Attachment 5 - Additional Info 693JK326RA002.docx

This is an additional information form (Attachment 5) for the U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration (PHMSA) Research Announcement 693JK326RA002, focused on Technology Transfer and Commercialization Advancement of pipeline safety innovations. The form serves as a template for proposing organizations to provide institutional details, identify key personnel, and certify compliance with federal cost-sharing requirements under 2 CFR 200.

The form requires proposers to submit their business classification (small business, disadvantaged business, woman-owned, veteran-owned, or large business), Unique Entity Identifier (UEI), and federal identification number. Organizations must identify three key contacts: a Program Manager or Principal Investigator, a Financial Administrator, and a Technical Coordinator, each with complete contact information. Proposers must confirm registration in the System for Award Management (SAM.gov) and provide the date of their latest update. Additionally, organizations must include a cost-share certification signed by an authorized representative, affirming that any proposed cost-share complies with federal uniform administrative requirements and cost principles. This form does not address specific products, services, response deadlines, or award amounts; it is purely an administrative submission template for the solicitation.