Sponsored Programs Subaward Agreement Request

Please complete this form to request a subcontract agreement be issued from BMC to your collaborator/subawardee. Please ensure that all the information entered is accurate. Incomplete and/or inaccurate information may lead to delays in processing your subcontract request.

Note: All attachments must be submitted in PDF file type format.

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Requestor Name

Requestor Email

Request type

Study Details:

BMC InfoEd Number

BMC Infor Project#

BMC PI Name

BMC PI Department

BMC Department/Financial Contact Name

BMC Department/Financial Contact Email

Project Sponsor

Project Title

Proposed Subcontract Site

Subcontract Site PI

Subcontract Site Contact Name

Subcontract Site Contact Email

Subcontract Site Central Awards/ Contracts Emailbox

Budget start date

Budget end date

Have we received the full subcontract proposal (LOI, SOW, Detailed budget etc)?

Submission Incomplete

This subcontract request is not ready for submission to the subawards team. The department must obtain necessary paperwork before proceeding.

Please confirm the following was received by SPA

 If any of the above items are not present in the InfoEd record, or if any information has changed since the time of proposal submission, a description of the changes, or revised documents need to be included as attachments of this request.

A Signed Letter of Intent saved in InfoEd record

A Statement / scope of work saved in InfoEd record

No changes to original budget proposed

Authorize automatic carryover of funds (for multi year awards and only if the sponsor allows)

Comments

The following documents must be attached to this request for subcontracts not originally included in the proposal application:

A Signed Letter of Intent

A statement/scope of work

A detailed budget

Authorize automatic carryover of funds (for multi year awards and only if the sponsor allows)

Add a new award year, indicate year of the award 2nd, 3rd, etc. (only include a statement of work if it has changed from the prior period)

Award year

From

New Funds Awarded with this action - Please do not include carryover funds (whole dollars only; omit cents or round up and match with any detailed budget attached):

If there are carryover funds, please explain:

Any changes in PI?

In submitting this request to issue an amendment to continue the work at the subsite with additional funding in the next budget period, the PI/DA certifies that the subsite remains compliant with the terms of the subaward agreement and that the PI/Department has received the required scientific/technical progress reports, timely invoices for project expenses incurred and other required deliverables as outlined in the terms of the original agreement during the most recent budget period completed.

Add additional funds to existing budget period (attach detailed budget)

Award year

From

New Funds Awarded with this action - Please do not include carryover funds (whole dollars only; omit cents or round up and match with any detailed budget attached):

Any changes in PI?

Comments:

No Cost Extension

Extend through

Any changes in PI?

In submitting this request to issue an amendment to continue the work at the subsite with or without additional funding during the no-cost extension period, the PI/DA certifies that the subsite remains compliant with the terms of the subaward agreement and that the PI/Department has received the required scientific/technical progress reports, timely invoices for project expenses incurred and other required deliverables as outlined in the terms of the original agreement during the most recent budget period completed.

No cost extension with new additional funds

Extend through

New funds awarded (attach a detailed budget, whole dollars only; omit cents or round up and match with any detailed budget attached)

Authorize carryover only (no new funds awarded)

Amount of carryover if known ($) (whole dollars only; omit cents or round up and match with any detailed budget attached)

Carryover periods?

From

Any changes in PI?

Change in PIs

Change in Prime PI

From

Effective Date:

Change in Sub PI

From

Effective Date:

Terminate a Subcontract Early

Effective Date

Reason for Termination

Deobligate Funds ($) (If known)

Training Grant

Training Program Grant Number:

TG Director:

Training Program Title:

Trainee/Appointee Information

Trainee Name:

Trainee Email:

Trainee Phone:

Trainee Site PI (if different from Training Mentor):

Trainee Institution:

Trainee Institution Address:

Trainee Status

Post - DocGraduate StudentUndergraduate Student

PGY Level (PGY0 - PGY7):

Prior TG Appointments (# of Years) (Maximum Post-Doc years - 3 years; Pre-doc/Undergraduate years - 5 years)

Current Appointment Start Date:

Current Appointment End Date:

TG Appointment Grant Year (See TG Notice of Award for Grant Year):

Trainee Project Title:

Stipend (Check NRSA level for TG grant Appt year):

Trainee Related Expenses:

Travel Funds:

Tuition/Fees:

Childcare Costs:

Total Funding for Appt. Period:

BMC Contacts

TG Program Director:

TG Program Director Email:

TG Program Director Phone:

Financial Contact:

Financial Contact Email:

Financial Contact Phone:

Admin Contact:

Admin Contact Email:

Admin Contact Phone:

Trainee Institution Contacts

Trainee Mentor Name:

Trainee Mentor Email:

Trainee Mentor Phone:

Trainee Financial Contact:

Trainee Financial Contact Email:

Trainee Financial Contact Phone:

Trainee Admin Contact:

Trainee Admin Contact Email:

Trainee Admin Contact Phone:

Please check the documents being attached:

Notice of Award for Training Grant Year of Appointment (Required)Completed Form PHS 2271 (Statement of Appointment for Trainee (Required)Completed Payback Agreement Form PHS 6031 (for first-time post doctoral appointees)

Attachments & Comments

Attachment #1

Allowed file type: pdf

Attachment #2

Allowed file type: pdf

Attachment #3

Allowed file type: pdf

Attachment #4

Allowed file type: pdf

Comments

Attestation:

I confirm that all the information provided in the preceding is accurate and that the required attachments are included in the subaward request form. I understand that I will not receive a draft copy of the agreement before it is sent for the execution and if any information provided changes before the agreement is released, it is my responsibility to contact SPA subawards team at subaward@bmc.org to provide the corrected/updated information.