PI must submit Completed and Signed ICF to ORGS with each application for funding prior to Submission Deadline
Proposals that were submitted to external sponsors without first completing the Internal Clearance Form may be withdrawn or refused at the discretion of the AVP of Research
If not using FGCU's federaly approved indirect Cost Rate of 42% MTDC, select one of the other options.
If rate is sponsor designated/not allowed by sponsor, please upload RFP or other grant documentation confirming this. If Indirect is to be used as match, please upload email approval from AVP for Research (please note: emails must be uploaded as a PDF document).
This project involves:
International Information – if any boxes referring to international information are checked, the appropriate Export Control Form must be completed. See the Export Controls page on the Research and Sponsored Programs website. The information and rules apply to funded and nonfunded projects.
International Travel – If International Travel is checked, the PI and any other traveler must consult with the FGCU International Services Office on university policies and procedures supporting academic related international travel. International travel preparations will require advanced planning to ensure appropriate immigration, risk management and university support services are in place. The Travel Authorization Request (TAR) must be submitted at least 30-days prior to travel for international travel. PI is responsible for knowing and complying with all host country requirements and protocols for conducting research at destinations outside of the U.S.
Financial Conflict of Interest – All investigators have read and understand Financial Conflict of Interest in Sponsored Research and have made all required disclosures. Please complete the Financial Conflict of Interest Form.
The objective of this section below is to assign credit to the research areas listed below. The information provided identifies particular areas of investigation for data collection. Primary Investigators should be identified in the top row of the table below. Use whole percentages for all entries identifying the percent of responsibility of each person in the proposed areas. These percentages need not represent salary or time distributions. Add a section for each investigator as needed.
Make sure that the Project Grand Total equals 100%
I affirm that the Grand total for the Project Assignment of Credit is equal to 100%.
Pursuant to Federal regulations, the Principal Investigator certifies to the following statements:1. The information submitted within the application is true, complete, and accurate.2. Any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties.3. I agree to accept responsibility for the scientific conduct of the project and to provide the required progress and effort reports if a grant is awarded as a result of the application.
I certify that:a. I am not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transaction by any Federal department or agency.b. I have not, within a three-year period preceding the application, been convicted of, or had a civil judgment rendered against me for:i. Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public transaction or contract under a public transaction;ii. Violation of federal or state antitrust statutes; oriii. Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.c. I presently, have not been indicted or otherwise criminally or civilly charged by a government entity (federal, state, local) with commission of any of the offenses enumerated in (4) above or,d. I have not, within a three-year period preceding this application had one or more public transactions (federal, state, local) terminated for cause or default.e. I have read and understand the policies and regulations of conflict of interest, including institutional policy.f. I certify that the proposed research work will be performed in compliance with sponsor and institutional policies, procedures and requirements.
Complete the Financial Conflict of Interest Form. (https://www.fgcu.edu/academics/research/files/COI-disclosure-2019-03-fillable_ada.pdf)
* The Principal Investigator verifies that all investigators have read and understand FGCU’s Financial Conflict of Interest Policy 2.018.
The application identified above has been reviewed by the undersigned. The review included the overall budget request, allowability of direct cost charging, individual commitments of effort, rates of compensation, stipend levels, requests for equipment and justification presented, and allocation of adequate space and facilities. Approval is given for the proposed activities to be undertaken in this unit by the personnel identified in the proposal, and for any cost sharing as described in the budget plan.