Research Corporation of the University of Hawaiʻi

EXHIBIT A
Task Order No. _____
RCUH Project No. ________

PROJECT TASK ORDER FORM

__________________________________________ (Client)/
THE RESEARCH CORPORATION OF THE UNIVERSITY OF HAWAII (RCUH)

In accordance with the terms and conditions of the Master Agreement between Client and RCUH, Client hereby requests that RCUH establish a direct project account and provide administrative services for the following:

Project Title: __________________________________________________________________
Principal Investigator: ____________________________________________________________
Email: ________________________________________ Phone: __________________________
Project Period: _________________________________________________________________
Amount of Task Order: ___________________________________________________________

Brief description of project: ______________________________________________________________________________
______________________________________________________________________________

Project scope of work and deliverables:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Source of funding. Please list the agency/sponsor and attach a copy of sponsored agreement, if applicable.
Agency/Sponsor Amount

Federal agency _________________________________ $_________________
State agency _________________________________ $_________________
Other _________________________________ $_________________
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Rev July 2020

Does your project have cost share or matching requirements? Yes ___ No ___. If yes, please provide details:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Will this project involve any of the following? Check all that apply and explain:
___Construction ________________________________________________
___Exporting of Tech Equip/Data ________________________________________________
___Firearms ________________________________________________
___Foreign Operations ________________________________________________
___Hazardous Materials ________________________________________________
___Helicopter/Aircrafts ________________________________________________
___HIPAA (Protected Health Info) ________________________________________________
___Human Subjects ________________________________________________
___Live Animals ________________________________________________
___Marine/Diving Activities ________________________________________________
___Subcontracts ________________________________________________

Budget:

Salaries ________________*
Fringe ________________
Supplies ________________
Travel ________________
Equipment ________________
Other ________________
__________ ________________
__________ ________________
__________ ________________
__________ ________________
__________ ________________

Total Direct Costs ________________

RCUH Indirect Costs (___ %) ________________ Indirect costs rate is subject to change with a 60-day notice from RCUH
Total ________________
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*Personnel requirements/brief job description:
Position Description
_____________________ ________________________________________________
_____________________ ________________________________________________
_____________________ ________________________________________________
_____________________ ________________________________________________
_____________________ ________________________________________________

Does this project have existing employees? Yes ___ No ___. If yes, is the intent for them to become RCUH employees? Yes ___ No ___.

Note: RCUH reserves the right to evaluate incumbent employees and determine appropriateness of conversion to RCUH.

Is there intellectual property associated with your project(s)? Yes ___ No ___. If yes, who is the owner of the intellectual property?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

An advance of $_____________ (equivalent to 2 months of estimated expenditures) will be provided to RCUH upon execution of this task order and receipt of the RCUH invoice. Payment of each subsequent monthly invoice is due within 30 days of receipt of invoice.

Email RCUH invoices to:

Name: ____________________________________
Email address: ______________________________
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_____________________________________________________

Requested by: _____________________________
Name: _____________________________
Title: _____________________________
Date: _____________________________

Reviewed and approved by: _____________________________
Name: _____________________________
Its: Financial Officer
Date: _____________________________

_____________________________
Name: _____________________________
Its: President/Executive Director
Date: _____________________________

Research Corporation of the University of Hawaii

Accepted by: _____________________________
Name: Leonard R. Gouveia, Jr.
Its: Executive Director
Date: _____________________________
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