Fillable Sbir/sttr Report Cover Page (Page 2 of 3) in pdf

If the NSF Program Officer believes that the business is not meeting certain funding agreement requirements, the

agency may request further clarification and supporting documentation in order to assist in the verification of any of

the information provided.

Even if correct information has been included in other materials submitted to the Federal government, any action

taken with respect to this certification does not affect the Government’s right to pursue criminal, civil or

administrative remedies for incorrect or incomplete information given in the certification. Each person signing this

certification may be prosecuted if they have provided false information.

The undersigned has reviewed, verified and certifies that (one box must be checked for each):

(1) The principal investigator is/was “primarily employed” by the awardee as defined in the solicitation

during the term of the funding agreement, or the awardee has requested and received a written deviation

from this requirement from the NSF Program Officer.

Yes

Deviation approved in writing by the NSF Program Officer .

(2) All, essentially equivalent work, or a portion of the work performed under this project (check the

applicable line):

Has not been submitted for funding by another Federal agency.

Has been submitted for funding by another Federal agency but has not been funded under any other

Federal grant, contract, subcontract or other transaction.

A portion has been funded by another grant, contract, or subcontract as described in detail in the

proposal and approved in writing by the NSF Program Officer.

(3) The work is completed and awardee has performed the applicable percentage of work, unless a

deviation from this requirement is approved in writing by the NSF Program Officer(check the applicable

line and fill in if needed):

SBIR Phase I: at least two-thirds (66⅔ %) of the research performed by the awardee.

SBIR Phase II: at least half (50%) of the research by the awardee.

STTR Phase I and Phase II: at least 40% of the research performed by the awardee and at least 30%

performed by the non-profit research institution

Deviation approved in writing by the NSF Program Officer.

Not applicable because the work has not been completed at this time

(4) The work for which payment is hereby requested was performed in accordance with the award terms

and conditions and that payment is due and has not been previously requested.

Yes

No payment requested

A deviation in payment has been approved in writing by the NSF

Program Officer.

(5) All of the funds committed to this award, including all associated supplemental awards, have been fully

expended as designated in the grant budget.

Yes

No (Please provide a detailed explanation in the report)

Not applicable because the work has not been completed at this time.

(6) The research/research and development is/was performed in the United States unless a deviation is

approved in writing by the NSF Program Officer.

Yes

Waiver has been granted.

(7) The research/research and development is/was performed at the awardee’s facilities described in the

proposal by the awardee’s employees, except as otherwise indicated in the SBIR application and approved

in the funding agreement.

Yes

(8)

I will notify NSF immediately if all or a portion of the work proposed is subsequently funded by

another Federal agency.

Sbir/sttr Report Cover Page Page 2

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