Draft RFA - Translating Research into Action | TRAction Project

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If there are COVERED PARTICIPANTS: USAID reserves the right to terminate assistance to, or take ortake other appropriate measures with respect to, any participant approved by USAID who is foundto have been convicted of a narcotics offense or to have been engaged in drug trafficking as definedin 22 CFR Part 140.PART II - OTHER STATEMENTS OF RECIPIENT1. AUTHORIZED INDIVIDUALSThe recipient represents that the following persons are authorized to negotiate on its behalf withthe Government and to bind the recipient in connection with this application or grant:Name Title Telephone No. Facsimile No.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. TAXPAYER IDENTIFICATION NUMBER (TIN)If the recipient is a U.S. organization, or a foreign organization which has income effectivelyconnected with the conduct of activities in the U.S. or has an office or a place of business or a fiscalpaying agent in the U.S., please indicate the recipient's TIN:TIN: ________________________________3. CONTRACTOR IDENTIFICATION NUMBER - DATA UNIVERSAL NUMBERING SYSTEM (DUNS)NUMBER(a) In the space provided at the end of this provision, the recipient should supply the Data UniversalNumbering System (DUNS) number applicable to that name and address. Recipients should takecare to report the number that identifies the recipient's name and address exactly as stated in theproposal.(b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If therecipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to therecipient. The recipient should be prepared to provide the following information:36
(1) Recipient's name.(2) Recipient's address.(3) Recipient's telephone number.(4) Line of business.(5) Chief executive officer/key manager.(6) Date the organization was started.(7) Number of people employed by the recipient.(8) Company affiliation.(c) Recipients located outside the United States may obtain the location and phone number of thelocal Dun and Bradstreet Information Services office from the Internet Home Page athttp://www.dbisna.com/dbis/customer/custlist.htm. If an offeror is unable to locate a local servicecenter, it may send an e-mail to Dun and Bradstreet at globalinfo@dbisma.com.The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system.DUNS: ________________________________________4. LETTER OF CREDIT (LOC) NUMBERIf the recipient has an existing Letter of Credit (LOC) with USAID, please indicate the LOC number:LOC: _________________________________________5. TYPE OF ORGANIZATIONThe recipient, by checking the applicable box, represents that -(a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of theState of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a stateor local governmental organization, [ ] a private college or university, [ ] a public college oruniversity, [ ] an international organization, or [ ] a joint venture; or(b) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of_____________________________ (country), [ ] an individual, [ ] a partnership, [ ] a37
Page 1 and 2: REQUEST FOR APPLICATIONSRFA SOLICIT
Page 3 and 4: 6.3 USAID Health Research Informati
Page 5 and 6: 1. TRANSLATING RESEARCH INTO ACTION
Page 7 and 8: implementation across sites and ove
Page 9: strategy that should be used to red
Page 12: capture). Community-based targeting
Page 16 and 17: delivered, satisfaction with servic
Page 18 and 19: amounts and formulas are correct an
Page 20 and 21: 3. (20 points) Potential for the ap
Page 22 and 23: and methods used to implement and m
Page 24 and 25: 6. URC may be required to report on
Page 26 and 27: APPENDIX A: FORMAT FOR ORGANIZATION
Page 28 and 29: APPENDIX C: BUDGET INSTRUCTIONS AND
Page 30 and 31: 1. AuthorityAPPENDIX D: LEGAL AUTHO
Page 32 and 33: APPENDIX F: CERTIFICATIONS AND REPR
Page 34 and 35: of any agency, a Member of Congress
Page 38: nongovernmental nonprofit organizat

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