BASIC INFORMATION SHEET

Date Updated:

Project/Country:

Donor:

Internal Project Code:

Start Date: End Date:

Project Director:

Agreement Information/Requirements

Agreement No:

List of Modifications & Purpose:

Mod # Purpose

Current USAID Agreement Officer:

Current CTO Name:

Authorized Geographic Code:

Deliverables and Reporting Requirements: See deliverables schedule

Tracking Requirements:

Key Personnel:
Name Position

Approval Requirements:
1.
2.
3.
1
Special Requirements:

FINANCIAL INFO
Total Budget:

Current Obligated Amount:

Indirect Costs Amount: Indirect Cost Rate: Max Indirect Rate:

Cost Share Amount:

Line Item Flexibility:

Payment Office:

Cooperative Agreement Budget by Line item:

Line-item Amount

SUB-RECIPIENTS/SUB-GRANTS

Sub-recipients:

Name:

Start Date: End Date: Ceiling Amount:

Name:

Start Date: End Date: Ceiling Amount: