Download Internal Approval for Proposal Transmittal Principal Investigator (s

Internal Approval for Proposal Transmittal
Principal Investigator (s)
Phone No.
College:
PS DEPT (####)
EMPL ID:
E-Mail
Award Credit
(100%)
Title of Project:
CFDA#:
Funding Agency:
If this is a sub award, name of prime funding agency source:
Total Amount Requested:
Period of Performance
Duration:
Agency Deadline:
Indirect Cost Rate %:
Is this project
on campus
Field of Study Codes
Are you requesting the in-state Tuition Differential Policy
Yes
No
off campus? If off campus, where will the work be located?
Type of Project:
Research Type (MUST CHECK ONE) –
Organized Research, check one:
Basic Research,
Sponsored Training,
Applied Research,
Equipment,
Development (Organized Research Definitions)
Other Sponsored Activity?
If this is a continuation or supplement, please enter existing PeopleSoft project number:
Is this a Coastal Institute Proposal? If yes, the Coastal Institute Cover Sheet must be attached to this transmittal and
you must include the Coastal Institute in the routing Cover Page
Yes
No
Is this an Institute for Integrated Health and Innovation Proposal?
If yes, the Institute for Integrated Health and Innovation Cover Sheet must be attached to this transmittal and you must include the
Institute for Integrated Health and Innovation in the routing (Cover Page)
Is this a George and Anne Ryan Institute for Neuroscience Proposal?
If yes, the George and Anne Ryan Institute for Neuroscience Cover Sheet must be attached to this transmittal and you must
include the George and Anne Ryan Institute for Neuroscience in the routing Cover Page
Yes
No
Yes
No
Is this in response to a Small Business Innovation Research (SBIR) or Small Business Technology Transfer (STTR)
solicitation? Or is this a contract with a for-profit entity?
Will this proposal result in a federal contract (requires E-Verify) as opposed to a grant or cooperative agreement?
Yes
No
Yes
No
Does this project have sub awards?
Yes
No
If Yes, all sub awards must have a Sub Recipient Monitoring Form for domestic subs and a Foreign Subrecipient Monitoring Profile for
Foreign subs completed by sub award institution included in proposal documents.
Matching Funds:
Does the project include any cost sharing or match? If yes, please fill out details on the Revenue/Cost Sharing Form
Yes
No
Research Integrity:
Disclosure of Significant Financial Conflict of Interest (SFCOI) forms – one package of SFCOI Forms is required for PI
and any other person, regardless of title or position, who is independently responsible for the design, conduct, or
reporting of funded research or research proposed for funding. URI Conflict of Interest in Research Policy (2013)
Does project involve Human Subjects at URI or sub award institutions (e.g., focus groups, participant observation or
questionnaires by subject participants, human volunteers as participants, collection or use human tissue or fluids,
work with human stem cells, or collection of identifiable private data)? If applicable, give IRB #:
Does project involve vertebrate animals at URI or sub award institutions? If applicable, give IACUC #:
Yes, forms
uploaded.
Yes
No
Yes
No
Does the project involve infectious agents/human blood or cell lines/rDNA? If applicable, give IBC #
Yes
No
Does project involve a clinical trial at URI or sub award institutions?
Yes
No
Does project involve the dive safety program?
Yes
No
For ALL NSF and USDA proposals and NIH training grants: if funded, Responsible Conduct of Research Training will
be required for all students and post-doc researchers. Please check YES if this is a NSF or USDA proposal or NIH
Training Grant.
Yes
No
Environmental Health and Safety
Does project involve shipping hazardous materials? Please note that IATA/DOT training is required prior to shipping
hazardous materials
Yes
No
Does project involve radioactive materials/X-ray/laser?
Yes
No
Does Project Involve:
Space/utilities modification?
Yes
No
Program Income?
Yes
No
RI Nuclear Science Center?
Yes
No
Patent or Copyright issues?
Yes
No
Outreach?
Yes
No
Security Clearance?
Yes
No
Export Controls:
Does the solicitation, RFP, RFQ, RFA, contract and/or discussions with the sponsor indicate potential
use/involvement of publication restrictions?
Yes
No
Does the solicitation, RFP, RFQ, RFA, contract and/or discussions with the sponsor indicate potential restrictions on
using foreign nationals?
Yes
No
Will this project involve an agreement or collaboration with any foreign entity or foreign person, including foreign
national graduate students or researchers?
Yes
No
Will this project involve shipment of equipment, materials or data outside the U.S.?
Yes
No
Will this project involve any foreign country or foreign travel? If yes, please identify:
Yes
No
Will this project involve proprietary or confidential information or materials from the sponsor or any third party?
Yes
No
Certifications for PI and Co-I’s:
The principal Investigator/co-investigator(s) hereby certify:
1. The information submitted on this form and within the named proposal is true, accurate, and complete to the best of
my knowledge.
2. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or
administrative penalties.
3. I agree to accept responsibility for the scientific conduct of the project and to provide the required reports if a
proposal is awarded and agree to comply with the URI policies and procedures for misconduct.
4. If an award is made, I am responsible for compliance with award terms and conditions and University policies and
procedures; particularly for the technical conduct of the work, submission of technical reports, regulatory compliance
and financial management.
5. I am aware of the requirement of the NIH Access Policy to submit journal articles that arise from NIH-funded projects
to the digital archive PubMed Central.
6. I am NOT debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from current
transactions by a federal department or agency.
7. If this is a NIH application and involves multiple PIs, I agree to the leadership plan as described in this application.
8. I am aware that all salaries and fringe benefits are estimates only and actual salaries and fringe benefits will be
governed by HR policies.
9. I agree that my signature, as PI or Co-I, will be available to the sponsoring agency or other authorized HHS or federal
official upon request.
10. I understand and agree with the URI policies and procedures for intellectual property.
11. I understand and agree to comply with Rhode Island State Laws regarding nepotism
Signatures
Name
Signature
Date
Principal Investigator:
Co-Investigator:
Co-Investigator:
SPR Notes and Approval:
Modified April 19, 2017