Office of Sponsored Programs Transmittal Sheet Research ♦ Scholarship ♦ Service ♦ Support
Please Note: Proposals must be submitted 3 working days prior to the proposal submission deadline. I. INVESTIGATOR(S) Name PI Co-PI Co-PI Co-PI Co-PI Position Title Department, Center or Institute
Proposal No. (assigned by OSP) Date Received (assigned by OSP) College/ Division Select Select Select Select Select Phone MS
II. PROJECT Project Title: Project Type: Drop-down Menu Select One Definitions at: www.boisestate.edu/research/osp/policies-admin-costs.shtml Proposal Type: Drop-down Menu Select One Total Project Period (m/d/yy): Start Date: End Date: III. SPONSOR Name of Granting Agency: If Federal Flow-Through, List Agency: Program/Solicitation Title: Program No.: Granting Agency Type: Drop-down Menu Select One Due Date (m/d/yy):
(If known.)
IV. BUDGET (Amount Requested from Sponsor for Entire Project Period) Total Direct Costs: $ Facilities & Administrative Costs: $ Rate: % F&A: Total (Direct and F&A): $ Base Rate: Drop-down Menu Select One PLEASE NOTE:
*Not Allowed by Agency *Limited by Agency **Requesting Waiver
*If the sponsor has a written and consistently applied policy to limit or prohibit F&A, attach documentation. **If you are not including F&A at the full rate allowed by the sponsor, you must complete a request for waiver form and submit it to the Office of Sponsored Programs. http://www.boisestate.edu/research/osp/forms.shtml
V. COST SHARE Is cost share included in the proposal? Yes No If yes, complete OSP Cost Share form.
VI. SPACE/FACILITIES Location of project: On-campus Off-campus Definitions at: www.boisestate.edu/research/osp/policies-admin-costs.shtml Will new or renovated space/facilities be required? * Yes No Will rental space be required? * Yes No * If yes, please attach additional information (square footage, location if known, etc.) VII. COMPLIANCE (If this proposal is funded, compliance approvals must be obtained before work is initiated.) Yes No If yes, complete an application http://www.boisestate.edu/research/compliance/irb.shtml Human Participants Yes No If yes, complete an application http://www.boisestate.edu/research/compliance/animal.shtml Animal Use Yes No If yes, complete an application http://www.boisestate.edu/research/compliance/ibc.shtml Biosafety Check all that apply and list where indicated. Recombinant DNA Select Agents Infectious Agents Biohazardous Agents/Toxins Human Blood, Blood Products or Blood Borne Pathogens Hazardous Materials & Chemicals Chemical Waste & Hazardous Waste Ionizing Radiation, X-ray Equipment or Lasers
OSP 676-01 (Rev. 08/08/2008)
VIII. ADDITIONAL INFORMATION Does the proposed project involve potentially patentable ideas? Is this proposal a result of the federal appropriation process (“Earmark”)?
Does this project require university commitments beyond the end date of the grant? Do you anticipate purchasing equipment with a unit cost equal to or exceeding $5,000?
Yes Yes Yes Yes
No No No No If yes, attach documentation.
Do you anticipate the inclusion of any of the following? Check all that apply. Consultant/Independent contractor(s) Payments to human participant(s) Non-compensatory payment(s) (i.e., fellowships, participant support costs etc.) Foreign travel Payment(s) to foreign nationals or on behalf of foreign nationals Are subrecipients (subcontracts/subawards) anticipated? Yes No If yes, please include the following: Subrecipient(s) budget Subrecipient(s) statement of work Letter of endorsement signed by subrecipient’s authorized institutional official Do you anticipate any of the following? Check all that apply. Faculty release time Overload (supplemental pay during contract period) Summer salary Clerical staff salary IX. FINANCIAL DISCLOSURE Initials of OSP RA: A. Principal investigators, co-investigator(s) and senior personnel are required to complete a financial disclosure form annually. Have all who are required to complete the annual financial disclosure form done so? Yes No If no, please attach a financial conflict of interest disclosure form http://www.boisestate.edu/research/osp/forms.shtml B. The principal investigator acknowledges that: (Check one) No financial conflict of interest exists related to this proposal and there are no material changes to the information described in the annual disclosure form; or A financial conflict of interest exists related to this proposal and has been disclosed in accordance with university and federal policy. X. CERTIFICATION/SIGNATURES Investigators, department chairs, directors, deans certify that 1) the proposed activities are appropriate to the research, instruction, and public service mission of the University; 2) if funded all necessary resources as proposed will be provided for the project (i.e., cost share, personnel, facilities). Investigators certify that 1) proposed activities are appropriate to the research, instruction and public service mission of the university; 2) the information submitted within the application is true, complete and accurate to the best of the PI’s knowledge; 3) all necessary resources to successfully complete the proposed project have been identified in the proposal; 4) any false, fictitious, or fraudulent statements or claims may subject the PI to criminal, civil, or administrative penalties; and 5) that the PI agrees to accept responsibility for the scientific conduct of the project and to provide the required progress reports. Deans acknowledge that Facilities and Administrative costs for projects involving more than one college will be distributed in accordance with University policy 6317-C unless otherwise directed in writing with approval from all deans involved. Business Manager (if applicable) has reviewed this proposal. Principal/Co-Investigator(s) Date Initial: Date OSP Review Dean(s) Initial: Date Dept Chair(s) or Director(s)
Director, Office of Sponsored Programs or Designee: I. DISTRIBUTION (To be completed by the Office of Sponsored Programs) Principal Investigator Co-Investigator (s) Business Manager
Date:
Compliance Coordinator
OSP 676-01 (Rev. 08/08/2008)