Forms 9.1 9.2 and 9.3.pdf

9.1 NOAA/SBIR Coverpage

This firm and/or Principal Investi gator ___ has __ has not submitted proposals for essentially equivalent w ork under other fede ral pro gram solicitations, or ___ has ___ has not received other federal awards for essentially equivalent work

NOAA/SBIR

SMALL BUSINESS INNOVATION RESEARCH

SOLICITATION NO.: NOAA 2011-1 CLOSING DATE: January 12, 2011

NAME OF SUBMITTING FIRM

TAXPAYER IDENTIFICATION NUMBER

DUNS NUMBER

ADDRESS OF FIRM (INCLUDING ZIP CODE + 4)

TITLE OF PROPOSED PROJECT

REQUESTED AMOUNT: $ PROPOSED DURATION: Six (6) Months

SOLICITATION SUBTOPIC NO. SOLICITATION SUBTOPIC TITLE

THE ABOVE ORGANIZATION CERTIFIES THAT: YES NO

1. It is a small business firm as defined on page 6.

2. The primary employment of the principal investigator will be with the firm at the time of award and during the conduct of the research.

3. A minimum of two-thirds of the research will be performed by this firm in Phase I.

4. It qualifies as a socially and economically disadvantaged small business as defined on page 7.

5. It qualifies as a woman-owned small business as defined on page 7.

6. It will permit the government to disclose the title and technical abstract page, plus the name, address and telephone number of the corporate official if the proposal does not result in an award to parties that may be interested in contacting you for further information or possible investment.

7. Is your business in a HUB Zone? (See: http://map.sba.gov/hubzone)

PRINCIPAL INVESTIGATOR/

PROJECT DIRECTOR

CORPORATE OFFICIAL

(BUSINESS) OTHER INFORMATION

NAME (Printed) NAME (Printed) YEAR FIRM FOUNDED

SIGNATURE SIG NATURE NUMBER OF EMPLOYEES

Average Previous 12 months _______

Currently _______

DATE DATE

TITLE TITLE HAS THIS PROPOSAL BEEN SUBMITTED

TO ANOTHER AGENCY?

Yes □ No □

IF YES, WHAT AGENCY?

TELEPHONE NO. + AREA CODE TELEPHONE NO. + AREA CODE

E-MAIL (Printed)

E-MAIL (Printed) FAX #

PROPRIETARY NOTICE

For any purpose other than to evaluate the proposal, this data shall not be disclosed outside of the Government and shall not be duplicated, used or disclosed in whole or in part, provided that if a funding agreement is awarded to this proposer as a result of or in connection with this submission of this data, the Government shall have the right to duplicate, use, or disclose the data to the extent provided in the funding agreement. This restriction does not limit the Government’s right to use information contained in the data source without restriction. The data in this proposal subject to this restriction is contained on separate proprietary page(s).

9.2 NOAA/SBIR Project Summary Form

NAME OF FIRM

AMOUNT REQUESTED

ADDRESS PHONE #

FAX #

E-MAIL:

PRINCIPAL INVESTIGATOR (NAME AND TITLE)

TITLE OF PROJECT

SOLICITATION SUBTOPIC NUMBER SOLICITATION SUBTOPIC TITLE

TECHNICAL ABSTRACT (LIMIT 200 WORDS)

SUMMARY OF ANTICIPATED RESULTS

9.3 NOAA/SBIR Proposal Summary Budget

FIRM: PROPOSAL NUMBER:

(Leave Blank)

PRINCIPAL INVESTIGATOR:

PRICE

DIRECT LABOR: $

OVERHEAD RATE: $

OTHER DIRECT COSTS: $

MATERIALS: $

GENERAL AND ADMINISTRATIVE (G&A): $

PROFIT: $

TOTAL PRICE PROPOSED: $

THIS PROPOSAL IS SUBMITTED IN RESPONSE TO NOAA SBIR PROGRAM SOLICITATION 2010-1 AND REFLECTS OUR BEST ESTIMATES AS

OF THIS DATE.

TYPED NAME AND TITLE DATE

SIGNATURE DATE