FDP Cost Reimbursement Subaward
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
Date
Date
Title:
By an Authorized Official of the PTE:
__________________________________________________
Name:
Title:
By an Authorized Official of the Subrecipient:
__________________________________________________
Name:
FDP SEPT 2019
.
.
1. PTE hereby awards a cost reimbursable Subaward, (as determined by 2 CFR 200.330), 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), breakdown by major cost category, 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
Contact, as shown in Attachment 3A, not later than 60 days after the
The final statement of costs shall constitute Subrecipient's final financial report.
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 the PTE's Contact and the Subrecipient’s
Contact 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.
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.
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. PTE notice shall be directed to the
Contact, and Subrecipient notice shall be directed to the
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.
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.
Select from drop down options
Financial
Financial
Project Period end date.
Authorized Official
Authorized Official
Unilaterally
Authorized Official
Authorized Official
click to sign
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 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
Subject to FFATA
Federal Award Issue Date
FAIN
CFDA No.
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.
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.
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 :
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.
Special Terms and Conditions:
Subrecipient agrees to comply with the Federal Awarding Agency's data sharing and/or access requirements as reflected in the NOA
or the Federal Awarding Agency's standard terms and conditions as referenced in General Terms and Conditions 1-4 above.
Data Sharing and Access:
Awarding Agency Institute (If Applicable)
CFDA Title
in the attached Federal Award.
?
Administrative
Additive
No additional requirements
Subrecipient Grants
Subrecipient
No Human or Vertebrate Animals
Additional Terms
Work Involving Human or Vertebrate Animals (Select Applicable Options)
Human Subjects Data
(Select One)
(as required by the Federal Award, to cover Human Subjects Data, or additional terms as may be required
by a risk assessment)
Human Subjects
Human Subjects Exempt
Vertebrate Animals
The PTE requires verification of IRB and/or IACUC approval be sent to the
Administrative Contact
as required above:
Subrecipient agrees that any non-exempt human and/or vertebrate animal research protocol conducted under this Subaward shall be reviewed and
approved by the appropriate Institutional Review Board (IRB) and/or its Institutional Animal Care and Use Committee (IACUC), as applicable and that
it will follow current and duly approved research protocols for all periods of the Subaward involving human and/or vertebrate animal research. If
Subrecipient is using its own IRB and/or IACUC, 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.
This section left intentionally blank
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
Yes
Subaward Number:
Zip Code Look-up
Subrecipient Information for FFATA reporting
Entity's DUNS Name:
No
This section for U.S. Entities:
Congressional District:
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:
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:
In accordance with 37 CFR 401.14, Subrecipient agrees to notify both the Federal Awarding Agency via iEdison
and PTE's within 60 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.
Additional Technical and Reporting Requirements:
.
Use this section to clarify carryover, add deliverable reporting,
or
add sponsor-required reporting terms.
Administrative Contact
30
Administrative Contact
30
Administrative Contact
Administrative Contact
60
Administrative Contact
Carryover is restricted for this subaward by the:
Federal Awarding Agency
Submit carryover requests to the
Administrative Contact
.
Carryover instructions and requirements are as
stated by the Federal Awarding Agency
guidance or as shown below.
Authorized Official
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
If subrecipient has cos
t share, then the detailed
budget should be attached to the agreement and
additional reporting ter
ms may be added in Att 4.
No
Modified Total Direct Costs
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.
Subaward Number: