NIST-1102 Letter of Intent NIST Construction Grant Program

OMB CONTROL NUMBER: 0693-0055 EXPIRATION DATE: 01/31/2013
U.S. DEPARTMENT OF COMMERCE
NATIONAL INSTITUTE OF STANDARDS AND
TECHNOLOGY

NIST-1102
DAO 203-26

LETTER OF INTENT
NIST CONSTRUCTION GRANT PROGRAM
1. Organization Name:

2. Organization Type:
Institution of Higher Education
Non-profit Science Research Organization (attach documentation supporting this type of
organization)
3. Project Title:

4. Estimated Project Costs – Indicate whole dollar amounts, not range, e.g., $12,000,000 not $10M $15M (estimates may change for full proposal):
$
$
$

Federal share
Non-Federal share
Total

5. Principal Investigator/scientist to use facility after facility is built/renovated:
First Name:
Position/Title:
Organization Name:

Last Name:

Middle Name:

CV Summary :

6. Identify Department of Commerce (DoC) organization(s) and the Program Priorities that the field(s)
of scientific research to be performed in facility will complement:
Organization
 NIST
 NOAA
 NTIA

DoC Program Priorities that the Field(s) of Scientific Research will Complement

7. Project Synopsis. Summarize the contributions, improvements, and impacts the project will have
on science and technology and associated infrastructure. Briefly describe building/facility to be built
or expanded.

8. Authorized Representative:
First Name:
Position/Title:
Mailing address:

Last Name:

Middle Name:

Telephone:
E-mail:
Signature: ___________________________________ Date: ___________________

Instructions for Form NIST-1102, Letter of Intent
NIST Construction Grant Program

1. Organization Name. Enter legal name of applicant that will undertake the assistance activity.

2. Organization Type. Place a check in the appropriate box. If “Non-profit Science Research Organization”
box is checked, you must attach a copy of the legal supporting documentation for this type of organization.

3. Project Title. Enter a brief descriptive title of the project.

4. Estimated Project Costs. Enter the Federal, non-Federal, and total costs for the entire project. Indicate
whole dollar amounts, not range, e.g., $12,000,000 not $10M - $15M (estimates may change for full
proposal).

5. Principal Investigator/scientist to use facility after facility is built/renovated. Self-explanatory.

6. Identify Department of Commerce (DoC) organization(s) and the Program Priorities that the field(s) of
scientific research to be performed in facility will complement. Self-explanatory.

7. Project Synopsis. Self-explanatory.

8. Authorized Representative. Enter the name and contact information for the person authorized to sign for
the applicant organization. The authorized representative must sign and date the form. A copy of the
governing body’s authorization for you to sign this form as the official representative must be on file in the
applicant’s office.