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SBIR/STTR PHASE I FINAL REPORT COVER PAGE

NSF Award Number:

Project Title:

Date:

Period Covered by this Report:

Company Name:

PI Name:

Email:

Telephone Number:

Fax Number:

Company Address:

Please check as appropriate:

       Plan to submit Phase II Proposal:           January        July

       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.”

Certifications:

I certify that the Principal Investigator currently is      , is not      , “primarily employed” by the grantee organization as defined in the SBIR Solicitation.

I certify that the work under this project has      , has not     , been submitted for funding to another Federal agency and that it has      , has not     , been funded under any other Federal grant, contract, or subcontract.

I certify that to the best of my knowledge 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.

I certify that to the best of my knowledge (1) the statements herein(excluding scientific hypotheses and scientific opinions) are true and complete, and (2) the text and graphics in this report as well as any accompanying publications or other documents, unless otherwise indicated, are the original work of the signatories or individuals working under their supervision.  I understand that the willful provision of false information or concealing a material fact in this report or any other communication submitted to NSF is a criminal offense (U.S. Code, Title 18, Section 1001).

Authorized Company Officer Name:___________________________________________

Signature:________________________________________________Date:_____________

PI Name :__________________________________________________________________

P.I. Signature:____________________________________________Date:_____________   

NSF FORM 1372 (SBIR 10/97)

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