PWSCIF Baseline Report

Public Wireless Supply Chain Innovation Fund Grant Program Reporting

PWSCIF BASELINE REPORT.xlsx

OMB: 0660-0053

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Overview

Baseline Report (T&E)
Baseline Report (R&D)

Sheet 1: Baseline Report (T&E)
















































































































































































OMB Control No. ####-#### Expiration Date: MM/DD/YYYY




















PUBLIC WIRELESS SUPPLY CHAIN INNOVATION FUND PROGRAM BASELINE REPORT




















GENERAL INFORMATION




















GENERAL Recipient Organization:
Report Period Start Date (MM/DD/YYYY):





















Recipient Street Address:
Report Period End Date (MM/DD/YYYY):





















City, State, Zip Code:
Period of Performance End Date (MM/DD/YYYY):





















UEI Number:
[Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: recommend adding a Funding amount section here as well Report Submission Date (MM/DD/YYYY):





















Period of Performance Start Date (MM/DD/YYYY):





















Award Identification Number:





















BASELINE EXPENDITURE PLAN
1 Please use the table provided to report your projected totals for each reporting period within each year of your project. You should begin projecting in the quarter that corresponds with your award date. The total for each quarter is based on the expenditure of your project budget and should be reported individually for that quarter.
BASELINE EXPENDITURE PLAN 2023 2024 2025 2026 2027 2028 TOTAL
Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 TOTAL EXPENDITURES
Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total
1a. Personnel
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1b. Fringe Benefits
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1c. Travel
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1d. Equipment
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1e. Supplies
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1f. Contractual
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1g. Construction
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1h. Other
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1i. Total Direct Charges (sum of 1a-1h)
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1j. Indirect Charges
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1k. TOTALS (sum of 1i and 1j)
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1l. Program Income
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WORK PLAN
2 2a. The plan should indicate what research will be done, where it will be done, and how the research will be carried out. The method(s) planned to achieve each objective or task should be discussed in detail. This shall also include steps to be taken to promote industry adoption of a successfully developed test method.










































MILESTONE PLAN
3 Each recipient shall provide a quarterly milestone plan of project activities. The duration of each milestone should align with recipient's approved project and occur within the period of performance as outlined in the recipient's award document.
MILESTONE PLAN 2023 2024 2025 2026 2027 2028
Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2
3a. T&E event(s)




















3b. T&E event(s) - Major Planning




















3c. T&E events - After Action




















3d. Additional Area (Optional)




















3e. Additional Area (Optional)




















3f. Additional Area (Optional)




















3g. Additional Area (Optional)




















3h. Any additional detail important to describe the work plan above.


PARTNERING AND COLLABORATION




















4 Please list all projected funded and unfunded collaborators in table below including consultants, collaborators and subrecipients.




















Consultants, Collaborators and Subrecipients




















Collaborator Organization Type Collaborator Organization Name Collaborator POC Name




























































































































































































FACILITIES AND EQUIPMENT




















5 Describe proposed facilities and equipment, including total capacity for testing events. Please provide an itemized list of any major equipment required to complete the work described.




















Facilities




















Proposed Facilities Total Capacity for Testing Events






























































































































































Equipment




















Proposed Equipment










































CERTIFICATION





















I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.




















Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension):



















































































Signature of Certifying Official: Email Address:









































Date:























































































Agency Disclosure Notice: This information collection is authorized by [OMB control #0660-XXXX]. Public reporting burden for this collection of information is estimated to average 20 hours [or 1,200 minutes] per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to U.S. Department of Commerce, (Carolyn Dunn, Grants Director, Innovation Fund, Office of International Affairs, National Telecommunications and Information Administration, U.S. Department of Commerce, 1401 Constitution Avenue, NW, Room 4701, Washington, DC 20230). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.




















Sheet 2: Baseline Report (R&D)
















































































































































































OMB Control No. ####-#### Expiration Date: MM/DD/YYYY




















PUBLIC WIRELESS SUPPLY CHAIN INNOVATION FUND PROGRAM BASELINE REPORT




















[Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: What about addind the funding amount in this section as well? N12 could be a great place? GENERAL INFORMATION




















GENERAL Recipient Organization:
Report Period Start Date (MM/DD/YYYY):





















Recipient Street Address:
Report Period End Date (MM/DD/YYYY):





















City, State, Zip Code:
Period of Performance End Date (MM/DD/YYYY):





















UEI Number:
Report Submission Date (MM/DD/YYYY):





















Period of Performance Start Date (MM/DD/YYYY):





















Award Identification Number:





















BASELINE EXPENDITURE PLAN
1 Please use the table provided to report your projected totals for each reporting period within each year of your project. You should begin projecting in the quarter that corresponds with your award date. The total for each quarter is based on the expenditure of your project budget and should be reported individually for that quarter.
BASELINE EXPENDITURE PLAN 2023 2024 2025 2026 2027 2028 TOTAL
Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Quarter 1 Quarter 2 TOTAL EXPENDITURES
Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total Projected Cumulative Total
1a. Personnel
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$-
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$- $-
1b. Fringe Benefits
$-
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$- $-
1c. Travel
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$- $-
1d. Equipment
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1e. Supplies
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1f. Contractual
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$- $-
1g. Construction
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1h. Other
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$- $-
1i. Total Direct Charges (sum of 1a-1h)
$-
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1j. Indirect Charges
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1k. TOTALS (sum of 1i and 1j)
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$- $-
1l. Program Income (if applicable)
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$- $-
WORK PLAN
2 2a. The plan should indicate what research will be done, where it will be done, and how the research will be carried out. The method(s) planned to achieve each objective or task should be discussed in detail. This shall also include steps to be taken to promote industry adoption of a successfully developed test method.










































PARTNERING AND COLLABORATION




















3 Please list all projected funded and unfunded collaborators in table below including consultants, collaborators, and subrecipients.




















Consultants, Collaborators, and Subrecipients




















Organization Type Organization Name POC Name




























































































































































































KEY INDIVIDUALS




















4 Identify key individuals directly involved in R&D, including related education, experience, and publications.




















Key Individuals




















Name of Key Individual Related Education and Experience Publications




























































































































































































CERTIFICATION





















I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.




















Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension):





















































































Signature of Certifying Official: Email Address:











































Date:

























































































Agency Disclosure Notice: This information collection is authorized by [OMB control #0660-XXXX]. Public reporting burden for this collection of information is estimated to average 20 hours [or 1,200 minutes] per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to U.S. Department of Commerce, (Carolyn Dunn, Grants Director, Innovation Fund, Office of International Affairs, National Telecommunications and Information Administration, U.S. Department of Commerce, 1401 Constitution Avenue, NW, Room 4701, Washington, DC 20230). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.




















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