ATTACHMENT19-Invoice_PreConferenceWorksheet.pdf

FORM APPROVED: OMB No. 0990-0115

Contractor Pre-Conference Expense Offset Worksheet

Contract Number:

Task Order/Work Assignment Number:

Conference Title:

Estimated Conference Expense/Registration Information Dollar Estimate

1. Direct Labor (specify by labor category)

2. Materials

3. Reproduction Costs

4. Conference Space/Meeting Rooms

5. Travel and/or Per Diem (deduct meals that are provided)

6. Hotel/Accommodations/Lodging rooms

7. Speaker Fees/Honoraria/Stipend

8. Audio Visual or other presentation costs

9. Transcription or Recording services

10. Light Refreshments

11. Meals

12. Other Direct Costs (list all other expenses and the associated costs for each)

13. Indirect Expenses (Fringe, Overhead, G&A)

14. Fee (if applicable)

15. Total Estimated Conference Costs (Sum of lines 1 - 14)

16. Per Person Registration Fee

17. Estimate of Fee Paying Attendees

18. Estimate of Total Registration Fees Collected (line 16 x line 17) *Must be less than Total Estimated Conference Costs (line 15)

19. Estimated Conference Costs Minus Registration Fee (line 15 – line 18)

NIH estimates that it will take 180 minutes to complete this form. This includes time for reviewing the instructions, gathering needed information, and completing the form. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. If you have comments regarding this burden estimate or any other aspects of the collection of information, including suggestions for reducing this burden, send comments to NIH Project Clearance Office, 6705 Rockledge Drive MSC 7974, Bethesda, MD 20892-7974, Attention: PRA (0990-0115). Do not return the completed form to this address.

Contractor Pre-Conference Expense Offset Worksheet (3/08) Page 1 of 1