AOACRI REVIEWED AND RECOGNIZED (R^2)

Project Application
First Name *
Last Name *
Organization *
Title *
Address *
City/Town, State/Country, Postal Code *
Telephone *
Email Address *
LEGAL NAME OF METHOD UNIT *
Date of Submission: *

Month Day Year
Date

PART I.A. - FINANCIAL CONTACT INFORMATION

Please provide the contact iinformation for the person within your organization that will be responsible for receiving and processing the payments for invoicing.
Financial Contact: First Name *
Financial Contact: Last Name *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Telephone *
E-mail

PART II - TERMS & CONDITIONS

Please read all Terms and Conditions ( Certain Terms and Conditions are subject to change ).
AOAC INTERNATIONAL Policy Documents

Use of Association Name

Anti-Trust

Volunteer Conflict of Interest
AOAC Research Institute Fee Schedule
I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS.

Accept Decline

PART III- METHOD REVIEW
I have completed a Consulting Service application:

YES NO Not Needed Consulting Needed
Reviewed & Recognized (R^2) Program:

AOACRI Reviewed and Recognized (R2) AOACRI Reviewed and Recognized (R2) with OMA harmonization R2 Pesticides
* Please note, following the R^2 review Method Developers will need to submit an OMA application to advance to the OMA program.

PART IV - METHOD AUTHOR CONTACT INFORMATION

The method or study author is the person who will be primary contact for the method submission, including correspondence regarding application notes and reviews.
Method Author Contact Information *
Co-Method Author Contact Information
PART V- METHOD INFORMATION
Legal Name of Method/Product: *
Brief description of technology utilized: *
Catalog Number(s) - (if applicable)
Briefly describe Sample Preparation Procedure
Briefly describe analyte isolation procedures (Enrichment, Extraction procedures - if available)
Briefly describe method of detection/ determination/identification
Briefly describe any method confirmation, if applicable
State Matrices to be reviewed: *
Method Applicability and Intended Use *
Please attach a copy of pertinent documents for platform. *
Please attach QA/QC synopsis for manufacturing location.
Comments:
Are you currently working with an AOACRI Technical Consultant? *

Sharon Brunelle Maria Nelson Zerlinde Johnson Karen Silbernagel Dawn Dowell No technical consultant as been assigned Don Gilliland
INDEPENDENT LABORATORY RECOMMENDATIONS

Please recommend at least three independent laboratories from which bids can be solicited. Please be sure that the three laboratories are different. The AOAC-RI reserves the right to choose additional laboratories from which to solicit independent laboratory bids.
Potential Independent Laboratory #1
Potential Independent Laboratory #2
Potential Independent Laboratory #3
I UNDERSTAND THAT THE METHOD DEVELOPER AGREES TO PAY THE AOAC RESEARCH INSTITUTE THE ESTIMATED COSTS PER THE ACCEPTED BID OF THE INDEPENDENT LABORATORY FOR THE INDEPENDENT VALIDATION EVALUATION. AFTER THE INDEPENDENT EVALUATION IS COMPLETE, AOAC RESEARCH INSTITUTE WILL PROVIDE THE METHOD DEVELOPER AN INVOICE FOR ACTUAL FEES. AMOUNTS WILL BE RECONCILED IF ESTIMATED COSTS DIFFER FROM ACTUAL COSTS. THE INDEPENDENT LABORATORY REPORT MAY NOT BE RELEASED UNTIL ALL INDEPENDENT LABORATORY FEES HAVE BEEN REMITTED TO THE AOAC RESEARCH INSTITUTE. ADDITIONAL INDEPENDENT TESTING REQUIRING AN INCREASE IN COSTS WILL NOT BE PERFORMED WITHOUT THE WRITTEN APPROVAL OF THE METHOD DEVELOPER. *

I AGREE I DISAGREE

I UNDERSTAND THAT APPLICATION FEES MUST BE REMITTED PRIOR TO THE COMPLETION OF THE METHOD REVIEW TO RECEIVE COMPLETED DATA FOR FINAL REVIEW *

YES NO
I CERTIFY THAT THE RESPONSES IN THIS APPLICATION ARE ACCURATE TO THE BEST OF MY KNOWLEDGE. *

YES NO
I CERTIFY THAT I AM AUTHORIZED TO SUBMIT THIS APPLICATION. *

YES NO
I UNDERSTAND THAT A R^2 REVIEW INVOICE WILL BE FORWARDED IN THE AMOUNT OF: $10,000 until April 01, 2022. Fees there after will revert to $15,000 for AOACRI Member or $21,000 Non-AOACRI Member *

Yes
I understand that as a requirement of AOACRI approval, submission of a Certificate of Authenticity is required for multi-lingual application notes/instructions if the method is approved. Please print this form for future use.
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