Attachment 11 - Proposal Summary and Data Record NIH2043.pdf
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- Attached to
- Interventional Agents Chemistry Services
- Solicitation number
- 75N93024R00002
About this file
This document contains a proposal summary and data record for a federal contract opportunity. The proposal summary outlines key details of a proposal submitted in response to RFP number NIH2043, including the legal name and address of the offeror, proposed performance period and costs, principal investigator contact information, and confirmation of compliance with human subjects research requirements. Additionally, the related federal contract opportunity describes a multiple award IDIQ contract to provide interventional agents chemistry services in support of therapeutic candidates for infectious diseases. Services will include non-GMP chemistry, GMP manufacturing, formulation and fill/finish activities. Awards will be made to organizations demonstrating capability in Task Area B for non-GMP chemistry or Task Area C for GMP activities. The focus is on supporting a variety of investigators and programs through case-by-case requests for task orders.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
NATIONAL INSTITUTES OF HEALTH
PROPOSAL SUMMARY AND DATA RECORD
PROJECT TITLE (Title or RFP or Contract Proposal)
RFP/CONTRACT NUMBER
LEGAL NAME AND ADDRESS OF OFFEROR PLACE OF PERFORMANCE (Full address including ZIP)
TYPE OF CONTRACT PROPOSED
� COST-REIMBURSEMENT � FIXED PRICE
ESTIMATED TIME REQUIRED TO COMPLETE PROJECT
ESTIMATED DIRECT COSTS IN PROPOSED YEAR (From Budget
� COST-PLUS-FIXED-FEE
PROPOSED STARTING DATE
� OTHER
DOES THIS PROPOSAL INCLUDE A SUBCONTRACT � YES � NO (If yes, please furnish name and location of organization, description of services, basis for selection, responsible person employed by subcontractor and cost information.)
NAME AND TITLE OF PRINCIPAL INVESTIGATOR SOCIAL SECURITY
NO.
EST. HOURS
WEEKLY
AREA
CODE/TEL.NO.
NAME AND TITLE OF CO-INVESTIGATOR (Use attachment if necessary.)
NAME AND TITLE OF INDIVIDUAL(S) AUTHORIZED TO
NEGOTIATE CONTRACTS
AREA CODE/TELEPHONE NUMBER
NAME AND TITLE OF INDIVIDUAL(S) AUTHORIZED TO
EXECUTE CONTRACTS
AREA CODE/TELEPHONE NUMBER
DOES THIS PROPOSAL INVOLVE EXPERIMENTS WITH HUMAN SUBJECTS � YES � NO
Institution’s General Assurance re: Human Subjects DATE APPROVED � PENDING Institution’s Review Board’s Approval of this Proposal DATE APPROVED � PENDING An example of the informed consent for this study is enclosed � YES � NO A Clinical Protocol is enclosed � YES � NO
OFFEROR’S ACKNOWLEDGMENT OF AMENDMENTS TO THE RFP (Use attachment if necessary)
ERRATA NUMBER DATE ERRATA NUMBER DATE
NAME, ADDRESS, AND PHONE NUMBER OF
COGNIZANT GOVERNMENT AUDIT AGENCY
NUMBER OF EMPLOYEES CURRENTLY EMPLOYED
DOLLAR VOLUME OF BUSINESS PER ANNUM
THIS OFFER EXPIRES DAYS FROM THE
DATE OF THIS OFFER (120 days if not specified)
FOR THE INSTITUTION
SIGNATURE OF PRINCIPAL INVESTIGATOR SIGNATURE OF BUSINESS REPRESENTATIVE
TYPED NAME AND TITLE TYPED NAME AND TITLE
EMPLOYER IDENTIFICATION NUMBER DATE OF OFFER
NIH-2043
June 1982
Provision of the Social Security Number is voluntary. Social Security
Numbers are requested for the purpose of accurate and efficient identification, review, and management of NIH Extramural Programs.
Authority for requesting this information is provided by Title III, Section
301, and Title IV of the Public Health Service Act, as amended.
NIH-2043
June 1982
File details come from the government source that posted it. Updated .