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TTAG

  
 

Technology Transfer Assistance Grant (TTAG) Program Application


Enterprise  Information
Company Name:
NAICS Code:  (Click here for NAICS Lookup)
Address:
City:
State:
ZIP:
County:
Number of Employees:
Year Established:
Company Web Site: Type the Web address: (Click here to test)  
Type the description: 
Contact Person:
Title:
Phone:
Email Address:
Fax:
Secondary Contact Name:
Secondary Contact Title:
Secondary Contact Phone:
Secondary Contact Email:
Resource Provider Information  (Note:  If the Resource Provider has not participated in the TTAG program before, a completed W-9 & Resource Provider Application will be required before grants can be awarded.)
Resource Provider:
Address:
City:
State:
ZIP:
County:
Project Contact:
Title:
Phone:
Email:
Fax:
Project Area:
 
Project Area:
Please indicate the area of the technology covered in this TTAG application using the drop-down list above.
Select the best choice for your business area or research.
(Please note some areas require you enter a brief description in the box below.)
Project Area Brief Description: Enter a brief description if you selected one of these Project Areas in the previous question:
  4, 9, 17, 18, 27, 31 or 32
Federal Agency:
(This section for SBIR/STTR applicants only)
SBIR/STTR applicants please indicate the Federal agency to which you are submitting your application.
1. Project Title:
Please supply a title for your project.
(SBIR/STTR applicants please use your SBIR/STTR title if possible.)
2. Competitive Challenges: Please describe your business and the competitive challenges you face.
(SBIR/STTR applicants please describe your area of research or technology.)
3. Specific Problem: Describe the specific problem that you hope to have the Resource Provider address with this TTAG application.
(SBIR/STTR applicants describe the SBIR/STTR solicitation you plan to apply for, include topic # if available.)
4. Solution: Describe the solution to the problem that you and the Resource Provider hope to implement with these TTAG funds.
(SBIR/STTR applicants describe the types of commercial application(s), products or processes you hope to develop using the SBIR/STTR grant.)
5. Implementation Plan: Describe in general terms how the Resource Provider is going to implement the solution.
(SBIR/STTR applicants briefly describe what goals you hope to accomplish during the SBIR/STTR grant period to demonstrate the technical feasibility of your technology for the targeted application.)
6. Maintenance Plan: Describe how your company will maintain the solution after it has been implemented and the Resource Provider has left.
(SBIR/STTR applicants briefly describe your strategy for Phase 3 if you are successful in Phases 1 & 2.)
Work Plan, Timeline and Budget
List steps required to meet this accomplishment and who will perform the work. Do not list work unless it is being paid for with these TTAG funds. (SBIR/STTR applicants please describe how you will use the TTAG funds to prepare the SBIR/STTR application.)
First Task Necessary to Complete Project:
Time (Hours):
 
Budget (Dollars):
Second Task Necessary to Complete Project:
Time (Hours):
Budget (Dollars):
Next Task Necessary to Complete Project, and so forth:
Time (Hours):
Budget (Dollars):
Estimated Project Impact  
(SBIR/STTR Applicants please insert anticipated award amount beside "Research" below.)
First Year
Financial Impact:  
Increased Sales:
Retained Sales:
Cost savings in:  
Inventory
Labor
Materials
Other
Increased investment in:
 
Plant or equipment
Information systems or software
Workforce practices/employee skills:
Research (SBIR/STTR awards):
Other areas of the business:
Avoided unnecessary investment:
Saved on investment:
Jobs Impact:
Retention of jobs that otherwise would have been lost:
Creation of additional jobs:
Additional Questions:

Can the work described in the attached work plan be accomplished in ninety (90) days?  (Check the box for "Yes")
 
  

Do any members of the Resource Provider organization have any personal or professional interest / affiliation with the Enterprise?  (Check the box for "Yes")
Survey Completion:

The Enterprise agrees to comply with the Authority's effort to document the results and impacts of the project for a period of up to 36 months from project completion.  The Enterprise agrees to complete the Customer Project Evaluation Survey (within 6 months after project completion), and if selected, respond to the National Institute of Standards and Technology Manufacturing Partnership (NIST MEP) survey conducted by Turner Marketing.  SBIR/STTR Applicants agree to complete a post award survey (survey will be delivered via email 6 to 12 months after TTAG completion date).
Project Funding:

Total Project Price (TTAG + Enterprise Contribution) = $5,000.00
  
(If Total Project Price does not equal $5,000.00, please explain.)
  

The Enterprise agrees to make a cash match in the amount of $1,250.00 for this project (or a lesser amount, if applicable, as specified in the TTAG program documentation).


Electronic Signature Panel:
 
Please enter the names & email addresses below for the authorized representatives for the resource provider and enterprise.   By entering these email addresses, parties agree to the terms and conditions of the award should the application be accepted for funding.
 
Resource Provider:
Name

Email
Enterprise:
Name

Email