Advanced Technology Program

0009 Attachment A

Advanced Technology Program

OMB: 0693-0009

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0693-0009 can be found here:

2007-09-28 - Revision of a currently approved collection

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Attachment A

OMB APPROVAL NUMBER: 0693-0009

APPROVAL EXPIRES MM/DD/YYYY

BASELINE REPORT

Introduction

This report is one of a series that you will complete throughout the life of your ATP project. These reports provide crucial information for ATP program officials to use in assessing the value of the ATP program, and reporting to policymakers and stakeholders. Thus it is important that you read the questions carefully and provide your best answer.

The primary purpose of the present report is to gather baseline information about your project and company. Because the information requested is quite diverse, the person completing this report may need to gather information from various company sources and personnel. These sources should include individuals with detailed knowledge of the technical and business aspects of the ATP-funded project, and general knowledge about your company as a whole.

Please respond to the questions on this report with regard to the following project:

Project title: []

Period of performance: []

Award Number: []

Administrative Information
Key Personnel
Subcontractors
Company Characteristics
ATP Project Characteristics
Research Effort
Technology Commercialization
Future BRS Reports

Section 1: Administrative Information

Principal Investigator

The Principal Investigator named in the terms and conditions of your ATP Cooperative Agreement is responsible for the overall direction and supervision of the ATP-funded project.

Please complete the following information for the Principal Investigator.

[If TYPE_OF_PARTICIPATION = JVP]

Technical Contact

The Technical Contact person for your company should be a mid- to senior-level person with responsibility for direction and supervision of technical work on this ATP-funded project.

Please complete the following information for your company’s Technical Contact.

TCON_FNAME First Name

TCON_LNAME Last Name

TCON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs., Ms.]

TCON_TITLE Position Title

TCON_GNDR Gender Male____ Female ______

TCON_ORG1 Organization Name Line 1

TCON_ORG2 Organization Name Line 2

TCON_ADD1 Street Address Line 1 (no PO Box addresses, please)

TCON_ADD2 Street Address Line 2

TCON_ADD3 Street Address Line 3

TCON_CITY City

TCON_STATE State

TCON_ZIP Zip

TCON_PHONE Telephone

TCON_EXT Ext.

TCON_FAX Fax

TCON_EMAIL E-mail

[Programmer Note: BCON_FNAME and BCON_LNAME are required fields]

Business Contact

The Business Contact person for your company should be a mid- to senior-level person with responsibility for business development and commercialization aspects of this ATP-funded project.

TCON_EQ_BCON

Is your Business Contact the same person as your

[If TYPE_OF_PARTICIPATION = SA or JVL

Principal Investigator: TCON_FNAME TCON_LNAME]

[If TYPE_OF_PARTICIPATION = JVP

Technical Contact: TCON_FNAME TCON_LNAME]

Yes 1

No 2

If TCON_EQ_BCON = 1 [Yes]: copy contact info for TCON into BCON variables

If TCON_EQ_BCON = 2 [No]:

Please complete the following information for your company’s Business Contact.

BCON_FNAME First Name

BCON_LNAME Last Name

BCON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs., Ms.]

BCON_TITLE Position Title

BCON_GNDR Gender Male____ Female ______

BCON_ORG1 Organization Name Line 1

BCON_ORG2 Organization Name Line 2

BCON_ADD1 Street Address Line 1 (no PO Box addresses, please)

BCON_ADD2 Street Address Line 2:

BCON_ADD3 Street Address Line 3

BCON_CITY City

BCON_STATE State

BCON_ZIP Zip

BCON_PHONE Telephone

BCON_EXT Ext.

BCON_FAX Fax

BCON_EMAIL E-mail

Administrative Contact

The Administrative Contact person is responsible for administrative issues relating to the ATP Cooperative Agreement, including managing contract, budget, and related matters.

Is your Administrative Contact the same person as your

ACON_EQ_TCON

[If TYPE_OF_PARTICIPATION = SA or JVL

Principal Investigator: TCON_FNAME TCON_LNAME]

[If TYPE_OF_PARTICIPATION = JVP

Technical Contact: TCON_FNAME TCON_LNAME]

[If TCON_EQ_BCON=No] or [If ACON_EQ_TCON =No]

ACON_EQ_BCON

Business Contact: [BCON_FNAME BCON_LNAME] ?

Yes 1

No 2

If ACON_EQ_TCON = Yes: copy contact info for TCON into ACON variables

If ACON_EQ_BCON = Yes: copy contact info for BCON into ACON variables

If both ACON_EQ_TCON and ACON_EQ_BCON =No:

Please complete the following information for your company’s Administrative Contact.

ACON_FNAME First Name

ACON_LNAME Last Name

ACON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs., Ms.]

ACON_TITLE Position Title

ACON_GNDR Gender Male____ Female ______

ACON_ORG1 Organization Name Line 1

ACON_ORG2 Organization Name Line 2

ACON_ADD1 Street Address Line 1 (no PO Box addresses, please)

ACON_ADD2 Street Address Line 2

ACON_ADD3 Street Address Line 3

ACON_CITY City

ACON_STATE State

ACON_ZIP Zip

ACON_PHONE Telephone

ACON_EXT Ext.

ACON_FAX Fax

ACON_EMAIL E-mail

Section 2: Key Personnel

Key Project Personnel

In the table below, please identify employees from your company who are key personnel for the ATP project at this time.

First Name	Last Name	Gender	Position Title	Delete Entry
[TCON_FNAME]	[TCON_LNAME]	Male………1 Female…….2	[TCON_TITLE]
[BCON_FNAME]	[BCON_LNAME]	Male………1 Female…….2	[BCON_TITLE]
[ACON_FNAME]	[ACON_LNAME]	Male………1 Female…….2	[ACON_TITLE]

KP#_FNAME	KP#_LNAME	KP#_GNDR	KP#_TITLE

Add/Update

Press ‘Add/Update’ button to add another row, or to update table.

[Programming note: The same person should not be listed more than once in this table]

For the key personnel listed below, please indicate the citizenship status of each person.

Name	Citizenship Status
[KP#_FNAME KP#_LNAME]	Born U.S. citizen = 1 Naturalized U.S. citizen =2 Permanent resident=3 Other=4

[KP#_FNAME KP#_LNAME]	KP#_CITIZEN

[Programmer note: Variables KP#_FNAME KP#_LNAME indicate the names of all key personnel, including TCON, BCON, ACON.]

For the key personnel shown below, please indicate graduate degrees that each person holds. Please check all that apply for each person.

Name	Master’s	PhD	MD	Other graduate degree

[KP#_FNAME KP#_LNAME]

[KP#_FNAME KP#_LNAME]	KP#_M	KP#_PHD	KP#_MD	KP#_OTH

For the key personnel shown below, please enter the university and department where the degree indicated was earned.

Name	Graduate degree	University	Department
[KP#_FNAME KP#_LNAME]	[highest degree selected in table above]

[KP#_FNAME KP#_LNAME]		KP#_DEG_UNIV	KP#_DEG_DEPT

[Programmer note: Show only the “highest” graduate degree selected in previous table. The order of priority is: (1) PhD, (2) MD, (3) Master’s, (4) Other graduate degree.]

For the key personnel listed below, please enter the total years of work experience of each person.

Name	Total years of work experience
	__ years
[KP#_FNAME KP#_LNAME ]

[KP#_FNAME KP#_LNAME ]	KP#_WRKEXP (0-99)

For the key personnel listed below, please indicate the role(s) each person serves on the ATP-funded project. Please check all that apply for each person.

Name	Technical Role	Business Development Role	Management Role

[KP#_FNAME KP#_LNAME]


[KP#_FNAME KP#_LNAME]	KP# _TECHROLE	KP# _BUSROLE	KP# _MGMTROLE

[Programmer note: In tables above, variable KP#_ indicates names of all key personnel, including TCON, BCON, ACON.]

Section 3: Subcontractors

Subcontractor Information

Does your company have any subcontractors for the ATP project? If so, please provide information on subcontractors that your company is using.

[If TYPE_OF_PARTICIPATION = JVL or JVP]

For joint venture (JV) projects, please report only subcontractors that your company pays directly. Other JV partner organizations will report subcontractors that they pay directly.

In the table below, please identify subcontractors working for your company on the ATP project.

Subcontractor Organization Name	City	State	Zip	Delete Entry


SUB#_ORG	SUB#_CITY	SUB#_STATE	SUB#_ZIP

Add/Update

Press ‘Add/Update’ button to add another row, or to update table.

[Fill out for each subcontractor]

SUB#_ORGTYPE

The subcontractor [SUB#_ORG] is a: (Check one)

For-profit business 1

University 2

Government laboratory 3

Non-profit organization 4

Other type of organization 5

SUB#_ EMPLOY

How many total employees does this subcontractor have?

Fewer than 10 1

10 to 99 2

100 to 499 3

500 or more 4

Please provide information for the person at [SUB#_ORG] responsible for carrying out the work on the subcontract.

SUB#_CON_FNAME First Name

SUB#_CON_LNAME Last Name

SUB#_CON_TITLE Position Title

SUB#_CON_SALUT [Drop down box with following options:

Dr., Mr., Miss, Mrs., Ms.]

SUB#_CON_GNDR Gender Male____ Female ______

SUB#_CON_ORG1 Organization Name Line 1

SUB#_CON_ORG2 Organization Name Line 2

SUB#_CON_ADD1 Address Line 1

SUB#_CON_ADD2 Address Line 2

SUB#_CON_ADD3 Address Line 3

SUB#_CON_CITY City

SUB#_CON_STATE State

SUB#_CON_ZIP Zip

SUB#_CON_PHONE Telephone

SUB#_CON_EXT Ext.

SUB#_CON_EMAIL E-mail

SUB#_PRIOR

Has your company worked with this subcontractor before (i.e., prior to the current ATP project)?

Yes 1

No 2

[If SUB_PRIOR = Yes]

SUB#_PRIORYRS

How many years of experience has your company had working with this subcontractor?

____ Years (1-99)

SUB#_AMOUNT

What is the total amount of this subcontract for the ATP project?

$__________ (0.00-999.99)

Thousands 1 SUB#_AMOUNT_UNITS

Millions 2

Does the work performed by this subcontractor on the ATP project involve:

		Yes	No
SUB#_RD	Collaborative R&D?	1	2
SUB#_EQUIP	Design and delivery of specialized equipment?	1	2
SUB#_MAT	Provision of specialized materials?	1	2
SUB#_TEST	Testing or laboratory services?	1	2
SUB#_OTH	Other	1	2
SUB#_OS	Please specify:

SUB#_DESC Please briefly describe the subcontract work, and indicate why this subcontractor was selected to perform the work.

________________________________________________

Section 4: Company Characteristics

Please provide descriptive information on your company [COMP_NAME]

Background Information

COMP_FORM

Is your company [COMP_NAME] a:

_Sole proprietorship? 1

_Partnership? 2

_Limited liability company (LLC)? 3

_Corporation? 4

COMP_MULTI_ESTAB

Does your company currently have more than one business location?

Yes 1

No 2

[If COMP_FORM = Corporation]

COMP_PUB

Is your company [COMP_NAME] a public company (i.e., company stock is publicly traded)?

Yes 1

No 2

COMP_PUB_TICKER

If yes, please provide the stock ticker symbol for your company:

____ Stock ticker symbol

[If COMP_FORM ≠ Corporation, then set COMP_PUB = No ]

[

If COMP_PUB = No]

COMP_EST_YR

In what year was your company established?

_____Year (1800-2005)

COMP_PARENT

Is your company wholly-owned or majority-owned by another company (i.e., a parent company)?

Yes 1

No 2

If COMP_PARENT = Yes:

COMP_PARENT_NAME

Please provide the name of your parent company:

________ Name

COMP_PUBPARENT

Is your parent company a public company (i.e., company stock is publicly traded)?

Yes 1

No 2

COMP_PARENT_TICKER

If yes, please provide the stock ticker symbol for your parent company:

____ Stock ticker symbol

COMP_PARENT_REVENUE

If your parent company is not a public company, what were total company revenues for your parent company last year?

$__________ (0.00-999.99)

Thousands 1 COMP_PAR_REV_UNITS

Millions 2

Billions 3

Employment Information

Please provide employment information for your company [COMP_NAME].

COMP_EMPLOY

Including full-time and part-time employees, how many employees did your company have at the end of the last calendar quarter?

_______ Total employees (0-999,999)

COMP_EMPLOY_RD

Including full-time and part-time employees, how many employees at your company worked in R&D at the end of the last calendar quarter?

____ R&D employees (0-999,999)

Financial Information

Please provide the following financial information for your company [COMP_NAME] from your last fiscal year financial report.

COMP_FISCALYR

What was the closing date for your last fiscal year reporting period?

____Month/Day/Year (Month: 1-12, Day: 1-31, Year: 2000-2005)

COMP_REVENUE

Including all sources of revenue (e.g., sales, licensing, research contracts, grants, etc.), what were total company revenues for the last fiscal year?

$__________ (0.00-999.99)

Thousands 1 COMP_REVENUE_UNITS

Millions 2

Billions 3

COMP_RD

What were total R&D expenditures at your company for the last fiscal year?

$__________ (0.00-999.99)

Thousands 1 COMP_RD_UNITS

Millions 2

Billions 3

[If COMP_PUB = No]

Please provide additional financial information for your company [COMP_NAME] from your last fiscal year financial report.

Income Statement

Amounts are reported in:

Thousands 1 INCOME_STATE_UNITS

Millions 2

Billions 3

COMP_REV Revenues $_____ (0.00-999.99)

COMP_COS Cost of Sales $_____ (0.00-999.99)

COMP_OI Income Before Taxes $_____ (-999.99-999.99)

COMP_NI Net Income $_____ (-999.99-999.99)

Balance Sheet

Amounts are reported in:

Thousands 1 BALANCE_STATE_UNITS

Millions 2

Billions 3

COMP_ASSET Total Assets $_____ (0.00-999.99)

COMP_ASSET_CURR Current assets $_____ (0.00-999.99)

COMP_ASSET_LT Long-term assets $_____ (0.00-999.99)

COMP_LIAB Total Liabilities $_____ (0.00-999.99)

COMP_LIAB_CURR Current liabilities $_____ (0.00-999.99)

COMP_LIAB_LT Long-term liabilities $_____ (0.00-999.99)

COMP_EQUITY Owners’ Equity $_____ (0.00-999.99)

[If COMP_EMPLOY < 500 AND COMP_PUB = No]

What share of your company’s ownership is held by:

Founders and top management ____% COMP_SHR_MGMT (0-100)

Individual investors (i.e., “angel” investors) ____% COMP_SHR_ANGEL (0-100)

Venture capital ____% COMP_SHR_VC (0-100)

Other companies ____% COMP_SHR_CORP (0-100)

Employees ____% COMP_SHR_EMPL (0-100)

Other, please specify: __________ ____% COMP_SHR_OTH (0-100)

COMP_SHR_OS

SUM 100%

Company Management

[If COMP_EMPLOY < 500 and COMP_PUB = No]

COMP_STARTUP

Do you consider your company to be a start-up company?

Yes 1

No 2

[If COMP_STARTUP = Yes]

STARTUP_PREV

Apart from your current company, have any of the senior members of your company been a founder of another start-up company?

Yes 1

No 2

STARTUP_EXP

Overall, how much experience do senior members of your company have with managing or directing start-up companies?

A great deal of experience 4

A moderate amount of experience 3

A little experience 2

No experience at all 1

[ If COMP_STARTUP = Yes]

STARTUP_BOARD

Does your company have a formally established Board of Directors?

Yes 1

No 2

STARTUP_SCIBOARD

Does your company have a formally established Scientific Advisory Board?

Yes 1

No 2

[ If COMP_STARTUP = Yes]

If STARTUP_BOARD = Yes:

STARTUP_BOARD_INTERACT

How often do senior members of your company consult with members of the Board of Directors (either formally or informally)?

More than once a week 6

Several times a month 5

About once a month 4

Several times a year 3

Once or twice a year 2

Less often than once a year 1

If STARTUP_SCIBOARD = Yes:

STARTUP_SCIBOARD_INTERACT

How often do senior members of your company consult with members of the Scientific Advisory Board (either formally or informally)?

More than once a week 6

Several times a month 5

About once a month 4

Several times a year 3

Once or twice a year 2

Less often than once a year 1

R&D Characteristics of Your Company

[If COMP_RD > 0]

You reported that your company’s total R&D expenditures for the fiscal year were: [COMP_RD][COMP_RD_UNITS].

What percent of your company’s R&D expenditures last fiscal year was devoted to:

Basic Research _____% COMP_RD_BAS (0-100)

Applied Research _____% COMP_RD_APP (0-100)

Product Development _____% COMP_RD_DEV (0-100)

SUM = 100%

COMP_RD_LT

What percent of your company’s R&D expenditures last fiscal year was devoted to research projects with project duration of three years or more?

_____% (0-100)

COMP_RD_EXT

What percent of your company’s R&D expenditures last fiscal year was funded from external resources (e.g., government sources, other companies)?

_____% (0-100)

If COMP_RD_EXT > 0:

Of your company’s externally funded R&D expenditures last year, what percent was from:

Federal government _____% COMP_RD_FED (0-100)

State and local government _____% COMP_RD_STATE (0-100)

Other companies _____% COMP_RD_CORP (0-100)

Other external sources _____% COMP_RD_OTH (0-100)

SUM = 100%

[If COMP_EMPLOY < 500]

COMP_SBIR

Has your company ever received R&D funding from a federal government SBIR program?

Yes 1

No 2

If yes, specify agency: __________ COMP_SBIR_SPEC

If COMP_SBIR = Yes:

COMP_SBIR_YR

What was the most recent year in which your company received an SBIR award?

_____ Year (1982-2005)

Has your company ever received assistance for R&D or business development through: (Please check all that apply.)

_ A state or local government program COMP_LOCALPROG

_ A university program COMP_UNIVPROG

_ A technology or business incubator COMP_INCUBATOR

COMP_PROGSUPPORT_YR

What was the most recent year in which your company received assistance from a state or local government program, university program, or technology or business incubator?

_____ Year (1980-2005)

[

If COMP_MULTI_ESTAB = Yes]

R&D Characteristics of Your Location

Since your company has more than one business location, please answer the following questions with respect to your own specific location.

ESTAB_TYPE

Is your business location dedicated exclusively to R&D (i.e., your business location performs only R&D, and no other functions such as manufacturing, sales, etc.)?

Yes 1

No 2

ESTAB_RD

What were total R&D expenditures at your business location for the last fiscal year?

$__________ (0.00-999.99)

Thousands 1 ESTAB_RD_UNITS

Millions 2

Billions 3

ESTAB_EMPLOY

At the end of the last calendar quarter, how many employees worked at your business location?

____ Employees (1-99,999)

ESTAB_EMPLOY_RD

At the end of the last calendar quarter, how many employees worked in R&D at your business location?

____ R&D employees (1-99,999)

Section 5: ATP Project Characteristics

Project Description

PROJ_DESC

Please describe the key technology and R&D expertise that your company brings to this project.

__________________________________

PROJ_GOAL

Please describe your company’s “big-picture” overall technical and business goal for this project?

__________________________________

Project Difficulty and Risk

PROJ_AMBITIOUS

Relative to other R&D initiatives in your industry, how ambitious would you say are the overall goals identified for this project?

Much less ambitious Equally ambitious Much more ambitious

1--------------2--------------3--------------4--------------5--------------6--------------7

To what extent would you say your project represents:

NEWDIR_COMP

A new R&D direction for your company?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

NEWDIR_FIELD

A new R&D direction for your industry or technology field?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

PROJ_DIFFICULT

Consider the technical difficulty of your ATP project. How does this project compare to a typical R&D project at your company?

Much less difficult Equally difficult Much more difficult

1--------------2--------------3--------------4--------------5--------------6--------------7

TYP_TECH_PROB

Consider technical risk. What would you say is the probability, from 0% to 100%, that a typical R&D project at your company can achieve all of the technical targets required for project success?

____% (0-100)

ATP_MINTECH_PROB

For your ATP project, consider the technical risk in achieving your minimal technical goals. What would you say is the probability, from 0% to 100%, that your company can achieve the minimal technical targets required for success on this project?

____% (0-100)

ATP_MAXTECH_PROB

For your ATP project, consider the technical risk in achieving your maximal “stretch” technical goals. What would you say is the probability, from 0% to 100%, that your company can achieve the maximal “stretch” technical goals for this project?

____% (0-100)

ATP_BUS_IMPACT_TIME

Consider the expected business impact of the ATP-funded project on your company. Approximately how many years after the start of the project do you expect results to first have an impact on company revenues or costs?

____years (0-99)

TYP_BUS_IMPACT_TIME

For a typical R&D project at your company, approximately how many years after the start of the project would you expect results to first have an impact on company revenues or costs?

____years (0-99)

[If TYPE_OF_PARTICIPATION = SA]

PROJ_PROB

Considering all aspects of technical and business risks and challenges, what is your current estimate of the probability, from 0% to 100%, that your company can fully achieve the overall goal for the project?

____% (0-100)

[If TYPE_OF_PARTICIPATION = JVL or JVP]

PROJ_PROB

Think about the overall goal of the joint venture (JV) project as a whole. Considering all aspects of technical and business risks and challenges, what is your current estimate of the probability, from 0% to 100%, that the JV project can fully achieve its overall goals?

____% (0-100)

PROJ_COMP_PROB

Think about your company’s overall goals for the project. Considering all aspects of technical and business risks and challenges, what is your current estimate of the probability, from 0% to 100%, that your company can fully achieve its overall goals?

____% (0-100)

Technology Source

Consider the relationship between your ATP project and other R&D projects at your company.

To what extent does your ATP project:

BUILD_PREV

Build on previous R&D work at your company?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

ENHANCE_PREV

Enhance the value of previous R&D work at your company?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

	To what extent is your ATP project based on:	Large Extent	Moderate Extent	Small Extent	Not at all
RES_UNIV	Research from universities	4	3	2	1
LIC_UNIV	Technology licensed from universities	4	3	2	1
RES_GOV	Research from government laboratories	4	3	2	1
LIC_GOV	Technology licensed from government laboratories	4	3	2	1
RES_NP	Research from non-profit institutions	4	3	2	1
LIC_NP	Technology licensed from non-profit institutions	4	3	2	1
RES_COMP	Research from other companies	4	3	2	1
LIC_COMP	Technology licensed from other companies	4	3	2	1

Technology Diffusion

Think about the types of knowledge that your ATP project is expected to produce.

Consider research findings to be knowledge that can be written down and easily communicated to others, and research “know-how” to be knowledge gained from experience and practice that is less easily transferred.

RESULTS_DIFFUSION

How quickly do you expect critical research findings from this project to become known to others outside your company?

Within 2 years of project end 1

2 to 5 years after project end 2

5 to 10 years after project end 3

10 or more years after project end 4

Never 5

KNOWHOW_DIFFUSION

How quickly do you expect the critical research “know-how” from this project to become known to others outside your company?

Within 2 years of project end 1

2 to 5 years after project end 2

5 to 10 years after project end 3

10 or more years after project end 4

Never 5

	To what extent does your company encourage staff to:	Large Extent	Moderate Extent	Small Extent	Not at all
RES_PUB	Publish articles in research journals	4	3	2	1
IND_PUB	Publish articles in trade publications	4	3	2	1
RES_CONF	Participate in research meetings and conferences	4	3	2	1
IND_CONF	Participate in industry meetings and conferences	4	3	2	1

To what extent does your company plan to actively disseminate:

RESULTS_DISSEM

Research findings from your ATP project?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

KNOWHOW_DISSEM

Research “know-how” from your ATP project?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

Intellectual Property and Innovation

[If TYPE_OF_PARTICIPATION = SA]

Consider the importance of existing intellectual property (IP) for carrying out your ATP project.

How important are each of the following:

Existing IP owned by your company OWN_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

Existing IP owned by other companies or organizations that your company already has access to under negotiated agreements LIC_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

Existing IP owned by other companies or organizations that your company will need to gain access to through future negotiation TBD_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

[If TYPE_OF_PARTICIPATION = JVL or JVP]

Consider the importance of existing intellectual property (IP) for carrying out your ATP joint venture (JV) project.

How important are each of the following:

Existing IP owned by your company OWN_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

Existing IP owned by your JV partners JVP_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

Existing IP owned by companies or organizations outside of your JV, that your company already has access to under negotiated agreements LIC_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

Existing IP owned by companies or organizations outside of your JV, that your company will need to gain access to through future negotiation TBD_BIP

Extremely important 4

Very important 3

Somewhat important 2

Not too important 1

BIP_PATENT

Does your ATP project depend on any key patents?

Yes 1

No 2

[If TYPE_OF_PARTICIPATION = SA] and [If BIP_PATENT = Yes]

Of the key patents that your ATP project depends on…

BIP_OWN_PATENTS

How many are owned by your company?

____ Patents (0-99)

BIP_LIC_PATENTS

How many are licensed from other companies or organizations?

____ Patents (0-99)

[If TYPE_OF_PARTICIPATION = JV] and [If BIP_PATENT = Yes]

Of the key patents that your ATP project depends on…

BIP_OWN_PATENTS

How many are owned by your company?

____ Patents (0-99)

BIP_JVP_PATENTS

How many are owned by your JV partners?

____ Patents (0-99)

BIP_LIC_PATENTS

How many are licensed from other companies or organizations outside your JV?

____ Patents (0-99)

	For your company, how important are each of the following means of capturing value from innovation:	Extremely important	Very important	Somewhat important	Not too important
VALCAP _SECRECY	Maintaining intellectual property through trade secrecy	4	3	2	1
VALCAP _PATENT	Maintaining intellectual property through patent or copyright protection	4	3	2	1
VALCAP _FIRSTMKT	Being first to market	4	3	2	1
VALCAP _RDCAPAB	Using complementary R&D capabilities	4	3	2	1
VALCAP _OTHCAPAB	Using complementary manufacturing, distribution, or service capabilities	4	3	2	1

	How important are the following reasons in your company’s decisions to patent technology:	Extremely important	Very important	Somewhat important	Not too important
PAT _PROFIT	To earn profits while keeping others from copying your technology	4	3	2	1
PAT _LICREV	To earn licensing revenues	4	3	2	1
PAT _TRADE	To gain access to the technology of others through cross-licensing agreements	4	3	2	1
PAT _BLOCK	To block others from patenting technology paths important to your company	4	3	2	1
PAT _DEFEND	To prevent patent infringement lawsuits against your company	4	3	2	1
PAT _RDREP	To enhance the reputation of your company and your R&D employees	4	3	2	1

R&D Collaboration

[If TYPE_OF_PARTICIPATION = SA]

COLLAB_RD

Has your company participated in collaborative R&D partnerships or relationships with other organizations within the past 3 years?

Yes 1

No 2

[If TYPE_OF_PARTICIPATION = JVL or JVP]

COLLAB_RD

Aside from your current ATP project, has your company participated in collaborative R&D partnerships or relationships with other organizations within the past 3 years?

Yes 1

No 2

[If COLLAB_RD = Yes]

Within the past 3 years, how many collaborative R&D partnerships or relationships has your company had with:

COLLAB_CORP

Other companies?

0 1

1-2 2

3-5 3

6-10 4

11+ 5

COLLAB_UNIV

Universities?

0 1

1-2 2

3-5 3

6-10 4

11+ 5

COLLAB_GOV

Government laboratories?

0 1

1-2 2

3-5 3

6-10 4

11+ 5

COLLAB_NP

Non-profit organizations?

0 1

1-2 2

3-5 3

6-10 4

11+ 5

[If TYPE_OF_PARTICIPATION = SA]

In developing your ATP-funded project, to what extent did …

SA_INDIV_TIES

Individuals in your company form new research ties or contacts with individuals at other organizations?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

SA_NEWREL

Your company establish new research partnerships or relationships with other organizations?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

SA_EXTENDREL

Your company extend or strengthen existing research relationships with other organizations?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

[If TYPE_OF_PARTICIPATION = JVL or JVP]

How important was each of the following reasons in your company’s decision to partner with other companies in the ATP-funded joint venture (JV) project.

		Extremely important	Very important	Somewhat important	Not too important
JV _POOL	To pool resources with other firms in order to reduce the cost of R&D or achieve a greater scale of effort	4	3	2	1
JV _RDCOMP	To benefit from complementary R&D expertise and capabilities of different firms	4	3	2	1
JV _LEARN	To gain knowledge and learn from other firms	4	3	2	1
JV _INDOBJ	To address a technological problem that is common to your industry	4	3	2	1
JV _BUS	To access commercialization capabilities of other firms	4	3	2	1
JV_OTH	Other,	4	3	2	1
JV_OS	please specify:

[

If TYPE_OF_PARTICIPATION = JVL or JVP]

JV_STRUCTURE

Which of the following best characterizes the structure of your JV?

One project leader; other partners have supporting roles 1

Some partners are principal participants; other partners have supporting roles 2

All partners have equally important roles 3

Would you characterize any of your JV partner companies as a:

JV_SUPPLIER

_ Supplier (partner company provides inputs to your company’s products/technologies)

JV_CUSTOMER

_ Customer (partner company purchases your company’s products/technologies)

JV_COMPLEMENTOR

_ “Complementor” (partner company’s products/technologies are used together with your company’s products/technologies)

JV_COMPETITOR

_ Competitor (partner company serves the same product market as your company)

JV_OTHER, JV_OSPEC

_ Other, please specify: ____________

JV_PRIOR_RESREL

Prior to this project, to what extent did your company have existing research relationships with your JV partner organizations?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

JV_PRIOR_BUSREL

Prior to this project, to what extent did your company have existing business relationships with your JV partner organizations?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

V_COLLAB_GENEXP

Prior to this project, to what extent did key members of your project team have experience working in R&D collaborations with other companies?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

JV_COLLAB_SPECEXP

Prior to this project, to what extent did key members of your project team have experience working with key members from your JV partners’ teams?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

Section 6: Research Effort

Line of Research

Consider the specific line of research represented by your ATP project.

LOR_DESC

Please provide a brief descriptive definition for this line of research.

_________________________

LOR_PREV3_RD

In the three years before the ATP award, how much R&D expenditure did your company devote to this line of research? (Your best estimate is fine. Please include expenditures from both internal and external sources of funding.)

$__________ (0.00-999.99)

Thousands 1 LOR_PREV3_UNITS

Millions 2

[If LOR_PREV3_RD > 0]

LOR_PREV3_RD_EXT

What percent of the R&D expenditures for this line of research was funded from external sources outside your company (e.g., government sources, other companies)?

_____% Percent of R&D funded from external sources (0-100)

[If LOR_PREV3_RD_EXT > 0]

For the three years prior to this ATP award, please indicate the sources of external funding for this line of research.

Did your company receive funding from the following sources?

LOR_FED, LOR_FED_SPEC

Federal government programs

Yes 1

No 2

Don’t Know -7

If Yes:

Specify agency and program:

______________________

LOR_LOCAL

State and local government programs

Yes 1

No 2

Don’t Know -7

LOR_OTH

Other companies

Yes 1

No 2

Don’t Know -7

Project Effort

PROJ_IDEA_DEV

To what extent had you developed this R&D project idea prior to thinking about applying to ATP?

Large extent 4

Moderate extent 3

Small extent 2

Not at all 1

PROJ_WO_ATP

If the ATP funding had not been received, do you think your company would be carrying out any part of this project at this time?

Yes 1

No 2

If PROJ_WO_ATP = Yes:

PROJ_WO_ATP_SCALE

Without ATP funding, how much of the ATP project do you think your company would be carrying out?

1% to 20% 1

21% to 40% 2

41% to 60% 3

61% to 80% 4

81% 100% 5

If PROJ_WO_ATP_SCALE = 5 (81% to 100%):

PROJ_WO_ATP_SAME

Without ATP funding, would you have undertaken a project with the same or equivalent technical goals and milestones as the ATP project?

Yes 1

No 2

[If TYPE_OF_PARTICIPATION = JVL or JVP]

JV_WO_ATP

If the ATP funding had not been received, do you think your company would be conducting collaborative work on this project research with any of your JV partner organizations at this time?

Yes 1

No 2

Section 7: Technology Commercialization

Commercialization Characteristics

NUM_LOB

How many lines of business does your company have?

__ Lines of business (0-99)

In the table below, please indicate the line(s) of business at your company that your project technology will serve.

Name of line of business	Approximately, what percent of your company’s revenues are from this line of business?	Approximately, what percent of your company’s R&D expenditures are devoted to this line of business?	Delete Entry
	____%	____%

LOB#_NAME	LOB#_REV	LOB#_RD
	(0-100)	(0-100)

Add/Update

Press ‘Add/Update’ button to add another row, or to update table.

Technology Innovation

TECH_INNOV

[If TYPE_OF_PARTICIPATION = SA]

Please briefly describe the key technological innovation of your ATP project.

[If TYPE_OF_PARTICIPATION = JVL or JVP]

Please briefly describe the key technological innovation of your ATP project, and your company’s contribution to that innovation.

__________________________________

TECH_ADVAN

What is the advantage of this technology over existing technologies or alternative technologies?

__________________________________

In the following questions, we use the term product to include both goods and services.

For your company, would you describe your ATP-funded technology as:

PRODUCT_TECH

A product technology to implement new or improved products with better performance characteristics

Yes 1

No 2

PROCESS_TECH

A process technology to implement new or improved methods of production or delivery

Yes 1

No 2

With commercialization of your technology, do you expect your company to …

REV_PROD

Earn new revenues from new products or significantly improved products?

Yes 1

No 2

Don’t Know -7

SAV_PROC

Realize cost savings from implementing new production or delivery processes?

Yes 1

No 2

Don’t Know -7

ROY_LIC

Receive royalties from licensing the technology to others?

Yes 1

No 2

Don’t Know -7

Product and Applications

We use the term product to include both goods and services.

Please think about the product (the good or service) from your company that incorporates the ATP project technology. This product embodies either a product innovation or a process innovation from the ATP project.

PROD_DESC

Please describe this product from your company. Describe the product in general terms; later in this section we will ask you to describe product applications.

[If TYPE_OF_PARTICIPATION = JVL or JVP ADD THE FOLLOWING]

For joint venture (JV) projects, please describe only your company’s product. Other JV partner companies will report on their products.

__________________________________

Compared to existing products, does this product provide …

__New features PROD_ADVAN_FEAT

__Improved performance PROD_ADVAN_PERF

__Lower cost PROD_ADVAN_COST

(Check all that apply.)

We use the term product application to mean applications to specific industry uses. Please describe potential product applications that your company has identified.

Potential product applications	Delete Entry



APP#_DESC

Add/Update

Press ‘Add/Update’ button to add another row, or to update table.

For product applications that will be commercialized from your ATP-funded technology, will your company carry out…

PROD_DEVEL

Product development?

Yes 1

No 2

Don’t Know -7

Not Applicable -8

PROD_MANU

Manufacturing?

Yes 1

No 2

Don’t Know -7

Not Applicable -8

PROD_MARKETING

Marketing/Sales?

Yes 1

No 2

Don’t Know -7

Not Applicable -8

PROD_DISTRIB

Distribution?

Yes 1

No 2

Don’t Know -7

Not Applicable -8

SEEK_SPART

Will your company seek strategic partners for commercializing your ATP project technology?

Yes 1

No 2

Don’t Know -7

Not Applicable -8

If SEEK_SPART =Yes:

What role will strategic partners play in commercializing your ATP project technology? (Check all that apply.)

__Product Development SPART_PD

__Manufacturing SPART_MANU

__Marketing/Sales SPART_MS

__Distribution SPART_DIST

__Other, please specify: ____________ SPART_OTH, SPART_OS

Commercialization Value

The following items ask about anticipated value from commercialization of your project technology.

ANNREV2, ANNREV5, ANNREV10

ANNREV2_UNITS, ANNREV5_UNITS, ANNREV10_UNITS

Consider the total impact of the ATP-funded technology on your company. What do you expect will be the net effect of this technology on your company’s annual revenues?

2 years after project end $_____ (0-999.9)

5 years after project end $_____ (0-999.9)

10 years after project end $_____ (0-999.9)

Thousands 1

Millions 2

Billions 3

PROFIT_MARGIN

What do you expect will be the gross profit margin on sales from your company’s products resulting from your technology?

____% (-100-999)

LOB_PROFIT_MARGIN

What is your company’s typical gross profit margin on sales in this line of business?

____% (-100-999)

ANNSAV2, ANNSAV5, ANNSAV10

ANNSAV2_UNITS, ANNSAV5_UNITS, ANNSAV10_UNITS

How much annual cost savings do you expect your company to receive from process improvements resulting from your technology?

2 years after project end $_____ (0-999.9)

5 years after project end $_____ (0-999.9)

10 years after project end $_____ (0-999.9)

Thousands 1

Millions 2

Billions 3

ANNLIC2, ANNLIC5, ANNLIC10

ANNLIC2_UNITS, ANNLIC5_UNITS, ANNLIC10_UNITS

How much in annual royalties do you expect your company to receive from licensing your technology to others?

2 years after project end $_____ (0-999.9)

5 years after project end $_____ (0-999.9)

10 years after project end $_____ (0-999.9)

Thousands 1

Millions 2

Billions 3

TOTAL_ADD_INVEST

Beyond the ATP project, how much total additional investment do you expect your company will need to make in order to commercialize the project technology?

$__________ (0-999.9)

Thousands 1 TOTAL_ADD_INVEST_UNITS

Millions 2

Billions 3

CALC_NPV

Did your company calculate a Net Present Value (NPV) in planning or seeking funding for this ATP project?

Yes 1

No 2

[If CALC_NPV = Yes]

NPV_VALUE

What was the Net Present Value your company calculated for this project?

$_____ Net present value (0-999.9)

Thousands 1 NPV_VALUE_UNITS

Millions 2

Billions 3

NPV_DISC_RATE

What discount rate did your company use in calculating the Net Present Value for this project?

____ % Discount rate (1-99)

CALC_IRR

Did your company calculate an Internal Rate of Return (IRR) in planning or seeking funding for this ATP project?

Yes 1

No 2

[If CALC_IRR = Yes]

IRR_VALUE

What was the Internal Rate of Return your company calculated for this project?

____ % Internal rate of return (-99-999)

USE_HURDLE

In making R&D or capital investment decisions, does your company base its decisions on a required rate of return (sometimes called the hurdle rate)?

Yes 1

No 2

[If USE_HURDLE = Yes]

RD_HURDLE

What is the required rate of return that your company typically applies to R&D investment decisions?

____ % Required rate of return for R&D investment (1-99)

CAP_HURDLE

What is the required rate of return that your company typically applies to capital investment decisions?

____ % Required rate of return for capital investment (1-99)

Finally, it is important that we have a ballpark estimate of the downstream benefits of your ATP-funded technology to industry users and consumers.

END_USER_NETVALUE2, END_USER_NETVALUE5, END_USER_NETVALUE10

END_USER_UNITS2, END_USER_UNITS5, END_USER_UNITS10

Think of how the industry might change, including both positive and negative effects, as a result of the commercialization of your ATP-funded technology. What is your estimate of the overall net value to your downstream industry users from products or services resulting from your technology?

2 years after project end $_____ (0-999.9)

5 years after project end $_____ (0-999.9)

10 years after project end $_____ (0-999.9)

Thousands 1

Millions 2

Billions 3

CONSUMER_NETVALUE2, CONSUMER_NETVALUE5, CONSUMER_NETVALUE10

NETVALUE_UNITS2, NETVALUE_UNITS5, NETVALUE_UNITS10

Think of how the consumer marketplace might change, including both positive and negative, as a result of the commercialization of your ATP-funded technology. What is your estimate of net benefits to consumers from products or services resulting from your technology?

2 years after project end $_____ (0-999.9)

5 years after project end $_____ (0-999.9)

10 years after project end $_____ (0-999.9)

Thousands 1

Millions 2

Billions 3

Section 8: Future BRS Reports

BRS Contact Person

The BRS Contact Person for your company will receive future notifications regarding BRS reports. From the list below, please designate your BRS Contact Person.

[INSERT KEY PERSONNEL TABLE WITH “ADD A NEW NAME OPTION”]

If TCON, BCON, or ACON selected, pre-fill all available information:

Please verify the following contact information for [selected name]:

RCON_FNAME First Name

RCON_LNAME Last Name

RCON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs.]

RCON_TITLE Position Title

RCON_GNDR Gender Male____ Female ______

RCON_ORG1 Organization Name Line 1

RCON_ORG2 Organization Name Line 2

RCON_ADD1 Street Address Line 1 (no PO Box addresses, please)

RCON_ADD2 Street Address Line 2:

RCON_ADD3 Street Address Line 3

RCON_CITY City

RCON_STATE State

RCON_ZIP Zip

RCON_PHONE Telephone

RCON_EXT Ext.

RCON_FAX Fax

RCON_EMAIL E-mail

If old name that is not TCON, BCON, OR ACON selected (pre-fill all available information):

Please provide the following contact information for [selected name]:

RCON_FNAME First Name

RCON_LNAME Last Name

RCON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs., Ms.]

RCON_TITLE Position Title

RCON_GNDR Gender Male____ Female ______

RCON_ORG1 Organization Name Line 1

RCON_ORG2 Organization Name Line 2

RCON_ADD1 Street Address Line 1 (no PO Box addresses, please)

RCON_ADD2 Street Address Line 2:

RCON_ADD3 Street Address Line 3

RCON_CITY City

RCON_STATE State

RCON_ZIP Zip

RCON_PHONE Telephone

RCON_EXT Ext.

RCON_FAX Fax

RCON_EMAIL E-mail

If “ADD A NEW NAME selected:

Please provide the following contact information for the BRS Contact Person:

RCON_FNAME First Name

RCON_LNAME Last Name

RCON_SALUT [Drop down box with following options: Dr., Mr., Miss, Mrs.]

RCON_TITLE Position Title

RCON_GNDR Gender Male____ Female ______

RCON_ORG1 Organization Name Line 1

RCON_ORG2 Organization Name Line 2

RCON_ADD1 Street Address Line 1 (no PO Box addresses, please)

RCON_ADD2 Street Address Line 2:

RCON_ADD3 Street Address Line 3

RCON_CITY City

RCON_STATE State

RCON_ZIP Zip

RCON_PHONE Telephone

RCON_EXT Ext.

RCON_FAX Fax

RCON_EMAIL E-mail

Comments

We are very interested in your reactions to this Baseline Report. Below are a few questions which will assist us in improving the report for future administrations.

DIFF_NAV

How difficult or easy was it to navigate through the report?

Very difficult 5

Somewhat difficult 4

Neither difficult or easy 3

Somewhat easy 2

Very easy 1

NUM_CONSULTED

How many people did you consult to answer questions on the report?

___________

REPORT_LIKED

Was there anything you particularly liked about this web-based report? If so, please tell us.

__________________________________

REPORT_IMPROVE

Are there any improvements that you would like to recommend? If so, please tell.

__________________________________

File Type	application/msword
File Title	Congratulations on your ATP award
Author	Jennifer O'Brien
Last Modified By	Ami Carbaugh
File Modified	2006-09-11
File Created	2006-09-11

Advanced Technology Program