HPOR Phase 1 Application_Final _10_12_21.docx

Department of Homeland Security SVIP Phase 1 Application Human Performance and Resiliency

***DELETE INSTRUCTIONS BEFORE APPLICATION SUBMISSION***

Department of Homeland Security Innovation OTS Application Instruction Sheet Human Performance and Resiliency General Instructions:

The International Organization for Standardization (ISO) uses specific verbal forms to convey clarity on what is a requirement and what is a recommendation or other type of statement. This Topic Call and application adopts and uses the following ISO document conventions:

· Requirements - SHALL, SHALL NOT

· Recommendations - SHOULD, SHOULD NOT

· Permission - MAY, MAY NOT

· Possibility and Capability - CAN, CANNOT

You may delete the instructions, but you may not rearrange or delete any of the numbered sections in the application itself. All sections of the application shall be completed including checking the appropriate check boxes in sections 2.5 (a-e), 2.9, 3.1 and 5.3, or your application will not be compliant.

Please review Human Performance and Resilience Topic Call document before submitting your application. The application shall not exceed 10 pages, including the architectural Intellectual Property diagram. The application shall not include a cover sheet. These instructions may be removed in the application submission.

There are two deadlines for this solicitation: January 13, 2022 at 12:00 PM/NOON PT (3:00 p.m. ET) to be considered in the first review round and the final deadline for submitting an application is April 13, 2022 at 12:00 PM/NOON PT (3:00 p.m. ET). To be considered for award, please complete this application, save it as a PDF, and send it via email to dhs-silicon-valley@hq.dhs.gov prior to the final closing date and time. Applications and application resubmissions received after the final closing date and time April 13, 2022 at 12:00 PM/NOON PT (3:00 p.m. ET) will not be considered for review, no exceptions.

In order to receive an award, you shall set up a user account and register your company in www.SAM.gov. This does not need to be done at the application phase but shall be done if the applicant is chosen to pitch.

DHS may decide to close the OTS Call early. If this action occurs, DHS will publish a notification on www.SAM.gov 30 days prior to closing the Call.

FOOTER: If applicable, insert appropriate marking to protect any proprietary or business sensitive information. Please keep the page number and Application template name/date as is.

SECTION 1- GENERAL INFORMATION

1.1 Date application was completed

1.2 Title: Include an application title

1.3 Provide a synopsis of the proposed project, describe what makes it potentially revolutionary, and must include answers to the following questions:

· What are you trying to do?

· How is it done today?

· What are the limitations to your solution?

· Who would benefit and what would the impact be if you are successful?

· How much would it cost, and how long would it take?

1.4 Please tell us how you heard about the program and/or this specific Call (e.g. tech accelerator, venture capitalist, startup, media, SAM.gov, etc.)

SECTION 2- COMPANY INFORMATION

2.1 This shall match your DUNS Number.

2.2 If you do not have a DUNS number, you shall not apply to this program until you receive a DUNS number. You may apply for a DUNS number at https://www.dnb.com/duns-number.html

2.3 Please provide Technical Contact information

2.4 Please provide Administrative Contact information

2.5 (a-e) You shall select one of the check boxes for each question to certify your company adheres to the eligibility requirements detailed in section 4 of the SVIP Other Transaction Solicitation SVIP OTS 70RSAT21R00000006. This certification applies to the company applying as well as any partner organization involved in this project that will be receiving funds as part of this award. If partner organizations are NOT receiving OTA funds, they do not need to comply with the eligibility requirement.

If you do not certify eligibility by checking the boxes, your application is noncompliant, and you are not eligible to apply to this program. Any questions regarding eligibility can be sent to the SVIP Team at dhs-silicon-valley@hq.dhs.gov. If additional space is necessary, you may delete the 2.5 (a-e) "REFERENCE” but the check boxes and certification sentences shall remain in your final submission.

2.6 Describe your company–

1. How old is the company?

2. Where is it located (e.g. multiple locations, sales/R&D in U.S. and other countries)?

3. Who is your target commercial market?

4. Why do you think you are a fit for the DHS market?

5. Describe if you have pursued (and received) any government, including state, local, federal, and international, contracts in the past?

2.7 Number of current employees for the company: This number shall only include employees and full-time equivalents (FTEs). Calculations for FTEs shall account for and include affiliated businesses—such as parent companies and subsidiaries—that are either in or outside of the USA.

2.8 Describe the management team and any organization(s) that will be partnering under this application:

1. What is their background and history (e.g. previous startups, successful exits, etc.)?

2. What are the qualifications and technical expertise of the key project personnel?

3. Please describe the relationship between any partner organizations that will be working/receiving funds on this effort including the breakdown in work between all parties. (also see 2.5 (b) REFERENCE below.

2.9 Investors:

· Has your company received outside investments? Check either yes or no

· If yes, please provide the following for each round of funding:

· Size of investment round

· Lead investors and major investors – including type of organization, POC, amount of investment, closing date

· Any and all non-U.S. investors of any investment size – including country of origin, type of organization, POC, amount of investment, closing date

2.10 Financial Health:

What is your annualized run-rate based on your current weekly/monthly revenue? What is your current monthly burn rate? What is your month-over-month revenue growth rate (USD)? How much revenue did you book in past 12 months? Are you cash flow positive?

2.11 Customers:

How many active customers or users do you currently have?

What actions have you taken to scale?

SECTION 3- Technical Information

3.1 Technology Description-

At least one Technical Topic Area (TTA) shall be selected. If the proposed technology addresses multiple TTAs, check the boxes for the applicable TTAs. Do not submit a separate application for each TTA, you shall address all applicable TTAs in one application.

The TTAs:

TTA 1: Biometric Wearables TTA 2: Sleep/Recovery Enhancement TTA 3: Artificial Intelligence-enabled Mobile Application

Please also address the following questions in 3.1:

1. How is your technology relevant to the Homeland Security problem outlined? You should demonstrate a good understanding of the technical challenges, present a credible (even if risky) plan to achieve the project’s goal, and it should result in a viable product.

2. What are you trying to do?

3. How will your technology work? Articulate your objectives technically and succinctly.

4. What is novel about your solution?

5. Why do you think your solution will succeed?

6. What are the technical challenges inherent in your solution and what is your plan to mitigate these risks?

7. How do you intend to measure progress and success?

8. What commercial market(s) are you already pursuing?

3.2 Innovation:

1. In what ways does your solution push the state-of-the-art?

2. What is novel about your solution as compared to others?

3. How does your solution compare or compete with those currently in the market?

3.3 Homeland Security Application:

1. How would you apply the DHS funding to adapt your product to the DHS use cases as outlined in the OTS Call?

3.4 Prototype Maturity:

1. Describe the maturity of the working prototype.

2. Describe the prototype that will be delivered at the conclusion of the phase to which this application pertains.

3.5 Work Statement (PHASE 1 ONLY):

This is a Phase 1 application. SVIP defines the objective of Phase 1 projects as the delivery of a Minimum Viable Product that demonstrates proof-of-concept and supporting documentation inclusive of verifiable test evidence, technical drawings, software demonstrations or other proof that the technical approach to address a DHS requirement or challenge as identified in this Call is sound. At the end of this Phase, successful applicants will have:

· Either created a proof of concept of a new technology suitable for demonstration or;

· Produced reviewable modifications to pre-existing technologies suitable for demonstration

· Documented a draft go-to-market commercialization plan/strategy

Provide a detailed description of the work you will perform specific to Phase 1.

1. Clearly identify tasks and subtasks and the corresponding milestones that will be carried out throughout the course of a 3 to 6-month investment period in order to get to a proof of concept demonstration stage.

2. Provide the schedule of performance. Please list all Deliverables you plan to submit to the Government in Section 4, Chart 1 that meet the Objectives defined by the Government for that phase. For purposes of the Other Transaction Agreement (OTA), a Milestone is defined as a developmental stage in the product development cycle which marks an achievement of one or more project Objective(s), whereas a Deliverable in this case is something actually delivered to the Government, be it technical data, reports, computer software, or other project-related items that allows the Government to evaluate your progress in meeting the Objective. For example, you may implement a software algorithm as a milestone towards meeting a Project Objective, but you may only submit a report of the functionality combined with a presentation and demo of the software working as a Deliverable to the Government.

3. Describe any dependency any of the specified tasks have of the Government, other than feedback, such as data. For Phase 1 proofs of concept, generally DHS does not expect to provide any data.

4. Provide as a deliverable a draft version of your commercialization plan for this technology that will be developed and/or adapted using the funding sought.

5. Monthly progress reports shall be included as deliverables

6. As part of your final deliverable, companies shall include an Overall Final Phase 1 Report in Word (.doc) format to SVIP.

3.5 (a) You shall include a Gantt-style chart, like the example in section 3.5 (a), to detail the breakdown of milestones. Note any dependencies as appropriate. Although DHS estimates that a Phase 1 effort may take up to 6 months to complete, if you require more than 6 months, please insert additional months into the Gantt chart. Total period of performance in months. Indicate the total number of months your phase 1 will take to complete.

3.6 Description of Overall Approach for All 4 Phases

Describe the overall vision for this project across all 4 Phases. What is the intended outcome and final Deliverable to the Government? How does it complement or match your existing commercial roadmap? What business model do you envision utilizing and notional product cost at scale? Provide as a deliverable a draft version of your commercialization plan for this technology that will be developed and/or adapted using the funding sought.

SECTION 4- COST INFORMATION

You shall provide a detailed breakout of how the money would be spent and how prices and rates were determined by completing the charts provided in section 4.

Milestones must match the payable milestones described in the work statement. Payment(s) will be issued upon delivery and Government acceptance of the associated milestone deliverable. Please take this into account when suggesting milestones in your final submission.

For purposes of the OTA, a Milestone is defined as a developmental stage in the product development cycle which marks an achievement of a project goal(s), whereas a Deliverable in this case is something actually delivered to the Government, be it technical data, reports, computer software, or other project-related items.

DHS will not require travel in phase 1 for this topic call but if you require travel to complete the work outlined in this application, please complete the travel chart. Please note that if your application is selected for a pitch, you will be asked to justify your travel. If travel is not required by your company, you may leave the travel chart at $0.

Per diem lodging rates can be found at: GSA Per Diem Rates. While vendors will not be able to claim government rates, travelers should attempt to make cost effective travel arrangements.

SECTION 5- INTELLECTUAL PROPERTY / RIGHTS OF ACCESS TO INFORMATION

Under this effort, companies shall retain ownership of the intellectual property rights to capabilities/technologies resulting from their proposed approach. It is the Government’s intent to obtain unlimited use rights to all reports delivered to the Government; and a limited use right to all applicable project data, materials, and/or technologies for the purpose of testing and evaluating the project, and any outputs, and capabilities. This does not grant the applicant the right to withhold delivery of Technical Data created or used in performance of the OTA upon request by the Government.

5.1 “Background Intellectual Property” is any intellectual property, proprietary information, trade secrets, or confidential know-how that is existing as of the date of execution of the Other Transaction Agreement and is intended to be used in performance of such Other Transaction Agreement.

5.2 Applicants expecting to use, but not to deliver, commercial open source tools or other materials in implementing their approach may be required to indemnify the U.S. Government against legal liability arising from such use when demonstrated on a Government owned or controlled network or environment.

5.3 Please indicate whether or not you are partnering with another company. If you are partnering with another company, please indicate if there are IP agreements in place. Please note that if there are IP agreements in place, you shall provide a copy of those to DHS if you are selected for award. If you are not partnering with another company, please check “no” for both questions in 5.3.

5.4 IP Architecture Diagram

As part of this application, you shall include an architectural diagram that differentiates any background IP (including both your proprietary IP and any third-party IP) you are bringing to the project from any IP developed under this project. The diagram should clearly lay out the IP for the elements of the solution proposed. The application, including the IP diagram, cannot exceed 10 pages. Note: The diagram provided in the application is an EXAMPLE.

***DELETE INSTRUCTIONS BEFORE APPLICATION SUBMISSION***

<<Insert appropriate marking to protect any proprietary or business sensitive information.>> HP&R Application Template – 10/2021

<<Insert appropriate marking to protect any proprietary or business sensitive information.>> HP&R Application Template – 10/2021

SECTION 1- GENERAL INFORMATION

1.1 Application Date: SECTION 2- COMPANY INFORMATION

Company Logo

2.5 Please certify the following eligibility requirements for the company listed in the application:

2.5 (a) (REFERENCE) In order to be eligible for SVIP, an applicant must be a nontraditional Government contractor. This means “…an entity that is not currently performing and has not performed, for at least the one-year period preceding the selection of sources” by the Government “…any contract or subcontract for the Department of Homeland Security that is subject to full coverage under the cost accounting standards pursuant to 41 U.S.C. 1502. We have also provided a link to 9903-201-2 for your convenience.

☐ I hereby certify that I have read the definitions provided under “41 U.S.C. 1502” and that the company listed on this application qualifies as a non-traditional Government contractor pursuant to “41 U.S.C. 1502“

2.5 (b) (REFERENCE) If multiple organizations jointly apply for a Phase 1, each organization must individually meet all of the eligibility requirements and must disclose in the application the nature of their business relationship, including the breakdown of work between all parties. The OTA will be awarded only to one organization.

☐ I hereby certify that all organizations proposed under this application meet all eligibility requirements and the nature of their business relationship(s) to the company applying in this phase 1 application is documented in section 2.8.

2.5 (c) (REFERENCE) In the event that an applicant establishes a business relationship with a traditional government contractor or academic institution, that business relationship shall remain outside the scope of the OT agreement. The SVIP’s OTAs will not be awarded to any company which does not meet the eligibility requirements as defined in 10 U.S.C. 2302(9).

☐ I hereby certify that if this application is selected for award, that any business relationship with a traditional government contractor or academic institution will remain outside the scope of the OTA.

2.5 (d) (REFERENCE) When applying for a Phase 1, applicants must not have been a party to any Federal Acquisition Regulation (FAR) based contracts (to include Small Business Innovation Research (SBIR)) and/or Federally awarded grants or cooperative agreements with a combined total of more than $1,000,000 in the past 12 months from date of application, whether as a prime contractor or subcontractor.

☐ I hereby certify that the company listed on this application has not been a party to any FAR based contracts, grants and/or cooperative agreements with a combined total of more than $1,000,000 in the past 12 months from the date of this application, whether as a prime contractor or subcontractor.

2.5 (e) (REFERENCE) When applying for Phase 1, applicants must have fewer than 200 employees or full-time equivalents (FTE)s. Calculations for FTEs must take into account and include affiliated businesses, such as parent companies and subsidiaries, that are either in or outside of the USA.

☐ I hereby certify that the company and all of its affiliated businesses, such as parent companies and subsidiaries, that are either in or outside of the USA has fewer than 200 employees and/or FTEs, total.

2.6 Company Description:

2.7 Number of current Employees for the company:

2.8 Management Team:

2.9 Investors: Please provide all of the details referenced in the instructions section and check the applicable box below.

Have you received outside investments? ☐ Yes ☐ No If yes, please provide the information listed in the instructions section 2.9

2.10 Financial Health:

2.11 Customers:

SECTION 3- TECHNICAL INFORMATION

3.1 Technology Description:

Which TTA/Use Case does this solution address: (Check all that apply)?

☐ TTA 1: Biometric Wearables ☐ TTA 2: Sleep/Recovery Enhancement ☐ TTA 3: Artificial Intelligence-enabled Mobile Application

3.2 Innovation:

3.3 Homeland Security Application

3.4 Prototype Maturity:

3.5 Work Statement (PHASE 1 ONLY):

3.5(a)- Sample Gantt-style chart Phase 1

(Example) Milestone 2 - Architectural Diagram

X

(Example) Milestone 3- Initial Technology Demonstration to DHS

X

3.6 Total Phase I Period of Performance in Months:

3.7 Description of Overall Approach for All 4 Phases:

SECTION 4- COST AND DELIVERABLE INFORMATION

Chart 1 - Cost Per Milestone

(Example)Milestone 1 - Equipment Purchase

(Example)Milestone 2 - Architectural Diagram

(Example) Milestone 3- Initial Demonstration

[REFERENCE] The total cost shall not exceed $200,000 and must reflect Phase 1 costs only. All numbers shall be rounded to the nearest dollar.

[REFERENCE] Payments are triggered by reasonable milestone achievement and completion of Deliverable(s). Deliverables are tangible items. If there is an advance/initial cost of materials, you shall make this a standalone milestone/deliverable.

CHART 2 -Labor Per Milestone Chart

Milestone 1

Milestone 2

TOTALS

CHART 3 -Materials, Hardware and Software Cost

CHART 4 -Travel Costs

*Misc includes tolls, airport parking, etc.

SECTION 5- INTELLECTUAL PROPERTY /RIGHTS OF ACCESS TO INFORMATION

5.1 What Background IP are you bringing to the project?

5.2 Include all proprietary claims to results, prototypes, deliverables, or systems supporting and/or necessary for the use of the research, results, prototypes, and/or deliverables.

Please note if there are IP agreements in place, you shall provide those to DHS if you are selected for award.

5.4 IP Architecture Diagram

Background IP

Project Funded IP image1.png