APPENDIX C
PROPOSAL PREFATORY MATERIALS
NRA 96-OSS-09
SUN-EARTH CONNECTION
SUPPORTING RESEARCH AND TECHNOLOGY,
SUBORBITAL, GUEST INVESTIGATOR,
AND EDUCATION PROGRAMS
- Notice of Intent to Propose C-2
- Proposal cover sheet C-3
- Proposal Summary C-4
- Instructions for budget preparation C-5
- Budget summary C-6
- Current and Pending Research Support C-7
- Certification Regarding Debarment, Suspension,
Other Responsibility Matters C-8
- Certification Regarding Drug-Free Workplace
Requirements C-9
- Certification Regarding Lobbying C-10
- Cover sheet for educational outreach supplement
proposals C-11
C-1
NOTICE OF INTENT TO PROPOSE
NRA 96-OSS-09
SUN-EARTH CONNECTION
SUPPORTING RESEARCH AND TECHNOLOGY,
SUBORBITAL, GUEST INVESTIGATOR,
AND EDUCATION PROGRAMS
PROGRAM ELEMENT: (check one)
¤ INTERBALL Guest Investigator Program
¤ Ionospheric, Thermospheric, and Mesospheric Physics
¤ ISTP Guest Investigator Program
¤ Heliospheric Physics
¤ Magnetospheric Physics
¤ MITM Suborbital:
- Part of Campaign proposal? YES/NO
(If YES, identify Campaign Scientist and name of Campaign)
¤ SOHO Guest Investigator Program
¤ Solar Physics
FOR ALL PROGRAM ELEMENTS:
* Intent to submit an Education Outreach (EO) Supplement? YES / NO
TECHNIQUE / RESEARCH AREA:
(e.g., Data Analysis/Solar Corona; Simulation/Magnetic Reconnection;
Experiment Concept/Ionosphere; Theory/Auroral Substorms; etc.)
TITLE OF INVESTIGATION:
PRINCIPAL INVESTIGATOR:
Name/Title
Mail address
Telephone
E-mail address
CO-INVESTIGATOR(S): Name(s) and Institutional Addresses(s)
C-2
PROPOSAL COVER SHEET
NRA 96-OSS-09
SUN-EARTH CONNECTION
SUPPORTING RESEARCH AND TECHNOLOGY,
SUBORBITAL, GUEST INVESTIGATOR,
AND EDUCATION PROGRAMS
PROGRAM ELEMENT: (check one)
¤ Interball Guest Investigator Program
¤ Ionospheric, Thermospheric, and Mesospheric Physics
¤ ISTP Guest Investigator Program
¤ Heliospheric Physics
¤ Magnetospheric Physics
¤ MITM Suborbital:
- Willing to consider participation in LVD Program? YES/NO
- Part of Campaign proposal? YES/NO
(If YES, identify Campaign Scientist and name of Campaign)
¤ SOHO Guest Investigator Program
¤ Solar Physics
FOR ALL PROGRAM ELEMENTS:
* Proposal includes an Education Outreach (EO) Supplement?
YES/NO
TECHNIQUE / RESEARCH AREA:
(e.g., Data Analysis/Solar Corona; Simulation/Magnetic Reconnection; etc.)
TITLE OF INVESTIGATION:
PRINCIPAL INVESTIGATOR: Name/Title
Institutional address
Telephone and E-mail address
Signature
CO-INVESTIGATOR(S): Name(s)
Institutional Address(es)
INSTITUTIONAL AUTHORIZATION:
Name/Title
Institutional address including telephone
Authorizing Signature/Date
BUDGET SUMMARY: 1st Year 2nd Year 3rd Year Total
* RESEARCH TASK ($K): ________ ________ ________
C-3
PROPOSAL SUMMARY
PROGRAM ELEMENT:
TITLE OF INVESTIGATION:
PRINCIPAL INVESTIGATOR / INSTITUTION:
SUMMARY OF PROPOSED INVESTIGATION:
Special Instructions:
- Proposal Summary may be single spaced and should not exceed the
remainder of this page
- Proposal Summary may serve as the abstract of the proposal, which need
not be repeated as part of the proposal.
- Proposal summary should address the following points:
(a) Overall objectives and strategy of the proposed work.
(b) If supported in immediately previous funding cycle by NASA, a summary
of recent progress and accomplishments, or state "New Task," as
appropriate.
(c) A brief description of what will be done and plan of activities.
(d) Statement of relevance of proposed research to NASA's Space Science
programs.
C-4
INSTRUCTIONS FOR BUDGET PREPARATION
General Instructions for PROPOSAL BUDGET SUMMARY
1. Provide a separate Budget Summary sheet for each year of the proposal
research.
2. Grantee estimated costs should be entered in Column A. Columns B and
C are for NASA use only. Column C represents the approved grant
budget.
3. Provide in attachments to the proposal the detailed computations of
estimates in each category, along with any narrative explanation
required to fully explain proposed costs.
Material to be included in budget attachment:
1. Direct Labor (salaries, wages and fringe benefits). Enclosures
should list number and titles of personnel, amount of time devoted to the
grant, and rates of pay.
2. Other Direct Costs.
a. Subcontracts - Enclosures should describe the work to be
subcontracted, estimated amount, recipient (if known), and the
reason for subcontracting this effort.
b. Consultants - Identify consultants to be used, why
they are necessary, time to be spent on the project, and rates of
pay.
c. Equipment - List separately and explain the need for items of
equipment exceeding $1,000. Describe the basis for the estimated
cost.
d. Supplies - Provide general categories of needed supplies, the
method of acquisition, estimated cost, and the basis for the
estimate.
e. Travel - List the proposed trips individually, describe their
purpose in relation to the grant, provide dates and
destinations where known, and explain how the cost for each was
derived.
f. Other - Enter the total of any other direct costs not covered by
2.a through 2.e. Enclose an itemized list explaining the need for
each item and the basis for the estimate.
3. Indirect Costs. Identify indirect cost rate(s) and base(s) as
approved by the cognizant Federal agency, including the effective period
of the rate. If unapproved rates are used, explain why and include a
computational basis for the indirect expense pool and corresponding
allocation base for each rate.
4. Other Applicable Costs. Enter the total of any other applicable costs
not covered by instructions 1 through 3. Enclose an itemized list
explaining the need for each item and the basis for the estimate.
5. Subtotal -- Estimated Costs. Enter the sum of items 1, 2.a through
2.f, 3, and 4.
6. Less Proposed Cost Sharing (if any). Enter the amount proposed, if
any. If cost sharing is based on specific cost items, identify each item
and amount in enclosures.
7. Carryover Funds (if any). Enter the dollar amount of any funds that
are expected to be available for carryover from the prior budget period.
8. Total Estimated Costs. Enter the total after subtracting items 6 and 7
from item 5.
C-5
PROPOSAL BUDGET SUMMARY
FROM: __(starting date)___to ____(ending date)___
TITLE OF INVESTIGATION:
PRINCIPAL INVESTIGATOR / INSTITUTION:
| NASA USE ONLY |
A B C
1. Direct Labor (salaries, wages, and
fringe benefits) ___________ __________ ____________
2. Other Direct Costs:
a. Subcontracts ___________ __________ ____________
b. Consultants ___________ __________ ____________
c. Equipment ___________ __________ ____________
d. Supplies ___________ __________ ____________
e. Travel ___________ __________ ____________
f. Other ___________ __________ ____________
3. Indirect Costs ___________ __________ ____________
4. Other Applicable Costs ___________ __________ ____________
5. Subtotal--Estimated Costs ___________ __________ ____________
6. Less Proposed Cost Sharing ___________ __________ ____________
7. Carryover Funds (if any)
a. Anticipated amount ___________ __________ ____________
b. Amount used to reduce budget
___________ __________ ____________
8. Total Estimated Costs ___________ __________ XXXXXXXX
APPROVED BUDGET XXXXXXX XXXXXXX ____________
C-6
CURRENT AND PENDING RESEARCH SUPPORT
1. For the Principal Investigator, provide separately for categories A
and B the following information:
- Project title and sentence abstract
- Source of support
- Award amount and period covered by award
- Work-year commitment of the proposed Investigator.
A. Currently supported research project(s) that will be active
during FY 1997 (October 1, 1996, through September 30, 1997).
B. Research project(s) for which support is pending selection
(including this proposal).
2. List the name of any other funding sponsor to which this proposal has
been or will be contemporaneously submitted, including relevant dates.
C-7
Certification Regarding
Debarment, Suspension, and Other Responsibility Matters
Primary Covered Transactions
This certification is required by the regulations implementing Executive
Order 12549, Debarment and Suspension, 34 CFR Part 85, Section 85.510,
Participant's responsibilities. The regulations were published as Part VII
of the May 26, 1988 Federal Register (pages 19160-19211). Copies of the
regulations may be obtained by contacting the U. S. Department of
Education, Grants and Contracts Service, 400 Maryland Avenue, S. W. (Room
3633 GSA Regional Office Building No. 3), Washington, D. C. 20202-4725,
telephone (202) 732-2505.
- (1) The prospective primary participant certifies to the best of its
knowledge and belief, that it and its principals:
- (a) Are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any Federal department or agency;
(b) Have not within a three-year period preceding this proposal been
convicted of or had a civil judgment rendered against them for commission
of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (Federal, State or local) transaction or
contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or
receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly
charged by a governmental entity (Federal, State or local) with commission
of any of the offenses enumerated in paragraph (1)(b) of this
certification; and
(d) Have not within a three-year period preceding this
application/proposal had one or more public transactions (Federal, State or
local) terminated for cause or default.
- (2) Where the prospective primary participant is unable to certify to
any of the statements in this certification, such prospective participant
shall attach an explanation to this proposal.
_____________________________________________________________________________
Institution Principal Investigator
_____________________________________________________________________________
Name and Title of Authorized Representative
_____________________________________________________________________________
Signature Date
C-8
Certification Regarding Drug-Free Workplace Requirements
Grantees Other Than Individuals
This certification is required by the regulations implementing the
Drug-Free Workplace Act of 1988, 34 CFR Part 85, Subpart F. The
regulations, published in the January 31, 1989 Federal Register, require
certification by grantees, prior to award, that they will maintain a
drug-free workplace. The certification set out below is a material
representation of fact upon which reliance will be placed when the agency
determines to award the grant. False certification or violation of the
certification shall be grounds for suspension of payments, suspension or
termination of grants, or government wide suspension or debarment (see 34
CFR Part 85, Sections 85.615 and 85.620).
The grantee certifies that it will provide a drug-free workplace by:
- (a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession or use of a controlled
substance is prohibited in the grantee's workplace and specifying the
actions that will be taken against employees for violation of such
prohibition;
- (b) Establishing a drug-free awareness program to inform employees about-
- (1) The dangers of drug abuse in the workplace;
- (2) The grantee's policy of maintaining a drug-free workplace;
- (3) Any available drug counseling, rehabilitation, and employee assistance
programs; and
- (4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
- (c) Making it a requirement that each employee to be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
- (d) Notifying the employee in the statement required by paragraph (a)
that, as a condition of employment under the grant, the employee will-
- (1) Abide by the terms of the statement; and
- (2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after such
conviction;
- (e) Notifying the agency within ten days after receiving notice under
subparagraph (d)(2) from an employee or otherwise receiving actual notice
of such conviction;
- (f) Taking one of the following actions, within 30 days of receiving
notice under subparagraph (d)(2), with respect to any employee who is so
convicted-
- (1) Taking appropriate personnel action against such an employee, up to
and including termination; or
- (2) Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
Federal, State, or local health, law enforcement, or other appropriate
agency;
- (g) Making a good faith effort to continue to maintain a drug-free
workplace through implementation of paragraphs (a), (b), (c), (d), (e) and
(f).
__________________________________________________________________________
Institution Principal Investigator
__________________________________________________________________________
Name and Title of Authorized Representative
__________________________________________________________________________
Signature Date
C-9
Certification Regarding Lobbying
As required by S1352 Title 31 of the U.S. Code for persons entering into a
grant or cooperative agreement over $100,000, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid by or on
behalf of the undersigned, to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, in
connection with making of any Federal grant, the entering into of any
cooperative, and the extension, continuation, renewal, amendment, or
modification of any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated funds have been paid or
will be paid to any person for influencing or attempting an officer or
employee of any agency, Member of Congress, an or an employee of a Member
of Congress in connection with this Federal grant or cooperative agreement,
the undersigned shall complete Standard Form -LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions.
(c) The undersigned shall require that the language of this certification
be included in the award documents for all subawards at all tiers
(including subgrants, contracts under grants and cooperative agreements,
and subcontracts), and that all subrecipients shall certify and disclose
accordingly.
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 S1352, title 31, U.S. Code. Any person who fails to
file the required certification shall be subject to a civil penalty of not
less that $10,000 and not more than $100,000 for each such failure.
__________________________________________________________________
Organization Name AO or NRA Number and Name
__________________________________________________________________
Printed Name and Title of Authorized Representative
__________________________________________________________________
Signature Date
__________________________________________________________________
Printed Principal Investigator Name Proposal Title
C-10
PROPOSAL COVER SHEET
NRA 96-OSS-09
SUN-EARTH CONNECTION
SUPPORTING RESEARCH AND TECHNOLOGY,
SUBORBITAL, GUEST INVESTIGATOR,
AND EDUCATION PROGRAMS
EDUCATIONAL OUTREACH SUPPLEMENT
PROGRAM ELEMENT OF "PARENT" RESEARCH TASK:
¤ Interball Guest Investigator Program
¤ Ionospheric, Thermospheric, and Mesospheric Physics
¤ ISTP Guest Investigator Program
¤ Heliospheric Physics
¤ Magnetospheric Physics
¤ MITM Suborbital
¤ SOHO Guest Investigator Program
¤ Solar Physics
"PARENT RESEARCH PROPOSAL:
* NEW - Provide research proposal name
/OR/
* EXISTING - Provide name and alpha-numeric identifier
for existing award
TITLE OF INVESTIGATION:
PRINCIPAL INVESTIGATOR: Name/Title
Institutional address
Telephone and E-mail address
Signature
CO-INVESTIGATOR(S): Name(s)
Institutional Address(es)
INSTITUTIONAL AUTHORIZATION:
Name/Title
Institutional address including telephone
Authorizing Signature/Date
BUDGET SUMMARY: 1st Year 2nd Year 3rd Year Total
* RESEARCH TASK ($K): ________ ________ ________ _________
C-11
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