(rev 10/99)

Louisiana Transportation

Research Center

Research Proposal	(LTRC USE ONLY)	Page 1

DATE OF RECEIPT
LTRC PROJECT NO.
STATE PROJECT NO.
PART I: GENERAL INFORMATION
1. AMOUNT REQUESTED (SAME AS PART III)

$	2. DURATION OF PROJECT

ANTICIPATED START DATE	ACTUAL START DATE

DURATION IN MONTHS	ENDING DATE

3. TITLE OF RESEARCH PROPOSAL (PLEASE BE BRIEF)

4. NAME AND BUSINESS ADDRESS OF PROPOSER

(INDIVIDUAL, INSTITUTION, FIRM, OR CORPORATION)

5. NAME, TITLE, AND MAILING ADDRESS OF PRINCIPAL INVESTIGATOR

(BEARING SCIENTIFIC RESPONSIBILITY)

TELEPHONE NUMBER AND EXTENSION OF BUSINESS OFFICE

TELEPHONE NUMBER AND EMAIL ADDRESS OF PRINCIPAL INVESTIGATOR

6. MAJOR SUB-DIVISION THAT WILL CONDUCT RESEARCH

7. NAME AND TITLE OF CO-PRINCIPAL INVESTIGATOR

PART II: APPROVAL
RECOMMEND BY THE ASSOCIATE DIRECTOR LTRC, RESEARCH

Harold R. Paul, P.E.	DATE

RECOMMENDED BY THE DIRECTOR, LTRC

Joe T. Baker, P.E.	DATE

RECOMMENDED BY CHAIRMAN, LTRC POLICY COMMITTEE

William H. Temple, P.E.	DATE

RECOMMENDED BY IMPLEMENTATION SPONSOR

William H. Temple, P.E.	DATE
APPROVED BY THE DOTD SECRETARY

Kam Movassaghi, Ph.D., P.E.	DATE

APPROVED MODIFICATIONS:

(LTRC USE ONLY)

PART III AMOUNTS REQUESTED FOR PROJECT (For period of time indicated in Part 1 Item 2)	Page 2
ITEM	Percent of Time

on Project	FUNDS (Omit Cents)
Tot. Proj. Cost	Fiscal Year	Fiscal Year	Fiscal Year	Remaining
1.	PERSONNEL

(List all positions and persons incl. principal and co-researcher.

Amounts requested must not exceed proportion of total salary computed from % of time spent based on a 40 hour work week. Include graduate students if any.)
Total Salaries and Wages
Plus	% for Employee Benefits
Total Personnel Costs
2.	NON EXPEND-ABLE EQUIPMENT

(Itemize)
Total Non-Expendable Equipment
3.	CONSUMABLE SUPPLIES

(Itemize)
Total Consumable Supplies
4.	TRAVEL

(Itemize)
Total Travel
5.	OTHER EXPENSES

(Itemize)
Total Other Expenses
6.	TOTAL DIRECT COSTS
7.	TOTAL INDIRECT COSTS

(attach documentation to substantiate indirect cost rate used and method of application in Part VIII)
8.	TOTAL COSTS (Total of 6 & 7)

Page 3

Part IV -	BIOGRAPHICAL SKETCHES - Provide brief sketches for professional personnel already selected who are to be actively engaged in this project. The following questions should be completed with co-principal researcher immediately following principal researcher, followed by other professional personnel.
NAME OF PRINCIPAL INVESTIGATOR	TITLE
DATE OF BIRTH	PLACE OF BIRTH	SEX	CITIZENSHIP	US

OTHER (SPECIFY)
EDUCATION	DEGREE	INSTITUTION CONFERRING	FIELDS	YEAR
(DEGREES CONFERRED - IDENTIFY HONORARY DEGREES IN FIELD)
OTHER RESEARCH TRAINING AND EXPERIENCE, PARTICULARLY IN AREA COVERED BY THIS APPLICATION	LOCATION	NATURE	YEAR
FIELDS OF PRESENT MAJOR SCIENTIFIC INTEREST IN ORDER OF CHOICE

NAME OF C0-PRINCIPAL INVESTIGATOR	TITLE
DATE OF BIRTH	PLACE OF BIRTH	SEX	CITIZENSHIP	US

OTHER (SPECIFY)
EDUCATION	DEGREE	INSTITUTION CONFERRING	FIELDS	YEAR
(DEGREES CONFERRED - IDENTIFY HONORARY DEGREES IN FIELD)
OTHER RESEARCH TRAINING AND EXPERIENCE, PARTICULARLY IN AREA COVERED BY THIS APPLICATION	LOCATION	NATURE	YEAR
FIELDS OF PRESENT MAJOR SCIENTIFIC INTEREST IN ORDER OF CHOICE

NAME	TITLE
DATE OF BIRTH	PLACE OF BIRTH	SEX	CITIZENSHIP	US

OTHER (SPECIFY)
EDUCATION	DEGREE	INSTITUTION CONFERRING	FIELDS	YEAR
(DEGREES CONFERRED - IDENTIFY HONORARY DEGREES IN FIELD)
OTHER RESEARCH TRAINING AND EXPERIENCE, PARTICULARLY IN AREA COVERED BY THIS APPLICATION	LOCATION	NATURE	YEAR
FIELDS OF PRESENT MAJOR SCIENTIFIC INTEREST IN ORDER OF CHOICE

Page 4

PART V

TITLE VI STATEMENT

The attention of the proposed research contracting agency or institution is directed to the need to comply with the requirements of Title VI of the Civil Rights Act of 1964.

(Name of Contracting Agency) acknowledges that we are aware of the requirements of Title VI and will not discriminate on the basis of race, creed, sex, or national origin and will endeavor to involve the members of minority groups in the conduct of the proposed contract research study.

TECHNICAL RESEARCH PROPOSAL

Details of the proposed plan and other necessary data shall be typed (double-spaced) in accordance with the sequence and requirements defined in Chapter 2 of the LTRC Research Procedure Manual. Continue numbering pages in sequence for the entire proposal using the continuation sheet.

PART VI

SUMMARY OF PROPOSED RESEARCH