Question 2: If you answered "Other" in the question above please give the name of your research institution.

Transcription

1 AI POC Application: GMS Test Application Id: Applicant: Contact: Phone: Application Status: Review tes: Applicant Information University of Colorado - Boulder University of Colorado - Anschutz University of Colorado - Denver University of Colorado - Colorado Springs Colorado State University Colorado School of Mines University of rthern Colorado University of Denver National Jewish Health Bonfils Blood Center Other (including Federal Labs) APP GMS Test GMS Test Draft Question 1: Name of Research Institution Submitting an Advanced Industry (AI) Proof of Concept (POC) Application. (If this is a joint application among two or more institutional partners provide the primary or lead institution here) Question 2: If you answered "Other" in the question above please give the name of your research institution. Question 3: Name of Technology Transfer Office (If this is a joint application among two or more institutional partners provide the primary or lead institution's TTO name here). (GMS Test) Page 1 of 10

2 Question 4: Is this grant application part of your institution's minimum annual allocation? Only the following institutions are eligible to select "" for this question: CU (all campuses), CSU, National Jewish Health, Colorado School of Mines and DU. Question 5: Type of Research Institution (If this is a joint application among two or more institutional partners select the primary or lead institution's type in this question.) Public or private nonprofit institution of higher education nprofit teaching hospital Federal laboratory Private technology and research center Private, nonprofit medical and research center Question 6: If this is a joint application of two or more institutional partners, list additional institution(s) & their TTO name(s). When two or more institutions apply jointly the $150,000 award cap can be removed if either of the two questions below is satisfied. Question 7: If this is a joint application of more than one research institution (and you are applying for more than $150,000 in grant funds), will the applicants have joint ownership of any intellectual property that results from this project? Question 8: If this is a joint application of more than one research institution (& it is for more than $150K) list each applicant institution & the dollar amount of the grant that will go to each applicant institution. Two institutions must receive at least 25%. Question 9: Name of primary contact for application. Question 10: Office phone of primary contact for application. Question 11: Cell phone of primary contact for application. Question 12: of primary contact for application. (GMS Test) Page 2 of 10

3 Question 13: Address for primary contact for application. Question 14: Please upload a scanned PDF of" the Application Certification TTO" document available on the advanced industries web site and attach it to this question. Attachments Project Summary & Grant Amount Question 15: Project Title. Question 16: Describe the project using five words that are most relevant to its objective. Question 17: Which advanced industries (AIs) are impacted by this proof of concept (POC) project? You can select more than one AI. If you select two or more AIs, the $150,000 POC award cap can be removed if the project's technology impacts across two or more AIs. Advanced Manufacturing Aerospace Bio-science Electronics Energy and Natural Resources (Including Clean Technology) Information Technology Infrastructure Engineering Question 18: If you selected Energy, Natural Resources (including Clean Technology), does this project specifically address Clean Technology? Question 19: If two or more AIs were selected & you intend to apply for more than $150K in POC grants please explain with examples how the project's technology directly impacts each AI and explain how this grant will specifically advance commercialization in each AI? Question 20: If two or more AIs were selected (& one was advanced manufacturing, electronics or IT) & you intend to apply for more than $150K in POC grants, explain how the project directly impacts scalability, process improvements or market adoption in the other AI. (GMS Test) Page 3 of 10

4 Question 21: Did you already receive a previous POC grant from the Bioscience Discovery Grant Evaluation Program (BDGEP) or AI program AND is this this application a Transition Request to move to a later Phase/Milestone in the POC process? Question 22: List other Advanced Industry/ BDEGP grants received for this technology by grant number (xxbgf-xx)., project name and grant amount. te if you answered "yes" to the question above, you were previously awarded an AI grant and you must list it here. Question 23: If this is a Transition Application what was the amount of your previous BDGEP or AI POC grant? You can not receive more than $150,000 in POC funds for working on a single technology. Question 24: If this is a Transition Application, provide a summary of findings from the previous Phase or Milestone, a description of how the Milestones were achieved, and summarize the final report from the earlier grant. Question 25: If this is a Transition Application, explain the status of any related IP generated during the previous Phase of POC research including licenses and licensees. Question 26: If this is a Transition Application, upload the final report from the Phase I project. Attachments Question 27: Please select EACH of the Milestones the project has already finished as of this grant application. ALL Phase I Milestones must be complete before receiving a Phase II grant. If you have not completed all Phase I Milestones, apply for a Phase I grant. Phase I: Proof of Principle (evaluate technology's commercial potential) Phase I: Intellectual Property Protection (pay for IP filings) Phase I: Prototypes and technical validation (create & test working prototype) Phase II: Market Assessment (feasibility analysis, commercialization, business plan) Phase II: Start-Up (company formation, legal costs, investor strategy, marketing, website) Question 28: Please explain key deliverables and work items that you previously completed which have allowed you to achieve the Commercialization Phases & Milestones you selected above. If this grant is a transition request view the "? help" icon for instructions. Question 29: Which Phases/ Milestones will be completed with this grant? The max grant amount is based on the selection in this question. You can only apply for either a Phase I or II grant at one time & you must finish P. I milestones before applying for P. II grant (GMS Test) Page 4 of 10

5 Phase I: Pre-Commercial Research, Milestone: Proof of Principle Only (Grant Max $20K) Phase I: Pre-Commercial Research, Milestone: Intellectual Property Protection Only (Grant Max $10K) Phase I: Pre-Commercial Res., Milestones: Proof of Principle & IP Protection (Max $30K, $20K & $10K) Phase I: Milestone: Prototypes and Technical Validation Only (Grant Max $150K) Phase I: IP Protection & Prototypes/Technical Validation (Grant Max $150K, up to $10K on IP valid.) Phase I: Proof of Principle & Prototypes/Tech. Valid. (Max $150K, up to $20K on Proof of Principle) Phase I: Proof of Principle & IP Protection & Prototypes/Tech. Valid. (Max $150K, $10K IP, $20K POP) Phase II: Commercialization Preparation, Milestone: Market Assessment (Grant Max $20K) Phase II: Commercialization Preparation, Milestone: Start Up (Grant Max $5K) Phase II: Commercialization Preparation, Milestones: Market Assessment & Start Up (Grant Max $25K) Question 30: How much grant money are you applying for? You can only request up to the "Grant Max" from the answer selected above unless two or more institutions apply jointly or project impacts two or more AIs & you qualify for lifting the $150K cap. Question 31: Do you currently have the full required dedicated matching funds (1/3 of the grant amount) in hand at your institution or documented in a third party grant award, corporate sponsorship letter or other funding commitment? Match must be cash (not in kind). & I understand my institution must have all matching funds when grant agreement is executed Question 32: How much in confirmed dedicated matching funds are in hand today at your research institution or documented in commitment letters? Match must equal 1/3 or more of the AI grant amount awarded. Match can not be spent until grant is awarded. Question 33: What are the specific sources of matching funds for the AI grant? The full final match, including all third party sources, must be in hand at your institution when the grant agreement is executed or the grant will be canceled. Question 34: If the match sources are government or other third-party grants or corporate sponsors or investors, upload the grant award notices or funding commitment letters in PDF file formats. These must be uploaded if your institution will rely on these sources. Attachments Question 35: Please confirm your understanding of the requirements listed below as answers to this question by selecting them. If you do not select ALL items, your grant application will be rejected. If you do not follow these terms, your grant will be canceled. (GMS Test) Page 5 of 10

6 This grant can only be used to accelerate product or service commercialization. This grant can not be used to support basic research. Grant funds can not be spent or obligated prior to execution of a grant agreement. A grant agreement must be executed within 30 days of a grant award letter. Stakeholder Collaboration Question 36: Does this technology impact across more than one advanced industry? Question 37: Does the project involve more than one research institution? Question 38: Does the project originate from a nonprofit research institution? Question 39: Is your project being sponsored by an Advanced Industry company with operations in Colorado? Question 40: If you answered "" to the question about sponsorship by a Colorado company, name the sponsor, explain how the sponsorship will work including resources provided (money, personnel, space, IP, and other resources), and ownership of resulting IP. Technological Merit Question 41: Provide a description of the Technology being used in this application. Question 42: What business, commercial or technical problem does this technology solve? (GMS Test) Page 6 of 10

7 Question 43: How does the technology provide a unique or improved approach for solving the business problem mentioned above compared to other methods used commercially or discussed in the scientific literature? Question 44: Describe the status of the Technology s development including studies completed and the conclusions derived. Any preliminary data or other results suggesting that the Technology is likely to work as predicted should be included. Question 45: Explain the research plan and methodology. Describe how the proposed work builds upon previous research that has been conducted by the applicant research institution and other institutions worldwide. Question 46: Describe the intellectual property already secured for the Technology & strategies for strengthening the Technology s IP portfolio. Include a brief summary of the IP landscape (e.g. the results of a patent search and include specific patent numbers). Question 47: Identify the biggest technical challenge that you expect to encounter and how you anticipate solving it? Market & Economic Potential Question 48: Describe the product or service that will ultimately be developed as a result of this project and assess its market potential. Question 49: Include a brief summary of the size of the market opportunity for the described products or services. Include an initial market segmentation analysis and suggest initial market segments that could be targeted. Question 50: Evaluate the strengths, weaknesses, opportunities and threats of this technology in meeting a market need. Address the competitive advantages of this technology and resulting products or services over competing technologies and products and services. Question 51: Which existing sectors, supply chains, businesses, or ecosystems in Colorado could benefit from this technology? Does the technology have the potential to be manufactured/produced in Colorado or is it likely to end up being commercialized out of state? Question 52: Apart from direct financial sponsorship of this project are there any other affiliations between this project and companies with operations in Colorado or outside Colorado? If yes identify the company, location and describe the nature of the affiliation. Question 53: Identify the number of jobs that will be created in Colorado that will result from this grant. Answer this question in FTEs (defined in? help section) that will be created over the next three years. (GMS Test) Page 7 of 10

8 Question 54: Identify the number of jobs that will be retained in Colorado that will result from this grant. Answer this question in FTEs (defined in? help section) that will be retained over the next three years. Question 55: Identify the anticipated capital investment in Colorado that will result from this grant. Question 56: Identify the anticipated capital retention in Colorado that will result from this grant. Question 57: Identify any other projected economic impacts that will result from this grant. Question 58: Provide an analysis demonstrating that the project will provide significant economic impact or competitive advantage for the state and AIs & that it will accelerate the pace of applied research leading to rapid commercialization of products and services. Commercialization Path & Risk Question 59: Describe the commercialization spectrum (from infancy to sales) explaining where the technology is today, and how far along the spectrum it will progress by completing the work you plan to undertake with the state grant and matching funds. Question 60: Summarize Milestones & deliverable that will be achieved as part of this grant, how long it will take & the estimated cost. Explain the Milestone/deliverables' significance in advancing the technology's commercialization. See "? help" for tips. Question 61: Please upload a timeline document that shows when you will complete deliverables, Commercialization Milestones & Phases as included in the Project Summary Phase/Milestone question & in the questions above. Use Timeline Template in resources section. Attachments Question 62: Project Term: Select the number of months needed to complete the proposed project work after the contract has been signed. Round up to nearest option. Do not select a term which is longer than is permitted based on phase and industry sector. more than 24 Months (Max term for all non-bio-science Phase I grants) more than 36 Months (Max term for bio-science Phase I grants) 3 months (max term for Phase II grants) Question 63: Describe the major risks of failure & plans to manage that risk (i.e. what will be done if the proposed approach (GMS Test) Page 8 of 10

9 is not successful)? How & when will "go" "no go" decisions be made on continuing the research & commercialization or changing approaches? Question 64: Specify anticipated capital needs, sources, and long-term milestones beyond the scope of the project proposed in this grant application. Question 65: If you have an active or planned SBIR/STTR grant, what are the aims of that project, the amount of actual or anticipated funding, and the agency providing the grant? Question 66: Do you plan to create a start up company at the end of this grant? Personnel, Budget & Plan Question 67: Describe the specific objectives of the project (in 70 words or less). If approved, this language will become the general description in a Statement of Work. Question 68: Describe why State funding is required, and what steps have been taken to secure other funding. Question 69: Has the subject technology of this application received other grant funding (beyond any SBIR/STTR grants described above)? If so, please provide source, amount, and scope of work funded. Question 70: Upload a detailed project budget that supports the work plan and justify all of the line items in the budget. This must use the template provided in the Resources section of this web site and should include AI grants and matching funds and costs. Attachments Question 71: Please justify with a written explanation why you need the funds for the largest categories of expenses shown in your uploaded budget. Explain why the funds are necessary for achieving your overall project goals. Question 72: Provide the name of Principle Investigator or Researcher and other key researchers and list each of their institutional affiliations. Question 73: Briefly summarize the investigation team's technology expertise including relevant publications and previous work that had led to technology commercialization and company formation. (GMS Test) Page 9 of 10

10 Question 74: Upload CVs of key research team members named above. Attachments Question 75: Is this application a re-submission of an earlier application that was declined? Question 76: If you answered "" to the question above, please provide a response to the reviewers' comments on your earlier application including how those comments were addressed in this re- submission. Question 77: Please provide any additional information needed to assess this application. Question 78: Please attach any additional files and documents needed to assess this application. The total number of these pages can not exceed five (5) or this material will not be considered. Attachments (GMS Test) Page 10 of 10