DEPARTMENT OF HEALTH & HUMAN SERVICES c«*w^i2XS

and Prevention (CDC)

Carol Spizzirri, President/Founder

Save-A-Life Foundation, Inc.
9950 West Lawrence Ave Suite 300
Schiller Park, IL 60176-1216

Reference: PA# 04164, Earmark for Save a Life Foundation

Dear Ms. Spizzirri:

The Save-A-Life Foundation has been identified to receive a CDC assistance award for
approximately $1,018,829. The budget period is expected to be from June 1,2004 through
May 31,2005. Although you were funded a grant award under another program
announcement, you will receive a new one-year award under Program Announcement
Number 04164.

The purpose of the earmark funds is to evaluate the effectiveness of the Save-A-Life
training program and to implement and expand state training sites to a national training
capacity. This funding will be used for all costs associated with expansion of training sites
and evaluating the program.

In order to process the award, you must submit an application package. This letter is
designed to provide the guidance required to prepare the application package. Please read
and follow all the instructions below.

The application package must arrive this office no later than April 16,2004. The
application packet should consist of an original plus 2 copies of the following:

• Cover Letter that includes the names of the program director/principal

investigator's (PI) and business official's name, title, complete mailing address,
phone number, and email address. Also, provide a point of contact name of person
who prepared the application package, if different from PI.

PHS Form 5161. To obtain instructions and afillablecopy of this form on line,
visit the following website: http://www.psc.pov/forms/FF99/PHS-5161-l/phs-
5161-l.html. Clearly reference the Piogram Announcement number on the
application. Number all pages including appendices. Print on only one side of each
page. Use single spacing. Do not staple or bind your application
 2
•) O
• SF 424. Within the website for the PHS Form 5161 are the SF 424's. Ensure the
amount entered on the SF-424 matches the Budget Narrative and detailed budget.

Important Note: Be sure to include the complete EIN for your organization,
including the two-digit suffix. If you have never applied for assistance and do
not have an EIN, please be sure to note that in your cover letter. Also, you are
required to have a Dun and Bradstreet Data Universal Numbering System (DUNS)
number to apply for a grant or cooperative agreement from the Federal government.
Your DUNS number must be entered on the face page of the application form next
to the EIN. The DUNS number is a nine-digit identification number, which
uniquely identifies business entities. Obtaining a DUNS number is easy and there is
no charge. To obtain a DUNS number, access www.dunandbradstreet.com or call 1-
866-705-5711.

• Program Narrative. The following information is provided to assist you in

preparing your program narrative:

—Program Goals and Objectives. Provide a plan of action that describes the
proposed program objectives and activities for the upcoming budget period. Each
activity should lead to the accomplishment of the proposed objectives. Each
objective must contain a performance or outcome measure that assesses the
effectiveness of the project. The applicant should adequately describe how it would
implement the program activities and disseminate the outcomes of the activities and
services provided. The application should include a detailed timeline for each
accomplishment.

—Program Requirements.

• Detailed budget and justification. Up to $ 1,018,829 is available to fund this

award. Please prepare a budget that does not exceed this amount (including direct
and indirect costs). A sample budget template is located at the following website:
http://www.cdc.gov/od/pgo/fundine/budpetpuide.hrm.

• Indirect Rate Agreement. Enclose a copy of your organization's most current

negotiated Federal indirect cost rate agreement. Note: Unless a cost rate agreement
has been federally approved by the Division of Cost Allocation, all budget items
should be direct costs.

• Other Information:
- Final Progress Report (within 90 days after the end of the project period)
- Final Financial Status Report (within 90 days after the end of the project period)
 J /

Applications may not be submitted electronically at this time. Please mail application
packet to the following address:

Angie Turtle, Grants Management Specialist

Acquisition and Assistance Branch A
Centers for Disease Control and Prevention
2920 Brandywine Road, Mailstop K-75
Atlanta, GA 30341-4146

If you need any programmatic guidance, please contact Jacqui Butler by telephone at
(770) 488-1496 or by email at JAButler@cdc.eov. If you need any budget guidance,
please contact me by telephone at (770) 488-2719 or by email at aen4@cdc.gov.

Sincerely,

AjJ^&^z
AngiffNvTuttle
GrantsManagement Specialist
Acquisition and Assistance, Branch A
Procurement and Grants Office

cc: Robin Forbes

 National Headquarters

SALF 9950 W. Lawrence Ave Ste 300

Schiller Park, Illinois 60176-1216
Ph: (847)928-9683
Fax: (847)928-9684
Toll Free: (888) 892-0606
Save A Life Foundation Websile: www.salf.org

Carol J. Spizzirri
Founder / President

Tuesday. April 13, 2004

Angie Turtle Grants Management Specialist

CDC Centers For Disease Control & Prevention
Acquisition and Assistance Branch A
2920 Brandywine Rd, Mailstop K
Atlanta, GA 30341-4146

DUN# 08-092-0437

Re: Program Announcement PA #04164 Earmark for Save A Life Foundation

Grant title: Expand The Training Of Basic Life Supporting and Emergency Preparedness Skills

Dear Ms. Tuttle:

Save A Life Foundation is a 501 C (3) organization dedicated to working with the public health
infrastructure to ensure the creation of a safety net for everyday citizens in the their communities. We
train citizens in life supporting first aid skills, with a particular focus on children (K-12) in age appropriate
programs that include i.e., Heimlich Maneuver, CPR. bleed control, blood borne - bio hazardous
precautions, access EMS, deployment of AED's. Since 1997 SALF has trained nearly 1 million children in
Illinois, moving into Wisconsin in 2003 and are about to expand our system of training into even more
emergency and public health departments which SALF establishes its branch sites. Using their local
emergency medical service providers as our instructors we are able to train children K-6th grades our
Save A Life For Kids program (1 hour), and 7th to 12th graders our Bystander Basic program (2 hours)
with remarkable success, both in skills retention and increased willingness by these same students to aid
the injured or ill at a time of an emergency. The proof of this accomplishment is due to our web base
data collection system participated by each student.

GRANT ACTIVITIES
In order for SALF to expand its base site in each targeted state SALF must:
Locate a hospital to home a branch
Find and train an individual with EMS credentials to serve as a Facilitator
Obtain support from a physician to serve as Project Medical Director
Obtain support of local mayors to establish a Citizen Corps Council and apply for funds to
support the school training
Identify EMS providers and train as instructors
Identify local corporations willing to Adopt A School to defer training costs
Identify schools, schedule classes between schools and Instructors
Evaluate class and test students for skills proficiency

Each Instructor receives compensation for their travel and time which aids greatly in supplementing their
meager professional income while off duty.

*'^Sfs5^ 228
 .\

Page 2
Save A Life Foundation
April 13, 2004

Over the years SALF has been embraced by many including being the second affiliate of the U.S.
Homeland Security's Citizen Corps in January 2003, Illinois Homeland Security's Terrorism Task Force,
2001 and alike. Our partners include the U.S. Conference of Mayors, State Municipal Leagues, Chicago
Bar Association, Chicago Public Schools, Global Ronald McDonald's House Charities, and so forth.

My greatest pleasure besides seeing the children's faces as they discover their new ability to save a life,
working with CDC since 2001, is serving with Dr. Peter Safar (Father of CPR) and Dr. Henry Heimlich
(Heimlich Maneuver) SALF's founding Medical Board, to train the critical mass should they faced an
emergency.

Everyone has a emergency role. The "Pre-EMS" role is the most crucial in maintaining life until advance
EMS arrives. SALF feel fortunate that CDC feels the same.

Sincerely,

end.
 OMB Approval No. 0348-0043
Applicant ldei.-..er
2. DATE SUBMITTED
APPLICATION FOR PA# 04164
April 13, 2004
FEDERAL ASSISTANCE State Application Identifier
3. DATE RECEIVED BY STATE
1. TYPE OF SUBMISSION:
Application Praapplication
p - Constructor |~" Construction 7 . DATE RECEIVED BY FEDERAL A B t N t V Federal Identifier

P " Non-Conslruclion
5. APPLICANT INFORMATION Organizational Unit
Legal Name:
Save A Life Foundation Nanttandteler^rumtberoMr^rsontobecon^
Address (eive cOy, county, stele. and zip eodof. (give area codo)
O'Hare Aerospace Center Carol J. Spizzirri President/Founder
9950 West Lawrence Ave. Ste #300 (847) 928-9683
Schiller Park, Illinois 60176
7. TYPE OF APPLICANT: (entor appmpriaw latter in box) I I
6. EMPLOYER IDENTIFICATION NUMBtH (UHf.
A. State H. Independent School Dist
B. County I. State Controted Institution ol Higher Learning
8. TYPE OF APPLICATION: C. Municipal J. Private University
P ? Now f Continuation V" n e « s l o n D. Township K. Indian Tribe
E. Interstate L Individual
F. tntermunidpal M. ProBt Organoation
[i Revision, enter appropriate letterls) in box(os): N. Other (SpecHy):
Q. Special District
C. Increase Duration
A. Increase Award B. Deeraaso Award 9. NAME OF FEDERAL AGENCY:
O. Docroase Duration Other (specify):
Centers For Disease control & Prevention
11. DESCRIPTIVE TTn.E OF APPUCANTS P R O J t u i :

m-c
1D. CATALOG OF FEDERAL DOMESTIC
ASSISTANCE NUMBER:
Expand The Training Of Basic Life
Support and Emergency Preparedness
Skills, especially to children
TITLE:
12. AREAS AFFECTED BY PROJECT folios, counties. sttles, ere.^
IL, WI, NC, NY, FL, PA,

14. CONGRESSIONAL DISTRICTS OF:

13. PROPOSED PROJECT: b. Project
Start Date Ending Date a. Applicant
Earmark f o r Save A L i f e
05/31/05 Cook County, IL - Dist Foundation
06/01/04
1 1 , 1 0 , 1 5 , 1 4 , 19
'B. IS APPLICATION SUBJECTTO REVIEW BY STATE EXECUUVE ORDER 1Z37Z K H V ^ .
15. ESTIMATED FUNDING:
YES THIS PREAPPUCAT.ON/APPUCAT.ON WAS MADE AVAILABLE TO THE STATE EXECUTIVE
a. Federal .00
ORDER 12372 PROCESS FOR REVIEW ON:
1,005,000
.00
b. Applicant
DATE

~00
c. State
b. NO. ( V PROGRAM IS NOT COVERED BY E.0.12372
d. Local
.00
r - OR PROGRAM HAS NOT BEEN SELECTED STATE FOR REVIEW
.00
e. Other
W. IS APPLICATION DELINQUENT ON ANY FEDERAL DEBT?
f. Program Income .00

.00
r -
YES H "Yes." attach an explanation.
r
g. TOTAL
1,005,000

BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLT w ■ n =« c .Telephone
c. Telephone number
number
b. Title
a. Typed Name of Authorized Representative 847-928-9683
President/Founder
Carol J . S p i z z i r r i e. Date Signed
04/13/04

Standard Form 424 (Rev. 7-97)

Prescribed by OMB Circular A-102
 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH SERVICE

GRANT APPLICATION

For use by:

• State and Local Government Applicants
. Nongovernmental Applicants for Health Services Projects

Unable to load image

f i l t e r library
Status: 1157

FORM PHS-5161-1
(Revised 7/00)
 Page 25
PHS-5161-1 (7/00) . , — — no->ruM5R
CHECKLIST OMB Approval No. 092<W>428

Public
ruBllc Burden Statement: ^ . T S S L S T U ^ ^ S K T S f i B ^
figS Z Z ^ & V ^ Z ^ ] ^ address.
existing data sources, gathering and maintainin£[the datajneedea APPUCANT: This form must be completed and
_£d completing and reviewing the collection of m » A submitted
m
withthe original of your application Be sure tc' complete
agency rrSy not conduct or sponsor, andlaipersonisnot squired to gu° ™« o f ^ form. C n e c & m e appropriate boxes; and provide
respond to a collection of information unless it d ' s j P ^ a w ^ u y 5£ informationrequested.This form should beiattached astoelast
valSl OMB control number. Send comments; r e g ^ n g J J g ^ J " ^ L S the signed original of the application. This page is reserved
estimate or any other aspect of * " « S f f i ? t o C D C ^ S S i toriPHS staff use only*
including suggestions for reducing this burden to CPU. rrojeci w__ „
—" " " _ , Noncompeting ,__ Competing __ e U O D l e m e n t a |
Type
Type orof App
Application:
canon: tXNEW
K NEW iT ooruiiiuauu"
Continuation 1 w
■ Continuation
„ 1 Supplemental
■ __■—_ chmiHed
:
ZT M Z (Cowing c h e l s t is provided to assure that proper signatures, assurances, and cenmcations n a v . g »
Included Applicable

Proper Signature and Date for Item 18 on SF 424 (FACE PAGE) ^

1.
2 Proper Signature and Date on PHS-5161-1 "Certifications page
3 Proper Signature and Date on appropriate "Assurances page, i.e
S F 4 M B (Non-Construction Programs) or SF-424D (Construction Programs) PC
4 f y o l r organization currently has on file with DHHS the following assurances
please identify which have been filed by Indicating the date of such filing on, the l.ne
provided. (All four have been consolidated into a single form. HHS Form 690)
p7 Civil Rights Assurance (45 CFR 80) —
p7 Assurance Concerning the Handicapped (45 CFR 84) — — — — — — — —
fX Assurance Concerning Sex Discrimination (45 CFR 86)
pT Assurance Concerning Age Discrimination (45 CFR 90 & ^ ^ ^

«; Human Subjects Certification; when applicable (45 CFR 46) ^

YES Applicable

1 Has a Public Health System impact Statement for the proposed program/project _ R

3. ffiieirra^ *
been ateched
4. K v K i o g ' ^ ' !*!L.. r *
or
s H^KudqeTi^ R
5
- SM24C ( £ & £ Programs), been completed and included? ••■ g -

8 F ^ S p i e m e ' n t o i - ^ i ^ ^ ^ ^ * ^ address only the additional r _

9. SoSSS^ r *
been included? .
PART C: .n the spaces provided below, please provide the requested ™°™™*«o:We« Director/Prineipal l n v e s l i g a t o r da.gna.eo to
Business Official to be notified if an award is to be made. ^ ^ m e o r o o o s e d Broiecl w Droaram.

Name c a r o l J . Spizzxm
M.-_ Carol J- S p i z z i m _ —
1:2=12
" : ~ Tlfl„ P r e s i d e n t / F o u n d e r
TUIe President/Founder I!_ Save —A— L i f e —Foundation
Save A L i f e Foundation organization
0r9an
-'°n " — — 9 950 West Lawrence Ave Ste #300
9950 West Lawrence Ave. Ste«300 ^ ^ S c h i l l e r Park, IL 60176
Address S c h i l l e r Park, IL 60176
e ti »*!„«« carol@salf. org
E-mail Address c a r o l @ s a l f . o r g E-mail Address
(847) 928-9683
(RAT)
v
928-9683 Telephone Number
Telephono Number ° ^ ' ■
(847) 928-9664
(Ri.7\ 928-9684 Fax Number _
Fax Number ^ a < t " . — - „ r l A L S E C U R I T Y NUMBER HIGHEST DEGREE
APPUCANT ORGANIZATION'S 12-DIGIT DHHS EIN H * > 4 « ^ SOCIAL SECURITY NUMBS ____..
' RN BS
c

10. Will comply, if applicable, with flood insurance
purchase requirements of Section 102(a) of the
Rood Disaster Protection Act of 1973 (P.L 93-234)
which requires recipients in a special flood hazard
area to participate in the program and to purchase
flood insurance if the total cost of insurable
construction and acquisition is $10,000 or more.
Will comply with environmental standards which
11. may be prescribed pursuant to the following: (a)
institution of environmental quality control
measures under the National Environmental Policy
Act of 1969 (P.L 91-190) and Executive Order
(EO) 11514; (b) notification of violating facilities
pursuant to EO 11738; (c) protection of wetland
pursuant to EO 11990; (d) evaluation of flood
hazards in fioodplains in accordance with EO
11988- (e) assurance of project consistency with
the approved State management program
developed under the Costal Zone Management Act
of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity
of Federal actions to State (Clear Air)
Implementation Plans under Section 176(c) of the
Clear Air Act of 1955, as amended (42 U.S.C.
§§7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Dnnking
Water Act of 1974, as amended, (P.L. 93-523); and
(h) protection of endangered species under the
Endangered Species Act of 1973, as amended,
(P.L. 93-205).
Will comply with the Wild and Scenic Rivers Act of
12. 1968 (16 U.S.C. §§1271 et seq.) related to
protecting components or potential components of
the national wild and scenic rivers system.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
3M9 f\L\feTCMhQKTWk
13. Will assist the awarding agency in assunng
compliance with Section 106 of the National
Historic Preservation Act of 1966, as amended (16
U S C §470), EO 11593 (identification and
protection of historic properties), and th®
Archaeological and Historic Preservation Act of
1974 (16 U.S.C. §§ 469a-1 et seq.).
Will comply with P.L. 93-348 regarding the
14. protection of human subjects involved in research,
development, and related activities supported by
this award of assistance.
Will comply with the Laboratory Animal Welfare Act
15. of 1966 (P.L. 89-544, as amended, 7 U.S.C.
§§2131 et seq.) pertaining to the care, handling,
and treatment of warm blooded animals held for
research, teaching, or other activities supported by
this award of assistance.
Will comply with the Lead-Based Paint Poisoning
16. Prevention Act (42 U.S.C. §§4801 et seq.) which
prohibits the use of lead based paint in
construction or rehabilitation of residence
structures.
17 Will cause to be performed the required financial
and compliance audits in accordance with the
Single Audit Act of 1984.
1B Will comply with all applicable requirements of all
other Federal laws, executive orders, regulations
and policies governing this program.
TITLE
"j^/nrftUKAtA^.
DATE SUBMITTED/
4hH
SF-424B (Rev. 7-97) Back
^MRVlc^

Public Health Service

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers For Disease Control
and Prevention (CDC)

I3JUN I

Carol J. Spizzirri, President / Founder

Save A Life Foundation
O'Hare Aerospace Center
9950 West Lawrence Avenue, Suite 300
Schiller Park, IL 60176

Reference: Award Number H28/CCH523764-01

PA Number 04164, EARMARK funds for Save A Life Foundation

Dear Ms. Spizzirri:

Enclosed is the Notice of Cooperative Agreement Award for Year 01 for the Save a Life
Program under Program Announcement Number 04164. This Notice of Award provides
the total funding approved for the budget period, which starts June 01,2004, and ends
May 31,2005. Please refer to the continuation pages of the Award Notice for pertinent
information regarding the award.

Please note that Angje Turtle is your Grants Management Specialist. If you have any
questions on this matter, please feel free to contact her at telephone number
(770) 488-2719, Fax number (770) 488-2671, or email aen4@cdc.gov.

Sincerely,

Cheryl M^Maddux /
-Grants Management Officer/
Acquisition and Assistance Branch A
Procurement and Grants Office

Attachments
cc: Business Office
Robin Forbes, NCIPC, K-62
Ben Moore, NCIPC, K-62
Jacqui Butler, NCIPC, F-41
06/01/04 PAGE
XXXXXXXXXXXXXXXXXXXXXXXKXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
xxxxx GRANTS MANAGEMENT INFORMATION SYSTEM GRANT REPORT FORM xxxxx
xxx PUBLIC HEALTH SERVICE AWARD APPROVAL LIST FOR C0021M04 xxx
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

TRANSACTION GRANT INSTITUTION GRANTEE BUDGET PERIOD ALLOWANCE CAN APPROVED

NUMBER NUMBER CODE NAME FROM THROUGH CODE NUMBER OBLIGATION

CCH523764 H28/CCH523764-01 AA SAVE A LIFE FOUNDATION 04-11957 04-92102MA FA 1,005,000

CITY: SCHILLER PARK '*'' STATE: IL ZIP: 60176
04-11817 04-9214072 FA 15,000

TOTAL FINANCIAL ASSISTANCE AMOUNT: + 1,020,000

/"•"%

C/I/0 : BREWER KENNETH R 05/28/2004

FINANCIAL MANAGEMENT OFFICER: SCOTT JANNIE M 05/28/2004
GRANTS MANAGEMENT OFFICER...: MADDUX CHERYL 06/01/2004
 06/01/2004 93.136 DEPARTMENT OF HEALTH A N D HUMAN StKVlULS
PUBLIC HEALTH SERVICE
SUPERSEDES .AWARD NOTICE DATED CENTERS F f ^ ' D I S E A S E CONTROL AND PREVENTION

:EPT THAT ANY ADDITIONS OR R E S T R I C T I O N S

PIOUSLY IHPOSED REHAIN I N EFFECT UNLESS !SPECIFICALLY RESCINDED. NOTICE OF GRANT AWARD
GRANT NO. 5. ADMINISTRATIVE CODES AUTHORIZATION CLEGISLATION/REGULATIONJ

H28/CCH523764-01 CCH28 SECTION 3 0 1 C A ) , 3 1 7 C I O C 2 ) , 3 9 1 , 392

PROJECT PERIOD
06/01/2004 05/31/2005
OH THROUGH
BU
WuT/2o04 05/31/2005
10H THROUGH
TITLE OF PROJECT COR PROGRAM}

EARMARK - PROMOTE TRAINING & ED IN BASIC LIFE SUPPORT FOR CHILD/ADOLESCENTS

GRANTEE NAHE AND ADDRESS 10. DIRECTOR OF PROJECTCPROBRAH DIRECTOR/PRINCIPAL IHVESTICATDRI

SAVE A LIFE FOUNDATION CAROL J. SPIZZIRRI

PRESIDENT AND FOUNDER PRESIDENT AND FOUNDET
9950 WEST LAWRENCE AVENUE, SUITE 300 9950 WEST LAWRENCE AVENUE, SUITE 300
SCHILLER PARK, IL 60176 SCHILLER PARK, IL 60176
APPROVED BUDGET (EXCLUDES PHS DIRECT ASSISTANCE) 12. AWARD COMPUTATION FDR FINANCIAL ASSISTANCE

PHS GRANT FUNDS ONLY

A. AHOUNT OF PHS FINANCIAL ASSISTANCE <FROH l l . U ) $ 1,020,000
TOTAL PROJECT COSTS INCLUDING GRANT FUHDS AND ALL OTHER FINANCIAL
PARTICIPATION .
B. LESS UNOBLIGATED BALANCE FRON PRIOR BUDGET PERIODS..t 0
(PLACE NUMERAL OH LINE) I
C. LESS CUMULATIVE PRIOR AWARD(S) THIS BUDGET PERIOD.. 0_
O. AHOUNT OF F I N A N C I A L A S S I S T . T H I S ACTION 1,020,000
SALARIES AND WAGES $ 194, 900 13. RECOKHENDED FUTURE SUPPORT (SUBJECT TO THE AVAILABILITY
OF FUNDS AND SATISFACTORY PROGRESS OF THE PROJECT)
FRINGE BENEFITS $ 32, 548 BUDGET TOTAL DIRECT BUDGET TOTAL DIRECT
TOTAL PERSONNEL COSTS 227, 448 YEAR COSTS YEAR C0S7S-

CONSULTANT COSTS 100, 000

EOUIPHENT 0
SUPPLIES 17, 486 TT IT TT
TRAVEL 59, 500 14. APPROVED DIRECT ASSISTANCE BUDGET CIN LIEU OF CASK)
PATIEHT CARE-INPATIENT 0 A. ANOUHT OF PHS DIRECT ASSISTANCE 9
PATIENT CARE-OUTPATIENT 0 B. LESS UNOBLIGATED BALANCE FRON PRIOR BUDGET PERIODS..*
ALTERATIONS AND RENOVATIONS 0 C. LESS CUHULATIVE PRIOR AWARDS FRON THIS BUDGET PERIODS
OTHER. 608, 895 D. AMOUNT OF DIRECT ASSISTANCE THIS ACTIONH
CONSORTIUM/CONTRACTUAL COSTS 6, 671
15. PROGRAM INCOME SUBJECT TO 45 CFR PART 74.SUBPART F>OR «5 CFR 92.25,
TRAINEE RELATED EXPENSES 0 SHALL BE USED IN ACCORDANCE WITH ONE OF THE FOLLOWING ALTERNATIVES 1
(SELECT OHE AND PUT LETTER IN BOX.)
TRAINEE STIPENDS 0
A. DEDUCTION
TRAINEE TUITIOH AHD FEES 0

H
B. ADDITIONAL COSTS
TRAIHEE TRAVEL 0
C. BATCHING
TOTAL DIRECT COSTS S 1 .O2O.000
0 F S M/TADC> D. OTHER RESEARCHCADD/DEDUCT OPTION)
INDIRECT COSTS t Q. 0 0 * *
E. OTHER (SEE REMARKS)
TOTAL APPROVED BUDGET. 1,020,000
THIS AWARD IS BASED OH AH APPLICATION SUBMITTED TO, AHD AS APPROVED BY. THE PHS ON
0" THE ABOVE TITLED PROJECT AHD IS SUBJECT TO THE TERNS AHD COHDITtOHS INCORPORATED
EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING!
A.THE GRANT PR06RAH LEGISLATION CITED ABOVE. B.THE GRAHT PROGRAM REGULATION
FEDERAL SHARE CITED ABOVE. C.THIS AWARD HOTICE INCLUDING TERHS AHD CONDITIONS,IF ANY.NOTED BELOW
NON-FEDERAL SHARE.
1,020,000 UNDER REHARKS. D.PHS GRAHTS POLICY STATEHEHT INCLUDING ADDENDA IH EFFECT AS OF THE
BEGIHHIHG DATE OF THE BUDGET PERIOD. E.45 CFR PART 74 OR 45 CFR PART 92 AS
0 APPLICABLE. IH THE EVENT THERE ARE CONFLICTING OR OTHERWISE INCONSISTENT POLICIES
APPLICABLE TO THE GRANT, THE ABOVE ORDER OF PRECEDENCE SHALL PREVAIL. ACCEPTANCE
OF THE GRAHT TERNS AND COHDITIOHS IS ACKNOWLEDGED BY THE GRANTEE WHEH FUNDS ARE
DRAWH OR OTHERWISE OBTAIHED FROH THE GRAHT PAYKEHT SYSTEM.

lHAKH.b lUIHIK ILHHil AHU lUWUH 1UH5 Al lACHlU

SPONSOR: NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL

(NAHE-TYPED/PRIHT)

M. MADDUX GRANTS MANAGEMENT OFFICER

CRS.EIN: 64 119. LIST NO.; CO-021 T*W
DOCUMENT NO. ADMINISTRATIVE CODE AHT.ACTIOH FIH.ASST AHT.ACTIOH DIR.ASST

CCH523764 . CCH28 1,005,000

11817 9214072 CCH525764 CCH28 15,000
S-51S2-1 (REV.7/92) (MODIFIED CDC VERSION 10/92)