Project Modification Request Form

You have indicated you would like to submit a Project Modification Request. Please review and complete all sections associated with your request to the best of your ability. If you have any questions or concerns please reach out to your Contracts & Grants Manager.

Name(Required)

First Last

Email(Required)

Phone

Please select your Contracts and Grants Manager(Required)

CJ Gosnell

Elizabeth Walker

Savanah Alberts

Project ID Requiring PMR(Required)

Project Modification Request Type(Required)

Please note that Equipment and Travel PMRs require both a Budget Modification PMR as well as the required Travel or Equipment PMR submissions to meet all college requirements. Please select all that apply to this transaction request:

Budget Modification Request

Change in Scope

Equipment Acquisition

No-Cost Extension

Travel PMR

Change in PI/Key Personnel

Budget Modification Request

You have indicated that you would like to enter a Budget Modification Request.

Will the Scope of the project change?(Required)

If yes, provide a detailed explanation of the change.(Required)

Please enter all Accounting Line Changes Below(Required)

Please review the attached List of Account Codes for entry. For multiple line items, please click + icon to include all requested line item changes. For changes to Equipment, Student Aid, or Subcontracts account for the change in Indirect Costs by using the Indirect Costs Calculator. Please be sure to indicate +$$$ for adding funds and -$$$ for removing funds in Amount Requested Column (total should add up to 0).

Account Code

Line Description

Amount Requested

Provide a detailed technical justification for EACH line item change above.(Required)

For each accounting line change requested above the College requires individual line item justifications.

Additional Approval Comments

File

Please upload any calculations, additional justifications, or any additional attachments below for this Budget Modification Request.

Drop files here or

Max. file size: 200 MB.

Equipment Acquisition Request

You have indicated that you would like to enter an Equipment Acquisition Request.

What is the project end date?(Required)

Is this purchase within 6 months of the project end date?(Required)

Under 6 months justification(Required)

Please explain why the purchase is being made this late in the project.

Technical Reason for Purchase(Required)

What is the technical reason why this equipment is needed, what is its purpose to the project research?

Scope(Required)

How does it relate to the original scope of the project?

Equipment Quotation(Required)

You must upload a DETAILED, CURRENT (within 30 days) quoted amount for the equipment. Quote must be signed by a representative from the Vendor/Company providing the quote.

Drop files here or

Max. file size: 200 MB.

Equipment % of usage across projects(Required)

Is requested equipment to be used 100% for the project?

% of Use Across Projects (Detail)(Required)

Estimate projected usage by percentage across specific projects – total must add up to 100%

Project ID

Percentage

% of Cost Across Projects(Required)

Is 100% of the cost being paid from this project or spread among Multiple Projects?

Multiple Project Cost Distribution(Required)

List all funding sources and cost distribution % – total must add up to 100%

Equipment Title Rights & Agency Approval(Required)

Does NCSU Retain the title to the equipment after purchase?

Agency Approval(Required)

Per your award, is agency approval needed?

Agency Approval Upload

Please upload a PDF of the project’s agency approval if received before PMR submission.

Drop files here or

Max. file size: 200 MB.

Was the equipment included in the Original Proposal?(Required)

Has the Equipment been purchase already?(Required)

Equipment Purchase Order #(Required)

Provide the PO# (or Requisition ID) associated with the Equipment purchase.

Please upload a copy of the PO/Requisition Request and Invoice(Required)

Drop files here or

Max. file size: 200 MB.

Additional Approval Comments

Please provide any additional comments you feel are important to the submission of the Equipment PMR.

No-Cost Extension (NCE)

You have indicated that you would like to enter a No-Cost Extension Request.

Is this the first No-Cost Extension request for this project?(Required)

What is the proposed end date?(Required)

Is there a deadline to request the extension?(Required)

Deadline Date(Required)

Is this request prior to the specified deadline?(Required)

Why was it not submitted within the specified time frame?(Required)

Provide a detailed and technical justification to support the NCE Reqeust(Required)

The justification for the request must include all of the following:

•Information regarding the current project end date to the expected new end date
•The amount of additional time requested
•The reason for the request:

‣You should explain the scientific need for the extension
‣The reason for the delay
‣What remains to be completed

Provide a detailed justification on how the remaining funding will be used.(Required)

Please provide a detailed justification explaining how the remaining funding in the project(s) will be used in relation to the scope of work and the research remaining to be completed.

Is Agency Approval needed?(Required)

Agency Approval

Please upload agency approval if already obtained.

Drop files here or

Max. file size: 200 MB.

Are there any Subaccounts or Segments that also need to be extended with this request?(Required)

Please provide the Subaccount/Segment Project ID(s)(Required)

Is a subcontract budgeted within the Project?(Required)

Provide the Subcontract Project ID(s)(Required)

Additional Approval Comments

Travel PMR

You have indicated that you would like to enter a Travel PMR.

Type of Travel(Required)

Is Agency Approval Required?(Required)

Agency Approval

Please upload a PDF of the agency approval if obtained.

Drop files here or

Max. file size: 200 MB.

Is the travel included and budgeted within the Award?(Required)

Has the travel already taken place?(Required)

Travel Authorization/Reimbursement Request Numbers(Required)

Please add the Travel Authorizations and Travel Reimbursement Numbers for ALL travelers. If the Travel Reimbursement has not been entered please indicate N/A.

Traveler Name

Traveler ID#

Travel Authorization #

Travel Reimbursement #

Planned Travelers(Required)

Please enter the Name, Employee ID, and dates of travel for ALL planned travelers.

Traveler Name

Traveler ID #

Arrival/Start Date

Return/End Date

Destination of Travel(Required)

How does the travel relate to the purpose of the Award?(Required)

Additional Approval Comments

Change in PI/Key Personnel

You have indicated that you would like to enter a Change in PI/Key Personnel Request.

New PI/Key Personnel(Required)

First Last

Effective Date of Change(Required)

Is the request for a change in PI or Key Personnel?(Required)

Provide a detailed explanation of why personnel is changing(Required)

Will the Scope of the project change?(Required)

What effect will the change have on the Project Scope?(Required)

Is Agency Approval Required?(Required)

Agency Approval

Please upload agency approval if obtained.

Drop files here or

Max. file size: 200 MB.

Statement of Work for New PI/Key Personnel(Required)

Drop files here or

Max. file size: 200 MB.

Biosketch of New PI/Key Personnel(Required)

Drop files here or

Max. file size: 200 MB.

Additional Approval Comments

Change in Scope

You have indicated that you would like to enter a Change in Scope Request or you selected the Scope would be impacted in previous PMR Request.

Will Principal Investigator effort change?(Required)

Describe any percentage change in Principal Investigator effort.(Required)

Provide a detailed explanation of the technical changes in scope.(Required)

Additional Approval Comments