BAA18_Cover_Sheet_for_Exploratory_Research.pdf

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Attached to
FY18 DHS/DNDO Exploratory Research Broad Agency Announcement Federal contract opportunity
Solicitation number
70RDND18R00000001
Issued by
Department of Homeland Security Office of Procurement Operations

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FY18 Cover Sheet ER BAA

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BAA18 Cover Sheet for Exploratory Research

White Paper/Proposal Contains Does Not Contain Proprietary Information

White Paper/ Proposal ID:

Research Topic Area: Solicitation Number:

Proposed Amount: Proposed Duration (in months): Anticipated Start Date (month/day/year):

Proposal Title:

Abstract (500 words or less)

Organization Information

Organization Name: Organization Address 1: Organization Address 2:

Organization City/Province: Organization State (2 letter designation):

Organization ZIP + Four:

Country:

Principal Investigator (PI)/Project Leader Information

PI First Name: PI Middle Initial: PI Last Name:

PI Address 1: PI Address 2:

PI City/Province: PI State (2 letter designation): PI ZIP + Four:

PI Phone (include area code): PI Fax (include area code): PI E-mail:

President/Company Officer/Technical Representative (For Business and Financial Matters)

First Name: Middle Initial: Last Name:

Address 1: Address 2:

City/Province: State (2 letter designation): ZIP + Four:

Phone (including area code): Fax (including area code): E-mail:

DUNS: TIN/EIN:

Banking Information

Bank Name: Bank Routing Number (ABA):

Swift (BIC - Bank Identifier Code; Applicable for Foreign Vendor Payments to non-US Banks):

Bank Account Number:

IBAN (Applicable for Foreign Vendor Payments to Non-US Banks):

Account Type (Checking/Savings):

Solicitation HSHQDC17R000xx:
Anticipated Start Date monthdateyear:
Proposal Title:
Organization Name:
Organization Address 1:
Organization Address 2:
Organization CityProvince:
Organization State 2 letter designation:
Organization ZIP Four:
Country:
PI First Name:
PI Middle Initial:
PI Last Name:
PI Address 1:
PI Address 2:
PI Email:
First Name:
Middle Initial:
Last Name:
Address 1:
Address 2:
CityProvince:
ZIP Four:
Email:
DUNS:
TINEIN:
Bank Name:
Bank Routing Number ABA:
Swift BIC Bank Identifier Code Applicable for Foreign Vendor Payments to nonUS Banks:
Bank Account Number:
IBAN Applicable for Foreign Vendor Payments to NonUS Banks:
Account Type CheckingSavings:
Phone (including area code):
Fax (including area code):
State 2 letter designation:
PI Fax (include area code):
PI Phone (include area code):
PI State (2 letter designation):
PI (City/Province):
PI ZIP+Four:
Abstract 500 words or less:
White Paper/Proposal ID:
Topic Area Title:
Anticipated Start Date:
Proposed Amount:
Check Box1: Off
Check Box2: Off

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