Health Program Research Project (HPRP) RFP Response Schedule OR P

Transcription

1 Health Program Research Project (HPRP) RFP Response Schedule OR P Our Ref: FF14/031 : DD14/ RESPONDENT IDENTIFICATION DETAILS RESPONDENT Legal Entity Name Trading Name ABN ACN Registered Office Address Other Address Postal Address Tender Enquiry Contact Name Tender Enquiry Contact Phone Tender Enquiry Contact - Chief Executive Officer Name Company - Website HPCA MCNSW HPRP Proposal Response Schedule Page 1 of 5

2 2 RESEARCH EXPERIENCE AND TRACK RECORD Please complete the following table and attach the required supporting documents: Experience and Track Record factor Response Names of researcher(s), research assistant(s) or other persons that would be involved in the project. Please attach a 2 page CV for each person, with a paragraph detailing expertise relevant to this tender. Where a researcher, research assistant or other person is proposed but not yet engaged, please supply a job description in lieu of a CV and advice about the expected role and time commitment of each person. Journal articles published since 1 January 2010 Peer reviewed funding since 1 January list granting agency, role on grant, grant title, sum awarded and any outcomes from the grant List of other current research commitments Contact details for two referees for the project manager / coordinator. These referees should be familiar with research conducted, project completion and report preparation by the manager / coordinator. HPCA MCNSW HPRP Proposal Response Schedule Page 2 of 5

3 3 POTENTIAL CONFLICT OF INTEREST OR BIAS Please advise of any potential conflict of interest or bias (or the possible perception of conflict of interest or bias) in respect of the tenderer or other persons who will be involved in the project. 4 CONFIDENTIALITY Please advise the measures that will be employed to ensure that all information involved in the conduct of the project is collected, maintained and destroyed in a secure and confidential manner. HPCA MCNSW HPRP Proposal Response Schedule Page 3 of 5

4 5 COMPLIANCE WITH STATEMENT OF REQUIREMENTS For each requirement in the table below, detail how you would comply with the requirement and the timeframe expected for each requirement. A desired payment schedule has been suggested. Please alter the payment schedule if an alternative is proposed. Requirements of the project must be completed in the order below. Please attach a separate document indicating how the proposed project intends to deliver on each of the eight requirements listed below, including expected broad timeframes. 1 2 Requirement: Completion of detailed statement of the research objectives research proposal approved by Council Proposed payment schedule (including Aims, Hypotheses if relevant, Approach, Statistical analysis Outcomes and Feasibility, Draft timeline, References, Draft budget and evidence of research track record and expertise) 15% Completion of Project implementation plan approved by Council (including timeline, implementation milestones, completion dates and detailed budget with justification) 15% 3 Ethics approval Execution research according to the timeline and implementation milestones with 6 month report to council demonstrating satisfactory progress towards milestones 25% Completion of research according to the timeline and implementation milestones with 12 month report to council demonstrating satisfactory progress towards milestones Submission of draft research paper(s) to the Council for review pre submission 7 Submission of Final Project Report to Council with recommendations 25% 8 Submission of revised research paper with councils emendations for publication to an approved peer-reviewed journal 20% HPCA MCNSW HPRP Proposal Response Schedule Page 4 of 5

5 6 BUDGET Provide the total price to deliver the scope of services as set out in the Statement of Requirements section of the Tendering Conditions and Statement of Requirements document in the following table: Price Project delivery price excl GST GST (if applicable) incl GST Provide a breakdown of the project delivery price: Applicants should provide details for each significant item of expenditure, justifying each such item and the basis on which they have been calculated. Appropriate salary scales for staff should be provided, with the applicant stating the basis for the salary scale chosen. If it is anticipated that any administrative or research support is required from Council staff, this should be detailed, including skill set and hours required and the estimated cost. The total cost of the project should not exceed $100,000. HPCA MCNSW HPRP Proposal Response Schedule Page 5 of 5