Attachment 5 - Additional Info 693JK324RA0001.doc

DOC document 61 KB Posted

Attached to
2024 Pipeline Safety Research and Development (R&D) - Other Transaction Agreements (OTAs)
Solicitation number
693JK324RA0001
Issued by

About this file

This document is Attachment 5 - Additional Information related to a U.S. Department of Transportation (USDOT) Pipeline and Hazardous Materials Safety Administration (PHMSA) solicitation for pipeline safety research and development projects. The solicitation, numbered 693JK324RA0001, is for Other Transaction Agreements (OTA) with a due date of June 14, 2024 for proposal submissions. The document requests information about the proposing organization, including business type, size, and registration status in the System for Award Management (SAM). It also requires certification of the proposed cost-share in accordance with federal regulations. The solicitation seeks applications for research projects relevant to PHMSA's focus areas, with PHMSA reserving the right to fund all, some, or none of the proposals. Questions on the solicitation must be submitted by May 15, 2024, and responses will be posted publicly on SAM.gov.

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U.S. Department of Transportation (USDOT)

RA #693JK324RA0001

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment #5

ADDITIONAL INFORMATION

Institution/Firm:
Proposal Title:
Type of Business (profit, non-profit):

Size (check all that apply):

FORMCHECKBOX

Small Business FORMCHECKBOX Small Disadvantaged Business

FORMCHECKBOX

8(a) Business FORMCHECKBOX Woman Owned Business

FORMCHECKBOX

HUBZone Business FORMCHECKBOX Veteran Owned Business

FORMCHECKBOX

SDVOB FORMCHECKBOX

Large Business

UEI Number:
Taxpayer/Federal Identification Number:

Contractor/Team Project Officials

Contractor/Team Program Manager / Principle Investigator

Name:
Address:
E-Mail:
Telephone:
Fax:

Contractor/Team Program Financial Administrator

Name:
Address:
E-Mail:
Telephone:
Fax:

Contractor/Team Technical Coordinator

Name:
Address:
E-Mail:
Telephone:
Fax:

System for Award Management (SAM)

Is your organization registered in www.SAM.gov? Yes FORMCHECKBOX No FORMCHECKBOX

If you answered Yes above, please indicate the date of your latest SAM update:

/ FORMTEXT

Cost-Share Certification

Please certify that the proposed cost-share for this project is in accordance with 2 CFR 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Section 306, Cost Sharing or Matching.

Name of Person Certifying:

Signature:

Date:

FORMTEXT

File details come from the government source that posted it. Updated .