Gra
nt No. Grant Title
Principal Investigator Department
Total cost share:
Of this, can be met through payroll records. Individuals providing the support should
certify time spent on the project (please attach Time & Effort Report).
Following is a break down, by line item, of the remaining contributed to this project:
Item Amount
Total
Please attach documentation for each item listed above. Acceptable forms of documentation include:
Copies of departmental PeopleSoft report showing expenditures in support of the project, along
with a signed statement of the individual with signature authority on that budget. The statement
should include the notation of the amount spent and the fact that it was spent in support of the
project
Letters from third parties contributing funding and/or time to the project. If the contribution is in
the form of time, the letter should include a statement of the amount of time spent and the rate
at which the contribution was figured (for example, "3 days at $150 per day for a total of $450.")
I certify that the above cost share has been met, the information provided is true and correct, and all
expenditures reported above were made in direct support of the project for which funding was received.
PI Signature Date
Received, Office of University Research Services-Post-Award Grant Financial Management:
By (Signature) Date
Documentation of Cost Share
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