Template 2- Requesting Supplemental Funds.pdf
PDF 211 KB Posted
- Attached to
- DOD-2023-APEX-ACCELERATOR-SUPPLEMENTAL-FUNDING
- Opportunity number
- DOD-2023-APEX-ACCELERATOR-SUPPLEMENTAL
- Issued by
-
Department of Defense
About this file
This document template requests supplemental federal grant funds from the Department of Defense APEX Accelerator Program. It collects applicant information and requires a narrative detailing specific costs proposed and benefits to the program, as well as risk levels in fund execution. It includes a spend plan with award values, expenses to date, and estimated final costs for federal and non-federal shares. Required attachments provide cost matching certification, third party commitment letters, fringe rate bases, indirect cost rates, distressed area analyses, program execution plans, personnel positions, program manager resumes, subaward budgets, single audit compliance, and budget breakdowns including additional personnel and budget details. The associated federal grant opportunity is for DOD-2023-APEX-ACCELERATOR-SUPPLEMENTAL-FUNDING assigned under the Procurement Technical Assistance For Business Firms federal grant program.
Template 2- Requesting Supplemental Funds
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Template 1- Return Funds.pdf | ||
| APEX Accelerator Notice of Supplemental Funding Opportunity_10 August.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Statement of Interest Requesting Supplemental Funds
Applicant Name
Applicant Unique Entity Identifier
Applicant Address
Applicant Point of Contact
By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S.
Code, Title 18, Section 1001).
** I Agree
Authorized Representative Name Title Signature
1. Provide amount of supplemental funds that are being requested, by cost element.
Non- Distressed Distressed Personnel
Fringe Benefits Travel
Equipment Supplies
Contractual Other
Indirect Costs Total
2. Input a narrative detailing the specific costs that are proposed along with the benefit to the APEX Accelerator program.
3. Input a narrative detailing the level of risk you will have in the execution of the requested funds.
4. Provide a spend plan detailing the new obligation total and showing estimate to complete.
Award Value Expensed to date
Estimate to Complete
Estimated Final Cost
Federal Non-Federal Share
| Attachment 1- Certification of Cost Matching Funds APEX Program |
| Attachment 2- Third Party Letter of Commitment APEX Accelerator Program |
| Attachment 3- Fringe Rate Basis |
| Attachment 4- Indirect Costs |
| Attachment 5- Distressed Area Analysis |
| Attachment 6- Determination of Statewide Coverage |
| Attachment 7- Program Execution Plan |
| Attachment 8- Personnel Positions |
| Attachment 9- Program Manager Resume |
| Attachment 10- Subaward SF 424a Budgets |
| Attachment 11- Single Aduit Act |
| Attachment 12- Budget Breakdown |
| Attachment 13- Personnel Costs |
| Attachment 14- Program Goals |
| Appendix 1-Additional detail for Attachment 12, Budget: |
| Applicant Name: |
| Applicant Unique Entity Identifier: |
| Applicant Address: |
| Applicant Point of Contact: |
| Authorized Representative: |
| Name: |
| Title: |
| Signature: |
| NonDistressedPersonnel: |
| DistressedPersonnel: |
| NonDistressedFringe Benefits: |
| DistressedFringe Benefits: |
| NonDistressedTravel: |
| DistressedTravel: |
| NonDistressedEquipment: |
| DistressedEquipment: |
| NonDistressedSupplies: |
| DistressedSupplies: |
| NonDistressedContractual: |
| DistressedContractual: |
| NonDistressedOther: |
| DistressedOther: |
| NonDistressedIndirect Costs: |
| DistressedIndirect Costs: |
| NonDistressedTotal: |
| DistressedTotal: |
| Award ValueFederal: |
| Expensed to dateFederal: |
| Estimate to CompleteFederal: |
| Estimated Final CostFederal: |
| Award ValueNonFederal Share: |
| Expensed to dateNonFederal Share: |
| Estimate to CompleteNonFederal Share: |
| Estimated Final CostNonFederal Share: |
| Text4: |
| Text6: |
File details come from the government source that posted it. Updated .