Atch 8_Model Grant.pdf

Grant/Cooperative Agreement Award

1. AWARD NO.

FA8651-23-1-0007

2. EFFECTIVE DATE

3. PURCHASE REQUEST NO.

See Block 16

4. CFDA NO.

12.630

PAGE OF

1 2

5. ISSUE BY AFRL/RWK CODE FA8651 6. AWARDED TO CAGE CODE 7. AUTHORITY

AIR FORCE RESEARCH LABORATORY

MUNITIONS RESEARCH LABORATORY

203 W EGLIN BLVD, BLDG 300

EGLIN AFB, FL 32542-6810

ADAM V. NOFFKE 850-883-7215

adam.noffke@us.af.mil

10 U.S.C. 4001

8. PERIOD OF PERFORMANCE

X Months (technical work) + X months for final report

9. SCOPE / AGREEMENT TERMS

"Title" submitted on DD Month YYYY in response to Call 03 BAA-FA8651-22-S-0001, dated DD Month YYYY. Recipient's signature not required on this agreement, however, the recipient agrees to the conditions specified in this award unless notice of disagreement is furnished to the awarding officer within 15 days after the signature date. In case of disagreement, the recipient shall not incur any costs until the disagreement is resolved.

10. RECIPIENT PRINCIPAL INVESTIGATOR

11. OTHER SPONSORING AGENCY(S)

12. ADMINISTRATIVE OFFICE CODE N66020 13. PAYING OFFICE CODE: F03000 14 STAFF JUDGE ADVOCATE OFFICE

OFC OF NAVAL RSCH (ONRRO)

ATLANTA

ATLANTA REGIONAL OFFICE

100 ALABAMA ST SW SUITE 4R15

ATLANTA GA 30303-3104

DFAS-DY

P.O. BOX 369024

COLUMBUS, OH 43218-9024

96 TW/JAQ

501 West Van Matre Avenue, Suite 1 Eglin AFB, FL 32542

15. GOVT PROGRAM MANAGER (Name, Org, Tel, Email)

16. ALLOCATED FUNDING: The following funds with associated Accounting Classification reference number(s) (ACRNs) are allotted to this agreement:

ACRN

FUND CITATION(s)

AMOUNT

SPECIAL INSTRUCTIONS: PAYMENT WILL BE MADE BY ELECTRONIC FUNDS TRANSFER.

PAYING OFFICE INSTRUCTIONS:

PAYMENT SCHEDULE (if applicable):

17. TOTAL FUNDS OBLIGATED Government Share

$0.00

Recipient Share

$0.00

Total

$0.00

18 INVOICE INSTRUCTION

19. AMOUNT OF AWARD Government Share

Recipient Share

$0.00

Total

20. OPTIONS Government Share Recipient Share Total 21. PERIOD

FOR THE RECIPIENT FOR THE UNITED STATES OF AMERICA

22. SIGNATURE

23. SIGNATURE

24. NAME AND TITLE

25. DATE SIGNED

26. NAME AND TITLE 27. DATE SIGNED

MISTI A. DESHIELDS

GRANTS OFFICER

ConWrite Version 7.6.1.0 Created 13 Apr 2023 7:54 AM