RSP #: _____________
Transmittal Form
External Grants & Contracts
Proposal Review & Approval
(Internal Use Only)
PLEASE ROUTE TRANSMITTAL FORM & COPY OF YOUR PROPOSAL TO RSP
OFFICE & ALLOW RSP OFFICE A MINIMUM OF 4 WORKING DAYS FOR PROCESSING
1.
Proposal Title:
2.
Principal Investigator: Name – Dept./Unit/Center – School/College
3.
Co-Investigator(s): Name – Dept./Unit/Center – School/College – (Co-PIs share the return on indirects and
must be SCSU employees)
4.
Other Participant(s):
5.
Contact Person:
If flow-through (i.e. subaward or subcontract, etc.)
funding, complete this section:
Prime Funding Agency:
Address:
Contact Person:
Funding Agency:
Phone:
6.
Phone:
Email:
Agency Type:
Email:
Business
Federal
Federal Flow-through
Other Government
MnSCU
State
Foundation
Other Non-Government
7.
Today's date:
8.
Project begin and end dates:
9.
Type of Proposal:
Proposal due date:
to
Grant (competitive)
OR
Contract (negotiated)
Cash
In-Kind
(pick one)
Cash
In-Kind
(pick one)
Office of Research & Sponsored Programs Use Only – AS 208
Award Status:
 Awarded
 Denied
Award Date:_____________________
Start Date:_______________________
All Funding:
IRB:
 Yes  No
Approval# ___________________
IACUC:  Yes  No
Approval#___________________
FCOI:
Exports:
 Yes  No
 Yes  No
End Date:_______________________
University-wide Projects:
 Yes  No
Revised July 2015
Account #:__________________________
Award Amount: ______________________
Agency Award #:_____________________
Federal Funding ONLY:
RCR:
 Yes  No
FFATA:
 Yes  No
T&E:
 Yes  No
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Proposal Budget and University’s Financial Commitment
10. Total funds requested from funding agency: $
11. Indirect cost rate included in budget:
%
Federal rate: 33.4% of modified total direct costs (see rate agreement for more information: http://osp.stcloudstate.edu/indirect_costs.htm);
Non-Federal rate is 12% of total direct costs.
12. Does the project require a variance on the University’s indirect cost recovery policy?
Yes
No
In accordance with Minnesota Statute 16A.127, SCSU requires indirect cost recovery on all externally funded activity. Variances are allowable only
when indirect costs are limited or disallowed by the funding agency. SCSU reserves the right to reject any proposal that does not include indirect costs.
Please justify the variance and attach documentation:
13. Does the project include a cash (hard) match?
If yes, amount:
Is the match required by the funding agency?
Yes
No
Yes
No
Yes
No
Yes
No
Who and which account will supply the cash match?
(Responsible person for match $ initial here
)
14. Does the project include a soft (in-kind) match? If yes, cash value:
Is the match required by the funding agency?
Specify type and source of soft match (e.g. personnel, supplies, equipment, facility use, etc.)
(Responsible person initial here
)
Reminder: Documentation is required for all cost shared items on federal grants (i.e. receipts, time logs, etc.)
Ethics and Compliance
15. Plagiarism: I hereby acknowledge this proposal or any sections within the proposal is not plagiarized.
Even if you use your own words, if you obtained the information or ideas you are presenting from a source or another author,
you must document the source. Unless a source is cited, written consent from the original author(s) to use text is required,
including SCSU institutional descriptions prepared by others.
16. IRB (Institutional Review Board): Does your project involve research with human subjects?
Yes
No
Yes
No
Yes
No
Yes
No
If yes, PI’s responsibility to submit for review. Provide approval # or submission date:
17. IACUC (Institutional Animal Care and Use Committee): Does your project involve research using animals?
If yes, PI’s responsibility to submit for review. Provide approval # or submission date:
18. FCOI (Financial Conflict of Interest): Related to this project or its funding, do you or any key personnel have a
financial interest or any personal beneficial interest directly or indirectly in contracts or purchase orders
for goods or services?
A financial interest includes salary or any other payments for services, equity interests, IP rights, or financial interest in any entity
whose financial interests would reasonably appear to be affected by the research. This applies to you, your immediate family,
your partner or an organization which employs or is about to employ any of these parties.
19. Export Controls: Export Controls may apply to projects that involve transactions with an inherently military use or
transfers of items of “dual-use” (commercial or military).
A. Does this project involve inherently military technologies related to electronic equipment, systems, software,
explosives, toxicological agents, radiological equipment, spacecraft systems or similar items?
Yes
No
B. Does this project involve “dual-use” items with a potential military application related to high-end computers,
encryption technology, composite materials, lasers, navigation equipment or similar items?
Yes
No
C. If “yes” to A or B, are restrictions placed on any publication which may arise from this research?
Yes
No
20. Are you currently delinquent on any Federal debt, debarred or suspended from receiving Federal assistance?
Revised July 2015
Yes
No
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Questions 21-23: Applicable for Federal Funding ONLY:
21. RCR (Responsible Conduct of Research): Does your project include compensation for undergraduate,
graduate and/or post-doc students?
Yes
No
Note: RCR training maybe required. See website for more info: http://stcloudstate.edu/osp/policies/conduct.asp
22. FFATA (Federal Funding Accountability and Transparency Act): Will any vendors be paid $25,000 or more for
work pertaining to this project?
23. T&E (Time & Effort Reporting): Will there be any special personnel arrangements related to project?
Yes
No
Yes
No
(e.g. professional overload, reassigned time, etc. for any SCSU employees)
Please explain:
Institutional Acknowledgements
24. Are there reassignment/classroom replacement arrangements for faculty/staff associated with this project?
Yes
No
Yes
No
Yes
No
Yes
No
If yes, please explain:
25. Does this project require special use of campus facilities (e.g. science/computer labs, dance studio, etc.)?
If yes, explain:
26. Does this project require significant facility changes or remodel?
If yes, attach approval document from Building Coordinator or SCSU Facilities Management.
27. I authorize RSP to share this proposal with others for the benefit of SCSU. (can deny without consequences)
28. I hereby acknowledge allowing work to begin on an externally-funded project without a fully-executed
agreement in place is a violation of Minnesota Statute 16A.15, Subd. 3.
Yes
SIGNATURES OBTAINED BY PRINCIPAL INVESTIGATOR:
I have read the proposal referenced above and agree to its submission under the conditions stated. I understand the use of all
external funding, regardless of source, is governed by State of MN regulations and MnSCU procedures and that grants and
contracts are awarded to the institution, not to individuals. As Principal Investigator (PI), I will be responsible for proper
management and spending of funds associated with the project(s) funded.
_______________________________________________________________________________________________
Principal Investigator Signature attests acceptance of academic and administrative responsibilities
Date
_______________________________________________________________________________________________
Department Chair(s) or Center/Unit Director(s) Signature authorizes use of dept. resources as
Date
described in items 13,14,23,24, 25 & 26
_______________________________________________________________________________________________
School/College Dean(s) or Vice President (s) Signature authorizes use of college resources as
Date
described in items 13, 14, 23, 24, 25 & 26 and attests to supervisory responsibility of the PI in executing the
grant or contract activity.
SIGNATURES OBTAINED BY RESEARCH & SPONSORED PROGRAMS:
I approve submission of the proposal under the conditions stated.
______________________
RSP Director Final Approval
_______________________________________________________________________________________________
Associate Provost for Research
Date
_______________________________________________________________________________________________
Provost and Vice President of Academic Affairs
Date
Revised July 2015
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