Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 970 - WOMEN'S HEALTH CODE › Subpart C - TICKET FOR THE CURE › Section 970.330 - Application Procedures for Research Concerning Breast Cancer

Current through Register Vol. 48, No. 28, July 12, 2024
The Department will provide written application instructions
				  and forms to potential applicants upon request. Information concerning the
				  grant will be available on the Department's website,
http://www.idph.state.il.us/fundop.htm
a) All applications shall include the
				following:
1) The principal investigator's
				name, address, and telephone and FAX and teletypewriter (TTY) numbers, if
				available;
2) The name, address,
				and telephone and FAX and TTY numbers, if available, of the entity (such as a
				university) through which the application is being submitted, if different from
				the information provided in subsection (a)(1) of this Section;
3) The curriculum vitae of the principal
				investigator;
4) A one-page
				non-technical abstract, which describes the significance of the applicant's
				project for breast cancer research;
5) The TIN;
6) The signature of the principal
				investigator or agency official authorized to certify the
				application;
7) An approximate
				timetable for project completion;
8) A detailed budget for the funding period,
				documenting sufficient resources to carry out the project. The budget shall be
				by line item category and shall provide sufficient detail to justify the use of
				grant funds to support project activities. The applicant shall indicate the
				total cost of conducting the projects, the anticipated funding request for
				years two and three of the project (if applicable), the source of other funds
				supporting the projects, and the amount of support requested from the
				Department;
9) A signed Statement
				of Assurances indicating compliance with applicable State and federal
				requirements, such as the Fiscal Control and Internal Auditing Act, Office of
				Management and Budget (OMB) Circular A-128 (local governments), OMB Circular
				A-133 (not-for-profit organizations), bribery certification, contract
				debarment, unlawful discrimination, Illinois Human Rights Act, The Civil Rights
				Act of 1964, The Drug-Free Workplace Act of 1988, The Davis-Bacon Act of 1931,
				conflict of interest as specified in the Illinois Procurement Code [30 ILCS 500
				], and protection of the confidentiality of services;
10) A statement of whether funds are being
				requested for a fellowship or a general award;
11) A statement of the research question or
				hypothesis, or a description of interventions or model programs on which the
				research will be based;
12) A
				prioritized listing of measurable objectives for the funding period;
13) For each objective proposed for the first
				year of the project, a sequential listing of activities to achieve the
				objective, the time line for completing each activity, identification of the
				individual responsible for coordinating the implementation of each objective;
				and
14) The evaluation methods to
				be used to measure progress in achieving objectives and a plan for monitoring
				the overall project.