;n ? 20 89 
5 \o J925 tbl 
DEPARTMENT OF HEALTH AND HUMAN SERVICE 
PUBLIC HEALTH SERVICE 
g LEAVE 
3LANK 
TYPE ACTIVITY 
NUMEE= 
GRANT APPLICATION 
REVIEW GROUP 
FORMERLY 
FOLLOW INSTRUCTIONS CAREFULLY 
| COUNCILBOARD ( Montn . year) 
DATE RECEIVED 
1. TITLE OF PROJECT (Up to 56 spaces) 
Mechanism and Genetics of Vancomvcin 
Resistance 
2. RESPONSE TO SPECIFIC PROGRAM ANNOUNCEMENT X NO 
FIRST Award 
_ YES (If "YES." state RFA number and/or announcement title) 
3. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR 
NEW INSTIGATOR XI 
3a. NAME -.Last, first, middle) 
Har.dwerger, Sandra 
3b. DEGREEiS) 
MD 
! 3c. SOCIAL SECUF "Y NUMEER 
121 - 44-0418 
3d. POSITION TITLE 
Assistant Professor of Medicine’ 
3f. DEPARTMENT. SERVICE. LABORATORY OR EQUIVALENT 
Department of Medicine 
Division of Infectious Diseases 
3e. MAILING ADDRESS (Street, city, state, zip coze 
Beth Israel Medical Center 
First Avenue at 16th Street 
New York, New York 10003 
3g. MAjOR SUBDIVISION 
Mount Sinai School of Medicine 
3h. TELEPHONE : Area code, n^moer anc extensio~ 
(212) 420-4005 
HUMAN SUBJECTS 
4a. IX No G Yes 
_ Exemption # . 
OR 
j IRB Approval Date , 
4b. Assurance of Compliance P 
5. VERTEBRATE ANIMALS 
5a. X No 
Yes 
IACUC Approval Date 
5b. Animal Welfare Assurance 
6. DATES OF ENTIRE PROPOSED PROJECT 7. COSTS REQUESTED FOR FiRST 
PERIOD ] 12-MONTH BUDGET PERIOD 
_ , 1 7a. Direct Costs 7b. Total Costs 
F-om: July 1989 j ; 
Througn: June 1994 jS $65,923 jS 108,296 
18. COSTS REQUESTED FCR ENTIRE 
PROPOSED PROJECT PERIOD 
8a. Direct Costs 8b. "eta 1 Tests 
'S 320,715 
S 532,779 
S. PERFORMANCE Si i ES ( Organizations and addresses) 
Beth Israel Medical Center 
Mount Sinai School of Medicine 
First Avenue at 16th Street 
New York, New York 10003 
; 10. INVENTIONS i Competing continuation application omy) 
NO 
YES 
Previously reported 
1 _ Not previously resorts" 
11. APPLICANT ORGANIZATION (Name, address, ana congressional 
district) 
Beth Israel Medical Center 
First Avenue at 16th Street 
New York, New York 10003 
18th Congressional District 
TY = E OF ORGANIZATION 
_ Puclic. Specify _ Feoeral 
X Private Nonprofit 
_ For Profit I General) 
_ For P'ofit r Small Businessi 
_ State . Local 
13. ENTITY IDENTIFICATION NUMEER 
1135564934 Al 
14. ORGANIZATIONAL COMPONENT TO RECE -'E D = EDIT 
TOWARDS A BIOMEDICAL RESEARCH SU==CR~ GRANT 
Code 
13 10 
Identification Hospital 
15. OFFICIAL IN BUSINESS OFFICE TO BE NOTIFIED IF AN 
AWARD IS MADE (Name, title, address and telephone number) 
Najmuddin Pervez 
Senior Vice President, Financial Affairs 
Beth Israel Medical Center 
First Avenue at 16th Street 
New York, New York 10003 (212)420-4005 
16. OFFICIAL SIGNING FOR APPUCfN 
cnona 
ORGAN IZA.WGAJ 
'/mh. title, address and taiecy’ronff'numcen ^ \ 
' ptxu /ui o _ 
Thomas Killip, M.D. 
Executive Vice President 
Beth Israel Medical Center 
First Avenue at 16th Street - NY ', NY lOuG 
17. PRINCIPAL INVESTIGATOR/ PROG RAM DIRECTOR ASSURANCE: I 
ac'ee to accept responsibility for tne scientific conduct of the project 
anc tc provide the recuired progress repons if a grant is awarded as 
a -esuit of tms application. Willful prevision of false information is a 
criminal offense (U.S. Code. Title t8. Section 1001). 
SIGNATURE OF PERSON NAMED IN 3a 
11 In ink. Per " signature .net acceptable.: 
•_/ 
/c /j /as 
1£. CERTIFICATION AND ACCEPTANCE: I certify that the statements 
herein are true and complete to the Dest of my knowlecge. and accept 
the ooiigation to comDlv with Public Health Service terms and condi- 
tions if a grant is awarded as the result of this application. A willfully 
false certification is a criminal offense (U.S. Cede. Title tS. Section 1001). 
SIGNATURE OF PERSON NAMED IN 
{(In ink. "Per" signature not acceptable . 1 
■fylr 
[ 414 ] 
Recombinant DNA Research, Volume 13 
