COOPERATIVE RESEARCH AND DEVELOPMENT AGREEMENT (CRADA)Worksheet
NMRC and Non-Navy Collaborators (NNC) - Please complete this form and return it to your Technology Transfer Point of Contact with a copy of your protocol (drafts accepted).
Agreement Information
Title:
Technology Area(s):
Duration (months):36 (60 months max for a CRADA)
Objective (Cite benefits to both Navy/NMRC and NNC;This is a publicly releasable section. Do NOT include any proprietary information):
Is CRADA work Classified? NO YES If yes, state level of classification:
Will there be funds provided to Navy by the NNC via this CRADA?
NO YES
If YES, total funding: / If YES, provide payment schedule
Would the investigator like Technology Transfer assistance with negotiating funding, personnel, equipment, or other resources?
Yes No If YES, describe:
Non-Navy Collaborator (NNC) Information
Org. Name:
Street 1:
Street 2:
City: / State: / Zip:
NNC type: <select>CorporationLocal GovernmentState GovernmentInstitution / Non-ProfitUniversityCollegeLimited PartnershipGeneral PartnershipSole Proprietorship / State of Incorporation: / Small Business? YES NO
Foreign operated, controlled or influenced? YES NO / If yes, which country:
NNC Personnel / Point of Contact (POC)
Administrative POC (Preferred Contact) / Technical POC (Principal Investigator)
Name: / Dr.Mr.Ms.Mrs.Miss / Name: / Dr.Mr.Ms.Mrs.Miss
Telephone: / Email / Telephone: / Email
Security POC (if work is CLASSIFIED) / Legal Council (Optional)
Name: / Dr.Mr.Ms.Mrs.Miss / Name: / Dr.Mr.Ms.Mrs.Miss
Telephone: / Telephone:
Email: / Email:
Signing Official
Name: / Dr.Mr.Ms.Mrs.Miss / Suffix:
Title:
Telephone: / Fax: / Email:
NMRC Personnel
Principal Investigator
Name:
Code: / Telephone: / Email:
Estimated NMRC work-years:
Preexisting Intellectual Property
List issued patents, filed patent applications, invention disclosures submitted and software related to the CRADA effort:
List NMRC Patents/Cases: / List Non-Navy Collaborator Patents (if known):
STATEMENT OF WORK
SOW (Please enumerate the specific tasks to be performed by Navy Collaborator, Non-Navy Collaborator and any joint tasks:
Protocol ID:
Protocol TITLE:
Contractor Required? (Insert contractor name if substantial technical input is expected.)
IF THERE ARE ADDDITIONAL COLLABORATORS:
Please provide contact information about:
1) PRINCIPLE INVESTIGATOR(S)
2) STATEMENT OF WORK for each of the additional collaborator(s) in either the space below or on a separate sheet.
Additional Collaborator 1 Information:
Additional Collaborator 2 Information:
Additional Collaborator 3 Information:
Additional Collaborator 4 Information:
CRADA Worksheet 6.6.12)
NMRC