SVIP_App_Instructions_Blockchain_Phase_I_-_04262019.docx

Department of Homeland Security Innovation OTS Application Preventing Forgery & Counterfeiting of Certificates and Licenses

***DELETE INSTRUCTIONS BEFORE APPLICATION SUBMISSION***

Department of Homeland Security Innovation OTS Application Instruction Sheet Preventing Forgery & Counterfeiting of Certificates and Licenses

General Instructions:

Please review the Preventing Forgery & Counterfeiting of Certificates and Licenses Technical Call document before submitting your application. The application cannot exceed 10 pages, including the architectural Intellectual Property diagram. These instructions can be removed in the application submission.

DHS S&T will evaluate all compliant and eligible applications three (3) times. The deadlines for submitting an application are: 01/11/2019, 05/24/2019, and 06/21/2019. Applications must be submitted prior to each of the deadlines to be evaluated in the respective review cycle. This call closes on 06/21/2019 at 12:00 PM PT. To be considered for this award, please complete this application, save it as a PDF, and send it via email to dhs-silicon-valley@hq.dhs.gov prior to the close date and time. Applications and Application resubmissions received after the close date and time will not be considered for review.

In order to receive an award, you must set up a user account and register your company in www.sam.gov. This does not need to be done at the application phase but must be done if the applicant is chosen to pitch and provides a successful pitch.

DHS may decide to close the OTS Call early. If this action occurs, DHS will publish a notification in Federal Business Opportunities (FBO) 30 days prior to closing the call.

SECTION 1- GENERAL INFORMATION

1.3 Provide a synopsis of the proposed project, describe what makes it potentially revolutionary, and must include answers to the following questions:

· What are you trying to do?

· How is it done today?

· What are the limitations to your solution?

· Who would benefit and what would the impact be if you are successful?

· How much would it cost, and how long would it take?

1.4 Please tell us how you heard about the program and/or this specific call (e.g. tech accelerator, venture capitalist, startup, media, FBO.gov, etc.)

SECTION 2- COMPANY INFORMATION

2.1 This should match your DUNS Number.

2.5 Use the check boxes to answer the questions and certify that your company adheres to the eligibility requirements detailed in section 4 of the SVIP Other Transaction Solicitation (HSHQDC-16-R-B0005) (as updated on March 28, 2018). Any questions regarding eligibility can be sent to the SVIP Team at dhs-silicon-valley@hq.dhs.gov.

2.6 Describe your company and its financials –

1. How old is it?

2. Where is it located (e.g. multiple locations, sales/R&D in U.S. and other countries)?

3. What level of outside investment has your company received?

4. From whom (Angel, Accelerator, or equivalent)? Please provide name of organization and POC. Please provide information on each of your company’s previous financing rounds, if any, including: a) Size of investment round, b) Lead investors and major investors, c) Closing date, d) Non-U.S. Investors, if any.

5. What is your annualized run-rate based on your current weekly/monthly revenue?

6. What is your current monthly burn rate?

7. What is your month-over-month revenue growth rate (USD)?

8. How much revenue did you book in the past 12 months?

9. Are you cash flow positive?

10. How many active customers or users do you currently have?

11. Who is your target market?

2.8 Describe the management team:

1. What is their background and history (e.g. previous startups, successful exits, etc.)?

2. What are the qualifications and technical expertise of the key project personnel?

SECTION 3- Technical Information

3.1 Technology Description- You must address the following questions:

1. How is your technology relevant to the Homeland Security problem outlined? You should demonstrate a good understanding of the technical challenges, present a credible (even if risky) plan to achieve the project’s goal, and it should result in a viable product.

2. What are you trying to do?

3. How will your technology work? Articulate your objectives technically and succinctly.

4. What is novel about your solution?

5. Why do you think your solution will succeed?

6. What are the technical challenges inherent in your solution and what is your plan to mitigate these risks?

7. How do you intend to measure progress and success?

8. What commercial market(s) are you already pursuing?

3.2 Innovation-

1. In what ways does your solution push the state-of-the-art?

2. What is novel about your solution as compared to others?

3. How does your solution compare or compete with those currently in the market?

3.3 Homeland Security Application-

1. How would you apply the DHS funding to adapt your product to the DHS use cases as outlined in the OTS Call?

3.4 Prototype Maturity:

1. Describe the maturity of the working prototype.

2. Describe the prototype that will be delivered at the conclusion of the Phase to which this application pertains.

3.6 Work Statement (PHASE 1 ONLY):

This is a Phase 1 application. Provide a detailed description of the work you will perform specific to Phase 1.

1. Clearly identify tasks and subtasks that will be carried out throughout the course of a 3 to 6 month investment period in order to get to a proof of concept demonstration stage.

2. Provide the schedule of performance. Please list all Deliverables you plan to submit to the government in Section 4, Chart 1 that meet the Objectives defined by the Government for that Phase. For purposes of the OTA, a Milestone is defined as a developmental stage in the product development cycle which marks an achievement of a one or more project Objective(s), whereas a Deliverable in this case is something actually delivered to the Government, be it technical data, reports, computer software, or other project-related items that allows the Government to evaluate your progress in meeting the Objective. For example, you may implement a software algorithm as a milestone towards meeting a Project Objective, but you may only submit a report of the functionality combined with a demo of the software working as a Deliverable to the Government.

3.6(a) Please also include a Gantt-style chart, like the example below, to detail the breakdown of tasks and when they will be completed. Note any task dependencies as appropriate.

3.6(a)- Sample Gantt-style chart Phase 1

Task 1

Task 2

3.8 Description of Overall Approach for All 4 Phases

Describe the overall vision for this project across all 4 Phases. What is the intended outcome and final Deliverable to the government? How does it complement or match your existing commercial roadmap?

SECTION 4- COST INFORMATION

Please provide a rationale for the total cost of the project. You should provide a detailed breakout of how the money would be spent and how prices and rates were determined.

Milestones must match the payable milestones described in the work statement.

For purposes of the OTA, a Milestone is defined as a developmental stage in the product development cycle which marks an achievement of a project goal(s), whereas a Deliverable in this case is something actually delivered to the Government, be it technical data, reports, computer software, or other project-related items.

At a minimum, Travel costs must include two trips to Washington, DC and one trip to San Francisco, CA. Provide estimated travel cost breakdown. Per diem and lodging rates can be found at: GSA Per Diem Rates. While vendors will not be able to claim government rates, travelers should attempt to make cost effective travel arrangements.

SECTION 5- LICENSE / RIGHTS OF ACCESS TO INFORMATION

Under this effort, companies shall retain ownership of the intellectual property rights to capabilities/technologies resulting from their proposed approach. It is the Government’s intent to obtain unlimited use rights to all reports delivered to the government; and a limited use right to all applicable project data, materials, and/or technologies for the purpose of testing and evaluating the project, and any outputs, and capabilities. This does not grant the applicant the right to withhold delivery of Technical Data created or used in performance of the OTA upon request by the Government.

5.1 “Background Intellectual Property” is any intellectual property, proprietary information, trade secrets, or confidential know-how that is existing as of the date of execution of the Other Transaction Agreement and is intended to be used in performance of such Other Transaction Agreement.

5.2 Applicants expecting to use, but not to deliver, commercial open source tools or other materials in implementing their approach may be required to indemnify the U.S. government against legal liability arising from such use when demonstrated on a Government owned or controlled network or environment.

5.3 If applicants desire to use their own or a third party’s proprietary background intellectual property (or both) as the basis of their proposed approach, in whole or in part, they should: 1) Clearly identify background intellectual property and its proposed particular use(s); 2) Explain how the Government will be able to reach its program goals (including transition) with the proprietary model offered; and 3) Provide possible nonproprietary alternatives in any area that might present transition difficulties or increased risk or cost to the U.S. government under the proposed proprietary solution.

You will need to provide documentation proving ownership or possession of appropriate licensing rights to all materials, data and/or technologies that will be used for the proposed project.

5.4 IP Architecture Diagram

As part of this application, you must include an architectural diagram that differentiates any background IP (including both your proprietary IP and any third party IP) you are bringing to the project from any IP developed under this project. The diagram should clearly lay out the IP for the elements of the solution proposed. The application, including the IP diagram, cannot exceed 10 pages. Note: The diagram provided in the application is an EXAMPLE. Your diagram can be in any format you wish.

Company Name Application Date

***DELETE INSTRUCTIONS BEFORE APPLICATION SUBMISSION***

Insert appropriate marking to protect any proprietary or business sensitive information.

*DO NOT REMOVE* - Application Template Version 2 – 11/2/18 Insert appropriate marking to protect any proprietary or business sensitive information.

*DO NOT REMOVE* - Application Template Version 2 – 11/2/18

SECTION 1- GENERAL INFORMATION

SECTION 2- COMPANY INFORMATION

Company Logo

2.5 Please respond to the following questions using the provided check boxes.

In the last year, has this company performed on “any contract or subcontract for the Department of Homeland Security that is subject to full coverage under the cost accounting standards pursuant to” 41 U.S.C. 1502?

☐Yes ☐No In the past 12 months from the date of this application, if your company been a party to Federal Acquisition Regulation (FAR) based contracts (to include SBIR) and/or federally awarded grants or cooperative agreements with a combined total of more than $1,000,000, please list the information below.

If you did not have any Federal Contracts and/or federally awarded grants or cooperative agreements in the past 12 months, by checking the box below you are certifying that this statement is true.

☐ I hereby certify that I do not have any Federal Contracts and/or federally awarded grants or cooperative agreements in the past 12 months from the date of this application.

List ALL contract number(s), whether you are the prime contractor or sub-contractor, type of contract, contract amount(s) and period(s) of performance from the last 12 months of the date of this application:

1. Contract number, type of contract, contract amount, and periods of performance

2. Contract number, type of contract, contract amount, and periods of performance

3. Contract number, type of contract, contract amount, and periods of performance

4. Contract number, type of contract, contract amount, and periods of performance

5. Contract number, type of contract, contract amount, and periods of performance

6. Contract number, type of contract, contract amount, and periods of performance

☐ I hereby certify that the above is an exhaustive list of Federal contracts/grants/cooperative agreements in the last 12 months from the date of this application and that the grand total of everything listed in Section 2.6 does not exceed $1 million Does this company have fewer than 200 full time equivalent (FTE) employees?

☐Yes ☐No

2.6 Company Description: Click here to enter text.

2.7 Number of Employees in Your Company: Click here to enter text.

2.8 Management Team: Click here to enter text.

2.9 Investors: Click here to enter text.

2.10 Financial Health: Click here to enter text.

2.11 Customers: Click here to enter text.

SECTION 3- TECHNICAL INFORMATION

3.1 Technology Description: Click here to enter text.

3.2 Innovation: Click here to enter text.

3.3 Homeland Security Application: Click here to enter text.

3.4 Prototype Maturity: Click here to enter text.

3.5 Which TTA does this solution address?

1. ☐ TTA #1: Issuance and Verification of Certificates, Licenses and Attestations

2. ☐ TTA #2: Storage and Management of Certificates, Licenses and Attestations

3. ☐ TTA #3: Decentralized and Derived PIV Credentials

3.6 Work Statement (PHASE 1 ONLY):

Click here to enter text.

3.6(a)- Sample Gantt-style chart Phase 1

Task 1

Task 2

3.7 Total Phase I Period of Performance in Weeks. Click here to enter text.

3.8 Description of Overall Approach for All 4 Phases:

SECTION 4- COST AND DELIVERABLE INFORMATION

Total Project Cost

*The total cost cannot exceed $200,000 and should reflect Phase 1 costs only.

Note: Payments are triggered by reasonable milestone achievement and completion of Deliverable. However, upfront payment may be made if there is an initial cost of materials (see Section 4 for Cost information).

Provide a description of all Deliverables (computer software, data, reports, etc.) to be provided to DHS for this tranche of funding.

Identify whether you are Delivering either Technical Data or Computer Software. Please see definitions in Section 5- License / Rights of Access to Information.

CHART 1- Milestones and Deliverables Pricing

TOTALS

CHART 2-Materials, Hardware and Software Cost

CHART 3-Travel Costs

*Misc includes tolls, airport parking, etc.

**At a minimum, Travel costs must include two trips to Washington, DC and one trip to San Francisco, CA.

SECTION 5- LICENSE / RIGHTS OF ACCESS TO INFORMATION

5.1 What Background IP are you bringing in to the project? Click here to enter text.

5.2 Include all proprietary claims to results, prototypes, deliverables, or systems supporting and/or necessary for the use of the research, results, prototypes, and/or deliverables. Click here to enter text.

5.3 List any commercial licenses or third-party licenses you will be using. Click here to enter text.

5.4 IP Architecture Diagram

Background IP

Project Funded IP image1.png