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					Form Approved Through 09/30/2007                                                                                                                            OMB No. 0925-0001
                     Department of Health and Human Services                                         LEAVE BLANK—FOR PHS USE ONLY.
                              Public Health Service                                                  Type                 Activity             Number
                                                                                                     Review Group                              Formerly
                             Grant Application
                                                                                                     Council/Board (Month, Year)               Date Received
   Do not exceed 56-character length restrictions, including spaces.
                     (Do
1. TITLE OF PROJECT not exceed 81 characters, including spaces and punctuation.)


                                                                                      NO
2. RESPONSE TO SPECIFIC REQUEST FOR APPLICATIONS OR PROGRAM ANNOUNCEMENT OR SOLICITATION                                                                           YES
 (If "Yes," state number and title)
       Number:                                 Title:
3. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR                                                          New Investigator                 No      Yes
3a. NAME (Last, first, middle)                                                                       3b. DEGREE(S)                             3h.eRA Commons User Name


3c. POSITION TITLE                                                                                   3d. MAILING ADDRESS (Street, city, state, zip code)
                                                                                                                  10900 Euclid Avenue
3e. DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT                                                                Cleveland OH 44106-7015

3f. MAJOR SUBDIVISION
              College of Arts and Sciences
3g. TELEPHONE AND FAX (Area code, number and extension)                                              E-MAIL ADDRESS:
TEL:                             FAX:
4. HUMAN SUBJECTS 4b. Human Subjects Assurance No.                                                  5. VERTEBRATE ANIMALS                       No         Yes
  RESEARCH                               FWA00004428
                                 4c. Clinical Trial                 4d. NIH-defined Phase III
         No        Yes
                                      No       Yes                Clinical Trial      No        Yes 5a.      If "Yes," IACUC approval Date     5b. Animal welfare assurance no
4a. Research Exempt
         No        Yes           If "Yes," Exemption No.                                                                                                    A3145-01
6. DATES OF PROPOSED PERIOD OF                                 7. COSTS REQUESTED FOR INITIAL                                    8. COSTS REQUESTED FOR PROPOSED
   SUPPORT (month, day, year--MM/DD/YY)                           BUDGET PERIOD                                                     PERIOD OF SUPPORT
 From                   Through                                 7a. Direct Costs ($)    7b. Total Costs ($)                       8a. Direct Costs ($) 8b. Total Costs ($)

                                                                           175,660                           244,004                   935,263               1,300,212
 9. APPLICANT ORGANIZATION                                                                          10. TYPE OF ORGANIZATION
 Name         Case Western Reserve University                                                           Public:       Federal        State       Local
 Address      10900 Euclid Avenue                                                                       Private:      Private Nonprofit
              Cleveland OH 44106-7015                                                                   For-profit:   General     Small Business
                                                                                                        Woman-owned    Socially and Economically Disadvantaged
                                                                                                    11. ENTITY IDENTIFICATION NUMBER
                                                                                                                  1341018992A1


                                                             DUNS NO. 07-775-8407   Cong. District: 11
 12. ADMINISTRATIVE OFFICIAL TO BE NOTIFIED IF AWARD IS MADE 13. OFFICIAL SIGNING FOR APPLICANT ORGANIZATION
 Name         Hossein Sadid                                                                          Name         Derek Humphrey
 Title        Chief Financial and Administrative Officer                                             Title        Assistant Director, OSPA
 Address      Case Western Reserve University                                                        Address      Case Western Reserve University
              10900 Euclid Avenue                                                                                 10900 Euclid Avenue
              Cleveland OH 44106-4919                                                                             Cleveland OH 44106-7015

Tel:          (216) 368-2009                            FAX:    (216) 368-4679                      Tel:          (216) 368-2009                   FAX:   (216) 368-4679
E-Mail:       derek.humphrey@case.edu                                                               E-Mail:       derek.humphrey@case.edu
                                                                                                    SIGNATURE OF OFFICIAL NAMED IN 13.                              DATE
 14. APPLICANT ORGANIZATION CERTIFICATION AND ACCEPTANCE: I certify that
 the statements herein are true, complete and accurate to the best of my knowledge, and             (In ink. "Per" signature not acceptable.)
 accept the obligation to comply with Public Health Service terms and conditions if a grant
 is awarded as a result of this application. I am aware that any false, fictitious, or fraudulent
 statements or claims may subject me to criminal, civil, or administrative penalties.


 PHS 398 (Rev. 09/04)                                                                           Face Page                                                        Form Page 1
Principal Investigator/Program Director (Last, first, middle):       0
                                                                                                              FROM                  THROUGH
            DETAILED BUDGET FOR INITIAL BUDGET PERIOD
                        DIRECT COSTS ONLY                                                                                                  12/30/04
 PERSONNEL (Applicant organization only)                                                                        DOLLAR AMOUNT REQUESTED (omit cents)

                                            ROLE ON           Calendar Academic    Summer       INST.          SALARY      FRINGE
               NAME                                                                             BASE
                                            PROJECT            Months   Months     Months                    REQUESTED    BENEFITS            TOTAL
                                                                                               SALARY
                                             Principal
  0                                        Investigator          0        2.25        0      $120,000        $30,000       $7,800          $37,800
                                         Research
  0                                      Assistant               0          0         0          $0             $0           $0                        0
                                         Program
  0                                      Coordinator             6          0         0       $22,000        $11,000       $2,860                13,860
  0                                                       0      0          0         0          $0             $0           $0                        0
  0                                                       0      0          0         0          $0             $0           $0                        0
  0                                                       0      0          0         0          $0             $0           $0                        0
  0                                                       0      0          0         0          $0             $0           $0                        0

                                       SUBTOTALS                                                                41,000       10,660              51,660
CONSULTANT COSTS

  0                                                                                                                                              15,000
EQUIPMENT (Itemize)
  0
                                   0                                                                                                              8,000
SUPPLIES (Itemize by category)
  0                                                                                                      0
  0                                                                                                      0
  0                                                                                                      0
  0                                                                                                      0
  0                                                                                                      0
                                   0                                                                     0                                            800
TRAVEL
  0                                                                                                                                               6,800
PATIENT CARE COSTS                     INPATIENT                                                                                                 17,000
                                       OUTPATIENT                                                                                                40,000
ALTERATIONS AND RENOVATIONS (Itemize by category)
  0                                                                                                                                              12,000
OTHER EXPENSES (Itemize by category)
  0                                                                  0
  0                                                                  0
  0                                                                  0
  0                                                                  0                                                                           14,000
CONSORTIUM/CONTRACTUAL COSTS                                                                                           DIRECT COSTS              10,400
SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD                                                                                        $       175,660
CONSORTIUM/CONTRACTUAL COSTS                                                                FACILITIES AND ADMINISTRATIVE COSTS                   5,200
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD                                      (Item 7a, Face Page)                                 $       180,860


 PHS 398 (Rev. 09/04)                                                    Page                                                              Form Page 4
Principal Investigator/Program Director (Last, first, middle):                                         0

                                          BUDGET FOR ENTIRE PROPOSED PROJECT PERIOD
                                                      DIRECT COSTS ONLY
                                                  INITIAL BUDGET
                                                                                                            ADDITIONAL YEARS OF SUPPORT REQUESTED
         BUDGET CATEGORY                               PERIOD
             TOTALS                              (from Form Page 4)                      2nd                           3rd                         4th               5th
 PERSONNEL: Salary and fringe
I benefits. Applicant organization
I only.                                                      51,660                        53,421                         56,092                    56,980             58,778
CONSULTANT COSTS                                             15,000                                    0                  15,914                    16,391             16,883
EQUIPMENT                                                       8,000                          8,240                         8,487                       8,742             9,004
SUPPLIES                                                            800                           824                           849                       874               900
TRAVEL                                                          6,800                          7,004                         7,214                       7,431             7,653
  PATIENT                INPATIENT                           17,000                        17,510                         18,035                    18,576             19,134
  CARE
  COSTS                  OUTPATIENT                          40,000                        41,200                         42,436                    43,709             45,020
ALTERATIONS AND
RENOVATIONS                                                  12,000                        12,360                         12,731                    13,113             13,506
OTHER EXPENSES                                               14,000                        14,420                         14,853                    15,298             15,757
CONSORTIUM/
CONTRACTUAL
COSTS
                         DIRECT                              10,400                        10,712                         11,033                    11,364             11,705
SUBTOTAL DIRECT COSTS
(Sum = Item 8a, Face Page)                                 175,660                       181,141                       187,643                     192,478           198,341
CONSORTIUM/
CONTRACTUAL
COSTS
                         F&A                                    5,200                          5,356                         5,517                       5,682             5,853
TOTAL DIRECT COSTS                                         180,860                       186,497                       193,160                     198,160           204,193

TOTAL DIRECT COSTS FOR ENTIRE PROPOSED PROJECT PERIOD                                                                                                            $   962,870
JUSTIFICATION. Follow the budget justification instructions exactly. Use continuation pages as needed.
   For all Years:
  From Budget for Entire Period:          Identify with an asterisk (*) on this page and justify any significant increase costs, alterations and
                            Explain and justify purchase of major equipment, unusual supplies requests, patient care or decrease in any category




 PHS 398 (Rev. 09/04)                                                                               Page                                                             Form Page 5
Principal Investigator/Program Director (Last, first, middle):             0
                                                                     CHECKLIST
TYPE OF APPLICATION (Check all that apply.)

       NEW application. (This application is being submitted to the PHS for the first time.)

      REVISION of application number:
      (This application replaces a prior unfunded version of a new, competing continuation, or supplemental application.)
                                                                                           INVENTIONS AND PATENTS
      COMPETING CONTINUATION of grant number:                                              (Competing continuation appl. and Phase II only)
      (This application is to extend a funded grant beyond its current project period.)                 No                            Previously reported
       SUPPLEMENT to grant number:                                                                      Yes. If "Yes,"                Not previously reported
       (This application is for additional funds to supplement a currently funded grant.)

       CHANGE of principal investigator/program director.
       Name of former principal investigator/program director:

      CHANGE of Grantee Institution. Name of former institution:

                                                                           List
       FOREIGN application             Domestic Grant with foreign involvement
                                                                           Country(ies)




1. PROGRAM INCOME (See instructions.)
All applications must indicate whether program income is anticipated during the period(s) for which grant support is requested. If program income is
anticipated, use the format below to reflect the amount and source(s).
            Budget Period                            Anticipated Amount                                             Source(s)
      N/A                                       N/A                                                     N/A




2. ASSURANCES/CERTIFICATIONS (See instructions.)                                 •Debarment and Suspension; •Drug- Free Workplace (applicable to new
In signing the application Face Page, the authorized organizational              [Type 1] or revised [Type 1] applications only) ; •Lobbying; •Non-
representative agrees to comply with the following policies, assurances          Delinquency on Federal Debt; •Research Misconduct; •Civil Rights
and/or certifications when applicable. Descriptions of individual                (Form HHS 441 or HHS 690); •Handicapped Individuals (Form HHS 641
assurances/certifications are provided in Part III. If unable to certify         or HHS 690); •Sex Discrimination (Form HHS 639-A or HHS 690); •Age
compliance, where applicable, provide an explanation and place it after          Discrimination (Form HHS 680 or HHS 690); •Recombinant DNA
this page.                                                                       Research, Including Human Gene Transfer Research; •Financial Conflict
•Human Subjects; •Research Using Human Embryonic Stem Cells                      of Interest (except Phase I SBIR/STTR); •Smoke Free Workplace;
•Research on Transplantation of Human Fetal Tissue •Women and                    •Prohibited Research; •Select Agent Research•PI Assurance
Minority Inclusion Policy •Inclusion of Children Policy • Vertebrate
Animals•


3. FACILITIES AND ADMINISTRATION COSTS (F&A)/ INDIRECT COSTS. See specific instructions.
  X    DHHS Agreement dated:                               06/01/05                                    No Facilities and Administration Costs Requested.

       DHHS Agreement being negotiated with                                                                   Regional Office.

       No DHHS Agreement, but rate established with                                                      Date
CALCULATION* (The entire grant application, including the Checklist, will be reproduced and provided to peer reviewers as confidential information.)
a. Initial budget period:    Amount of base: $             115,860 x Rate applied         0.545     % = F&A costs         $           63,144
b. 02 year                          Amount of base: $                120,747 x Rate applied            0.545      % = F&A costs           $          65,807
c. 03 year                          Amount of base: $                124,201 x Rate applied            0.545      % = F&A costs           $          67,690
d. 04 year                          Amount of base: $                127,133 x Rate applied            0.545      % = F&A costs           $          69,287
e. 05 year                          Amount of base: $                131,035 x Rate applied            0.545      % = F&A costs           $          71,414
                                                                                                                  TOTAL F&A Costs         $        337,342

*Check appropriate box(es):
     Salary and wages base                           X     Modified total direct cost base                         Other base (Explain)
     Off-site, other special rate, or more than one rate involved (Explain)
Explanation (Attach separate sheet, if necessary.) :
 PHS 398 (Rev. 09/04)                     Yes                                  Page                                                 Checklist Form Page
Explanation of F&A Costs:                                                                                                             0

       DHHS Agreement dated 10/9/97

                                       Exemptions from Facilities & Administrative Costs               Modified
                        Total                                                                           Total                     Total
                        Direct          Capital        Patien       Tuition &       Subcontract(        Direct          F&A       F&A
BudgetPeriod            Costs          Equipment       t Care        Fees             s) > 25K          Costs           Rate      Costs
                                                                                                               0       54.50%          0
Yr 1   7/1/02 - 6/30/03 180,860    -       8,000   -   #####    -           0   -              0   =    115,860    x   54.50%   = 63,144
Yr 2   7/1/03 - 6/30/04 186,497    -       8,240   -   #####    -           0   -              0   =    120,747    x   54.50%   = 65,807
Yr 3   7/1/04 - 6/30/05 193,160    -       8,487   -   #####    -           0   -              0   =    124,201    x   54.50%   = 67,690
Yr 4   7/1/05 - 6/30/06 198,160    -       8,742   -   #####    -           0   -              0   =    127,133    x   54.50%   = 69,287
Yr 5   7/1/06 - 6/30/07 204,193    -       9,004   -   #####    -           0   -              0   =    131,035    x   54.50%   = 71,414
       Total            $962,870         $42,473       #####               $0                 $0       $618,976                  #######




                                                                    Page ___
    not  (Attach separate sheet,
                     (See instructions, Page
    Internal Use Only: if necessary.)32.)
                                                                                                                   #REF!
                                                                                                                   #REF!


INDIRECT COSTS CALCULATION PAGE


Important Note: The Indirect Cost calculation is different for each applicant institution, therefore, the user must adjust or modify
                 the "% RATE APPLIED", "Less MTDC", and pro-rated "AMOUNT OF BASE" as necessary. The formulas or
                 numbers in Red below will not be the same for your use.




                                                   AMOUNT                   % RATE                     INDIRECT
                                                   OF BASE                 APPLIED                        COSTS
    #REF!        through        06/30/96           #REF!        X             54.40         =           #REF!
    07/01/96     through        #REF!              #REF!        X             54.40         =           #REF!
                                01YR TOTAL         #REF!                                                #REF!


                                02YR TOTAL         #REF!        X             54.40                     #REF!
                                03YR TOTAL         #REF!        X             54.40                     #REF!
                                04YR TOTAL         #REF!        X             54.40                     #REF!
                                05YR TOTAL         #REF!        X             54.40                     #REF!
                                                   #REF!                                                #REF!
                                                    #REF!

    "BASE" CALCULATION:
                                           Total                               Less                                  Total Base
                                        Direct                                MTDC                                         MTDC
                        01YR       #REF!                    -              #REF!                   =                   #REF!
                        02YR       #REF!                    -              #REF!                   =                   #REF!
                        03YR       #REF!                    -              #REF!                   =                   #REF!
                        04YR       #REF!                    -              #REF!                   =                   #REF!
                        05YR       #REF!                    -              #REF!                   =                   #REF!
                        Total      #REF!                    -              #REF!                   =                   #REF!
                                    #REF!



          Internal use:

    AMOUNTS FOR ROUTING SHEET, BO54:


                                           Total                               Total                                     TOTAL
                                        Direct                              Indirect                                     COSTS
                        01YR       #REF!                    +              #REF!                   =                   #REF!
                        02YR       #REF!                    +              #REF!                   =                   #REF!
                        03YR       #REF!                    +              #REF!                   =                   #REF!
                        04YR       #REF!                    +              #REF!                   =                   #REF!
                        05YR       #REF!                    +              #REF!                   =                   #REF!
                        Total      #REF!                    +              #REF!                   =                   #REF!
                                    #REF!                                                                              #REF!
PRSALARY
    TRUE           names a reference cell = "mnths" , (FIRSTBUD, Cells C7...C14)
    TRUE           names a reference cell = "effort" , (FIRSTBUD, Cells D7...D14)
    TRUE           names a reference cell = "base" : base salary, (FIRSTBUD, Cells K7...K14)
    TRUE           names a reference cell = "sdate" : start date, (FIRSTBUD, Cell F4)
    TRUE           names a reference cell = "col" : percentage increase, (FIRSTBUD, Cell K4)
              1    states month of the start date
             12    calculates how many months left in next FY. Must edit the last number in formula
                   to represent starting month of your institution's fiscal year, ie., 1 = Jan.(default), 7 = July.
            0      calculated how many months left in current FY
       104000      calculates portion of salary based on number of months in next FY
            0      calculates portion of salary based on number of months in current FY
    TRUE           returns value of full salary based on "appointment" and "percent effort"



           Note:   This section is a macro for salary calculation for the Initial Budget Period ,
                   Form Page 4. It considers start date, salary, effort, appointment (in months),
                   and an inflation rate ("col"). It also prorates by Fiscal Year. See above cell D8
                   to adjust for your beginning FY month start.
                                                                            DETAILBUD


                                                 BUDGET YEAR 1
                                     BUDGET YEAR 1                               BUDGET YEAR 1 BUDGET YEAR 1                BUDGET YEAR 1 BUDGET YEAR 2
PERSONNEL (Applicant organization only)             Months devoted to project                                                                   Months devoted to project
                                          ROLE IN    Calendar   Acad Summer              INST. BASE    Salary      Fringe        Totals        Calendar
               NAME                   PROJECT        months     months months             SALARY      Requested    Beneft                       months
                                     Principal
                                     Investigator     0.000      2.3     0.0             $120,000     $30,000      $7,800        $37,800          0.0
                                     Research
                                     Assistant        0.000      0.0     0.0                                $0          $0                $0      0.0
                                                      6.000      0.0     0.0              $22,000     $11,000      $2,860        $13,860          6.0
                                                      0.000      0.0     0.0                               $0          $0             $0          0.0
                                                      0.000      0.0     0.0                               $0          $0             $0          0.0
                                                      0.000      0.0     0.0                               $0          $0             $0          0.0
                                                      0.000      0.0     0.0                               $0          $0             $0          0.0
                                                      0.000      0.0     0.0                               $0          $0             $0          0.0
                                                                                          SUBTOTAL    $41,000     $10,660        $51,660
CONSULTANTS COSTS


                                                                                                                                $15,000
EQUIPMENT (ITEMIZE)




                                                                                                                                 $8,000
SUPPLIES (Itemize by category)




                                                                                                                                    $800
TRAVEL
                                                                                                                                 $6,800
                                     INPATIENT                                                                                  $17,000
PATIENT CARE COSTS



                                                                                Page 8
                                                     DETAILBUD


 PATIENT CARE COSTS
                                    OUTPATIENT                                           $40,000
 ALTERATIONS AND RENOVATIONS (Itemize by category)
                                                                                         $12,000
 OTHER EXPENSES (Itemize by category)




                                                                                         $14,000
 Consortium Direct Costs #1                                                               $2,400
 Consortium Direct Costs #2                                                               $3,000
 Consortium Direct Costs #3                                                               $5,000
 SUB-TOTAL DIRECT COSTS                                                                 $175,660

 Consortium Indirect Costs #1                                                             $1,200
 Consortium Indirect Costs #2                                                             $1,500
 Consortium Indirect Costs #3                                                             $2,500
 TOTAL COSTS                                                                            $180,860

            ------------------------------------------------------------------
---------------------------------------------                         -----------------------------------------
                                                                                           -22600




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DETAILBUD




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                                                                                        DETAILBUD


UDGET YEAR 2         BUDGET YEAR 2BUDGET YEAR 2                       BUDGET YEAR 3
                                                                             #NAME?                           BUDGET YEAR 3
                                                                                                  BUDGET YEAR 3                           BUDGET YEAR 4 BUDGET YEAR 4
    Months devoted to project                                               Months devoted to project                                          Months devoted to project
              Acad   Sum         Salary      Fringe     Totals               Calendar     Acad     Sum    Salary     Fringe     Totals         Calen Acad     Sum
            months months       Requested    Benft                           months      months months Requesetd     Beneft                    months monthsmonths

              2.3      0        $30,900      $8,189    $39,089                   0.0        2.3 0.0      $32,507     $8,777    $41,283          0.0 2.3 0.0
              0.0      0              $0          $0             $0              0.0        0.0 0.0            $0         $0         $0         0.0 0.0 0.0
              0.0      0        $11,330      $3,002    $14,332                   6.0        0.0 0.0      $11,660     $3,148    $14,808          6.0 0.0 0.0
              0.0      0  $0                     $0         $0                   0.0        0.0   0.0         $0         $0         $0          0.0    0.0    0.0
              0.0      0  $0                     $0         $0                   0.0        0.0   0.0         $0         $0         $0          0.0    0.0    0.0
              0.0      0  $0                     $0         $0                   0.0        0.0   0.0         $0         $0         $0          0.0    0.0    0.0
              0.0      0  $0                     $0         $0                   0.0        0.0   0.0         $0         $0         $0          0.0    0.0    0.0
              0.0      0  $0                     $0         $0                   0.0        0.0   0.0         $0         $0         $0          0.0    0.0    0.0
            SUBTOTAL $42,230                $11,191    $53,421                           SUBTOTAL        $44,167    $11,925    $56,092                SUBTOTAL



                                                       $15,450                                                                 $15,914




                                                        $8,240                                                                  $8,487




                                                          $824                                                                    $849

                                                        $7,004                                                                  $7,214
                                                       $17,510                                                                 $18,035



                                                                                         Page 11
                                                             DETAILBUD


                                      $41,200                                    $42,436

                                      $12,360                                    $12,731




                                      $14,420                                    $14,853
                                       $2,472                                     $2,546
                                       $3,090                                     $3,183
                                       $5,150                                     $5,305
                                     $181,141                                   $187,643

                                       $1,236                                     $1,273
                                       $1,545                                     $1,591
                                       $2,575                                     $2,652
                                     $186,497                                   $193,160

------------------------------------
---------------------------------------------------------------------    -------------------------------------------------




                                                              Page 12
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                                                                                       DETAILBUD


        BUDGET YEAR 4BUDGET YEAR 4                         BUDGET YEAR 5 BUDGET YEAR 5BUDGET YEAR 5
s devoted to project
                       Salary     Fringe     Totals             Calen Acad   Sum      Salary      Fringe     Totals
                   Requested      Benfit                        monthsmonthsmonths   Requested    Beneft

                 $32,700          $8,993    $41,693              0.0 2.3 0.0         $33,600      $9,408    $43,008
                            $0         $0             $0         0.0 0.0 0.0               $0          $0             $0
                 $11,990          $3,297    $15,287              6.0 0.0 0.0         $12,320      $3,450    $15,770
                      $0              $0         $0              0.0   0.0   0.0     $0               $0         $0
                      $0              $0         $0              0.0   0.0   0.0     $0               $0         $0
                      $0              $0         $0              0.0   0.0   0.0     $0               $0         $0
                      $0              $0         $0              0.0   0.0   0.0     $0               $0         $0
                      $0              $0         $0              0.0   0.0   0.0     $0               $0         $0
                 $44,690         $12,290    $56,980                    SUBTOTAL $45,920          $12,858    $58,778


                                            $16,391                                                         $16,883




                                             $8,742                                                          $9,004




                                               $874                                                            $900

                                             $7,431                                                          $7,653
                                            $18,576                                                         $19,134



                                                                                         Page 14
                                                              DETAILBUD


                             $43,709                                         $45,020

                             $13,113                                         $13,506




                             $15,298                                         $15,757
                              $2,623                                          $2,701
                              $3,278                                          $3,377
                              $5,464                                          $5,628
                            $192,478                                        $198,341

                              $1,311                                          $1,351
                              $1,639                                          $1,688
                              $2,732                                          $2,814
                            $198,160                                        $204,193

---------------------------                 ------------------------------------------
-------------------------------------------------




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