unrestricted surces. If ther than departmental funds, attach detail with apprval signature(s): If necessary, attach a mem r letter t the RES frm which reflects the detail f the cst sharing and which has been signed by the individual wh has the authrity t cmmit the funds. If departmental funds are being cmmitted, the MSO/DBO signature in the RES frm indicates apprval. Questin J: Will nn-ucsd cst sharing be included?: This is when nn-ucsd cst sharing is prvided by anther entity that is participating in the prpsal, such as a subcntractr. It als includes the surce f pssible fellwship funding prvided by an utside entity that is supprting a Pstdc n a UCSD budget. If Yes, list entity: This is the name f the ther institutin, fr example; industrial cmpany, Universities ther than UCSD, etc., that is prviding the nn-ucsd cst sharing. List ttal $: List the dllar amunt f the nn-ucsd cst sharing in this space. Questin K: Will any genetically-mdified agents be invlved? Fr example; recmbinant DNA: Check the Yes r N bx, as applicable. If yu are nt certain, cntact the Envirnmental Health & Safety (EH&S) Office. Questin L: Will any bihazardus materials be invlved? Fr example; material f human/primate rigin r infectius agents: Check the Yes r N bx, as applicable. If yu are nt certain, cntact the Envirnmental Health & Safety (EH&S) Office. Office f Cntract and Grant Administratin 8/2011 12

Sectin 9 - Cntinued Yes r N Questins: RES Frm Questin M: SIO Only Will scuba r surface-supplied diving be used fr data cllectin?: Check the Yes bx if scuba diving will be dne in the perfrmance f the prject. The SIO Cntract and Grant Office will btain apprval frm the Diving Officer. If nt, check the N bx. If ship time is required, list ship name?: If a UNOLS ship r R/P FLIP will be used in the perfrmance f the prject, indicate which SIO UNOLS ship (R/V Revelle, Melville, New Hrizn, r Rbert Sprul), R/P FLIP r ther UNOLS ship will be used. If using a UNOLS ship, cmplete the nline UNOLS ship frm. If using the R/R FLIP, cntact Captain Gaines, Marine Physical Labratry, at (858) 534-1797 r at wag@mpl.ucsd.edu. Questin N: SIO Only Will Graduate Student Researchers be supprted? If Yes, hw many?: Check the Yes r N bx as applicable. If the N bx is checked and the budget fr the prject exceeds $75,000 in any ne year, cmplete a GSR Exceptin Mem addressed t the SIO Department Chair, which has t be signed by the Principal Investigatr and endrsed by the Principal Investigatr s Department Chair. If the Yes bx is checked, indicate the number f Graduate Student Researchers. Questin O: SIO Only Will additinal space be used? If Yes, include RES Addendum frm: If any additinal space will be required, fr either persnnel r equipment, ther than what has already been specifically listed under questins "A", "B", and/r C f the RES frm, then a RES Space Addendum is required and will need t be submitted t the SIO Cntract and Grant ffice alng with the RES frm. Questin O: SIO Only Has the PI certified cmpletin f lab safety training fr all emplyees, students, vlunteers, and visiting scientists wrking in the PI's labratry(ies)?: Check the Yes r N bx as applicable if the PI has certified that persnnel wh wrk/cnduct research in SIO labratries have taken the required EH&S safety training. Sectin 10 Apprval Signatures: Apprval Signatures Faxed signatures are acceptable: The RES frm is t be signed, with names printed r typed, and dated by the Principal Investigatr, the Department Chair/ORU Directr, and the MSO/DBO f the Department/ORU that is submitting the prpsal. If there are any C- Principal Investigatrs frm that same Department/ORU, they are t sign as well. If researchers frm Departments/ORUs ther than the ne that is submitting the prpsal are participating in the prpsal in any capacity, a cpy f the RES frm must be signed by each such Department Chair/ORU Directr and MSO/DBO. Office f Cntract and Grant Administratin 8/2011 13

Sectin 10 - Cntinued Space Apprval and VA Medical Center Research Administratin signatures will be ruted fr apprvals by yur prpsal review ffice. OCGA/SIO/HSSPPO USE ONLY: This sectin is cmpleted by OCGA, SIO Cntract and Grant Office, r HSSPPO after receipt f the RES frm and prpsal. Office f Cntract and Grant Administratin 8/2011 14