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Admin Tribe Selection Last updated: 09/15/2015 This is my Form. Page 1 Please select to which tribe this Organization has applied to: Salt River 1 of 1 Last updated: 09/16/2015 Page 1 General information Organization Translational Genomics Research Institute Contact First name Alicia Contact Last name Cybulski Contact e-mail acybulski@tgen.org Contact phone number 6023438411 Address Street 445 N. 5th Street Suite 120 City Phoenix State AZ ZIP Code 85004 What is the name of the program or project for which your organization is requesting grant funds? Accelerating Personalized Medicine For what grant amount does the organization wish to request? 150,000.00 1 of 1 Deportment of the Treasury 4'1 IRS Infernal Revenue Service In reply refer to: 0248653327 P.O. Cincinnati Box 2508 OH 45201 Sep. 23 7 2009 LTR 4168C E0 33-1092191 000000 00 00013451 BODC: TE TRANSLATIONAL GENOMICS RESEARCH INSTITUTE FOUNDATION TGEN FOUNDATION 400 E VAN BUREN ST STE 850 PHOENIX AZ 85004-2249 L4358 Employer Identification Number: 33-1092191 Person to Contact: Ms. Espelage Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your request of Sep. 14, 2009, regarding your tax-exempt status. Our records indicate that a determination letter was issued in September 2004, that recognized you as exempt from Federal income tax, and discloses that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, 11€2Atie__(-1(_ Michele M. Sullivan, Oper. Mgr. Accounts Management Operations I tge FOUNDATION July 23, 2015 Ms. Angela Salazar-Willeford 12% Grant Application Office of Congressional and Legislative Affairs 10005 E. Osborn Rd. Scottsdale, AZ 85256 Dear Ms. Salazar-Willeford, We are honored to submit the enclosed application from the Translational Genomics Research Institute (TGen) for the consideration of the Salt River Pima-Maricopa Indian Community's 12 percent Gaming Contributions Committee. We appreciate the opportunity to apply for funding and are grateful for your support. The proposal continues to build upon the previous generous contributions from SRP- MIC to enhance TGen's commitment to apply the latest tools of genomic medicine to diagnose, treat, and prevent disease. On behalf of Dr. Jeffrey Trent and TGen's scientists and clinicians, thank you for your visionary leadership and support of our research. We are honored to partner with you and hope that you are pleased with the continued return on your investment. If you have any questions regarding the enclosed proposal or would like additional information about our research programs, please contact me directly by phone at (602) 343-8639 or via email at acybulski@tgen.org . Sincerely, ,K) Alicia Cybulski Database Specialist TGen Foundation 1 445 North Fifth Street, Suite 120 1 Phoenix, Arizona 85004 Main 602.3418411 1 Toll Free 1.866.370.8436 Fax 602,343.8441 1 helptgen.org SALT RIVER PIMA-MARICOPA INDIAN COMMUNITY 10005 E. Osborn Road, Scottsdale, Arizona 85256 / (480) 362 -7400 12% GAMING CONTRIBUTIONS APPLICATION Date of Application: July 23, 2015 Organization name: Translational Genomics Research Institute (TGen) Organization/Municipal Government Street & Mailing Address: Maricopa County, Government Relations, 301 W. Jefferson, 10 th Floor, Phoenix, Arizona 85255 Contact person and Project Manager if different from Contact Person: Alicia Cybulski Title: Database Specialist Address: 445 N. 5th Street, Suite 120, Phoenix, AZ 85004 Phone: (602) 343-8639 Fax: (602) 343-8441 Email Address: acybulski@tgen.org Project Name: Accelerating Personalized Medicine Please provide a brief description of the project submitted to the 12% SRPMIC Grant Program. TGen continues to deliver against its mission to translate genomic discoveries into advances in human health and thus, positioning precision medicine at the forefront of health care delivery and strives to build on the generous investment that Salt River Pima-Maricopa Indian Community has made in this area. Through continued research and development, TGen is making technological strides in genomic applications that are successfully tackling some of the most complex health issues of today. These technologies are unlocking the biology of the complexity and clinical diversity of disease in ways not previously possible, leading to transformative changes in health care practices in how we diagnosis and treat disease. We are working to accelerate personalized medicine: bringing the right treatment to the right patient at the right time. By using state-of-the-art technology, such as Next Generation Sequencing, we are able to deliver molecularly informed treatment strategies to patients and provide hope and answers to them and their families. This funding will be used to support the highly specialized people, equipment, and materials needed to quickly move discoveries from the "bench to bedside" and ensure that these become the standard of care. From research to study biomarkers to detect disease early, diagnosing children with rare disorders, and understanding the spread of cancer, genomics shapes our understanding of disease and its prevention and treatment. Beginning Date of Project: Ongoing Research End Date of the Project: Ongoing Research Geographic Area: Maricopa County, as well as the State of Arizona Budget Cost Sequencing Costs $ 100,000 Data Administration $ 20,000 IT and Technology Support $ 20,000 Project Management $ 10,000 Total: $ 150,000 Amount of Total Project: Scalable Project Amount of 12% Request: $150,000 If the Amount of funding received is less than the amount needed for the project, do you have other funds to complete the project? (Please explain) TGen will continue to rely on funding from grants, contracts, and additional philanthropic gifts. If you receive SRPMIC 12% funding, will it be spent (Check One): Monthly El Quarterly 0 Lump Sum List SRPMIC 12% monies you have received in the past. Year Amount Purpose June 2003 $5 million pledge Start-up funding to support TGen's biotechnology research efforts October 2003 $1 million payment Start-up funding to support TGen's biotechnology research efforts November 2004 $1 million payment Start-up funding to support TGen's biotechnology research efforts December 2005 $1 million payment Start-up funding to support TGen's biotechnology research efforts I November 2007 $2 million payment Start-up funding to support TGen's biotechnology research efforts January 2010 $200,000 Key technologies to provide earlier diagnostics,better prognostics, and smarter treatments December 2010 $175,000 Support for next generation sequencing capabilities December 2011 $175,000 Molecular profiling of rare pediatric disorders January 2013 $150,000 General molecular profiling December 2013 $125,000 General molecular profiling December 2014 $125,000 "Accelerating Personalized Medicine" List any other 12% grant funds your organization may be seeking from other Tribal Governments in 2015-2016. TGen is not currently seeking 12% grant monies from any other Tribal Governments. List any other monies you have received from the SRPMIC and identify the source: N/A Funding for the project/programs may be based on available funding. As such, if funding were not available for the full amount of the request, how would you prioritize funding. The program is scalable, and the funding would be used to sequence the genomes of as many patients as possible. Which municipal governmental entity will serve as your pass through or accept 12% funds on your behalf? Maricopa County By execution of this 12% Gaming Contributions Grant Application, the undersigned agrees that the information contained in the Application is true to the best of the Applicant's knowledge. The Applicant shall notify the SRPMIC if any information in this Application changes. 7-23- 1 -5 Date Michael Bassoff — President, TGen Foundation Name and Title The Application shall be signed by the senior elected official of the local government, or in the case of a nonprofit entity, the Chief Executive Officer authorized to commit the nonprofit entity to apply for, accept and implement an award from the SRPMIC utilizing 12% Gaming Contributions.