Proposal Review & Approval
Please complete, sign, and return this form to the Office of Research & Sponsored Programs 5 business days prior
to the submission of the final proposal.
Proposal
Due Date: _____________________________________________________
Receipt
Postmark
Sponsor: _______________________________________________________________________
Prime Sponsor: ________________________________________________________________________
Solicitation Number/Website Link:_________________________________________________________
Project Title: __________________________________________________________________________
New
PreProposal
Resubmission
Transfer
Supplement
Existing DU Fund Number: _____________
Noncompeting
Continuation
Competing
:
Renewal
Modification/
Amendment
Program/Project Information
Principal Investigator (PI): ________________________________________________________________
Banner ID: ____________________________________ Department: ____________________________
Email: ________________________________________ Phone Number: __________________________
Co-PI: ____________________________________________ Banner ID: _________________________________
Department: _______________________________________ Email: _____________________________________
Co-PI: ____________________________________________ Banner ID: _________________________________
Department: _______________________________________ Email: _____________________________________
Co-PI: ____________________________________________ Banner ID: _________________________________
Department: _______________________________________ Email: _____________________________________
Proposed Project Start Date: ______________________ Proposed Project End Date: ________________
Project Type:
Research
Instruction
Service/Outreach
Other Activities
Financial Considerations
_____________________
Estimated Total Funds
Requested
______________________
DU Costshare*
_________________________
_____________________
Indirect Cost Rate (IDC)
allowed by sponsor**
Proposed IDC Rate
*Only if applicable. Must complete ORSP Costshare/Match Form.
**If the proposed IDC rate is lower than DU’s negotiated rate or lower than the rate allowed by the Sponsor, an IDC
waiver must be authorized by the Associate Provost for Research. Please contact ORSP for more information.
1. Are overload payments requested? Include a list of individuals, departments, and total amounts below:
Yes
No
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
2. Will subcontracts be included? Include a list of subcontractor(s) and estimated funding below:
Yes
No
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
3. Will consultants be included? A consultant cannot be an employee of the University. Include a list of consultant(s) below:
Yes
No
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Are any consultants DU employees?
Are all consultants US Citizens?
Yes
No
Yes
No
4. Is there any indication that the sponsor funds are directly or indirectly from a non-U.S. source?
Yes
No
Unknown
5. Are GRA’s requested?
If Yes, Please Explain: ______________________________________________________
Yes
No
How many? _____________________________
Regulatory Considerations
1. Training (NSF Proposals Only): CITI Responsible Conduct of Research
Completion Date: ________________________________________________________________
2. Human Subjects: Does this project involve a survey, questionnaire, focus group, interview or any other
form of human subject participation? Human subject participation includes the gathering of data or
private information from an individual.
Yes
No
Yes
No
Does the project involve the use of personal or health data from human subjects?
IRB Protocol Number: _________________________________ Date Approved: ___________________
If yes, IRB application must be submitted to ORSP Research Compliance. Approval must be
received from the IRB prior to the start of the project.
3. Animals: Does this project require the use and/or care of animals?
Yes
No
IACUC Protocol Number: ________________________________ Date Approved: __________________
If yes, IACUC application must be submitted to ORSP Research Compliance. Approval must be
received from the IACUC prior to the start of the project.
4. Personal Interest, Commitments and Lobbying Activities
Do you, as PI, or any other key personnel on this project have a relationship with and/or a financial
interest in the sponsor?
Yes
No
Do you, as PI, or any other key personnel on this project have a relationship with and/or a
financial interest in the subcontractor(s) or consultant(s) (if any)?
Yes
No
If yes, submit a Conflict of Interest disclosure to ORSP Research Compliance prior to the start of the
project.
Have you, as PI, or any other key personnel engaged in activities to influence any federal
official or congressional member to support the proposed program?
Yes
No
During the period of these lobbying activities, have you or any other key personnel been
paid from federal funding sources (either directly or indirectly)?
Yes
No
Yes
No
If yes, federal form may be require. Your ORSP Project Administrator will assist you.
Is a DU Employee Patent Agreement on file for all DU personnel?
5. Hazardous Material
Does the project include the use of hazardous chemical materials?
Yes
No
If yes, please refer to the DU Chemical Hygiene Plan (CHP)
Does this project include the use of recombinant DNA, tissue, bodily fluids, or human
infectious diseases?
Yes
No
IBC Protocol Number: __________________________________ Date Approved: ___________________
Does this project include the use of controlled substances?
Yes
No
IBC Protocol Number: _________________________________ Date Approved: ___________________
Does this project include the use of biological agents or toxins?
For a list, visit www.cdc.gov/od/sap/ and follow the link for “Select Biological Agents and Toxins”
Yes
No
If yes, submit IBC application to ORSP Research Compliance prior to the start of the project.
6. Export Controls/Publication Restrictions
Is there any indication the project involves military, defense, space or aerospace applications (e.g.,
firearms, explosives, tanks, military training, satellites, Unmanned Aerial Vehicles, missiles, rockets)?
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Is there any indication the project involves chemical, biological or nuclear weapons or delivery
systems for such weapons?
Does the project involve nuclear energy, nuclear propulsion or nuclear applications (including reactor
related activities)?
Are all DU employees, DU students, consultants and other third parties involved in the project U.S.
citizens, Lawful Permanent Residents (“Green Card” holders) or U.S. authorized political asylum
holders?
Unknown
Yes
No
Are there deliverables such as software, prototypes or “proof of concept” demonstrations?
Unknown
Yes
No
Are there any publication restrictions?
Unknown
Yes
No
Will the research incorporate or otherwise require the use of another party’s proprietary (restricted)
information or materials covered by a separate non-disclosure agreement (NDA/PIA), material
transfer agreement (MTA) or teaming agreement?
Unknown
Yes
No
A “yes” response to any of these questions will require a documented export control review. Your ORSP Project
Administrator will assist you. For more information, please visit the ORSP/Export Control website.
Certifications and Approvals
1a:
1b:
1c:
I hereby certify that the above statements are complete and accurate representations of the project being
proposed.
I understand that any false, fictitious, or fraudulent statements or claims may be case for criminal, civil, or
administrative penalties against me.
I agree to accept responsibility for the scientific conduct of the project and to provide the required progress
reports in a timely manner if a grant is awarded as a result of this application.
Principal Investigator: ________________________________________ Date: ______________
Co-PI: ____________________________________________________ Date: ______________
Co-PI: ____________________________________________________ Date: ______________
Co-PI: ____________________________________________________ Date: ______________
2.
I approve support for this project. (Department Chair/Director/Dean)
Designee: _____________________________________________________________________
Title: _____________________________________________________ Date: _______________
Designee: _____________________________________________________________________
Title: _____________________________________________________ Date: _______________
3.
I approve University support of cost-sharing and indirect cost waivers as indicated. Please attach email
approval if unable to receive signature.
Associate Provost for Research: ________________________________ Date: _______________
4.
ORSP Certification that proposal has received full university review and approval.
Manager, Sponsored Programs: ________________________________ Date: _______________
Assistant Controller, Research Administration: ________________________
Date: _______________
Scope of Work
Please include a brief summary of the project below.