Form SP-30 OSP (revised 04.7.11)
UNIVERSITY OF VIRGINIA
SUBCONTRACT/SUBAWARD REQUEST FORM
Request to issue Subcontract/Subaward or Modification to outside entity
This form must be completed in its entirety
Sponsor:
Principal Investigator:
Parent Award/Project #
SECTION A.
ORG # (OPTIONAL)
WHAT TYPE OF REQUEST IS THIS? (Make choice)
NEW REQUEST FOR SUBCONTRACT/SUBAWARD
Yes
No
Was the subcontract in the original proposal?
If No, Attach explanation and sponsor approval if required.
If this subcontract was not in the proposal AND is greater than $10,000 AND Subcontractor is privately funded, an OSP Sole Source document is
required. See: http://www.virginia.edu/finance/polproc/proc/8-9b.html
Budget Period
Start Date:
End Date:
Total Amount $
Subcontractor Legal Name:
Subcontractor PI:
Address:
Phone No.:
Fax No:
Email:
Fax No:
Email:
Subcontractor Sponsored
Programs Contact:
Subcontractor Address:
Subcontractor Phone No.:
SECTION B. REQUIRED SUBCONTRACT ATTACHMENTS
Distinct statement of work (SOW) for subcontractor for New subcontract or a Mod if SOW has been revised
Detail budget (direct + indirect) for subcontractor and a budget justification. Budget must include cost share if applicable.
Yes
No
Subcontractor's work involves human subjects. If Yes, attach their current IRB approval
Yes
No
Subcontractor's work involves animals. If Yes, attach their current IACUC approval. If at a foreign site, follow UVA ACUC guidance
(434-924-0405) & attach the Certification of Review of Animal Research Subcontracted to Foreign Institutions issued by the ACUC.
SECTION C. SET UP SUBCONTRACT PROJECT BUDGET IN INTEGRATED SYSTEM AS FOLLOWS:
(This total must be the same as the attached budget)
Total Subcontractor Budget(direct + indirect) =
UVA F & A (if allowed on first $25,000)
=
Total funds to transfer to subcontract project
=
Transfer funds FROM
IS Award-Project No.:
SECTION D. CERTIFICATION AND SIGNATURE
Do you, your spouse, or any other persons living with you have any financial interests (more than 3% equity or more than $10,000 annual income) in the
subcontracting organization, or which might reasonably appear to be affected by the proposed research.?
Yes
No
http://www.virginia.edu/vprgs/polproc.html and http://www.virginia.edu/vprgs/rsrchcompliance.html If Yes, refer also to
the UVA financial Administration Procedure Manual for additional details on filing the necessary disclosure and the Virginia Statement of Economic
Interests. See: http:/www.virginia.edu/finance/polproc/proc/15-1.html
This request and its attachments have been reviewed and approved by the undersigned:
Principal Investigator: ____________________________________________________
Department Administrator : _____________________Date:___________
Contact person for OSP questions:
FOR OSP USE ONLY
Date: ________________________________________
School Administrator: ___________________________Date: _______________
Contact's Email Address
End date of Master
Funds Available $