PART A - To Be Completed By Sponsor

Sponsor Name:
Allowed F&A/Indirect Cost Rate:
Is there a Prime Sponsor: Yes No / If Yes, Who Is the Prime Sponsor:
What is the Allowed F&A/Indirect Cost Rate of the Prime Sponsor:
Do you have a Written Policy Limiting Indirect Costs: Yes No
If Yes, Please either Attach a Copy of the Policy or Indicate the URL Where the Policy May Be Found:
If No, Please Justify the Limitation of Indirect Costs

As an Authorized Official of the above named organization, I certify that all the information above is accurate and that our policy limiting indirect costs is applied to all activities sponsored by our organization. I further certify that I have the authority to sign contractual documents on behalf of the organization.

Signature: ______Date:______

Name and Title of Authorized Official: ______

PART B - To Be Completed By Duke University Dept/School/Institute/Center If the Sponsor Does Not Have A Written Policy

Principal Investigator:
Project Title:
SPS Number:
Justification for Accepting Limited F&A/Indirect Costs On this Project:

It is Duke University's policy to require the inclusion of full F&A/Indirect Cost recovery on all proposals for external funding, except gifts. If the sponsor does not have a written policy limiting F&A/indirect costs, then such a limitation must be approved by the Vice Provost for Research. By signing below, I indicate my support to limit F&A/Indirect Cost recovery on this project for the reasons listed above.

Principal Investigator/Project Director: ______Date: ______

Business Manager: ______Date: ______

Department Chair: ______Date: ______

(A&S, Nicholas, and Pratt)

Dean / Director: ______Date: ______

(Trinity A&S, Divinity, Fuqua, Law, Nicholas, Pratt, Sanford, Univ. Centers)

Vice Provost for Research: ______Date: ______