ProposalIntent.doc

PROPOSAL INTENT RESPONSE SHEET

RFP No.: NIHAO2008012 RFP Title: Operation of a Facility for the Study of Influenza Viruses and Vaccines in Adult Human Subjects.

Please review the attached Request for Proposal. Furnish the information requested below and return this page by 7/14/08. Your expression of intent is not binding but will greatly assist us in planning for proposal evaluation.

[ ] DO INTEND TO SUBMIT A PROPOSAL

[ ] DO NOT INTEND TO SUBMIT A PROPOSAL FOR THE FOLLOWING REASONS:

Company/Institution Name (print): ______________________________________

Address (print): _______________________________________________________

Project Director's Name (print): ________________________________________

Title (print): _________________________________________________________

Signature/Date: ________________________________________________

Telephone Number and E‑mail Address (print clearly): _____________________________________________________________

*Name of individual to whom any proposal instructions should be sent:

Name: ___________________________________________________

Title: ___________________________________________________

E‑Mail Address: __________________________________________

Telephone Number: _______________________________________

Names of Collaborating Institutions and Investigators (include Subcontractors and Consultants) (print):

(Continue list on a separate page if necessary)

RETURN VIA FAX OR E‑MAIL TO:

AMOB, NIAID, NIH

Room 2NE18

10401 Fernwood Road, MSC 4813

Bethesda, MD 20892‑4813

Attn: Alexander Kramer

RFP: NIHAO2008012

FAX# (301) 480-0689

Email : kramera@niaid.nih.gov