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{"sheet":"Form","index":0,"n_rows":40,"n_cols":5,"rows_kept":40,"cut":false,"hidden":false,"merged":[]}
["TEXAS STATE UNIVERSITY"]
["TESTING SERVICES RATE REQUEST FORM"]
[]
[]
["This request is to be completed when a department is requesting a fee to charge outside parties for specific technical or administrative services primarily for the benefit of the outside parties. This does not include activity performed by Research Service Centers including “recharge centers” and “specialized service centers”.  Examples of specialized service facilities include computing centers, printing and mailing centers, and telecommunications centers.  These are confined to testing of a limited amount of material on a single piece of equipment."]
[]
["Complete the attached Rate Development Information Form"]
[]
["We, the following undersigned University employees, proposed Project Leader(s), Department Chair/School Director, wherein the Project is to be conducted, verify each of the following statements:"]
[]
["1.   The proposed RATE REQUEST involves only the testing, classification, or diagnostics of Sponsor’s data, samples, mechanisms, procedures, products or processes (PROJECT).  "]
[]
["2.  The services involved in the Project will be done in accordance with the specifications or protocols which have been prepared or supplied by the Sponsor or Sponsor’s duly authorized agent(s). No University employee involved in the Project or under the department’s direction, have prepared or provided scientific input into the Project specifications or protocol or if the specification or protocols have been prepared, or other University employees involved in the Project or under my direction, said specifications or protocols have been prepared using only Sponsor provided information, specifications, or protocols."]
[" "]
["3.   The department has not provided, nor will provide any basic or applied research in the preparation of or for the proposed Project and will not provide the results of any basic or applied research in the conduct of the Project."]
[]
["4.   The conduct of the proposed Project will not involve or employ the use of any inventions or technologies, including software, learned, created, or developed under federally-sponsored or privately-sponsored research projects or grants in which the University has been involved, except those listed herein: "]
[]
["5. We have read, are knowledgeable of, and will honor the confidentiality obligations of the Project as specified in an executed Confidentiality Agreement and will inform and ensure compliance with said obligations by all University employees, including students, working on or with the Project under our direction."]
["By signing this application, we verify and acknowledge that we are indicating to the best of our knowledge and belief our assent to and accuracy of the above noted statements and that there is no real or potential conflict of interest arising from the provision of these services.  If any of the above statements are not correct or if there are any exceptions, we have noted the particulars on a memorandum attached to this verification form. "]
[]
[]
["Project Leader                                                                                          Date",null,null,null,"  "]
[]
["The Department has reviewed the terms and conditions of current awards to ensure there do not exist any conflicting or inconsistent contractual arrangements that would prevent the University from entering into this proposed Service Agreement or burden or otherwise impede past and/or current grants or contractual arrangements with other parties."]
[]
[]
["Department Chair/School Director                                                        Date            "]
[]
["I authorize the use of the equipment(s) for the purpose set above."]
[]
[]
["Custodian of the Equipment                                                                 Date"]
[]
[]
["Office of Technology Commercialization                                            Date"]
[]
[]
["OSP USE ONLY"]
["Date Received:                                             Staff:"]

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["Texas State University - San Marcos \n"]
["Office of Sponsored Programs"]
["Rate Development Information Form"]
["Who am I?",{"$nulls":7},"What is my department?"]
[]
["What service am I offering?"]
[]
[]
[]
[]
[]
[]
["I plan on charging those who use my service by: (measure)"]
[null,"Hour",null,null,"Test",null,null,"Day",null,null,"Other ____________"]
[]
["I plan on offering this service:   "]
[null,"On Campus users",null,null,"The Public",null,null,"Both"]
[]
["How many of these services do I plan on providing in any year?  (use the measure above)"]
[]
[null,"Hours",null,null,"Tests",null,null,"Days",null,null,"Other ____________"]

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["Texas State University - San Marcos \nOffice of Sponsored Programs\nIndustrial Testing Agreement/Service Center Request"]
["SALARY & WAGE (S&W) SCHEDULE"]
["Only complete what you know"]
["Employee Name","Title","Pernr No.","Annual Salary","Fringe %","Actual Fringe","% time to this service","% Total S&W","Comments*:"]
["example:"]
["John","Supv, Lab Srvcs Tech","00012345",50000,0.28000000000000003,{"$f":"+D6*E6","v":14000.000000000002},0.15,{"$f":"+(+D6+F6)*G6","v":9600}]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[{"$nulls":5},0,null,0]
[]
[{"$nulls":6},"Total Annual Salary/Wage Expense",{"$f":"SUM(H7:H27)","v":0}]
["*note per-hour labor in comment section"]

{"sheet":"What equipment am I using","index":3,"n_rows":5,"n_cols":7,"rows_kept":5,"cut":false,"hidden":false,"merged":[[1,0,1,10],[0,0,0,10]]}
["Texas State University - San Marcos \nOffice of Sponsored Programs\nIndustrial Testing Agreement/Service Center Request"]
["EQUIPMENT"]
[]
["Equipment Description","Inventory/Asset Number","How much am I using it --->","Hours","Days","Other","Define other"]
["example:  Microscope",1234567,null,1]

{"sheet":"What supplies am I using","index":4,"n_rows":32,"n_cols":5,"rows_kept":32,"cut":false,"hidden":false,"merged":[[0,0,0,4],[1,0,1,4]]}
["Texas State University - San Marcos \nOffice of Sponsored Programs\nIndustrial Testing Agreement/Service Center Request"]
["OTHER ITEMIZED EXPENSES SCHEDULE"]
[]
[]
["Description of Service or Supply","how many/much per service","cost each","Amount \n","Notes"]
["example:  Gloves",1,5,{"$f":"+B6*C6","v":5}]
["liquid nitrogen",2,15,{"$f":"+B7*C7","v":30}]
{"$rows_empty":24}
[null,null,null,{"$f":"SUM(D8:D31)","v":0}]