REPORTING: Funded Projects Pilot; Developing Standardized Forms

Pilot to Develop Standardized Reporting Forms for Federally Funded Public Health Projects and Agreements

LFFM ORS Capability Inquiry Template.xlsx

REPORTING: Funded Projects Pilot; Developing Standardized Forms

OMB: 0910-0909

Document [xlsx]
Download: xlsx | pdf

Overview

Coversheet
Capability Inquiry


Sheet 1: Coversheet




















Recipent Name (Select)
Select

State
Select Recipient Name





Federal Award Identification Number
Select Recipient Name





Report Frequency







Date Completed

























Project Period Start Date







Project End Date







Budget Period Start Date







Budget Period End Date

























Principal Investigator (PI)


PI Email


PI Phone








Sheet 2: Capability Inquiry


























Date:










Matrices:










Analyte(s):










Methods:










Comments:











Lab Name Are you able to analyze any or all the matrices listed using the method(s) cited? Please list what matrices you could test. Has your lab analyzed these matrices using these methods in the past? Which methods do you use? Please list all methods available. Are the methods validated for the matrices? Please list matrix, method and validation status. Do you have trained staff proficient for this analysis? Are any or all of methods on your scope of accreditation? Please list which methods are on your accreditation scope. Are you willing to pivot current approved sampling plan to this activity? How many samples can you do in a week? (Estimate only) How many samples would you be willing test in total? (Estimate only)? Are you able to arrange collection of these samples in your state? Please Provide Any Additional Information To Explain Your Labs Capabilities
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