PRINCIPAL INVESTIGATOR SPONSORED RESEARCH OFFICIAL Name: Name: Title: Title: Email: Email: Telephone: Telephone: PRINCIPAL INVESTIGATOR ASSURANCE: SPONSORED RESEARCH OFFICIAL ASSURANCE: I certify that the statements herein are true, complete and accurate to the I certify that the statements herein are true, complete and best of my knowledge. I am aware that any false, fictitious, or accurate to the best of my knowledge, and accept the obligation fraudulent statements or claims may subject me to criminal, civil, to comply with terms and conditions associated with this grant. I or administrative penalties. I agree to accept responsibility for am aware that any false, fictitious, or fraudulent statements or the scientific conduct of the project and to provide the required claims may subject me to criminal, civil, or administrative progress reports as requested. penalties. SIGNATURE OF PI: SIGNATURE OF SRO: Date Date ** FOR DEPARTMENT OF HEALTH USE ONLY ** SIGNATURE OF GRANT MANAGER: SIGNATURE OF DIRECTOR: Grant Manager Melissa Jordan, Director Public Health Research Public Health Research Date Date
PRINCIPAL INVESTIGATOR Name: Title: Email: Telephone: SPONSORED RESEARCH OFFICIAL Name: Title: Email: Telephone: PRINCIPAL INVESTIGATOR ASSURANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. I agree to accept responsibility for the scientific conduct of the project and to provide the required progress reports as requested. SPONSORED RESEARCH OFFICIAL ASSURANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge, and accept the obligation to comply with terms and conditions associated with this grant. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. SIGNATURE OF PI: Date SIGNATURE OF SRO: Date ** FOR DEPARTMENT OF HEALTH USE ONLY ** SIGNATURE OF GRANT MANAGER: Grant Manager Public Health Research Date SIGNATURE OF DIRECTOR: Melissa Jordan, Director Public Health Research Date
Cumulative%20Grant%20Progress%20Report%2003.2018.docx