Applicant
(Legal Name of Submitting Institution)

The University of Wisconsin-La Crosse (on behalf of The Board of Regents of the University of Wisconsin System)

Type of Institution

The University of Wisconsin-La Crosse, a state agency, is a public, nonprofit educational institution exempt under Section 115 of the IRS code. In addition, donations, gifts, etc. to UW-L are exempt under Section 170(c) (1).

Approval and Authorized Signatory

(College Deans and/or Principal Investigators are not authorized to sign).

I.      Faculty research/scholarly grants and contracts

Review and Signature by:  Vijendra Agarwal, (608) 785-8007, agarwal.vije@uwlax.edu

 II.    Service contracts by Academic Affairs staff

Review by: Barry Miller, (608) 785-8504, miller.barr@uwlax.edu

Signed by: Sharon Radtke, (608) 785-8554, radtke.shar@uwlax.edu

Copies sent to: Vijendra Agarwal and Dan Sweetman 

III.    All other contracts

Review by: Barry Miller (608) 785-8504, miller.barr@uwlax.edu

Signed by: Sharon Radtke, (608) 785-8554, radtke.shar@uwlax.edu

 Copy to: Dan Sweetman, (608) 785-6800, sweetman.dani@uwlax.edu

Address of Institution and Contact Telephone Number

Mailing Address:
University of Wisconsin-La Crosse
Office of Sponsored Research, Scholarly & Creative Activities
1725 State Street
145 Graff Main Hall
La Crosse, WI  54601
Phone # (608) 785-8007     
Fax # (608) 785-8046

Accreditation

North Central Association

Assembly Senate Legislative District

State Senator 32^d District (La Crosse County), Dan Kapanke

Congressional District

WI 3^rd Congressional District, Ron Kind

Checks Should be Made Payable to

University of Wisconsin-La Crosse

Cognizant Federal Audit Agency

U.S. Department of Health & Human Services

200 Independence Avenue, SW

Washington, D.C. 20201

Telephone: 202-619-0257
Toll Free: 1-877-696-6775          http://www.hhs.gov/

County

La Crosse

Data Universal Numbering System (DUNS) Number (UW-L)

# 068191097
(Note: To be used only with extramural support grants and contracts.)

Employer Identification Number  (EIN)

 Call (608) 785-8007 or (608) 785-6800 for UWL EIN #

Entity Identification Number / Institution Code

# 0039198000

Animal Welfare Assurance Number

# A 4153-01

Approval Date:  10/03/07

Human Subjects Assurance Number

# FWA00002685

Approval Date:  6/14/02

Health & Human Services Assurance of Compliance

1. Title VI-Civil Rights Assurance (45 CFR 80)

2. Assurance Concerning the Handicapped (45 CFR 84)

3. Assurance Concerning Sex Discrimination (45 CFR 86)

4. Assurance Concerning Age Discrimination (45 CFR 90 & 45 CFR 91)

Filing Date:  12/13/06

Institutional Review Board (IRB) Contact Information

Email:  irb@uwlax.edu  Telephone # (608) 785-8124  Fax # (608) 785-8046

(Institutional Review Board (IRB) #

# IRB00001294

Approval Date:  6/14/02

Office of Research Integrity (ORI)

# 0578508

US-DHHS Independent Ethics Committee (IEC) IRB Registration Number

# 00001294

Federal-Wide Assurance Number

# 00001294

Indirect Cost Rates

SECTION I.  FACILITIES AND ADMINISTRATIVE COST RATES*

Predetermined:    07/01/03 to 06/30/07, Rate = 38.5% On Site, All programs

Predetermined:    07/01/03 to 06/30/07, Rate = 15.5% Off Site, All programs

Provisional: 07/01/07 UNTIL AMENDED (Use same rates & conditions as those cited for fiscal year ending June 30, 2007)

 * BASE:     Direct salaries and wages including all fringe benefits.

UW-La Crosse Overhead Rate Agreement

UW-La Crosse Overhead Rate Agreement can be found as follows:

pdf of overhead rate agreement – document 1

pdf of overhead rate agreement – document 2 

NOTE:   Both copies of the pdf (document 1 and 2 are required for the total agreement)  

Gift Information

GIFT TRANSMITTAL FORM

Please be aware that all gifts-in-kind (non-monetary contributions) given to UW-L or any of its offices, departments or programs must be officially accepted by the university administration and reported to UW System and the Board of Regents. See form @

Gifts in Kind Transmittal Form