Internal Routing Form 2011-1

/ UniversidadCentralDelCaribe
OfficeoftheAssociate DeanForResearchandGraduateStudies
RESEARCH
InternalRoutingFormforGrants andContracts / Tobecompleted byOADRGS
Proposal#
ProjectTitle:
*Limit length to 81 characters, including the spaces between words and punctuation. Titles in excess of 81 characters will be truncated by NIH and other PHS agencies.
PrincipalInvestigator: / Dept/Unit: / %Effort
Phone: / Fax:
E-mail:
PIOtherSupport
ProjectTitle / %Effort
Howwillcommitmentoverlapsberesolved(ifany) / 15%effortmustbereservedfor institutionalduties;commitmentof
100%efforttoresearchrequires priorapprovalfromthePresident throughtheOADRGS.
UCCCo-InvestigatorsKeyPersonnel
Name / Dept/Unit: / %Effort
Co-InvestigatorsKeyPersonnelfrom other institutions
Name / Institution / Subaward
(yes/no)
ResearchArea
DrugAbuse HIV Neuroscience CellBiology Cancer
Other
ProjectSummary
Project Performance Site(s) Name and Location
ProposalInformation
ProgramAnnouncementorSolicitationNumber:
Title:
Category / UCCis
GrantProposal / SoleAwardee
Contract/Subcontract / LeadInstitution
CooperativeAgreement / Subawardee
Other(describe) / Other(describe)
Executive Order 12372 Review
Is application subject to review by state executive order 12372 Process? _____Yes _____No
Have you contacted the Junta de Planificacion? _____Yes _____No
Project Type / ProposalInformation
Research / Grantproposalduedate:
___post-markedor___arrive
ProjectStartDate:
ProjectEndDate:
PublicService
Fellowship
MajorEquipment
Conference / ___Papersubmission
ElectronicSubmission:
___Grants.gov
___ Fast Lane
___ Other: ______please specify
ClinicalTrial
Construction
Other(Describe): / Webpage:
Ifyes,pleaselist: / Doesthisproposalinvolve: / Needaccount for electronic submission
___ eRA Commons
___ Fast Lane
___ Other: ______please specify
Consultants?
PersonalServicesAgreement?
Subcontract(s)?
SpecialApprovals/Requirements(Check allthatapply)
Contact the corresponding committee for an orientation about the procedures to obtain the appropriate approvals to perform the research.
For contact information visit
Research involvesApproval / ResearchinvolvesApproval
HumanSubjects / IRB / RecombinantDNA / Biosafety
AnimalSubjects / IACUC / SelectAgents/Pathogens / Biosafety
RadioactiveMaterials / Radiation
Safety / HumanCells/Tissues / IRB
ControlledSubstances / OADRGS / StemCells / IRB
ConflictofInterest / OADRGS / ChemicalHazards / ChemicalSafety
Tuitionrequested / OADRGS / Other(Describe)
*Pleasenotethatcopiesofapprovaldocumentswillberequiredintheeventanawardismade
Research Facilities Involve (Check all that apply)
Question 1: Did you use the facility to generate preliminary date for this application?
Question 2: Do you plan to use any core facility?
If yes, consult with the coordinator of each facility to inquire about fees-for-service for you project. Please request fee-for-service in your proposals, these funds are necessary to support the core facilities to assure their long-term existence.
For contact information visit
Research FacilitiesInvolves / Research Facilities Involves
Q 1 / Q 2 / Q 1 / Q 2
Animal Resources Center (ARC) / HIV and Substance of Abuse Laboratory Core (H-SALC)
Behavioral Testing Facility (BTF) / Immunocytochemistry Laboratory
Biomedical Proteomic Facility (BPF) / Neuronal Glia Culture Facility
Biospecimen Repository (BR) / Optical Imaging Facility
Common Instrumentation and Technical Support Unit / Protein and Nucleic Acid Core Facility
Data Management and Statistical Research Support Unit (DMSRSU) / Transmission Electron Microscopy Laboratory
Sponsor type:
____Federal ____State ____Private Nonprofit ____Private Industry
Sponsor:
Yes____ No____ Will alterations, renovations or additional space be required? (Describe)
Yes____ No____ Does this work require purchase of a network-connected device other than a computer
or printer? (Describe)
Yes____ No____ Does the sponsor imposes restrictions on publishing research results? (Describe)
Yes____ No____ Does this work require special security considerations (confident research, security
clearance, control substances, etc.) (Describe)

PLEASEATTACHYOURYEAR1DETAILBUDGET

BUDGETINFORMATION
Indirect CostInformation / Period / DirectCosts / IndirectCosts / TotalRequested / CostSharing
Amounts**
Rate used: / % / Year1
Year2
CurrentUCCrateis69% SUBMISSIONOF
GRANTSWITHLOWER
RATESREQUIRESPRIOR APPROVALBYTHE PRESIDENT / Year3
Year4
Year5
TOTAL
**PleaselisttheCostSharing/Institutional FundsUnit(s)andaccount#s(if applicable):
1)Unit:Account#:
2)Unit:Account#:
YesNoWillyouneedtopurchaseasinglepieceofequipmentcostingmorethan$5,000?
Description / Cost
YesNoCostSharingRequiredbytheSponsor?
YesNoAreindirectcostsformallylimitedbySponsor?
Limitedto%Base
YesNoThisgrantincludesCostSharing
(RequirespriorapprovalfromthePresidentthroughtheOADRGS) Describe
YesNoMatchingFunds Required?Cash In-Kind (RequirespriorapprovalfromthePresidentthroughtheOADRGS)
Describe
YesNoThisgrantincludesInstitutionalCommitments (RequirespriorapprovalfromthePresidentthroughtheOADRGS) Describe
YesNoWillInstitutionalFunds beusedtosupportaportionofthisproject? (RequirespriorapprovalfromthePresidentthroughtheOADRGS)
Describe
YesNoThisgrantincludesContinuing Obligationsaftertheawardperiod. (RequirespriorapprovalfromthePresidentthroughtheOADRGS)
Describe

Budget Note: Chargesashighas$3,000havebeenaccessesduetoopenaccess. Remembertobudgetfor publicationexpenses.

APPROVALS
PRINCIPAL INVESTIGATOR: / Signatures
Mysignaturecertifiesthat:
1)Theinformationsubmittedwithinthisformandthe correspondingapplicationistrue,completeandaccurateto thebestofthePI’sknowledge;
2)Anyfalse,fictitious,orfraudulentstatementsorclaims maysubjectthePItocriminal,civil,oradministrative penalties;
3)PIagreestoacceptresponsibilityforthescientific conductoftheprojectandtoprovidetherequiredprogress reportsifagrantisawardedasaresultoftheapplication.
4)Ifthisproposalisawarded,Ihavearrangedforfunding anycostsharingrequirements.
5)Ifanawardismade,Iamresponsibleforcompliancewith awardtermsandconditionsandUniversitypoliciesand procedures,particularlyforthetechnicalconductofthe
work,submissionoftechnicalreports,andforcompliance withUCCpoliciesregardingfinancialmanagementand areasrequiringspecialapproval.
PrincipalInvestigator / Date
DepartmentChairorDirector / Date
CollaboratingDepartmentChair(ifapplicable) / Date
Vicmag Cabrera, Sponsored Program Officer / Date
LuisCubano,Ph.D.,AssociateDean / Date
JoséGinelRodríguez,M.D., FAAP
President and Dean of Medicine / Date

Comments

DepartmentChairorDirector
CollaboratingDepartmentChairorDirector
Sponsored Programs Office
Associate Dean
President

INTERNAL ROUTINGFORMINSTRUCTIONS

GrantwritersareencouragedtoconsultwiththePresidentthroughtheOADRGSpriortobeginningthegrant writingprocessforanygrantsthatrequirecost sharing,institutionalcommitments,continuingobligationsor matchingfunds. FinalapprovaltosubmittheproposalisdeterminedbythePresident.

SoleAwardee: UCCistheinstitutionreceivingthefunds.
LeadInstitution: Grantincollaborationwithotherinstitutions. UCCwillissuesubcontracts.
Subawardee: UCCisasubcontractorinagrantmanagedbyanotherinstitution.
Indirect CostRateInformation:Ifreductionorwaiverofindirectcostsisrequiredbecausethesponsorhasa universallyappliedpolicytopaylessthantheUCCindirectcostrateortopaynoindirectcosts,check“yes”and includeacopyofthesponsor’sguidelines.
CostSharing:(RequirespriorapprovalfromthePresidentthroughtheOADRGS)
Providedetailsofthesource(s)ofcostsharing. Costsharingincludeseithermatchingfunds(dollars)orin-kind contributions. Includethesourceofthecostsharing(e.g.department,etc.),theamountfromeachsource,andthe accountnumberfromwhichtheyoriginate.
InstitutionalCommitments: (RequirespriorapprovalfromthePresidentthroughtheOADRGS) Providedetailsoftheinstitutionalcommitmentsdescribedintheproposal.
Continuing Obligations:(RequirespriorapprovalfromthePresidentthroughtheOADRGS) Projectactivitiestobecontinuedaftertheawardperiodwithinstitutionalfunds.
MatchingFunds Required:(RequirespriorapprovalfromthePresidentthroughtheOADRGS)

Matchingfunds,providedbyUCC,mayberequiredbyasponsor.
Ifmatchingisrequired anaccountmust beidentified whenthegrant proposalissubmitted.
Providedetailsofthesourceofmatchingfundsbyyearinthe“CostSharing”section.

DepartmentChairorDirector:Signatureindicatesyourreviewandapprovalofthesubmissionoftheapplication accompanyingthisroutingform,aswellaswillingness,ifanawardismade,tohavetheworkconductedinyour Department,spaceandotherDepartmentalresourcesspecifiedintheroutingformandapplication.

CollaboratingDepartmentChair:Signatureindicatesyourwillingness,ifanawardismade,tohaveaportionofthe projectconductedinyourDepartment’sspace,useofresourcesandforyourfacultymembertoparticipateuptothe percentagestatedintheapplication.

GrantApplicationswillnotbesubmittedwithoutthisform.

Pleaseallow threebusinessdaysforapprovaloftheform. Toassureproper processing,proposals mustbeattheSponsoredProgramOfficetwodaysbefore thedeadline. (Fivedaystotal)

Pleasereturnyour completedInternalRoutingFormto:

OfficeofSponsored Programs