CRADA Input Information Insert Date
ver. 2-25-16

1.  CRADA title:

2.  Collaborator name:

3.  Collaborator address:

4.  Collaborator headquarters/main administrative address (If different from above):

5.  NRL principal investigator name, code, phone number and e-mail address:

6.  Collaborator principal investigator name, phone number and e-mail address:

7.  Collaborator legal counsel name and phone number:

8.  Is the Collaborator a small business (U.S. based AND £500 employees)?

9.  Is the Collaborator foreign owned, controlled, or influenced?

10.  NRL mission that relates to the CRADA research (A phrase describing the mission of the branch or division):

11.  Duration (Must agree with the SOW and funding available, either under the CRADA or from government programs):

12.  Funding (from Collaborator to NRL) and payment schedule (If the source of this funding is a Government Agency [e.g. DARPA, DTRA] please provide agency name and contract number):

13.  Is Collaborator currently receiving SBIR or STTR funding or anticipates SBIR or STTR funding? If yes, will it be used to fund NRL for this effort?

14.  Field of planned commercial use by the Collaborator:

15.  NRL has extensive expertise and information in…(Research area pertaining to CRADA)

16.  Related NRL inventions (Patents, patent applications, or invention disclosures):

17.  Related Collaborator inventions (optional) (Patents, patent applications, or invention disclosures):

18.  Other relevant background information (e.g. related DARPA program [not funding this project], other CRADAs using the same technology, etc.):

19.  Will any Classified Information be exchanged or utilized under this CRADA?

20.  Is it anticipated that any Classified Information will be developed under this CRADA?

21.  Please list the NRL employees anticipated to be performing any portion of the CRADA work:

22.  Is it contemplated that NRL may use contractors or postdocs to perform work on NRL’s behalf? If so, identify their employer, address, and the name of the individual performing the work.

23.  Is it contemplated that the Collaborator may use contractors to perform work on the Collaborator’s behalf? If so, identify this third party, their address, and the name of the individual performing the work.

24.  Does the Collaborator have any existing Navy contracts, collaborations, or licenses in this field of use?

25.  What equipment and facilities will be provided by NRL for the performance of the CRADA? Where will the equipment be located (At NRL, loaned to the Company, elsewhere)?

26.  Will there be any biological materials exchanged under the CRADA?

BACKGROUND AND RATIONALE: (In a paragraph or two, describe what each side “brings to the table,” the reason for the CRADA, and the benefit of doing the CRADA to the NRL/Navy. This will be the executive summary accompanying the agreement.)

OBJECTIVES (1-3 sentences succinctly stating the goals/objectives of the CRADA; i.e. where you will be at the end of the project, not the steps you will take to get there.)

STATEMENT OF WORK (Be as specific as possible in listing numbered tasks, using the framework below:)

NRL will be responsible for the following tasks:

The Collaborator will be responsible for the following tasks:

NRL and the Collaborator will jointly be responsible for the following tasks: