INDIRECT COST SUBMISSION CHECKLIST

**Company Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Fiscal Year(s)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

Please check the Yes, No or N/A columns below to answer the questions
or, where applicable, to indicate that the requested supporting
documentation has been included in your submission. Explain responses in
further detail by attaching as many pages as necessary. Please list
related attachments under the Comments/Attachment column and reference
each attached sheet to the related checklist number.

+---+------------------------------+---+---+----+---------------------+
|   |                              | * | * | *  | **Co                |
|   |                              | * | * | *N | mments/Attachment** |
|   |                              | Y | N | /A |                     |
|   |                              | e | o | ** |                     |
|   |                              | s | * |    |                     |
|   |                              | * | * |    |                     |
|   |                              | * |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Provide copies of Financial  |   |   |    |                     |
|   | Statements (audited          |   |   |    |                     |
|   | statements preferred) for    |   |   |    |                     |
|   | your most recently completed |   |   |    |                     |
|   | fiscal year. Please          |   |   |    |                     |
|   | reconcile and                |   |   |    |                     |
|   | cross-reference amounts      |   |   |    |                     |
|   | shown on your indirect cost  |   |   |    |                     |
|   | proposal(s) to those on the  |   |   |    |                     |
|   | income statement(s) if       |   |   |    |                     |
|   | applicable.                  |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 2 | Provide a copy of the        |   |   |    |                     |
| \ | Company's Personnel Manual.  |   |   |    |                     |
| . |                              |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 3 | Pension and /or Profit       |   |   |    |                     |
| \ | Sharing                      |   |   |    |                     |
| . |                              |   |   |    |                     |
|   | (a) Are Pension and/or       |   |   |    |                     |
|   |     Profit Sharing costs     |   |   |    |                     |
|   |     included in the          |   |   |    |                     |
|   |     proposal?                |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If so, have              |   |   |    |                     |
|   |     contributions been made  |   |   |    |                     |
|   |     to the Pension and/or    |   |   |    |                     |
|   |     Profit Sharing plans?    |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (c) Please include a         |   |   |    |                     |
|   |     schedule indicating when |   |   |    |                     |
|   |     contributions were made  |   |   |    |                     |
|   |     (amounts and dates)?     |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (d) Provide a copy or        |   |   |    |                     |
|   |     synopsis of the plan.    |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 4 | Paid Absences (vacation,     |   |   |    |                     |
| \ | holiday and sick leave )     |   |   |    |                     |
| . |                              |   |   |    |                     |
|   | (a) Provide an explanation   |   |   |    |                     |
|   |     of how the company       |   |   |    |                     |
|   |     accounts for paid        |   |   |    |                     |
|   |     absences.                |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) Are they charged to the  |   |   |    |                     |
|   |     fringe benefit pool      |   |   |    |                     |
|   |     (indirect cost pool if   |   |   |    |                     |
|   |     not a separate fringe    |   |   |    |                     |
|   |     rate)?                   |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (c) Or are they charged as   |   |   |    |                     |
|   |     part of salaries and     |   |   |    |                     |
|   |     wages?                   |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (d) Provide a copy of the    |   |   |    |                     |
|   |     Company's leave policy.  |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 5 | Bonuses                      |   |   |    |                     |
| \ |                              |   |   |    |                     |
| . | (a) Have the costs of        |   |   |    |                     |
|   |     bonuses been included in |   |   |    |                     |
|   |     the indirect cost        |   |   |    |                     |
|   |     proposal?                |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If yes, are bonuses paid |   |   |    |                     |
|   |     pursuant to a formal     |   |   |    |                     |
|   |     agreement?               |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (c) Provide a copy of the    |   |   |    |                     |
|   |     agreement.               |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (d) Provide a schedule of    |   |   |    |                     |
|   |     bonuses, which includes  |   |   |    |                     |
|   |     name, title, annual      |   |   |    |                     |
|   |     salary and bonus amount  |   |   |    |                     |
|   |     for each employee        |   |   |    |                     |
|   |     receiving a bonus.       |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+

+---+------------------------------+---+---+----+---------------------+
|   |                              | * | * | *  | **Co                |
|   |                              | * | * | *N | mments/Attachment** |
|   |                              | Y | N | /A |                     |
|   |                              | e | o | ** |                     |
|   |                              | s | * |    |                     |
|   |                              | * | * |    |                     |
|   |                              | * |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 6 | Leases With Related Parties  |   |   |    |                     |
| \ |                              |   |   |    |                     |
| . | (a) Does the Company lease   |   |   |    |                     |
|   |     from a related party     |   |   |    |                     |
|   |     (e.g., owner,            |   |   |    |                     |
|   |     stockholder or an        |   |   |    |                     |
|   |     affiliate)?              |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If yes, explain the      |   |   |    |                     |
|   |     relationship and provide |   |   |    |                     |
|   |     cost of ownership as     |   |   |    |                     |
|   |     detailed in FAR          |   |   |    |                     |
|   |     31.205-36(b)(3).         |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 7 | Off-Site Locations           |   |   |    |                     |
| \ |                              |   |   |    |                     |
| . | (a) Are contracts/grants     |   |   |    |                     |
|   |     performed at customer    |   |   |    |                     |
|   |     owned off-site           |   |   |    |                     |
|   |     locations?               |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If yes, are separate     |   |   |    |                     |
|   |     off-site indirect        |   |   |    |                     |
|   |     expense pools applicable |   |   |    |                     |
|   |     to the off-site location |   |   |    |                     |
|   |     maintained?              |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 8 | Professional Fees            |   |   |    |                     |
| \ |                              |   |   |    |                     |
| . | (a) Have professional fees   |   |   |    |                     |
|   |     (e.g., legal and         |   |   |    |                     |
|   |     accounting), consultants |   |   |    |                     |
|   |     and/or Outside Services  |   |   |    |                     |
|   |     been included in the     |   |   |    |                     |
|   |     indirect cost pool?      |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If yes, provide a        |   |   |    |                     |
|   |     detailed schedule of     |   |   |    |                     |
|   |     these costs with the     |   |   |    |                     |
|   |     following information:   |   |   |    |                     |
|   |                              |   |   |    |                     |
|   | ```{=html}                   |   |   |    |                     |
|   | <!-- -->                     |   |   |    |                     |
|   | ```                          |   |   |    |                     |
|   | 1)  Firm or individual       |   |   |    |                     |
|   |     providing the service,   |   |   |    |                     |
|   |                              |   |   |    |                     |
|   | 2)  Cost of the service, and |   |   |    |                     |
|   |                              |   |   |    |                     |
|   | 3)  Description of the       |   |   |    |                     |
|   |     service.                 |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 9 | Independent Research         |   |   |    |                     |
| \ | (self-sponsored) Research &  |   |   |    |                     |
| . | Development (IR&D)           |   |   |    |                     |
|   |                              |   |   |    |                     |
|   | (a) Does the Company have    |   |   |    |                     |
|   |     IR&D Costs?              |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (b) If yes, have IR&D costs  |   |   |    |                     |
|   |     been treated in          |   |   |    |                     |
|   |     accordance with DHHS     |   |   |    |                     |
|   |     policy (i.e., excluded   |   |   |    |                     |
|   |     from the indirect cost   |   |   |    |                     |
|   |     pool and included in the |   |   |    |                     |
|   |     base)?                   |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
|   | (c) Identify the costs for   |   |   |    |                     |
|   |     the individual elements  |   |   |    |                     |
|   |     of IR&D (e.g., labor,    |   |   |    |                     |
|   |     materials, and other     |   |   |    |                     |
|   |     direct costs).           |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Please complete the attached |   |   |    |                     |
| 0 | Accounting System/Internal   |   |   |    |                     |
| \ | Control Questionnaire.       |   |   |    |                     |
| . |                              |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Does the Company show        |   |   |    |                     |
| 1 | miscellaneous income as a    |   |   |    |                     |
| \ | reduction to expenses (e.g., |   |   |    |                     |
| . | rental income)? If so,       |   |   |    |                     |
|   | please detail.               |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Provide a listing of the     |   |   |    |                     |
| 2 | categories of cost you       |   |   |    |                     |
| \ | normally classify and claim  |   |   |    |                     |
| . | as direct on contracts,      |   |   |    |                     |
|   | grants and other projects.   |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Provide a schedule of the    |   |   |    |                     |
| 3 | amount(s) of Federal         |   |   |    |                     |
| \ | cost-reimbursement type      |   |   |    |                     |
| . | project costs included in    |   |   |    |                     |
|   | the indirect cost base(s)    |   |   |    |                     |
|   | for each fiscal year covered |   |   |    |                     |
|   | by your IDC submission.      |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | Provide a completed          |   |   |    |                     |
| 4 | Executive Compensation       |   |   |    |                     |
| \ | Schedule (see attached       |   |   |    |                     |
| . | form).                       |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+

+---+------------------------------+---+---+----+---------------------+
|   |                              | * | * | *  | **Co                |
|   |                              | * | * | *N | mments/Attachment** |
|   |                              | Y | N | /A |                     |
|   |                              | e | o | ** |                     |
|   |                              | s | * |    |                     |
|   |                              | * | * |    |                     |
|   |                              | * |   |    |                     |
+---+------------------------------+---+---+----+---------------------+
| 1 | If your ICD Submission       |   |   |    |                     |
| 5 | covers final indirect cost   |   |   |    |                     |
| \ | rates, provide a completed   |   |   |    |                     |
| . | Certificate of Indirect      |   |   |    |                     |
|   | Costs (see attached). Be     |   |   |    |                     |
|   | sure to complete paragraph   |   |   |    |                     |
|   | #1 of the certificate---the  |   |   |    |                     |
|   | blanks relate to your IDC    |   |   |    |                     |
|   | submission not grant         |   |   |    |                     |
|   | applications or contract     |   |   |    |                     |
|   | proposals.                   |   |   |    |                     |
|   |                              |   |   |    |                     |
|   | Please note that the         |   |   |    |                     |
|   | certifying official must be  |   |   |    |                     |
|   | at a level no lower than a   |   |   |    |                     |
|   | vice president or chief      |   |   |    |                     |
|   | financial officer of the     |   |   |    |                     |
|   | business segment that is     |   |   |    |                     |
|   | submitting the proposal.     |   |   |    |                     |
+---+------------------------------+---+---+----+---------------------+

**Official Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**