FDP Cost Reimbursement Research Subaward Agreement
Federal Awarding Agency:
Pass-Through Entity (PTE):
Subrecipient:
PTE Federal Award No:
Subaward No:
PTE PI:
Sub PI:
Project Title:
Subaward Period of Performance (Budget Period):
Start: End:
Amount Funded This Action (USD):
$
Estimated Project Period (if incrementally funded):
Start: End:
Incrementally Estimated Total (USD): $
Terms and Conditions
Contact, as shown in Attachment 3A, not later than 60 days after the
7.
The PTE may issue non-substantive changes to the Period of Performance and budget
Unilateral modification shall be considered valid 14 days after receipt unless
otherwise indicated by Subrecipient when
sent to Subrecipient's
Contact, as shown in Attachment 3B.
By an Authorized Official of Subrecipient:
Date
1. PTE hereby awards a cost reimbursable subaward, as described above, to Subrecipient. The Statement of Work and
budget for this Subaward are as shown in Attachment 5. In its performance of Subaward work, Subrecipient shall be an
independent entity and not an employee or agent of PTE.
2. Subrecipient shall submit invoices not more often than monthly and not less frequently than quarterly for allowable costs
incurred. Upon the receipt of proper invoices, the PTE agrees to process payments in accordance with this Subaward
and 2 CFR 200.305. All invoices shall be submitted using Subrecipient’s standard invoice, but at a minimum shall include
current and cumulative costs (including cost sharing), Subaward number, and certification, as required in 2 CFR 200.415
(a). Invoices that do not reference PTE Subaward number shall be returned to Subrecipient. Invoices and questions
concerning invoice receipt or payments shall be directed to the party's
Contact, shown in
Attachment 3A.
3. A final statement of cumulative costs incurred, including cost sharing, marked "FINAL" must be submitted to PTE’s
4. All payments shall be considered provisional and are subject to adjustment within the total estimated cost in the event
such adjustment is necessary as a result of an adverse audit finding against the Subrecipient.
5. Matters concerning the technical performance of this Subaward shall be directed to the appropriate party’s Principal
Investigator as shown in Attachments 3A and 3B. Technical reports are required as shown in Attachment 4.
6. Matters concerning the request or negotiation of any changes in the terms, conditions, or amounts cited in this
Subaward, and any changes requiring prior approval, shall be directed to each party’s
Contact, as
shown in Attachments 3A and
3B. Any such change made to this Subaward requires the written approval of each
party's Authorized Official, as shown in Attachments 3A and 3B.
10. By signing this Subaward, including the attachments hereto which are hereby incorporated by reference, Subrecipient
certifies that it will perform the Statement of Work in accordance with the terms and conditions of this Subaward and the
applicable terms of the Federal Award, including the appropriate Research Terms and Conditions ("RTCs") of the
Federal Awarding Agency, as referenced in Attachment 2. The parties further agree that they intend this Subaward to
comply with all applicable laws, regulations and requirements.
Date
By an Authorized Official of Pass-through Entity:
__________________________________________________
Name:
Title:
__________________________________________________
Name:
Title:
8. Each party shall be responsible for its negligent acts or omissions and the negligent acts or omissions of its employees,
officers, or directors, to the extent allowed by law.
9. Either party may terminate this Subaward with 30 days written notice to the appropriate party’s
Contact, as shown in Attachments 3A and 3B. PTE shall pay Subrecipient for termination costs as allowable under
Uniform Guidance, 2 CFR 200, or 45 CFR Part 75 Appendix IX, as applicable.
FDP Sept 2017
The final statement of costs shall constitute Subrecipient's final financial report.
Select from drop down options
Financial
Principal Investigator
Project Period end date.
Authorized Official
Unilaterally
Authorized Official
Principal Investigator
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signature
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Attachment 1
Certifications and Assurances
Certification Regarding Lobbying (2 CFR 200.450)
By signing this Subaward, the Subrecipient Authorized Official certifies, to the best of his/her knowledge and belief, that
no Federal appropriated funds have been paid or will be paid, by or on behalf of the Subrecipient, to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, loan, or cooperative agreement in accordance with 2 CFR 200.450.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
intending to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement,
the Subrecipient shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," to the PTE.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
Debarment, Suspension, and Other Responsibility Matters (2 CFR 200.213 and 2 CFR 180)
By signing this Subaward, the Subrecipient Authorized Official certifies, to the best of his/her knowledge and belief that
neither the Subrecipient nor its principals are presently debarred, suspended, proposed for debarment, declared
ineligible or voluntarily excluded from participation in this transaction by any federal department or agency, in
accordance with 2 CFR 200.213 and 2 CFR 180.
Audit and Access to Records
Per 2 CFR 200.501- 200.521, Subrecipient certifies that it will provide notice of any adverse findings which impact this
Subaward and will provide access to records as required by parts 2 CFR 200.336, 200.337, and 200.201 as applicable.
If Subrecipient is not subject to the Single Audit Act, then Subrecipient will provide notice of the completion of any
required audits and provide access to such audits upon request.
Program for Enhancement of Contractor Employee Protections (41 U.S.C 4712)
Subrecipient is hereby notified that they are required to: inform their employees working on any federal award that they
are subject to the whistleblower rights and remedies of the pilot program; inform their employees in writing of employee
whistleblower protections under 41 U.S.C §4712 in the predominant native language of the workforce; and include such
requirements in any agreement made with a subcontractor or subgrantee.
The Subrecipient shall require that the language of the certifications above in this Attachment 1 be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
Use of Name
Neither party shall use the other party’s name, trademarks, or other logos in any publicity, advertising, or news release
without the prior written approval of an authorized representative of that party. The parties agree that each party may use
factual information regarding the existence and purpose of the relationship that is the subject of this Subaward for
legitimate business purposes, to satisfy any reporting and funding obligations, or as required by applicable law or
regulation without written permission from the other party. In any such statement, the relationship of the parties shall be
accurately and appropriately described.
Subaward Number:
Attachment 2
Federal Award Terms and Conditions
Required Data Elements
General Terms and Conditions
By signing this Subaward, Subrecipient agrees to the following:
Subaward Number
The data elements required by Uniform
Guidance are incorporated
This Subaward Is:
Research & Development
Data Sharing and Access (Check if applicable):
Subrecipient agrees to comply with the Federal Awarding Agency's data sharing and access requirements as reflected in the NOA (or in
the special terms below) and the Data Management/Sharing Plan submitted to the Federal Awarding Agency and
Subject to FFATA
Special Terms and Conditions:
CFDA Title
Federal Award Issue Date
FAIN
CFDA No.
Copyrights:
to PTE an irrevocable, royalty-free, non-transferable, non-exclusive right and license to use, reproduce,
make derivative works, display, and perform publicly any copyrights or copyrighted material (including any computer software and its
documentation and/or databases) first developed and delivered under this Subaward solely for the purpose of and only to the extent
required to meet PTE's obligations to the Federal Government under its PTE Federal Award.
Subrecipient grants to PTE the right to use any written progress reports and deliverables created under this Subaward solely for the
purpose of and only to the extent required to meet PTE’s obligations to the Federal Government under its Federal Award.
Data Rights:
Subrecipient grants to PTE the right to use data created in the performance of this Subaward solely for the purpose of and only to the
extent required to meet PTE's obligations to the Federal Government under its PTE Federal Award.
5.
Key Personnel Per NOA
Treatment of program income:
1. To abide by the conditions on activities and restrictions on expenditure of federal funds in appropriations acts that are
applicable to this Subaward to the extent those restrictions are pertinent. This includes any recent legislation noted on the Federal
Awarding Agency’s website:
2. 2 CFR 200
3. The Federal Awarding Agency's grants policy guidance, including addenda in effect as of the beginning date of the period of
performance or as amended found at:
4. Research Terms and Conditions, including any Federal Awarding Agency's Specific Requirements found at:
a. No-cost extensions require the written approval of the PTE. Any requests for a no-cost extension shall be directed to the
Contact shown in Attachment 3A, not less than 30 days prior to the desired effective date of the requested
change.
b. Any payment mechanisms and financial reporting requirements described in the applicable Federal Awarding Agency Terms and
Conditions and Agency-Specific Requirements are replaced with Terms and Conditions (1) through (4) of this Subaward; and
c. Any prior approvals are to be sought from the PTE and not the Federal Awarding Agency.
d. Title to equipment as defined in 2 CFR 200.33 that is purchased or fabricated with research funds or Subrecipient cost sharing funds,
as direct costs of the project or program, shall vest in the Subrecipient subject to the conditions specified in 2 CFR 200.313.
e. Prior approval must be sought for a change in Subrecipient PI or change in Key Personnel (defined as listed on the NOA).
except for the following :
in the attached Federal Award.
Principal Investigator
Other [enter text]
This section intentionally left blank
Subrecipient Grants
attached.
No Human or Vertebrate Animals
Promoting Objectivity in Research (COI):
Subrecipient must designate herein which entity’s Financial Conflicts of Interest policy (COI) will apply:
If applying its own COI policy, by execution of this Subaward, Subrecipient certifies that its policy complies with the requirements of the
relevant Federal Awarding Agency as identified herein:
Subrecipient shall report any financial conflict of interest to PTE’s Administrative Representative or COI contact, as designated on
Attachment 3A. Any financial conflicts of interest identified shall, when applicable, subsequently be reported to Federal Awarding
Agency. Such report shall be made before expenditure of funds authorized in this Subaward and within 45 days of any subsequently
identified COI.
Additional Terms
Work Involving Human or Vertebrate Animals (Select Applicable Options)
Human Subjects Data (Select One)
Human Subjects
Vertebrate Animals
Subrecipient agrees that any non-exempt human and/or vertebrate animal research protocol conducted under this Subaward shall be reviewed and
approved by its Institutional Review Board (IRB) and/or its Institutional Animal Care and Use Committee (IACUC), as applicable and that it will maintain
current and duly approved research protocols for all periods of the Subaward involving human and/or vertebrate animal research. Subrecipient certifies
that its IRB and/or IACUC are in full compliance with applicable state and federal laws and regulations. The Subrecipient certifies that any submitted IRB /
IACUC approval represents a valid, approved protocol that is entirely consistent with the Project associated with this Subaward. In no event shall
Subrecipient invoice or be reimbursed for any human or vertebrate animals related expenses incurred in a period where any applicable IRB / IACUC
approval is not properly in place.
Not Applicable
This section left intentionally blank
Subaward Number:
Attachment 3A
Pass-Through Entity (PTE) Contacts
PTE Information
Entity Name:
Legal Address:
Yes
No
Invoice email (if different):
Website:
PTE Contacts
Central Email:
Principal Investigator Name:
Email:
Administrative Contact Name:
Email:
COI Contact email (if different to above):
Financial Contact Name:
Email invoices?
Authorized Official Name:
Email:
Email:
Telephone Number:
Telephone Number:
Telephone Number:
Telephone Number:
PI Address:
Administrative Address:
Invoice Address:
Attachment
3B
Subrecipient Contacts
FDP 3B.1 SEPT 2017
Yes
Subaward Number:
Subrecipient Information for FFATA reporting
Entity's DUNS Name:
No
This section for U.S. Entities:
Congressional District:
Zip Code
Zip Code+4:
Institution Type:
Currently registered in SAM.gov: Yes
Exempt from reporting executive compensation:
EIN No.:
DUNS:
Parent DUNS:
No (if no, complete 3Bpg2)
Legal Address:
Subrecipient Contacts
Email:
Administrative Address:
Payment Address:
Telephone Number:
Email:
Administrative Contact Name:
Telephone Number:
Telephone Number:
Telephone Number:
Email:
Invoice/Payment Email:
Authorized Official Name:
Financial Contact Name:
Email:
Principal Investigator Name:
Central Email:
Website:
Place of Performance Address
Attachment 3B-2
Highest Compensated Officers
Subaward Number:
Subrecipient:
Institution Name:
Highest Compensated Officers
The names and total compensation of the five most highly compensated officers of the entity(ies) must be listed if
the entity in the preceding fiscal year received 80 percent or more of its annual gross revenues in
Federal awards; and $25,000,000 or more in annual gross revenues from Federal awards; and the public does
not have access to this information about the compensation of the senior executives of the entity through
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. §§
78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. See FFATA § 2(b)(1) Internal Revenue
Code of 1986.
Officer 1 Name:
Officer 1 Compensation:
Offic
er 2 Name:
PI Name:
Officer 2 Compensation:
Officer 3 Compensation:
Officer 4 Compensation:
Officer 5 Compensation:
Officer 3 Name:
Officer 4 Name:
Officer 5 Name:
FDP 3B.2 Sept 2016
Attachment 4
Reporting and Prior Approval Terms
to the PTE’s
. Such report shall also include a detailed budget for the next Budget Period,
S
ubaward Number:
Quarterly technical/progress reports will be submitted within 30 days after the end of each project quarter to
the PTE’s
days prior to the end of each budget period
Subrecipient agrees to submit the following reports (PTE contacts are identified in Attachment 3A):
Technical Reports:
within
days of
Monthly technical/progress reports will be submitted to the PTE’s
of the end of the month.
Annual technical / progress reports will be submitted within
updated other support for key personnel, certification of appropriate education in the conduct of human subject
research of any new key personnel, and annual IRB or IACUC approval, if applicable.
days of the
within
in order for the PTE
A Final technical/progress report will be submitted to the PTE’s
end of the Project Period or after termination of this award, whichever comes first.
Technical/progress reports on the project as may be required by PTE’s
to satisfy its reporting obligations to the Federal Awarding Agency.
Prior Approvals:
Carryover:
Other Reports:
Other Special Reporting Requirements:
In accordance with 37 CFR 401.14, Subrecipient agrees to notify PTE’s
within
days
after Subrecipient’s inventor discloses invention(s) in writing to Subrecipient’s personnel responsible
for patent matters. The Subrecipient will submit a final invention report using Federal Awarding Agency
specific forms to the PTE’s within 60 days of the end of the Project Period to be
included as part of the PTE's final invention report to the Federal Awarding Agency.
A negative report is required:
Property Inventory Report (only when required by Federal Awarding Agency), specific requirements below.
Administrative Contact
15
Administrative Contact
60
Administrative Contact
Administrative Contact
60
Administrative Contact
Carryover is automatic
60
Administrative Contact
Administrative Contact
Attachment 5
Statement of Work, Cost Sharing, Indirects & Budget
Statement of Work
Below Attached, pages
If award is FFATA eligible and SOW exceeds 4000 characters, include a Subrecipient Federal Award Project Description
%
Budget Information
Subaward Number:
Cost Sharing
If Yes, include Amount: $
Below
Attached,
pages
Direct Costs $
Indirect Costs $
Total Costs $
All amounts are in United States Dollars
Indirect Information
Indirect Cost Rate (IDC) Applied
Rate Type:
Budget Details
Budget Totals
Modified Total Direct Costs
No
Attachment 6
Notice of Award (NOA) and any additional documents
The following pages include the NOA and if applicable any additional documentation referenced
throughout this Subaward.
Not incorporating the NOA or any additional documentation to this Subaward.
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