Attachments- HALEU Transportation Package NOFO.pdf

Notice of Funding Opportunity: DE-FOA-0002967

High-Assay Low-Enriched Uranium (HALEU) Transportation Package

DOE Provided Templates

Per NOFO Part 1, Application Content Requirement—Required Application Documents, the following templates, forms, and documents are being provided for the administrative convenience of the applicant as part of this funding opportunity package. See attached.

Any additional templates, forms, and documents stated as a requirement in NOFO Part 1, Application Content Requirement—Required Application Documents can be downloaded from various sites as indicated in each of their sections in NOFO Part 2.

It is the applicant's responsibility to ensure that all requirements for application submissions align with NOFO Part 1 & 2.

1. Statement of Project Objectives

2. Project Management Plan

3. Research and Related Budget – Section A-B Form

4. Budget Justification – Applicant (same document to be used for prime and sub-recipients)

5. Community Benefits Plan for Research and Development (R&D)

6. Current and Pending Support

7. Location(s) of Work

8. Offeror Environmental Report

9. Disclosure of Lobbing Activities

10. Certification Regarding Lobbing

11. Summary for Public Release

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Project/Performance Site Location(s)

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Project/Performance Site Location(s)

OMB Number: 4040-0010

Expiration Date: 12/31/2026

Project/Performance Site Primary Location

I am submitting an application as an individual, and not on behalf of a company, state, local or tribal government, academia, or other type of organization.

Organization Name:

UEI:

* Street1:

Street2:

* City:

County:

* State:

Province:

* Country:

* ZIP / Postal Code:

* Project/ Performance Site Congressional District:

Project/Performance Site Location

I am submitting an application as an individual, and not on behalf of a company, state, local or tribal government, academia, or other type of organization.

Organization Name:

UEI:

* Street1:

Street2:

* City:

County:

* State:

Province:

* Country:

* ZIP / Postal Code:

* Project/ Performance Site Congressional District:

Additional Location(s)

Project/Performance Site Location(s)

XDPFirstField:

ViewBurdenStatement:

TextField1:

FileName:

MimeType:

href:

hashAlgorithm:

HashValue_data:

Mandatory:

Individual: Select if submitting application as an individual and not on behalf of or representing any organization.: N: No

ORGANIZATION NAME (Project Performance Site): Indicate the organization name of the primary site where the work will be performed. If a portion of the project will be performed at any other sites(s), identify the site location(s) in the block(s) provided. (This field is not applicable for applicants using SF 424 Individual Form Set.):

UEI: Enter the UEI associated with the organization where the project will be performed. This field is optional.:

Street1 (Project Performance Site): Enter first line of the street address in "Street 1" field of the primary performance site location. This field is required.:

Street2 (Project Performance Site): Enter second line of the street address in "Street 2" field for the primary performance site location. This field is optional.:

City (Project Performance Site): Enter the City for address of the primary performance site location. This field is required.:

County (Project Performance Site): Enter the County of the performance site location.:

State (Project Performance Site): Enter the State where the primary performance site location is located. This field is required if the Project Performance Site is located in the United States.:

Province (Project Performance Site): Enter the Province where the primary performance site location is located. :

Country (Project Performance Site): Select the country for the primary performance site location.:

Zip / Postal Code (Project Performance Site): Enter the nine-digit Postal Code (e.g., ZIP code) of the primary performance site location. This field is required if the Project Performance Site is located in the United States.:

Program District: Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district.

If all districts in a state are affected, enter "all" for the district number. Example: MD-all for all congressional districts in Maryland.

If nationwide (all districts in all states), enter US-all.

If the program/project is outside the US, enter 00-000.

To locate your congressional district, visit the Grants.gov web site. Note it is likely that this field will be identical to the “Congressional Districts of Applicant” field provided elsewhere in this application. :

rNo:

Individual: Select if submitting application as an individual and not on behalf of or representing any organization.:

DE:

ORGANIZATION NAME (Project Performance Site): Indicate the organization name of the primary site where the work will be performed. If a portion of the project will be performed at any other sites(s), identify the site location(s) in the block(s) provided. (This field is not applicable for applicants using SF 424 Individual Form Set.):

UEI: Enter the UEI associated with the organization where the project will be performed. This field is optional.:

Street1 (Project Performance Site): Enter first line of the street address in "Street 1" field of the primary performance site location. This field is required.:

Street2 (Project Performance Site): Enter second line of the street address in "Street 2" field for the primary performance site location. This field is optional.:

City (Project Performance Site): Enter the City for address of the primary performance site location. This field is required.:

County (Project Performance Site): Enter the County of the performance site location.:

State (Project Performance Site): Enter the State where the primary performance site location is located. This field is required if the Project Performance Site is located in the United States.:

Province (Project Performance Site): Enter the Province where the primary performance site location is located. :

Country (Project Performance Site): Select the name of the country for the primary project performance site.:

Zip / Postal Code (Project Performance Site): Enter the nine-digit Postal Code (e.g., ZIP code) of the primary performance site location. This field is required if the Project Performance Site is located in the United States.:

Program District: Enter the Congressional District in the format: 2 character State Abbreviation - 3 character District Number. Examples: CA-005 for California's 5th district, CA-012 for California's 12th district.

If all districts in a state are affected, enter "all" for the district number. Example: MD-all for all congressional districts in Maryland.

If nationwide (all districts in all states), enter US-all.

If the program/project is outside the US, enter 00-000.

To locate your congressional district, visit the Grants.gov web site. Note it is likely that this field will be identical to the “Congressional Districts of Applicant” field provided elsewhere in this application. :

Delete Entry: Delete the currently displayed Other Site Entry.:

Next Site: Press this button to show next page for Other Sites.:

Additional Location(s): Attach a file using the appropriate buttons.:

Additional Location(s) Add Attachment: Attach a file using the appropriate buttons.:

Additional Location(s) Delete Attachment: Attach a file using the appropriate buttons.:

Additional Location(s) View Attachment: Attach a file using the appropriate buttons.:

LastField:

ID F 450.01

(10/2024) Replaces (04/2020)

U.S. DEPARTMENT OF ENERGY

IDAHO OPERATIONS OFFICE

Offeror Environmental Report

Directions: The following information must be provided to and approved by the Department of Energy (DOE) before a proposal/project can be awarded. Please address each section of this outline in narrative report form and submit with the project proposal. The information provided in this report is important for establishing the basis, expediting the DOE environmental review process, and enabling DOE to make a National Environmental Policy Act (NEPA) determination. If any query below does not apply to the project, cite as “N/A”, and include a short explanation.

1.0 Project title

1.1 Applicant/offeror organization

1.2 Applicant/offeror organization contact

1.3 Telephone number and email address

2.0 Description of the proposed project: Please prepare a self-contained description that summarizes the proposed action in detail. Discuss the objectives of the proposed project and describe the proposed site. Describe the work to be performed, the schedule, associated requirements (e.g., land, natural resources), and changes that will be necessary to the existing site, systems, or processes. Provide a complete description of potential alternatives to the project including a “no action” alternative, and alternatives to technology specific, process design, site-specific location project aspects. If the project changes for any reason during the application period, you must notify DOE and describe the changes. Please include a project site plan and topographic map of the area. Off-site facility requirements shall also be identified in this description.

3.0 Existing environment and potential/anticipated environmental impacts: Discuss the existing environment at the project location(s) and the potential environmental impacts from the project including consequences from any construction, operation/testing, and disposition activities. Ensure postulated direct, indirect, short-term, and long-term impacts resulting from project activities are identified clearly. Identify mitigative measures formulated that will address these impacts. This information must convey subject matter expert level knowledge of the environmental conditions.

4.0 Land use: Provide a description of the affected land area and its dimensions; a discussion of current land usage (e.g., farming, industrial, etc.); and descriptions of nearby pipelines and transmission lines, as well as transportation access (rail, road, barge, etc.). Describe land use impacts from any construction and operation activities; waste disposal problems (for non-toxic, toxic, and/or hazardous substances); and effluent discharges requiring the development of settling ponds.

5.0 Air quality: Identify the air quality control regions in the project area, the local climate and existing air quality conditions in the immediate proposed project/site area.

6.0 Hydrologic conditions/water quality: Identify watersheds and downstream drainage, surface and groundwater quality (nearby aquifers and the depth of groundwater) in the project area, existing floodplains, unique aquatic habitats, recreational areas, public water supplies; describe constraints on water availability imposed by treaties, court decree, state and Federal water laws; and identify existing wastewater treatment and/or disposal facilities. Describe changes in groundwater/surface water quality and quantity, stream diversion resulting from construction, runoff from storage piles (source, discharge rate, discharge frequency and duration), leachates from waste disposal sites; and wastewater treatment and discharges.

7.0 Geologic/soil conditions: Describe the topographic stability (e.g., formations and/or faulting, karst), the productivity of soil, unique soil species, and the soil’s susceptibility to erosion. Describe notable seismic conditions, subsidence that might be caused by construction; possible erosion, stream diversion, floodplain and wetland intrusion, and increases or decreases in soil permeability and infiltration.

8.0. Vegetation resources: Identify the vegetative biome and predominant/representative plant species in the project area. Describe impacts to indigenous flora, state and Federally listed endangered species and their habitats, and sensitive plant habitats such as wetlands, floodplains, or other ecologically sensitive terrain.

9.0 Wildlife resources: Identify the predominant/representative wildlife species in the project area, local indigenous flora and fauna, state and Federally listed endangered or threatened wildlife species and their habitats, and sensitive habitats such as wetlands, floodplains, or other ecologically sensitive terrain.

10.0 Visual resources: Describe any scenic values/vistas or existing aesthetic environmental conditions in the project area.

11.0 Climate change: Considerations related to climate change include: 1) the potential effects of a proposed action on climate change (through greenhouse gas emissions or carbon sequestration and reductions from the proposed action). Climate change analysis also enables agencies to evaluate reasonable alternatives and mitigation measures that could avoid or reduce potential climate change-related effects and help address mounting climate resilience and adaptation challenges. 2) the effects of climate change on a proposed project and how climate change may influence the purpose and need for projects in the short-term (within the next 10 to 15 years) and long-term (over the next several decades); and, 3) the implications of climate change on the environmental effects of a proposed action.

12.0 Historic/cultural resources: Describe historic and/or cultural places in the project area, as well as archeological sites, disturbance to historical or archaeological sites caused by construction, interference with Native American tribal or other religious practices or sites; and impacts on local community character. This includes the potential impact to an historic property or building that may be governed by provisions of the National Historic Preservation Act. Describe consultation predicted or undertaken with potentially affected American Indian Tribes.

13.0 Waste generation: This section shall describe waste material (solid, hazardous or radioactive) that will be generated from project activities. Include the source/type of any and all wastes produced, and the approximate weight, density, and volume of the waste, its method of disposal, location, and any permitting requirements necessary.

14.0 Socioeconomic conditions and environmental justice implications: Discuss the population in the project area and describe the employment, labor mix and potentially disadvantaged communities that may be marginalized, underserved, or overburdened by pollution.

Describe if and how the project may be able to benefit these communities across one or more of the following seven areas: climate change, clean energy and energy efficiency, clean transit, affordable and sustainable housing, training and workforce development, remediation and reduction of legacy pollution, and the development of critical clean water and wastewater infrastructure.

15.0 Health and safety aspects: Discuss the current/background conditions at proposed project areas including emissions, effluents and noise and the potential cumulative effects of the project proposal.

16.0 Environmental regulation: Briefly describe current and anticipated state and Federal environmental regulations, permits and agreements that will govern the project.

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Disclosure of Lobbying Activities (SF-LLL)

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10. a. Name and Address of Lobbying Registrant:

9. Award Amount, if known:$

* Street 1

* City

State

Zip

Street 2

* Last Name

Prefix

* First Name

Middle Name

Suffix

DISCLOSURE OF LOBBYING ACTIVITIES

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352

OMB Number: 4040-0013

Expiration Date: 02/28/2025

1. * Type of Federal Action:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Type of Federal Action is required: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. * Status of Federal Action:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Status of Federal Action is required: Identify the status of the covered Federal action.

3. * Report Type:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

For Material Change Only:

year quarter date of last report

4. Name and Address of Reporting Entity:

Reporting Entity: Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. This field is required.

Reporting Entity is required: Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

Tier if known:

* Name

* Street 1

Street 2

* City

State

Zip

Congressional District, if known:

Congressional District, if known:

* Name

* City

State

* Street 1

Street 2

Zip

6. * Federal Department/Agency:

7. * Federal Program Name/Description:

CFDA Number, if applicable:

8. Federal Action Number, if known:

b. Individual Performing Services (including address if different from No. 10a)

Prefix

* First Name

Middle Name

* Street 1

* City

State

Zip

Street 2

11.

* Last Name

Suffix

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

* Signature:

*Name:

Prefix

* First Name

Middle Name

* Last Name

Suffix

Title:

Telephone No.:

Date:

Federal Use Only:

Authorized for Local Reproduction

Standard Form - LLL (Rev. 7-97)

CoopAgree

InitialAward

InitialFiling

Y: Yes

XDPFirstField:

Mandatory:

Disclosure Statement: Click the button to read the "Review Public Burden Disclosure Statement".:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Contract: Click if the Type of Federal Action is a contract.:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Grant: Click if the Type of Federal Action is a grant.:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Cooperative Agreement: Click if the Type of Federal Action is a cooperative agreement.:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Loan: Click if the Type of Federal Action is a loan.:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Loan Guarantee: Click if the Type of Federal Action is a loan guarantee.:

Type of Federal Action: Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. This field is required.

Loan Insurance: Click if the Type of Federal Action is a loan insurance.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Bid, Offer, Application: Click if the Status of Federal Action is a bid, an offer or an application.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Initial Award: Click if the Status of Federal Action is an initial award.:

Status of Federal Action: Identify the status of the covered Federal action. This field is required.

Post Award: Click if the Status of Federal Action is a post-award.:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

Initial Filing: Click if the Report Type is a initial filing.:

Report Type: Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the previously submitted report by this reporting entity for this covered Federal action. This field is required.

Material Change: Click if the Report Type is a material change.:

Year: If this is a follow up report caused by a material change to the information previously reported, enter the year in which the change occurred.:

Quarter: If this is a follow up report caused by a material change to the information previously reported, enter the quarter in which the change occurred.:

Date of last report: Enter the date of the previously submitted report by this reporting entity for this covered Federal action.:

ReportTypeAttr:

ReportingEntityEntityType:

Reporting Entity: Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. This field is required.

Prime: Click to designate the organization filing the report as the Prime Federal recipient.:

SubAwardee: Click to designate the organization filing the report as the SubAwardee Federal recipient. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.:

ReportEntityType:

Tier: Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. :

Reporting Entity Organization Name: Enter the name of reporting entity. This field is required.:

Street 1: Enter the first line of the street address for the Reporting Entity. This field is required.:

Street 2: Enter the second line of the street address for the Reporting Entity.:

City: Enter the city of the Reporting Entity. This field is required.:

State: Select the state for the Reporting Entity's address from this pull down menu.:

Zip / Postal Code: Zip Code (or ZIP+4) of the Reporting Entity.:

Congressional District: If known, the Congressional District of the reporting entity. Should be numeric characters.:

Section5Text:

Prime Organization Name: If the organization filing the report in item 4, checks "Subawardee", enter the full name of the prime Federal recipient.:

Street 1: If the organization filing the report in item 4, checks "Subawardee", enter the address of the prime Federal recipient.:

Street 2: If the organization filing the report in item 4, checks "Subawardee", enter the address of the prime Federal recipient.:

City: If the organization filing the report in item 4, checks "Subawardee", enter the city of the prime Federal recipient.:

State: If the organization filing the report in item 4, checks "Subawardee", select the appropriate state from this pull down menu.:

Zip / Postal Code: If the organization filing the report in item 4, checks "Subawardee", enter the zip code.:

Congressional District: If the organization filing the report in item 4, checks "Subawardee", enter the Congressional District of the prime Federal recipient, if known. Should be numeric characters.:

EntityType: Prime

Federal Department/Agency: Enter the name of the Federal Department or Agency making the award or loan commitment. This field is required.:

Federal Department/Agency: Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. :

CFDA Number: Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.:

Federal Action Number: Enter the most appropriate Federal identifying number available for the Federal action, identified in item 1 (e.g., Request for Proposal (RFP) number, invitation for Bid (IFB) number, grant announcement number, the contract, grant, or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001".:

Award Amount: For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment of the prime entity identified in item 4 or 5.:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Lobbying Registrant.:

First Name: Enter the first name of Lobbying Registrant. This field is required.:

Middle Name: Enter the middle name of Lobbying Registrant.:

Last Name: Enter the last name of Lobbying Registrant. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Lobbying Registrant.:

Street 1: Enter the first line of street address for the Lobbying Registrant.:

Street 2: Enter the second line of street address for the Lobbying Registrant.:

City: Enter the city of the Lobbying Registrant.:

State: Select the appropriate state of the Lobbying Registrant.:

Zip / Postal Code: Enter the Zip Code (or ZIP+4) of the Lobbying Registrant.:

DataEntered1:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Individual Performing Services.:

First Name: Enter the first name of the Individual Performing Services. This field is required.:

Middle Name: Enter the middle name of the Individual Performing Services.:

Last Name: Enter the last name of the Individual Performing Services. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Individual Performing Services.:

Street 2: Enter the second line of street address for the Individual Performing Services.:

City: Enter the city of the Individual Performing Services. :

State: Select the state for the address of the Individual Performing Services from this pull down menu.:

Zip / Postal Code: Enter the Zip Code (or ZIP+4) of the Individual Performing Services.:

Street 1: Enter the first line of street address for the Individual Performing Services.:

DataEntered2:

Prefix: Enter the prefix (e.g., Mr., Mrs., Miss), if appropriate, for the Certifying Official.:

First Name: Enter the first name of Certifying Official. This field is required.:

Middle Name: Enter the middle name of the Certifying Official.:

Last Name: Enter the last name of the Certifying Official. This field is required.:

Suffix: Enter the suffix (e.g., Jr. Sr., PhD), if appropriate, for the Certifying Official.:

Title: Enter the title of the Certifying Official.:

Telephone Number: Enter the telephone number of the certifying official.:

LastField:

Signature: Enter the Signature. This field is required.

Date: Enter the date signed. Enter in the format mm/dd/yyyy. This field is required.:

Statement of Project Objectives (SOPO)

Sample Template

NOFO Announcement Number: Starts with DE-FOA- on the NOFO Part 1 Title Page

Title: Click here to enter text.

Principal Investigator(s):

Name; Title; Institute; Address; Telephone; Email

Collaborator(s):

Technical Topic Area Identifier, choose one:

Topic Area 1: Applications for NRC certification of new package design concepts.

__Oxide __ Metal __ UF6 __ Combination (List: _________________________)

Topic Area 2: Applications for NRC certification of modification to existing design packages.

__Oxide __ Metal __ UF6 __ Combination (List: _________________________)

Requesting FFRDC capabilities at these partners, check all applicable boxes:

☐ Ames National Laboratory

☐ Los Alamos National Laboratory

☐ Argonne National Laboratory

☐ National Renewable Energy Laboratory

☐ Brookhaven National Laboratory

☐ Oak Ridge National Laboratory

☐ FERMI National Accelerator Center

☐ Pacific Northwest National Laboratory

☐ Idaho National Laboratory

☐ Princeton Plasma Physics Laboratory

☐ Savannah River Site

☐ SLAC National Accelerator Laboratory

☐ Lawrence Berkley National Laboratory

☐ Sandia National Laboratory

☐ Lawrence Livermore National Laboratory

☐ Thomas Jefferson National Accelerator Facility

Note: Applicants will need to ensure they refer to NOFO Part 1 to ensure all applicant requirements are met

I. Project Goals and Objectives

Provide a concise description of the motivation, technical merit, technical objectives and mission relevance. List the project goals in order of priority. It's best to take this directly from the proposal narrative.

II. Experiment Description

Note: If you need to insert a table, you may create it in another document, then copy and paste it into a paragraph field.

A. Test Matrix

Provide a listing of the materials to be tested, including:

material compositions number of samples geometry of test samples (with needed tolerances) Provide the source or supplier of materials that will be utilized to fabricate samples into the final desired geometry.

For previously irradiated fuels and materials not residing in the NSUF Nuclear Fuels and Materials Library, identify:

location (as specific as possible) condition provenance/pedigree radioactivity levels isotopic content material composition configuration ownership other information needed to ship and/or prepare the fuel or material for examination.

A test matrix sample table like this is helpful:

Notes:

For irradiation tests, experiment feasibility will be strongly influenced by whether a specific material is allowed in the proposed reactor and by the ability to handle the samples for post-irradiation examination.

Proprietary materials processing methods do not have to be identified, however, any materials tested in-reactor will need material certifications identifying all measurable elemental constituents.

If material composition certifications are not provided by the material supplier, then material samples will have to be sent to an independent testing lab for elemental composition analysis.

B. Testing Conditions & Capsule Design Concept

1. Indicate the desired testing conditions including:

flux and +/- % variation total fluence and +/- % variation neutron or beam energy spectrum include details on how this might be achieved (filtering, etc.)

temperature and +/- % variation irradiation environment (dry, water, PWR conditions, etc.)

C. PIE Plan

Provide a description of the post-irradiation examination activities needed to achieve the technical objectives. This plan may cover up to a period of three years.

Include all anticipated types of analysis and the number of samples that will need to be analyzed in each test Include facilities to be utilized for each test Provide a prioritized list of specific samples to be analyzed, as the workscope may be reduced if estimated PIE costs are excessive A PIE table like this is helpful:

Excess samples from the experiment that have not been analyzed will be placed into the Nuclear Fuels and Materials Library and made available for future researchers.

D. Data Needs

Describe all the data needed to meet the technical objectives. This should include:

E. Facilities Needed (If Applicable)

Identify all testing facilities that may be needed to conduct experiments in its entirety.

testing equipment that may be utilized at other institutions and paid for with other funds. (e.g. R&D funds, collaborating partner, university, etc.).

This information is needed to estimate total project costs incurred for sample shipments.

III. Project Management Plan

See separate template provided for project management plan, attached to the NOFO.

Appendices

Additional information may be added though appendices are not required.

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Grants.gov Lobbying Form

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Certification for Contracts, Grants, Loans, and Cooperative Agreements

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard

Form-LLL, ''Disclosure of Lobbying Activities,'' in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, ''Disclosure of Lobbying Activities,'' in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

* APPLICANT'S ORGANIZATION

* SIGNATURE:

* DATE:

* PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

Suffix:

Middle Name:

* Title:

* First Name:

* Last Name:

Prefix:

CERTIFICATION REGARDING LOBBYING

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of

Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

The undersigned certifies, to the best of his or her knowledge and belief, that:

Statement for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief, that:

OMB Number: 4040-0013

Expiration Date: 02/28/2025

Mandatory:

Applicant's Organization: Enter the legal name of the organization that will undertake the assistance activity. This should normally be the name under which the organization has registered with the Business Partner Network.:

Prefix: Select the prefix (e.g., Mr., Mrs., Rev.) for the name of the Authorized Representative.:

Suffix: Select the suffix (e.g., Jr, Sr, PhD) for the name of the Authorized Representative.:

First Name: Enter the first (given) name of the Authorized Representative who is signing this form.:

Middle Name: Enter the middle name of the Authorized Representative.:

Title: Enter the title of the Authorized Representative who is signing this form.:

Last Name: Enter the last (family) name of the Authorized Representative signing this form.:

Signature: It is the organization's responsibility to assure that only properly authorized individuals sign in this capacity and/or submit the application to Grants.gov. Enter the Signature of Authorized Representative.:

Date Signed: Enter the date the AOR signed the application.:

XDPFirstField:

LastField:

Project Title

[Replace “Project Title” with actual title of project; do not use all CAPS.]

PI: [PI Name & Institution]

Collaborators: Name – Organization [N/A if none]

Program:

NOFO ID: DE-FOA-

Notice of Funding Opportunity Title:

ABSTRACT:

[For Appendix C, provide a one-page maximum summary of the project, including background and objectives and replace text here.] image1.png

Project Management Plan

Sample Template

Title of the Project:

Topic Area:

Lead PI/Project Coordinator:

Collaborators:

*Note: Project Management Plan will need to address the criterion identified in NOFO Part 1, Technical Criteria on pg. 29.

Provide a summary-level description of the project, including but not limited to elements such as:

1. Technical Scope Summary (divided by budget periods).

2. Proposed Go/No-Go Decision Points for budget period.

3. Work Breakdown Structure (WBS).

4. Integrated Project Schedule (IPS) showing critical path for the entire project, and including task and subtask durations, milestones, Community Benefits Plan, and Go/No-Go decision.

5. Task Description Summary:

a. A concise description of the specific activities to be conducted over the life of the project (including project construction and operations) for each task/subtask. This should include identification of the anticipated Federal, state, and local codes, regulations, and permitting requirements applicable to siting, construction, and operation of the proposed project.

6. Buy America Buy America (BABA) Requirements for Infrastructure Projects:

a. The workplan must, include a short statement on whether the project will involve the construction, alteration, and/or repair of infrastructure in the United States. Build America, Buy America | Department of Energy for applicable definitions and other information to inform this statement.

7. Milestone Summary.

8. A summary of the End of Project Goal(s).

9. Process for making decisions on scientific/technical direction:

a. Discuss the process for deviations from the technical direction outlined in the scope and how final decisions regarding technical direction will be made.

10. Publications:

a. Discuss anticipated publications from the research, how publication decisions will be made, and who will be responsible for defining who participated in any given publication.

11. Intellectual Property Issues:

a. Discuss any intellectual property issues and how they will be resolved between different entities.

12. Communication Plans:

a. Discuss plans for communications and how groups will coordinate and collaborate on the project. Discuss communication strategies that will enable project success.

13. Procedures for resolving conflicts:

a. Describe the process for resolving competing hypotheses, differences of professional opinion, and other potential conflicts between team members.

14. PIs’ roles and administrative, technical, and scientific responsibilities for the project:

a. Describe each PI and collaborator’s role in the project including administrative, technical, and scientific responsibilities.

Budget 1 A-B

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium:

*Name of Organization:

*Start Date: *End Date: *Budget Period: 1

A. Senior/Key Person

Prefix *First Name Middle Name *Last Name Suffix *Project Role Base Salary $ Cal. Months Acad. Months Sum. Months *Requested Salary ($) *Fringe Benefits ($) *Funds Requested ($)

1. Principal Investigator $ - 0

2. Co-PI $ - 0

3. $ - 0

4. $ - 0

5. $ - 0 $ - 0 $ - 0 $ - 0

6. $ - 0 $ - 0 $ - 0 $ - 0

7. $ - 0 $ - 0 $ - 0 $ - 0

8. $ - 0 $ - 0 $ - 0 $ - 0

9. Total Funds requested for all Senior Key Persons in the attached file. $ - 0

Total Senior/Key Person $ - 0

Additional Senior Key Persons: Attachments: Yes No

B. Other Personnel

*Number of Personnel *Project Role Cal. Months Acad. Months Sum. Months *Requested Salary ($) *Fringe Benefits ($) *Funds Requested ($)

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

0 Total Number Other Personnel Total Other Personnel $ - 0

Total Salary, Wages and Fringe Benefits (A+B) $ - 0

* Required Field

RESEARCH and RELATED BUDGET - SECTION A-B, BUDGET PERIOD 1

RESEARCH and RELATED Budget {A-B} (Funds Requested) OMB Number 4040-001 Expiration Date: 06/30/2011

Budget 1 C-E

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium:

*Name of Organization:

*Start Date: *End Date: *Budget Period: 1

C. Equipment Description

List items and dollar amount for each item exceeding $5,000

Equipment Item *Funds Requested ($)

1. $ - 0

2. $ - 0

3. $ - 0

4. $ - 0

5. $ - 0

6. $ - 0

7. $ - 0

8. $ - 0

9. $ - 0

10. $ - 0

11. Total funds requested for all equipment listed in the attached file. $ - 0

Total Equipment $ - 0

Additional Equipment: Attachments: Yes No

D. Travel *Funds Requested ($)

1. Domestic Travel Costs (Incl. Canada, Mexico and U.S. Possessions)

2. Foreign Travel Costs

Total Travel Cost $ - 0

E. Participant/Trainee Support Costs *Funds Requested ($)

1. Tuition/Fees/Health Insurance $ - 0

2. Stipends $ - 0

3. Travel $ - 0

4. Subsistence $ - 0

5. Other $ - 0

Number of Participants/Trainees Total Participant/Trainee Support Costs $ - 0

Total C-E $ - 0

*Required Field

RESEARCH and RELATED BUDGET - SECTION C- E,BUDGET PERIOD 1

RESEARCH and RELATED Budget {C-E} (Funds Requested) OMB Number 4040-0001

Budget 1 F-K

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium:

*Name of Organization:

*Start Date: *End Date: *Budget Period: 1

F. Other Direct Costs *Funds Requested ($)

1. Materials and Supplies $ - 0

2. Publication Costs $ - 0

3. Consultant Services $ - 0

4. ADP/Computer Services $ - 0

5. Subawards/Consortium/Contractual Costs

6. Equipment or Facility Rental/User Fees $ - 0

7. Alterations and Renovations $ - 0

8. $ - 0

9. $ - 0

10. $ - 0

Total Other Direct Costs $ - 0

G. Direct Costs Funds Requested ($)

Total Direct Costs (A thru F) $ - 0

H. Indirect Costs

Indirect Cost Type *Indirect Cost Rate (%) *Indirect Cost Base ($) *Funds Requested ($)

1. 0.00% $ - 0 $ - 0

2. 0.00% $ - 0 $ - 0

3. 0.00% $ - 0 $ - 0

4. 0.00% $ - 0 $ - 0

Total Indirect Costs $ - 0

Cognizant Federal Agency

(Agency Name, POC Name, and POC Phone Number)

I. Total Direct and Indirect Costs Funds Requested ($)

Total Direct and Indirect Institutional Costs (G + H) $ - 0

J. Fee Funds Requested ($)

$ - 0

K. *Budget Justification (Only attach one file)

* Required Field

RESEARCH and RELATED BUDGET - SECTION F-K BUDGET PERIOD 1

RESEARCH and RELATED Budget {F-K} (Funds Requested) OMB Number 4040-0001

Budget 2 A-B

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium:

*Name of Organization:

*Start Date: *End Date: *Budget Period: 2

A. Senior/Key Person

Prefix *First Name Middle Name *Last Name Suffix *Project Role Base Salary $ Cal. Months Acad. Months Sum. Months *Requested Salary ($) *Fringe Benefits ($) *Funds Requested ($)

1. $ - 0 $ - 0 $ - 0

2. $ - 0 $ - 0 $ - 0

3. $ - 0 $ - 0 $ - 0

4. $ - 0 $ - 0 $ - 0

5. $ - 0 $ - 0 $ - 0 $ - 0

6. $ - 0 $ - 0 $ - 0 $ - 0

7. $ - 0 $ - 0 $ - 0 $ - 0

8. $ - 0 $ - 0 $ - 0 $ - 0

9. Total Funds requested for all Senior Key Persons in the attached file. $ - 0

Total Senior/Key Person $ - 0

Additional Senior Key Persons: Attachments: Yes No

B. Other Personnel

*Number of Personnel *Project Role Cal. Months Acad. Months Sum. Months *Requested Salary ($) *Fringe Benefits ($) *Funds Requested ($)

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0 $ - 0 $ - 0

$ - 0

$ - 0

$ - 0 $ - 0 $ - 0

0 Total Number Other Personnel Total Other Personnel $ - 0

Total Salary, Wages and Fringe Benefits (A+B) $ - 0

* Required Field

RESEARCH and RELATED BUDGET - SECTION A-B, BUDGET PERIOD 2

RESEARCH and RELATED Budget {A-B} (Funds Requested) OMB Number 4040-001

Budget 2 C-E

*ORGANIZATIONAL DUNS: 0

*Budget Type: Project: 0 Subaward/Consortium:

*Name of Organization: 0

*Start Date: 12/31/1899 *End Date: 12/31/1899 *Budget Period: 2

C. Equipment Description

List items and dollar amount for each item exceeding $5,000

Equipment Item *Funds Requested ($)

1. $ - 0

2. $ - 0

3. $ - 0

4. $ - 0

5. $ - 0

6. $ - 0

7. $ - 0

8. $ - 0

9. $ - 0

10. $ - 0

11. Total funds requested for all equipment listed in the attached file. $ - 0

Total Equipment $ - 0

Additional Equipment: Attachments: Yes No

D. Travel *Funds Requested ($)

1. Domestic Travel Costs (Incl. Canada, Mexico and U.S. Possessions)

2. Foreign Travel Costs $ - 0

Total Travel Cost $ - 0

E. Participant/Trainee Support Costs *Funds Requested ($)

1. Tuition/Fees/Health Insurance $ - 0

2. Stipends $ - 0

3. Travel $ - 0

4. Subsistence $ - 0

5. Other $ - 0

Number of Participants/Trainees Total Participant/Trainee Support Costs $ - 0

Total C-E $ - 0

*Required Field

RESEARCH and RELATED BUDGET - SECTION C-E BUDGET PERIOD 2

RESEARCH and RELATED Budget {C-E} (Funds Requested) OMB Number 4040-0001

Budget 2 F-K

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium:

*Name of Organization:

*Start Date: *End Date: *Budget Period: 2

F. Other Direct Costs *Funds Requested ($)

1. Materials and Supplies $ - 0

2. Publication Costs $ - 0

3. Consultant Services $ - 0

4. ADP/Computer Services $ - 0

5. Subawards/Consortium/Contractual Costs

6. Equipment or Facility Rental/User Fees $ - 0

7. Alterations and Renovations $ - 0

8.

9. $ - 0

10. $ - 0

Total Other Direct Costs $ - 0

G. Direct Costs Funds Requested ($)

Total Direct Costs (A thru F) $ - 0

H. Indirect Costs

Indirect Cost Type *Indirect Cost Rate (%) *Indirect Cost Base ($) *Funds Requested ($)

1. Modified Total Direct 0.00% $ - 0 $ - 0

2. 0.00% $ - 0 $ - 0

3. 0.00% $ - 0 $ - 0

4. 0.00% $ - 0 $ - 0

Total Indirect Costs $ - 0

Cognizant Federal Agency

(Agency Name, POC Name, and POC Phone Number)

I. Total Direct and Indirect Costs Funds Requested ($)

Total Direct and Indirect Institutional Costs (G + H) $ - 0

J. Fee Funds Requested ($)

$ - 0

K. *Budget Justification (Only attach one file)

* Required Field

RESEARCH and RELATED BUDGET - SECTION F-K BUDGET PERIOD 2

RESEARCH and RELATED Budget {F-K} (Funds Requested) OMB Number 4040-0001

Budget 3 A-B

*ORGANIZATIONAL DUNS:

*Budget Type: Project: Subaward/Consortium: