2019-subrecipient-commitment-form-PI

The University of Vermont Complete this form when submitting a proposal to UVM.. Complete and accurate information facilitates quicker processing of a subaward.. Will Animals Res Ğarch S

The University of Vermont

Complete this form when submitting a proposal to UVM It provides a checklist of documents and certifications required by sponsors, as well as an area for the authorized institutional representative to sign Complete and accurate information facilitates quicker processing of a subaward 

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dŚĞĨŽůůŽǁŝŶŐĚŽĐƵŵĞŶƚƐĂƌĞŝŶĐůƵĚĞĚŝŶŽƵƌƐƵďĂǁĂƌĚƉƌŽƉŽƐĂůƐƵďŵŝƐƐŝŽŶĂŶĚĐŽǀĞƌĞĚďLJƚŚĞĐĞƌƚŝĨŝĐĂƚŝŽŶƐďĞůŽǁ͗

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1 Facilities and Administration Rates ŝŶĐůƵĚĞĚŝŶƚŚŝƐƉƌŽƉŽƐĂůŚĂǀĞďĞĞŶĐĂůĐƵůĂƚĞĚďĂƐĞĚŽŶ͗

KƵƌĨĞĚĞƌĂůůLJͲŶĞŐŽƚŝĂƚĞĚ&ΘƌĂƚĞƐĨŽƌƚŚŝƐƚLJƉĞŽĨǁŽƌŬ͕ŽƌĂƌĞĚƵĐĞĚ&ΘƌĂƚĞƚŚĂƚǁĞŚĞƌĞďLJĂŐƌĞĞƚŽĂĐĐĞƉƚ͘

Link to rate agreement:

KƚŚĞƌƌĂƚĞƐ(please specify the basis on which the rate has been calculated in Section C below͕Ğ͘Ő͕͘ĚĞŵŝŶŝŵŝƐϭϬйƌĂƚĞ) EŽƚĂƉƉůŝĐĂďůĞ(no indirect cost request or cost share for subrecipient) 

2 Fringe Benefit Rates ŝŶĐůƵĚĞĚŝŶƚŚŝƐƉƌŽƉŽƐĂůŚĂǀĞďĞĞŶĐĂůĐƵůĂƚĞĚďĂƐĞĚŽŶ͗

ZĂƚĞƐĐŽŶƐŝƐƚĞŶƚǁŝƚŚŽƌůŽǁĞƌƚŚĂŶŽƵƌĨĞĚĞƌĂůůLJͲŶĞŐŽƚŝĂƚĞĚƌĂƚĞƐ

Link to rate agreement:

KƚŚĞƌƌĂƚĞƐ(please specify the basis on which the rate has been calculated in Section C Comments below)

EŽƚĂƉƉůŝĐĂďůĞ(no fringe benefit request or cost share for subrecipient) 

3 Will Human Subjects be involved to complete the scope of work?

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SECTION B: CERTIFICATIONS

^WKE^KZWZK:dD/E/^dZd/KE

Subrecipient Commitment & Audit Certification Form

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4 Will Animals Res Ğarch Subjects be involved to complete the scope of work?

5 Will Recombinant DNA Materials be involved to complete the scope of work?

/" Financial Conflict of Interest in Research ;^ƵďƌĞĐŝƉŝĞŶƚKƌŐĂŶŝnjĂƚŝŽŶƐͬ/ŶƐƚŝƚƵƚŝŽŶƐŽŶůLJŶĞĞĚƚŽĐĞƌƚŝĨLJǁŚĞŶƚŚĞƉƌŝŵĞĂǁĂƌĚ ŝƐĨƌŽŵƚŚĞWƵďůŝĐ,ĞĂůƚŚ^ĞƌǀŝĐĞ΀W,^΁ŽƌŽƚŚĞƌƐƉŽŶƐŽƌĨŽůůŽǁŝŶŐW,^ƉŽůŝĐLJͿ͘

ZĞǀŝĞǁƉŽůŝĐLJĂƚŚƚƚƉ͗ͬͬŐƌĂŶƚƐ͘ŶŝŚ͘ŐŽǀͬŐƌĂŶƚƐͬƉŽůŝĐLJͬĐŽŝͬ

Ă͘ ^ƵďƌĞĐŝƉŝĞŶƚKƌŐĂŶŝnjĂƚŝŽŶͬ/ŶƐƚŝƚƵƚŝŽŶŚĞƌĞďLJĐĞƌƚŝĨŝĞƐƚŚĂƚŝƚŚĂƐĂŶĂĐƚŝǀĞĂŶĚĞŶĨŽƌĐĞĚĨŝŶĂŶĐŝĂůĐŽŶĨůŝĐƚŽĨŝŶƚĞƌĞƐƚŝŶƌĞƐĞĂƌĐŚ ƉŽůŝĐLJƚŚĂƚĐŽŵƉůŝĞƐǁŝƚŚƚŚĞƉƌŽǀŝƐŝŽŶŽĨϰϮ&ZWĂƌƚϱϬ͕^ƵďƉĂƌƚ&͞ZĞƐƉŽŶƐŝďŝůŝƚLJŽĨƉƉůŝĐĂŶƚƐĨŽƌWƌŽŵŽƚŝŶŐKďũĞĐƚŝǀŝƚLJŝŶ

ZĞƐĞĂƌĐŚ͟;ƚŚĞΗW,^ZĞŐƵůĂƚŝŽŶƐΗͿ͘^ƵďƌĞĐŝƉŝĞŶƚĂůƐŽĐĞƌƚŝĨŝĞƐƚŚĂƚ͕ƚŽƚŚĞďĞƐƚŽĨ/ŶƐƚŝƚƵƚŝŽŶΖƐŬŶŽǁůĞĚŐĞ͕;ϭͿĂůůĨŝŶĂŶĐŝĂůĚŝƐĐůŽƐƵƌĞƐ ŚĂǀĞďĞĞŶŵĂĚĞƌĞůĂƚĞĚƚŽƚŚĞĂĐƚŝǀŝƚŝĞƐƚŚĂƚŵĂLJďĞĨƵŶĚĞĚďLJŽƌƚŚƌŽƵŐŚĂƌĞƐƵůƚŝŶŐĂŐƌĞĞŵĞŶƚ͕ĂŶĚƌĞƋƵŝƌĞĚďLJŝƚƐĐŽŶĨůŝĐƚŽĨ ŝŶƚĞƌĞƐƚƉŽůŝĐLJ͖ĂŶĚ͕;ϮͿĂůůŝĚĞŶƚŝĨŝĞĚĐŽŶĨůŝĐƚƐŽĨŝŶƚĞƌĞƐƚŚĂǀĞŽƌǁŝůůŚĂǀĞďĞĞŶƐĂƚŝƐĨĂĐƚŽƌŝůLJŵĂŶĂŐĞĚ͕ƌĞĚƵĐĞĚŽƌĞůŝŵŝŶĂƚĞĚŝŶ

ĂĐĐŽƌĚĂŶĐĞǁŝƚŚƐƵďƌĞĐŝƉŝĞŶƚΖƐĐŽŶĨůŝĐƚŽĨŝŶƚĞƌĞƐƚƉŽůŝĐLJƉƌŝŽƌƚŽƚŚĞĞdžƉĞŶĚŝƚƵƌĞŽĨĂŶLJĨƵŶĚƐƵŶĚĞƌĂŶLJƌĞƐƵůƚĂŶƚĂŐƌĞĞŵĞŶƚ͘

ď͘ ^ƵďƌĞĐŝƉŝĞŶƚKƌŐĂŶŝnjĂƚŝŽŶͬ/ŶƐƚŝƚƵƚŝŽŶǁŝůůĂĚŽƉƚĂŶĚĞŶĨŽƌĐĞĂĨŝŶĂŶĐŝĂůĐŽŶĨůŝĐƚŽĨŝŶƚĞƌĞƐƚƉŽůŝĐLJƐŽĂƐƚŽďĞĐŽŵĞĐŽŵƉůŝĂŶƚǁŝƚŚĂůů ƚŚĞƚĞƌŵƐƉĂƌĂŐƌĂƉŚĂ͘ŽĨƚŚŝƐƐĞĐƚŝŽŶŶŽůĂƚĞƌƚŚĂŶĂƚƚŝŵĞŽĨĂǁĂƌĚŽĨƚŚĞƌĞƐĞĂƌĐŚƉƌŽũĞĐƚƚŽhsD͘ƐĂŵƉůĞŵŽĚĞůŽĨĂĐŽŵƉůŝĂŶƚ ƉŽůŝĐLJŵĂLJďĞĨŽƵŶĚŽŶƚŚĞ&ĞĚĞƌĂůĞŵŽŶƐƚƌĂƚŝŽŶWĂƌƚŶĞƌƐŚŝƉ&K/tĞďƐŝƚĞ͘ƚƚŝŵĞŽĨƉƌŽƉŽƐĂů͕^ƵďƌĞĐŝƉŝĞŶƚKƌŐĂŶŝnjĂƚŝŽŶͬ

/ŶƐƚŝƚƵƚŝŽŶĂůƐŽĐĞƌƚŝĨŝĞƐƚŚĂƚ͕ƚŽƚŚĞďĞƐƚŽĨŝƚƐŬŶŽǁůĞĚŐĞ͕ĂůůĨŝŶĂŶĐŝĂůĚŝƐĐůŽƐƵƌĞƐƌĞůĂƚĞĚƚŽƚŚĞĂĐƚŝǀŝƚŝĞƐƚŚĂƚŵĂLJďĞĨƵŶĚĞĚďLJŽƌ ƚŚƌŽƵŐŚĂƌĞƐƵůƚŝŶŐĂŐƌĞĞŵĞŶƚ͕ĂƐƌĞƋƵŝƌĞĚƵŶĚĞƌƚŚĞW,^ƌĞŐƵůĂƚŝŽŶƐ͕ŚĂǀĞďĞĞŶŵĂĚĞƚŽhsD͘

EͬʹƉƌŽƉŽƐĂůŽƌƌĞƋƵĞƐƚĞĚĨƵŶĚƐĂƌĞŶŽƚƵŶĚĞƌĂW,^ĂǁĂƌĚ

(" Certification Regarding Debarment and Suspension /ƐƚŚĞĞŶƚŝƚLJ͕W/ŽƌĂŶLJŽƚŚĞƌĞŵƉůŽLJĞĞŽƌƐƚƵĚĞŶƚƉĂƌƚŝĐŝƉĂƚŝŶŐŝŶƚŚŝƐ ƉƌŽũĞĐƚĚĞďĂƌƌĞĚ͕ƐƵƐƉĞŶĚĞĚŽƌŽƚŚĞƌǁŝƐĞĞdžĐůƵĚĞĚĨƌŽŵŽƌŝŶĞůŝŐŝďůĞĨŽƌƉĂƌƚŝĐŝƉĂƚŝŽŶŝŶĨĞĚĞƌĂůĚĞƉĂƌƚŵĞŶƚ͕ĂŐĞŶĐLJ͕ĂƐƐŝƐƚĂŶĐĞ ƉƌŽŐƌĂŵƐŽƌĂĐƚŝǀŝƚŝĞƐ͍ zĞƐ EŽ(If “yes”, explain in Section C, Comments, below.)

Subawards to any entity or individual included in the Federal excluded Parties are prohibited͘

0" Registration /ƐƚŚĞƐƵďƌĞĐŝƉŝĞŶƚĐƵƌƌĞŶƚůLJƌĞŐŝƐƚĞƌĞĚŝŶ^D͍

6" Audit ŝĚƚŚĞƐƵďƌĞĐŝƉŝĞŶƚƌĞĐĞŝǀĞĂŶĂŶŶƵĂůƐŝŶŐůĞĂƵĚŝƚƉĞƌĂƉƉůŝĐĂďůĞĨĞĚĞƌĂů

/ĨƚŚĞƐƵďƌĞĐŝƉŝĞŶƚƵŶĚĞƌǁĞŶƚƚŚĞƐŝŶŐůĞĂƵĚŝƚ͕ŝŶĚŝĐĂƚĞƚŚĞĨŝƐĐĂůLJĞĂƌĂŶĚƉƌŽǀŝĚĞůŝŶŬŽƌĂƚƚĂĐŚĐƵƌƌĞŶƚƌĞƉŽƌƚ͘

&ŝƐĐĂůzĞĂƌ͗   >ŝŶŬ͗

tĞƌĞƚŚĞƌĞĂŶLJĨŝŶĚŝŶŐƐŝŶƚŚĞŵŽƐƚƌĞĐĞŶƚƐŝŶŐůĞĂƵĚŝƚƌĞůĂƚĞĚƚŽhsDŝƐƐƵĞĚƐƵďĂǁĂƌĚƐƚŽLJŽƵƌŝŶƐƚŝƚƵƚŝŽŶ͍zĞƐ EŽ



/ĨƚŚĞƐƵďƌĞĐŝƉŝĞŶƚĚŝĚŶŽƚƵŶĚĞƌŐŽĂƐŝŶŐůĞĂƵĚŝƚ͕ƉƌŽǀŝĚĞĞdžƉůĂŶĂƚŝŽŶǁŚLJƚŚĞƐŝŶŐůĞĂƵĚŝƚǁĂƐŶŽƚƉĞƌĨŽƌŵĞĚ;Ğ͘Ő͘ďĞůŽǁƚŚƌĞƐŚŽůĚ͕

ĨŽƌͲƉƌŽĨŝƚĐŽŵƉĂŶLJ͕ĞƚĐ͘ͿĂŶĚĂƚƚĂĐŚƚŚĞŵŽƐƚƌĞĐĞŶƚůLJĐŽŵƉůĞƚĞĚĨŝƐĐĂůLJĞĂƌĂƵĚŝƚƌĞƉŽƌƚŝŶĐůƵĚŝŶŐŝŶĚĞƉĞŶĚĞŶƚĂƵĚŝƚŽƌ͛ƐůĞƚƚĞƌ͕

ŵĂŶĂŐĞŵĞŶƚƐĐŽƌƌĞĐƚŝǀĞĂĐƚŝŽŶŽŶĂŶLJĨŝŶĚŝŶŐƐĂŶĚĂŶƐǁĞƌƚŚĞĨŝŶĂŶĐŝĂůƐƚĂƚƵƐƋƵĞƐƚŝŽŶƐ͘

ƚŚĞĨŽůůŽǁŝŶŐ͗(Attach additional pages as needed.)

ĨŝŶĂŶĐŝĂůŵĂŶĂŐĞŵĞŶƚƐLJƐƚĞŵƚŚĂƚƉƌŽǀŝĚĞƐƌĞĐŽƌĚƐƚŚĂƚĐĂŶŝĚĞŶƚŝĨLJƚŚĞƐŽƵƌĐĞĂŶĚĂƉƉůŝĐĂƚŝŽŶŽĨĨƵŶĚƐĨŽƌĂǁĂƌĚƐƵƉƉŽƌƚĞĚ ĂĐƚŝǀŝƚŝĞƐŝŶĐůƵĚŝŶŐĐŽƐƚͲƐŚĂƌŝŶŐ;ŝĨĂƉƉůŝĐĂďůĞͿ

ŽŶƚƌŽůƐƚŽƉƌĞǀĞŶƚĞdžƉĞŶĚŝƚƵƌĞƐŝŶĞdžĐĞƐƐŽĨĂƉƉƌŽǀĞĚďƵĚŐĞƚĂŵŽƵŶƚƐ

WƵƌĐŚĂƐŝŶŐͬWƌŽĐƵƌĞŵĞŶƚƉŽůŝĐLJĐƌĞĂƚŝŶŐƐƚĂŶĚĂƌĚƐŝŶƚŚĞƉƌŽĐƵƌĞŵĞŶƚŽĨƐƵƉƉůŝĞƐĂŶĚŽƚŚĞƌĞdžƉĂŶĚĂďůĞƉƌŽƉĞƌƚLJ͕ĞƋƵŝƉŵĞŶƚ͕ƌĞĂů ƉƌŽƉĞƌƚLJĂŶĚŽƚŚĞƌƐĞƌǀŝĐĞƐǁŝƚŚĨĞĚĞƌĂůĨƵŶĚƐ

ŶŝŶǀĞŶƚŽƌLJŝŶŐƐLJƐƚĞŵĨŽƌĞƋƵŝƉŵĞŶƚŝŶĐůƵĚŝŶŐĚĂƚĂĨŽƌĨĞĚĞƌĂůŐŽǀĞƌŶŵĞŶƚƉƌŽƉĞƌƚLJƚŚĂƚŝĚĞŶƚŝĨŝĞƐƉƵƌĐŚĂƐĞĚĂƚĞ͕ĐŽƐƚ͕ǀĞŶĚŽƌ͕ ĚĞƐĐƌŝƉƚŝŽŶ͕ƐĞƌŝĂůŶƵŵďĞƌ͕ůŽĐĂƚŝŽŶƐĂŶĚƵůƚŝŵĂƚĞĚŝƐƉŽƐŝƚŝŽŶ

ZĞĐŽƌĚƌĞƚĞŶƚŝŽŶĨŽƌĂƉĞƌŝŽĚŽĨƚŚƌĞĞLJĞĂƌƐĨŽůůŽǁŝŶŐƚŚĞƐƵďŵŝƐƐŝŽŶŽĨƚŚĞĨŝŶĂůĨŝŶĂŶĐŝĂůĂŶĚƉƌŽŐƌĂŵŵĂƚŝĐƌĞƉŽƌƚƐƚŽƚŚĞWƌŝŵĞ ZĞĐŝƉŝĞŶƚ

tŚĂƚŝŶƚĞƌŶĂůĐŽŶƚƌŽůƐĚŽĞƐLJŽƵƌŝŶƐƚŝƚƵƚŝŽŶŚĂǀĞƚŽĞŶƐƵƌĞƚŚĂƚĂůůhsDƐƵďͲĂǁĂƌĚƌĞůĂƚĞĚĞdžƉĞŶƐĞƐĂƌĞĂůůŽǁĂďůĞǁŝƚŚŝŶƚŚĞŽƐƚ WƌŝŶĐŝƉůĞƐ ŽĨ ĂƉƉůŝĐĂďůĞ &ĞĚĞƌĂů ŐƵŝĚĞůŝŶĞƐ͍  dŚŝƐ ŝŶĐůƵĚĞƐ ďƵƚ ŝƐ ŶŽƚ ůŝŵŝƚĞĚ ƚŽ ĞĨĨŽƌƚ ƌĞƉŽƌƚŝŶŐ ĂŶĚ ƚŝŵĞ ŵĂŶĂŐĞŵĞŶƚ ĂŶĚ

ĂƉƉƌŽƉƌŝĂƚĞƚƌĂǀĞůƉŽůŝĐŝĞƐĂŶĚƉƌŽĐĞĚƵƌĞƐ͘

^d/KE ͗ KDDEd^

APPROVED FOR SUBRECIPIENT: dŚĞŝŶĨŽƌŵĂƚŝŽŶ͕ĐĞƌƚŝĨŝĐĂƚŝŽŶƐĂŶĚƌĞƉƌĞƐĞŶƚĂƚŝŽŶƐĂďŽǀĞŚĂǀĞďĞĞŶƌĞĂĚ͕ƐŝŐŶĞĚĂŶĚŵĂĚĞ

ďLJĂŶĂƵƚŚŽƌŝnjĞĚŽĨĨŝĐŝĂůŽĨƚŚĞƐƵďƌĞĐŝƉŝĞŶƚŶĂŵĞĚŚĞƌĞŝŶ͘dŚĞĂƉƉƌŽƉƌŝĂƚĞƉƌŽŐƌĂŵŵĂƚŝĐĂŶĚĂĚŵŝŶŝƐƚƌĂƚŝǀĞƉĞƌƐŽŶŶĞůŝŶǀŽůǀĞĚŝŶ ƚŚŝƐĂƉƉůŝĐĂƚŝŽŶĂƌĞĂǁĂƌĞŽĨĂŐĞŶĐLJƉŽůŝĐLJŝŶƌĞŐĂƌĚƚŽƐƵďĂǁĂƌĚƐĂŶĚĂƌĞƉƌĞƉĂƌĞĚƚŽĞƐƚĂďůŝƐŚƚŚĞŶĞĐĞƐƐĂƌLJŝŶƚĞƌͲŝŶƐƚŝƚƵƚŝŽŶĂů ĂŐƌĞĞŵĞŶƚƐĐŽŶƐŝƐƚĞŶƚǁŝƚŚƚŚŽƐĞƉŽůŝĐŝĞƐƐŚŽƵůĚĂŶĂǁĂƌĚďĞŵĂĚĞ͘

ŶLJǁŽƌŬďĞŐƵŶĂŶĚͬŽƌĞdžƉĞŶƐĞƐŝŶĐƵƌƌĞĚƉƌŝŽƌƚŽĞdžĞĐƵƚŝŽŶŽĨĂƐƵďĂǁĂƌĚĂŐƌĞĞŵĞŶƚĂƌĞĂƚƚŚĞƐƵďƌĞĐŝƉŝĞŶƚΖƐŽǁŶƌŝƐŬ͘

ŵĂŝů͗

This section is only to be completed to update information previously provided on the commitment form

11 Audit: ,ĂƐĂŶLJŽĨƚŚĞŝŶĨŽƌŵĂƚŝŽŶƉƌŽǀŝĚĞĚŝŶŝƚĞŵϵ;ĂďŽǀĞͿĐŚĂŶŐĞĚƐŝŶĐĞƚŚĞŝŶŝƚŝĂůĐĞƌƚŝĨŝĐĂƚŝŽŶ͍zĞƐ EŽ

12 Additional Changes ŽƌĐŽŵŵĞŶƚƐƐŝŶĐĞƚŚĞŝŶŝƚŝĂůĐĞƌƚŝĨŝĐĂƚŝŽŶ

^d/KE ͗ hd,KZ/ ^/'EdhZ

^d/KE ͗ Zs/^/KE^