Item 14 Project Director/Principal Investigator Contact Information. Enter all of the information requested for the Project Director/Principal Investigator, including position/title, name, address (including county), organizational affiliation (e.g., organization, department, division, etc.), telephone and fax numbers, and email address. Use the drop down menus where they are provided. Item 15 Estimated Project Funding Total Federal Funds Requested. Enter the total Federal funds requested for the entire project period. The total Federal funds requested must not exceed the cost maximums for the selected network role (see ). Total Non-Federal Funds. Enter the total Non-Federal funds requested for the entire project period. Federal & Non-Federal Funds. Enter the total estimated funds for the entire project period, including both Federal and Non-Federal funds. Estimated Program Income. Identify any program estimated for the project period, if applicable. Item 16 Is Application Subject to Review by State Executive Order 12372 Process? The Institute is not soliciting applications that are subject to review by Executive Order 12372; therefore, check the box is not covered by E.O. 12372” to indicate for this item. “Program “No” Item 17 This is the Authorized Organization Representative’s electronic signature. By providing the electronic signature, the Authorized Organization Representative certifies the following: To the statements contained in the list of certifications, and That the statements are true, complete and accurate to the best of his/her knowledge. By providing the electronic signature, the Authorized Organization Representative also provides the required assurances, agrees to comply with any resulting terms if an award is accepted, and acknowledges that any false, fictitious, or fraudulent statements or claims may subject him/her to criminal, civil, or administrative penalties. Note: The certifications and assurances referred to here are described in . Item 18 SF LLL or Explanatory Documentation. Do not add the SF LLL here. A copy of the SF LLL is provided as an optional document within the application package. See to determine applicability. If it is applicable to the grant submission, choose the SF LLL from the optional document menu, complete it, and save the completed SF LLL form as part of the application package.
Item 14 Project Director/Principal Investigator Contact Information. Enter all of the information requested for the Project Director/Principal Investigator, including position/title, name, address (including county), organizational affiliation (e.g., organization, department, division, etc.), telephone and fax numbers, and email address. Use the drop down menus where they are provided. Item 15 Estimated Project Funding Total Federal Funds Requested. Enter the total Federal funds requested for the entire project period. The total Federal funds requested must not exceed the cost maximums for the selected network role (see ). Total Non-Federal Funds. Enter the total Non-Federal funds requested for the entire project period. Federal & Non-Federal Funds. Enter the total estimated funds for the entire project period, including both Federal and Non-Federal funds. Estimated Program Income. Identify any program estimated for the project period, if applicable. Item 16 Is Application Subject to Review by State Executive Order 12372 Process? The Institute is not soliciting applications that are subject to review by Executive Order 12372; therefore, check the box “Program is not covered by E.O. 12372” to indicate “No” for this item. Item 17 This is the Authorized Organization Representative’s electronic signature. By providing the electronic signature, the Authorized Organization Representative certifies the following: To the statements contained in the list of certifications, and That the statements are true, complete and accurate to the best of his/her knowledge. By providing the electronic signature, the Authorized Organization Representative also provides the required assurances, agrees to comply with any resulting terms if an award is accepted, and acknowledges that any false, fictitious, or fraudulent statements or claims may subject him/her to criminal, civil, or administrative penalties. Note: The certifications and assurances referred to here are described in . Item 18 SF LLL or Explanatory Documentation. Do not add the SF LLL here. A copy of the SF LLL is provided as an optional document within the application package. See to determine applicability. If it is applicable to the grant submission, choose the SF LLL from the optional document menu, complete it, and save the completed SF LLL form as part of the application package.
2018_84324N.docx