Southern Illinois University Carbondale Institutional Information Applicant Organization Board of Trustees of Southern Illinois University Applicant Address c/o Office of Sponsored Projects Administration Southern Illinois University Carbondale 900 S. Normal Avenue, Mail Code 4709 Carbondale, IL 62901-4302 Applicant Telephone, Fax, and E-mail phone: (618) 453-4540 Fax: (618) 453-8038 e-mail: [email protected] Authorized Institutional Gary R. Kinsel, Interim Vice Chancellor for Research Representative For Austin A. Lane Chancellor Southern Illinois University Carbondale 9 Digit U.S. Postal Zip Code 62901-4302 Southern Illinois Established 1869 Carnegie Foundation for the Research Universities – High Research Activity (second-highest tier) Advancement of Teaching: 2005 Designation Employer Identification Number (EIN) 37-6005961 and Federal Tax ID Number Data Universal Numbering System 939007555 (DUNS) Number Federal Interagency Committee on 001758 Education (FICE) Code Tax Exempt Number E9990-8433-05 (Illinois Dept. of Revenue) NAICS Code 611310 CAGE Code 3NDX8 Illinois Dept. of Human Rights (IDHR) 110743-00 Bidder Eligibility Number DHHS-PMS PIN (CSREES) 0N00P SAM Expiration 5/15/2021 J-1 Visa Number P-1281 Type of Institution Body politic and corporate of Southern Illinois University Congressional/Legislative Information U.S. Congressional District IL-012 U.S. Representative Mike Bost 1440 Longworth House Office Building, Washington, DC 20515 | website U.S. Senators Richard Durbin 711 Hart Senate Bldg, Washington, DC 20510 | website Tammy Duckworth 120 Constitution Avenue, NE, Washington DC, 20510 | website Illinois Senate Districts 58 & 59 State Senators Paul Schimpf (58) 342 North St., Suite C, Murphysboro, IL 62966 | website Dale Fowler (59) 2 North Vine, 6th Floor, Harrisburg, IL 62946 | website Illinois House Districts 115 & 118 State Representatives Terri Bryant (115) 3307 Broadway St. Suite 150, Mt. Vernon, IL 62966 | website Brandon Phelps (118) 607 S. Commercial St. #B, Harrisburg, IL 62946 | website County Jackson
Fiscal Information Checks should be made payable Board of Trustees of Southern Illinois University Institutional Fiscal Officer for Grants Shelley Perez and Contracts Chief Accountant, Grant & Contract Accounting Mail Code 4709 900 S. Normal Avenue Southern Illinois University Carbondale Carbondale, IL 62901 Facilities and Administrative Costs Cognizant Agency: DHHS (Indirect Costs) Rate Agreement – Agency Contact: Arif Karim Cognizant Agency, Contact, Date Phone: 214-767-3261 Signed Date Signed: June 20, 2017 Is organization delinquent on any No federal debt? Is organization …debarred, suspended No Assurance/Compliance Information Human Subjects Assurance Number FWA 00005334 IRB Registration No. 00000059 Animal Welfare Assurance Number D16-00044 Radiation Safety Number IL-01633-01 Affirmative Action Plan March 1, 2017 – February 28, 2018 Misconduct in Science Filed May 2, 2016 Agency Specific Information NSF Institutional Code 0017582000 NIH Institutional Profile Number 1194502 DHHS EIN Number 1 376005961 A1