Forms and Information

Forms and Information

Conducting research or other sponsored programs requires that information be gathered for the protection of the university, researchers, and research subjects. Links to many of the relevant forms in compliance, proposal development and post award management are collected below. Please contact the Office of Sponsored Programs at (707) 638-5862 with questions or comments

For Proposal Submission:

·  Pre-Approval Form(PDF, updated 12/10/2012)

This form is used for internal proposal review, approval and routing. It requires attachment of an abstract, budget, budget justification and any other required forms such as a Cost Share Request Form and/or F&A Waiver Request Form. The PI must route this package for signature approval at least 5 business days prior to agency deadline. Proposals cannot be submitted unless OSP has received this form with the appropriate approval signatures.

·  Facilities and Administrative (F&A) Waiver Request Form(PDF, updated 12/12/2012),

F&A Waiver Guidelines and procedures

Required with Pre-Approval package when requesting institutional approval of a rate lower than the federally negotiated F & A rate.

Facilities and Administrative (F&A) Federally negotiated Agreement, (7/1/12)

·  Cost Share Request Form(PDF, updated 1/22/13),

Information

The Cost Share form is required when requesting institutional approval to commit voluntary or mandatory cost share/match to the sponsor.

·  In-Kind/Third Party Contribution Certification (PDF, updated 2/12)

Required form when third party contributions will be made to a project.

·  Search Waiver Addendum (PDF, updated 2/5/2013)

Complete if an individual has been significantly involved in the preparation of the proposal and will be hired if the project is funded.

·  Additional Space/Facilities Addendum (PDF, updated 2/5/2013)

Complete if additional space or facilities will be required.

·  Additional IT Support/Facilities Addendum (PDF, updated 2/5/2013)

Complete if additional IT support, new computer hardware/software, new phones or fax lines will be required.

·  COI Financial Disclosure (Form 1)(PDF, updated 08/2012), Instructions

This form is required to be submitted with each proposal. The Principal investigators/program directors are responsible for obtaining disclosure forms from all those responsible for the design, conduct or reporting of the sponsored or non-sponsored research project or the sponsored educational or service activity. Principal investigators should submit their own forms plus those of other respondents.

·  Limited submission Pre-proposal Form(PDF).
This form is used to obtain approval for a Pre-proposal when a program limits the number of submissions from any one institution, and the number of TUC submissions exceeds the sponsor's limit.

Samples, Examples and Budget Templates:

·  MPI Plan Information Samples

– TUC faculty only

– different institutions

·  Effort Conversion Table

·  Resource Sharing Plan

For Proposals Involving Subcontracts:

A consortium agreement must be established when subcontracting institutions are involved in a project.You may find more information onsubcontractsin Direct Costs. The following consortiumagreement templates should be used if a proposal requires the establishment of a consortium agreement.

·  TUC Consortium Agreement Template
This template is to be used when TUC is the subcontractor on another institution's proposal.

·  Non-TUC Consortium Agreement Template,
This template is to be used when another institution is a subcontractor on TUC's proposal (Instructions).

·  COI Disclosure Form for NON-TUC Investigators(PDF, updated 08/2012)

All non-Touro investigators proposing to do research with Touro University California must complete this form and return it to the TUC Office of Sponsored Programs prior to or when submitting a funding proposal. This requirement stems from the U.S. Public Health Service (PHS) regulations, Responsibility of Applicants for Promoting Objectivity in Research, (42 CFR 50 Subpart F) and Responsible Prospective Contractors (45 CFR 94).

·  Subrecipient FCOI Addendum(PDF document, updated 08/2012)

New PHS Financial Conflict of Interest requirements require that TUC determines if a potential subrecipient has a PHS-compliant FCOI policy. This form must be completed and returned prior to award if sponsor is PHS or has adopted the PHS requirements.

·  COI Financial Disclosure (Form 5)(PDF, updated 08/2012)

This form is required to be completed by each investigator of a subrecipient institution without a PHS-compliant policy. These forms must be received at Proposal stage.

·  Cost Analysis and Sole Source Justification for SubAwards under Contracts – This form is required to be completed by the PI when proposing a subaward for a sponsored research project to be funded under a contract.

For Post Award Activities:

·  PHS FCOI PI Certification (PDF, updated 08/2012)

This form is required by PI at Award stage. This is a certification from PI that all investigators on the project have completed the PHS-compliant training. Required for PHS sponsors or agencies that have adopted the new PHD regulation such as: American Heart Association, American Lung Association, American Cancer Society, Susan G. Komen Foundation, the Alliance for Lupus Research, and the Arthritis Foundation.

·  Pre-Award Spending Request Form(PDF, updated 08/14/12),Instructions
This form is used to request for advance spending prior to the start of the award process.

·  No-Cost Action Request Form(PDF, updated 08/14/2012)

·  NIH PI Assurance Certification (PDF, updated 10/2012) – This form must be submitted with all NIH progress reports and prior approval requests. Original signatures (in blue ink only) are required.

This form is used to request any type of action within an award: No Cost Extension, Carry Forward, Change of Scope, Key Personnel change, rebudget, etc. that may/may not need agency approval and will not require additional funds but will need internal OSP approval.

·  No-Cost Extension Request Form - if awarded under FDP (Word document, updated 08/14/2012)

This form is used to request a No Cost Extension for up to 12 months.

For Post Award Activities involving Subcontracts:

·  SubAward RequestForm – Form required to request a new or amended subaward. An agreement or amendment cannot be initiated until this form is received with applicable documents to OSP.

·  SubAward Final Close-Out - This form is used to certify satisfactory performance, receipt of all reports, invoices and deliverables have been received from the subrecipient.

For Purchasing Activities:

·  Purchase Order Request Form (Excel, updated 5/12/12)

This form is to be used to place all orders, and accompanied with travel requests. This form must be signed by the PI. All requests are required to be submitted to the Grants Manager, OSP for review and processing.

·  Request for Exception of a Generally Unallowable Cost Form(PDF, updated 08/20/12), Instructions
This form is used to request an approval to charge a generally unallowable item as a direct cost to a sponsored project. This form is required to be submitted and approved prior to submission of a PO request.

·  Gift Cards for Subject Payments Questionnaire (PDF, updated 1/2/2013)

Questionnaire is required to be completed by PI if the purchase of gift cards is requested to subjects for payments or incentives in participating with a sponsored project. The questionnaire must be submitted to OSP prior to PO request of gift cards.

·  Request for Prior Approval to Purchase Computers or Other Information Technology Devices (PDF. Updated 1/15/13)

This form is required prior to purchase of a computer or other Information Technology device only if using Federal funds, Federal flow-through funds, or non-Federal funds used as cost-sharing on a Federal award when the item gas not been properly described in the projects budget justification of the proposal or if the item is requested within 90 days of the project end date, or if additional information is deemed necessary by OSP.

·  Sole Source Form (PDF, updated 8/21/12)

This form must be used whenever a Purchase Request dollar amount exceeds $10,000 and competitive bidding is unavailable or deemed unacceptable.

·  Questionnaire for MTA (Incoming Material)

·  Questionnaire for MTA (Outgoing Material)

·  Letter of Agreement for the Transfer of Materials (simple)

Touro University California Conflict of Interest Forms: Instructions & Guidelines

·  FCOI Forms Instructions

·  FCOI Policy Guidelines

·  Annual Financial Interest Disclosure Form (PDF, updated 08/2012)

This form must be completed annually by all investigators proposing to do PHS-compliant research. It is the responsibility of the PI to ensure that each Investigator working under his/her supervision submits an annual disclosure form.

·  COI Financial Disclosure (Form 1)(PDF, updated 08/2012)

This form is required to be submitted at Proposal stage. The Principal investigators/program directors are responsible for obtaining disclosure forms from all those responsible for the design, conduct or reporting of the sponsored or non-sponsored research project or the sponsored educational or service activity. Principal investigators should submit their own forms plus those of other respondents. A proposal will not be considered complete and cannot be submitted to the funding agency by the Office of Sponsored Programs unless required financial disclosures are in place.

·  COI Financial Disclosure (Form 2)(PDF, updated 08/2012)

This form is required to be completed if and when a proposal receives a JIT request or some other indication from the funding agency that indicates it is likely to be funded and when the PHS Financial Disclosure (Form 1) has “yes” responses. Only those investigators with “yes” responses will be contacted by the Conflict of Interest (COI) Coordinator (OSP) to request completion and submission of the PHS Financial Disclosure (Form 2)

·  COI Financial Disclosure (Form 3)(PDF, updated 08/2012)

This form is required to be completed if an investigator is notified by the COI Coordinator that s/he has a related SFI.

·  COI Financial Disclosure (Form 4)(PDF, updated 08/2012)

This form is required to be completed if an investigator’s newly acquired significant financial interest consists of only sponsored or reimbursed travel. Excluded is travel that is reimbursed or sponsored by federal, state, or local government, an institution of higher education, an academic teaching hospital, a medical center, or a research institute affiliated with an Institution of higher education.

·  COI Financial Disclosure (Form 5)(PDF, updated 08/2012)

This form is required to be completed by each investigator of a subrecipient institution without a PHS-compliant policy. These forms must be received at Proposal stage.

·  PHS FCOI PI Certification (PDF, updated 08/2012)

Certification from PI that all investigators on the project have completed the PHS-compliant training. Submitted by the PI of a project at Award Stage, non-competing continuation awards, no-cost extensions and with supplements that extend a project’s period of performance.