SBIR/STTR REPORT COVER PAGE (10-17-2012)
NSF Award Number:
Project Title:
Date:
Period Covered by this Report:
Company Name:
PI Name:
Telephone Number:
Email Address:
Company Address:
SBIR/ STTR Program Officer:
Please check as appropriate:
Phase I Award Interim Report
Phase I Award Final Report
Plan to submit Phase II Proposal
Phase II Award Interim Report
Phase II Award Final Report
Report contains Proprietary Information
Acknowledgment of NSF support and disclaimer:
“This material is based upon work supported by the National Science Foundation under Award
Number:______________. Any opinions, findings, and conclusions or recommendations expressed in this
publication are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.”
SBIR/STTR Funding Agreement Certification – Life Cycle Certification
All SBIR/STTR Phase I and Phase II awardees must complete this certification at all times set forth in the funding
Small Business Innovation Research Program Policy Directive
Small
agreement (as specified in the 2012
and
Business Technology Transfer Program Policy Directive
). This includes checking all of the boxes and having an
authorized officer of the awardee sign and date the certification each time it is requested.
Please read carefully the following certification statements. The Federal government relies on the information to
ensure compliance with specific program requirements during the life of the funding agreement. The definitions for
the terms used in this certification are set forth in the Small Business Act, the SBIR and STTR Policy Directive, and
also any statutory and regulatory provisions referenced in those authorities.