**\*\*\*\* (USE BELOW, WHEN THE CONTRACT REQUIRES THE INCLUSION OF
NIH(RC)-1.) \*\*\*\***

[INVOICE/FINANCING REQUEST INSTRUCTIONS]{.underline}

[FOR NIH COST-REIMBURSEMENT TYPE CONTRACTS, NIH(RC)-1]{.underline}

**Format:** Payment requests shall be submitted on the Contractor's
self-generated form in the manner and format prescribed herein and as
illustrated in the Sample Invoice/Financing Request. Standard Form 1034,
Public Voucher for Purchases and Services Other Than Personal, may be
used in lieu of the Contractor's self-generated form provided it
contains all of the information shown on the Sample Invoice/Financing
Request. DO NOT include a cover letter with the payment request.

**Number of Copies:** Payment requests shall be submitted in the
quantity specified in the Invoice Submission Instructions in Section G
of the Contract Schedule.

**Frequency:** Payment requests shall not be submitted more frequently
than once every two weeks in accordance with the Allowable Cost and
Payment Clause incorporated into this contract. Small business concerns
may submit invoices/financing requests more frequently than every two
weeks when authorized by the Contracting Officer.

**Cost Incurrence Period:** Costs incurred must be within the contract
performance period or covered by precontract cost provisions.

**Billing of Costs Incurred:** If billed costs include (1) costs of a
prior billing period, but not previously billed, or (2) costs incurred
during the contract period and claimed after the contract period has
expired, the Contractor shall site the amount(s) and month(s) in which
it incurred such costs.

**Contractor\'s Fiscal Year:** Payment requests shall be prepared in
such a manner that the Government can identify costs claimed with the
Contractor\'s fiscal year.

**Currency:** All NIH contracts are expressed in United States dollars.
When the Government pays in a currency other than United States dollars,
billings shall be expressed, and payment by the Government shall be
made, in that other currency at amounts coincident with actual costs
incurred. Currency fluctuations may not be a basis of gain or loss to
the Contractor. Notwithstanding the above, the total of all invoices
paid under this contract may not exceed the United States dollars
authorized.

**Costs Requiring Prior Approval:** Costs requiring the Contracting
Officer\'s approval, which are not set forth in an Advance Understanding
in the contract, shall be identified and reference the Contracting
Officer\'s Authorization (COA) Number. In addition, the Contractor shall
show any cost set forth in an Advance Understanding as a separate line
item on the payment request.

**Invoice/Financing Request Identification:** Each payment request shall
be identified as either:

\(a\) **Interim Invoice/Contract Financing Request:** These are interim
payment requests submitted during the contract performance period.

\(b\) **Completion Invoice:** The completion invoice shall be submitted
promptly upon completion of the work, but no later than one year from
the contract completion date, or within 120 days after settlement of the
final indirect cost rates covering the year in which the contract is
physically complete (whichever date is later). The Contractor shall
submit the completion invoice when all costs have been assigned to the
contract and it completes all performance provisions.

\(c\) **Final Invoice:** A final invoice may be required after the
amounts owed have been settled between the Government and the Contractor
(e.g., resolution of all suspensions and audit exceptions).

**Preparation and Itemization of the Invoice/Financing Request:** The
Contractor shall furnish the information set forth in the instructions
below. The instructions are keyed to the entries on the Sample
Invoice/Financing Request.

\(a\) **Designated Billing Office Name and Address:** Enter the
designated billing office name and address, as identified in the Invoice
Submission Instructions in Section G of the Contract Schedule.

\(b\) **Contractor\'s Name, Address, Point of Contact, VIN, and DUNS or
DUNS+4 Number:** Show the Contractor\'s name and address exactly as they
appear in the contract, along with the name, title, phone number, and
e-mail address of the person to notify in the event of an improper
invoice or, in the case of payment by method other than Electronic Funds
Transfer, to whom payment is to be sent. Provide the Contractor's Vendor
Identification Number (VIN), and Data Universal Numbering System (DUNS)
number or DUNS+4. The DUNS number must identify the Contractor's name
and address exactly as stated on the face page of the contract. When an
approved assignment has been made by the Contractor, or a different
payee has been designated, provide the same information for the payee as
is required for the Contractor (i.e., name, address, point of contact,
VIN, and DUNS).

\(c\) **Invoice/Financing Request Number:** Insert the appropriate
serial number of the payment request.

\(d\) **Date Invoice/Financing Request Prepared:** Insert the date the
payment request is prepared.

\(e\) **Contract Number and Order Number (if applicable):** Insert the
contract number and order number (if applicable).

\(f\) **Effective Date:** Insert the effective date of the contract or
if billing under an order, the effective date of the order.

\(g\) **Total Estimated Cost of Contract/Order:** Insert the total
estimated cost of the contract, exclusive of fixed-fee. If billing under
an order, insert the total estimated cost of the order, exclusive of
fixed-fee. For incrementally funded contracts/orders, enter the amount
currently obligated and available for payment.

\(h\) **Total Fixed-Fee:** Insert the total fixed-fee (where
applicable). For incrementally funded contracts/orders, enter the amount
currently obligated and available for payment.

\(i\) **Two-Way/Three-Way Match:** Identify whether payment is to be
made using a two-way or three-way match. To determine required payment
method, refer to the Invoice Submission Instructions in Section G of the
Contract Schedule.

\(j\) **Office of Acquisitions:** Insert the name of the Office of
Acquisitions, as identified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(k\) **Central Point of Distribution:** Insert the Central Point of
Distribution, as identified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(l\) **Billing Period:** Insert the beginning and ending dates (month,
day, and year) of the period in which costs were incurred and for which
reimbursement is claimed.

\(m\) **Amount Billed - Current Period:** Insert the amount claimed for
the current billing period by major cost element, including any
adjustments and fixed-fee. If the Contract Schedule contains separately
priced line items, identify the contract line item(s) on the payment
request and include a separate breakdown (by major cost element) for
each line item.

\(n\) **Amount Billed - Cumulative:** Insert the cumulative amounts
claimed by major cost element, including any adjustments and fixed-fee.
If the Contract Schedule contains separately priced line items, identify
the contract line item(s) on the payment request and include a separate
breakdown (by major cost element) for each line item.

\(o\) **Direct Costs:** Insert the major cost elements. For each
element, consider the application of the paragraph entitled \"Costs
Requiring Prior Approval\" on page 1 of these instructions.

\(1\) **Direct Labor:** Include salaries and wages paid (or accrued) for
direct performance of the contract.

> For Level of Effort contracts only, the Contractor shall provide the
> following information on a separate sheet of paper attached to the
> payment request:
>
> -hours or percentage of effort and cost by labor category (as
> specified in the Level of Effort Article in Section F of the contract)
> for the current billing period, and
>
> -hours or percentage of effort and cost by labor category from
> contract inception through the current billing period. (NOTE: The
> Contracting Officer may require the Contractor to provide additional
> breakdown for direct labor, such as position title, employee name, and
> salary or hourly rate.)

\(2\) **Fringe Benefits:** List any fringe benefits applicable to direct
labor and billed as a direct cost. Do not include in this category
fringe benefits that are included in indirect costs.

\(3\) **Accountable Personal Property:** Include permanent research
equipment and general purpose equipment having a unit acquisition cost
of \$1,000 or more, with a life expectancy of more than two years, and
sensitive property regardless of cost (see the HHS *Contractor\'s Guide
for Control of Government Property*). Show permanent research equipment
separate from general purpose equipment.

> On a separate sheet of paper attached to the payment request, list
> each item for which reimbursement is requested. An asterisk (\*) shall
> precede the item if the equipment is below the \$1,000 approval level.
> Include reference to the following (as applicable):
>
> -item number for the specific piece of equipment listed in the
> Property Schedule, and
>
> -COA number, if the equipment is not covered by the Property Schedule.
>
> The Contracting Officer may require the Contractor to provide further
> itemization of property having specific limitations set forth in the
> contract.

\(4\) **Materials and Supplies:** Include equipment with unit costs of
less than \$1,000 or an expected service life of two years or less, and
consumable material and supplies regardless of amount.

\(5\) **Premium Pay:** List remuneration in excess of the basic hourly
rate.

\(6\) **Consultant Fee:** List fees paid to consultants. Identify
consultant by name or category as set forth in the contract or COA, as
well as the effort (i.e., number of hours, days, etc.) and rate billed.

\(7\) **Travel:** Include domestic and foreign travel. Foreign travel is
travel outside of Canada, the United States and its territories and
possessions. However, for an organization located outside Canada, the
United States and its territories and possessions, foreign travel means
travel outside that country. Foreign travel must be billed separately
from domestic travel.

\(8\) **Subcontract Costs:** List subcontractor(s) by name and amount
billed.

\(9\) **Other:** List all other direct costs in total unless exceeding
\$1,000 in amount. If over \$1,000, list cost elements and dollar
amounts separately. If the contract contains restrictions on any cost
element, that cost element must be listed separately.

\(p\) **Cost of Money (COM):** Cite the COM factor and base in effect
during the time the cost was incurred and for which reimbursement is
claimed.

\(q\) **Indirect Costs:** Identify the indirect cost base (IDC),
indirect cost rate, and amount billed for each indirect cost category.

\(r\) **Fixed-Fee:** Cite the formula or method of computation for
fixed-fee, if applicable. The fixed-fee must be claimed as provided for
by the contract.

\(s\) **Total Amounts Claimed:** Insert the total amounts claimed for
the current and cumulative periods.

\(t\) **Adjustments:** Include amounts conceded by the Contractor,
outstanding suspensions, and/or disapprovals subject to appeal.

\(u\) **Grand Totals**

\(v\) **Certification of Salary Rate Limitation:** If required by the
contract (see Invoice Submission Instructions in Section G of the
Contract Schedule), the Contractor shall include the following
certification at the bottom of the payment request:

> "I hereby certify that the salaries billed in this payment request are
> in compliance with the Salary Rate Limitation Provisions in Section H
> of the contract."

**The Contracting Officer may require the Contractor to submit detailed
support for costs claimed on one or more interim payment requests.**

**SAMPLE INVOICE/FINANCING REQUEST**

\(a\) Designated Billing Office Name and Address: (c) Invoice/Financing
Request No.:

National Institutes of Health (d) Date Invoice Prepared:

Office of Financial Management

Commercial Accounts (e) Contract No. and Order No. (if applicable):

2115 East Jefferson Street, Room 4B432, MSC 8500

Bethesda, MD 20892-8500

\(f\) Effective Date:

\(b\) Contractor\'s Name, Address, Point of Contact,

VIN, and DUNS or DUNS+4 Number: (g) Total Estimated Cost of
Contract/Order:

ABC CORPORATION

100 Main Street (h) Total Fixed-Fee (if applicable):

Anywhere, U.S.A. Zip Code

[Name, Title, Phone Number, and E-mail]{.underline} (i) Two-Way Match:

[Address of person to notify in the event of an]{.underline} Three-Way
Match:

[improper invoice or, in the case of payment]{.underline}

> [by method other than Electronic Funds]{.underline} (j) Office of
> Acquisitions:

[Transfer, to whom payment is to be sent.]{.underline}

\(k\) Central Point of Distribution:

VIN:

DUNS or DUNS+4:

\(l\) This invoice/financing request represents reimbursable costs from
Aug. l, 2007 through Aug. 31, 2007.

\(m\) Amount Billed - (n) Amount - Billed

[Current Period]{.underline} [Cumulative]{.underline}

\(o\) Direct Costs

\(1\) Direct Labor \$ 3,400 \$ 6,800

\(2\) Fringe Benefits 600 1,200

\(3\) Accountable Personal Property

Permanent Research 3,000 6,000

General Purpose 2,000 2,000

\(4\) Materials and Supplies 2,000 4,000

\(5\) Premium Pay 100 150

\(6\) Consultant Fee-Dr. Jones 1 day @ 100 (COA #3) 100 100

\(7\) Travel (Domestic) 200 200

(Foreign) 200 200

\(8\) Subcontract Costs -0- -0-

\(9\) Other [-0-]{.underline} [-0-]{.underline}

Total Direct Costs \$11,600 \$20,650

\(p\) Cost of Money ([Factor]{.underline}) of ([Appropriate
Base]{.underline}) 2,400 3,600

\(q\) Indirect Costs

\_\_\_\_\_\_% of IDC Base (Formula) 4,000 6,000

\(r\) Fixed-Fee (Formula) [700]{.underline} [1,400]{.underline}

\(s\) Total Amount Claimed \$18,700 \$31,650

\(t\) Adjustments

Outstanding Suspensions [(1,700)]{.underline}

\(u\) Grand Totals \$18,700 \$29,950

\"I certify that all payments requested are for appropriate purposes and
in accordance with the contract.\"

(Name of Official) (Title)

**\*\*\*\* (USE BELOW, WHEN THE CONTRACT REQUIRES THE INCLUSION OF
NIH(RC)-2.) \*\*\*\***

[INVOICE INSTRUCTIONS FOR NIH FIXED-PRICE CONTRACTS,
NIH(RC)-2]{.underline}

**Format:** Payment requests shall be submitted on Standard Form 1034,
Public Voucher for Purchases and Services Other Than Personal, or the
Contractor's self-generated form provided it contains all of the
information prescribed herein. DO NOT include a cover letter with the
payment request.

**Number of Copies:** Payment requests shall be submitted in the
quantity specified in the Invoice Submission Instructions in Section G
of the Contract Schedule.

**Frequency:** Payment requests shall be submitted upon delivery and
acceptance of goods or services unless otherwise authorized by the
Contracting Officer.

**Preparation and Itemization of the Payment Request:** Payment requets
shall be prepared as follows:

\(a\) **Designated Billing Office Name and Address:** Enter the
designated billing office name and address, as identified in the Invoice
Submission Instructions in Section G of the Contract Schedule.

\(b\) **Invoice/Voucher Number:** Insert the appropriate serial number
of the payment request.

\(c\) **Date Invoice/Voucher Prepared:** Insert the date the payment
request is prepared.

\(d\) **Contract Number and Order Number (if applicable):** Insert the
contract number and order number (if applicable).

\(e\) **Contractor\'s Name, Address, Point of Contact, VIN, and DUNS or
DUNS+4 Number:** Show the Contractor\'s name and address exactly as they
appear in the contract, along with the name, title, phone number, and
e-mail address of the person to notify in the event of an improper
invoice or, in the case of payment by method other than Electronic Funds
Transfer, to whom payment is to be sent. Provide the Contractor's Vendor
Identification Number (VIN), and Data Universal Numbering System (DUNS)
number or DUNS+4. The DUNS number must identify the Contractor's name
and address exactly as stated on the face page of the contract. When an
approved assignment has been made by the Contractor, or a different
payee has been designated, provide the same information for the payee as
is required for the Contractor (i.e., name, address, point of contact,
VIN, and DUNS).

\(f\) **Two-Way/Three-Way Match:** Identify whether payment is to be
made using a two-way or three-way match. To determine required payment
method, refer to the Invoice Submission Instructions in Section G of the
Contract Schedule.

\(g\) **Office of Acquisitions:** Insert the name of the Office of
Acquisitions, as identified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(h\) **Central Point of Distribution:** Identify the Central Point of
Distribution, as specified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(i\) **Description of Supplies or Services:** Provide a description of
the supplies or services, by line item (if applicable), quantity, unit
price (where appropriate), and total amount.

\(j\) **Freight or Delivery Charges:** Identify charges for freight or
express shipments other than f.o.b. destination. (If shipped by freight
or express, and charges are more than \$25, attach prepaid bill.)

\(k\) **Government Property:** If the contract authorizes the purchase
of any item of Government Property (e.g., equipment), the invoice must
list each item for which reimbursement is requested. Reference shall be
made to the following (as applicable):

> -item number for the specific piece of equipment listed in the
> Property Schedule, and
>
> -COA number, if the equipment is not covered by the Property Schedule.

**Currency:** All NIH contracts are expressed in United States dollars.
When the Government pays in a currency other than United States dollars,
billings shall be expressed, and payment by the Government shall be
made, in that other currency at amounts coincident with actual costs
incurred. Currency fluctuations may not be a basis of gain or loss to
the Contractor. Notwithstanding the above, the total of all invoices
paid under this contract may not exceed the United States dollars
authorized.

**\*\*\*\* (USE BELOW, WHEN THE CONTRACTING OFFICER ELECTS TO USE
NIH(RC)-4.) \*\*\*\***

[INVOICE/FINANCING REQUEST AND CONTRACT FINANCIAL REPORTING]{.underline}

[INSTRUCTIONS FOR NIH COST-REIMBURSEMENT CONTRACTS,
NIH(RC)-4]{.underline}

**Format:** Payment requests shall be submitted on the Contractor's
self-generated form in the manner and format prescribed herein and as
illustrated in the Sample Invoice/Financing Request. Standard Form 1034,
Public Voucher for Purchases and Services Other Than Personal, may be
used in lieu of the Contractor's self-generated form provided it
contains all of the information shown on the Sample Invoice/Financing
Request. DO NOT include a cover letter with the payment request.

**Number of Copies:** Payment requests shall be submitted in the
quantity specified in the Invoice Submission Instructions in Section G
of the Contract Schedule.

**Frequency:** Payment requests shall not be submitted more frequently
than once every two weeks in accordance with the Allowable Cost and
Payment Clause incorporated into this contract. Small business concerns
may submit invoices/financing requests more frequently than every two
weeks when authorized by the Contracting Officer.

**Cost Incurrence Period:** Costs incurred must be within the contract
performance period or covered by precontract cost provisions.

**Billing of Costs Incurred:** If billed costs include (1) costs of a
prior billing period, but not previously billed, or (2) costs incurred
during the contract period and claimed after the contract period has
expired, the Contractor shall site the amount(s) and month(s) in which
it incurred such costs.

**Contractor\'s Fiscal Year:** Payment requests shall be prepared in
such a manner that the Government can identify costs claimed with the
Contractor\'s fiscal year.

**Currency:** All NIH contracts are expressed in United States dollars.
When the Government pays in a currency other than United States dollars,
billings shall be expressed, and payment by the Government shall be
made, in that other currency at amounts coincident with actual costs
incurred. Currency fluctuations may not be a basis of gain or loss to
the Contractor. Notwithstanding the above, the total of all invoices
paid under this contract may not exceed the United States dollars
authorized.

**Costs Requiring Prior Approval:** Costs requiring the Contracting
Officer\'s approval, which are not set forth in an Advance Understanding
in the contract, shall be identified and reference the Contracting
Officer\'s Authorization (COA) Number. In addition, the Contractor shall
show any cost set forth in an Advance Understanding as a separate line
item on the payment request.

**Invoice/Financing Request Identification:** Each payment request shall
be identified as either:

\(a\) **Interim Invoice/Contract Financing Request:** These are interim
payment requests submitted during the contract performance period.

\(b\) **Completion Invoice:** The completion invoice shall be submitted
promptly upon completion of the work, but no later than one year from
the contract completion date, or within 120 days after settlement of the
final indirect cost rates covering the year in which the contract is
physically complete (whichever date is later). The Contractor shall
submit the completion invoice when all costs have been assigned to the
contract and it completes all performance provisions.

\(c\) **Final Invoice:** A final invoice may be required after the
amounts owed have been settled between the Government and the Contractor
(e.g., resolution of all suspensions and audit exceptions).

**Preparation and Itemization of the Invoice/Financing Request:** The
Contractor shall furnish the information set forth in the instructions
below. The instructions are keyed to the entries on the Sample
Invoice/Financing Request.

\(a\) **Designated Billing Office Name and Address:** Enter the
designated billing office name and address, as identified in the Invoice
Submission Instructions in Section G of the Contract Schedule.

\(b\) **Contractor\'s Name, Address, Point of Contact, VIN, and DUNS or
DUNS+4 Number:** Show the Contractor\'s name and address exactly as they
appear in the contract, along with the name, title, phone number, and
e-mail address of the person to notify in the event of an improper
invoice or, in the case of payment by method other than Electronic Funds
Transfer, to whom payment is to be sent. Provide the Contractor's Vendor
Identification Number (VIN), and Data Universal Numbering System (DUNS)
number or DUNS+4. The DUNS number must identify the Contractor's name
and address exactly as stated on the face page of the contract. When an
approved assignment has been made by the Contractor, or a different
payee has been designated, provide the same information for the payee as
is required for the Contractor (i.e., name, address, point of contact,
VIN, and DUNS).

\(c\) **Invoice/Financing Request Number:** Insert the appropriate
serial number of the payment request.

\(d\) **Date Invoice/Financing Request Prepared:** Insert the date the
payment request is prepared.

\(e\) **Contract Number and Order Number (if applicable):** Insert the
contract number and order number (if applicable).

\(f\) **Effective Date:** Insert the effective date of the contract or
if billing under an order, the effective date of the order.

\(g\) **Total Estimated Cost of Contract/Order:** Insert the total
estimated cost of the contract, exclusive of fixed-fee. If billing under
an order, insert the total estimated cost of the order, exclusive of
fixed-fee. For incrementally funded contracts/orders, enter the amount
currently obligated and available for payment.

\(h\) **Total Fixed-Fee:** Insert the total fixed-fee (where
applicable). For incrementally funded contracts/orders, enter the amount
currently obligated and available for payment.

\(i\) **Two-Way/Three-Way Match:** Identify whether payment is to be
made using a two-way or three-way match. To determine required payment
method, refer to the Invoice Submission Instructions in Section G of the
Contract Schedule.

\(j\) **Office of Acquisitions:** Insert the name of the Office of
Acquisitions, as identified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(k\) **Central Point of Distribution:** Insert the Central Point of
Distribution, as identified in the Invoice Submission Instructions in
Section G of the Contract Schedule.

\(l\) **Billing Period:** Insert the beginning and ending dates (month,
day, and year) of the period in which costs were incurred and for which
reimbursement is claimed.

\(m\) **Amount Billed - Current Period:** Insert the amount claimed for
the current billing period by major cost element, including any
adjustments and fixed-fee. If the Contract Schedule contains separately
priced line items, identify the contract line item(s) on the payment
request and include a separate breakdown (by major cost element) for
each line item.

\(n\) **Amount Billed - Cumulative:** Insert the cumulative amounts
claimed by major cost element, including any adjustments and fixed-fee.
If the Contract Schedule contains separately priced line items, identify
the contract line item(s) on the payment request and include a separate
breakdown (by major cost element) for each line item.

\(o\) **Direct Costs:** Insert the major cost elements. For each
element, consider the application of the paragraph entitled \"Costs
Requiring Prior Approval\" on page 1 of these instructions.

\(1\) **Direct Labor:** Include salaries and wages paid (or accrued) for
direct performance of the contract.

> For Level of Effort contracts only, the Contractor shall provide the
> following information on a separate sheet of paper attached to the
> payment request:
>
> -hours or percentage of effort and cost by labor category (as
> specified in the Level of Effort Article in Section F of the contract)
> for the current billing period, and
>
> -hours or percentage of effort and cost by labor category from
> contract inception through the current billing period. (NOTE: The
> Contracting Officer may require the Contractor to provide additional
> breakdown for direct labor, such as position title, employee name, and
> salary or hourly rate.)

\(2\) **Fringe Benefits:** List any fringe benefits applicable to direct
labor and billed as a direct cost. Do not include in this category
fringe benefits that are included in indirect costs.

\(3\) **Accountable Personal Property:** Include permanent research
equipment and general purpose equipment having a unit acquisition cost
of \$1,000 or more, with a life expectancy of more than two years, and
sensitive property regardless of cost (see the HHS *Contractor\'s Guide
for Control of Government Property*). Show permanent research equipment
separate from general purpose equipment.

> On a separate sheet of paper attached to the payment request, list
> each item for which reimbursement is requested. An asterisk (\*) shall
> precede the item if the equipment is below the \$1,000 approval level.
> Include reference to the following (as applicable):
>
> -item number for the specific piece of equipment listed in the
> Property Schedule, and
>
> -COA number, if the equipment is not covered by the Property Schedule.
>
> The Contracting Officer may require the Contractor to provide further
> itemization of property having specific limitations set forth in the
> contract.

\(4\) **Materials and Supplies:** Include equipment with unit costs of
less than \$1,000 or an expected service life of two years or less, and
consumable material and supplies regardless of amount.

\(5\) **Premium Pay:** List remuneration in excess of the basic hourly
rate.

\(6\) **Consultant Fee:** List fees paid to consultants. Identify
consultant by name or category as set forth in the contract or COA, as
well as the effort (i.e., number of hours, days, etc.) and rate billed.

\(7\) **Travel:** Include domestic and foreign travel. Foreign travel is
travel outside of Canada, the United States and its territories and
possessions. However, for an organization located outside Canada, the
United States and its territories and possessions, foreign travel means
travel outside that country. Foreign travel must be billed separately
from domestic travel.

\(8\) **Subcontract Costs:** List subcontractor(s) by name and amount
billed.

\(9\) **Other:** List all other direct costs in total unless exceeding
\$1,000 in amount. If over \$1,000, list cost elements and dollar
amounts separately. If the contract contains restrictions on any cost
element, that cost element must be listed separately.

\(p\) **Cost of Money (COM):** Cite the COM factor and base in effect
during the time the cost was incurred and for which reimbursement is
claimed.

\(q\) **Indirect Costs:** Identify the indirect cost base (IDC),
indirect cost rate, and amount billed for each indirect cost category.

\(r\) **Fixed-Fee:** Cite the formula or method of computation for
fixed-fee, if applicable. The fixed-fee must be claimed as provided for
by the contract.

\(s\) **Total Amounts Claimed:** Insert the total amounts claimed for
the current and cumulative periods.

\(t\) **Adjustments:** Include amounts conceded by the Contractor,
outstanding suspensions, and/or disapprovals subject to appeal.

\(u\) **Grand Totals**

\(v\) **Certification of Salary Rate Limitation:** If required by the
contract (see Invoice Submission Instructions in Section G of the
Contract Schedule), the Contractor shall include the following
certification at the bottom of the payment request:

> "I hereby certify that the salaries billed in this payment request are
> in compliance with the Salary Rate Limitation Provisions in Section H
> of the contract."

**The Contracting Officer may require the Contractor to submit detailed
support for costs claimed on one or more interim payment requests.**

**FINANCIAL REPORTING INSTRUCTIONS**:

These instructions are keyed to the Columns on the sample
invoice/financing request.

**Column A - Expenditure Category:** Enter the expenditure categories
required by the contract.

**Column B - Cumulative Percentage of Effort/Hrs. - Negotiated:** Enter
the percentage of effort or number of hours agreed to for each employee
or labor category listed in Column A.

**Column C - Cumulative Percentage of Effort/Hrs. - Actual:** Enter the
percentage of effort or number of hours worked by each employee or labor
category listed in Column A.

**Column D - Amount Billed - Current:** Enter amounts billed during the
current period.

**Column E - Amount Billed - Cumulative:** Enter the cumulative amounts
to date.

**Column F - Cost at Completion:** Enter data only when the Contractor
estimates that a particular expenditure category will vary from the
amount negotiated. Realistic estimates are essential.

**Column G - Contract Amount:** Enter the costs agreed to for all
expenditure categories listed in Column A.

**Column H - Variance (Over or Under):** Show the difference between the
estimated costs at completion (Column F) and negotiated costs (Column G)
when entries have been made in Column F. This column need not be filled
in when Column F is blank. When a line item varies by plus or minus 10
percent, i.e., the percentage arrived at by dividing Column F by Column
G, an explanation of the variance should be submitted. In the case of an
overrun (net negative variance), this submission shall not be deemed as
notice under the Limitation of Cost (Funds) Clause of the contract.

**Modifications:** Any modification in the amount negotiated for an item
since the preceding report should be listed in the appropriate cost
category.

**Expenditures Not Negotiated:** An expenditure for an item for which no
amount was negotiated (e.g., at the discretion of the Contractor in
performance of its contract) should be listed in the appropriate cost
category and all columns filled in, except for G. Column H will of
course show a 100 percent variance and will be explained along with
those identified under H above.

**SAMPLE INVOICE/FINANCING REQUEST AND CONTRACT FINANCIAL REPORT**

+----------------+-------+------+------+--------+------+------+------+
| \(a\)          |       |      | \    |        |      |      |      |
| Designated     |       |      | (c\) |        |      |      |      |
| Billing Office |       |      | I    |        |      |      |      |
| Name and       |       |      | nvoi |        |      |      |      |
| Address:       |       |      | ce/F |        |      |      |      |
|                |       |      | inan |        |      |      |      |
| National       |       |      | cing |        |      |      |      |
| Institutes of  |       |      | Req  |        |      |      |      |
| Health         |       |      | uest |        |      |      |      |
|                |       |      | No.: |        |      |      |      |
| > Office of    |       |      |      |        |      |      |      |
| > Financial    |       |      | \    |        |      |      |      |
| > Management   |       |      | (d\) |        |      |      |      |
| >              |       |      | Date |        |      |      |      |
| > Commercial   |       |      | Inv  |        |      |      |      |
| > Accounts     |       |      | oice |        |      |      |      |
|                |       |      | P    |        |      |      |      |
| 2115 East      |       |      | repa |        |      |      |      |
| Jefferson      |       |      | red: |        |      |      |      |
| Street, Room   |       |      |      |        |      |      |      |
| 4B432, MSC     |       |      | \    |        |      |      |      |
| 8500 Bethesda, |       |      | (e\) |        |      |      |      |
| MD 20892-8500  |       |      | Cont |        |      |      |      |
|                |       |      | ract |        |      |      |      |
| \(b\)          |       |      | No.  |        |      |      |      |
| Contractor's   |       |      | and  |        |      |      |      |
| Name, Address, |       |      | O    |        |      |      |      |
| Point of       |       |      | rder |        |      |      |      |
| Contact, VIN,  |       |      | No.  |        |      |      |      |
| and DUNS or    |       |      | (if  |        |      |      |      |
| DUNS+4 Number: |       |      | appl |        |      |      |      |
|                |       |      | icab |        |      |      |      |
| ABC            |       |      | le): |        |      |      |      |
| CORPORATION    |       |      | \_   |        |      |      |      |
|                |       |      | \_\_ |        |      |      |      |
| 100 Main       |       |      | \_\_ |        |      |      |      |
| Street         |       |      | \_\_ |        |      |      |      |
|                |       |      | \_\_ |        |      |      |      |
| Anywhere, USA  |       |      | \_\_ |        |      |      |      |
| Zip Code       |       |      | \_\_ |        |      |      |      |
|                |       |      | \_\_ |        |      |      |      |
| > Name, Title, |       |      | \_\_ |        |      |      |      |
| > Phone        |       |      | \_\_ |        |      |      |      |
| > Number, and  |       |      |      |        |      |      |      |
| > E-mail       |       |      | \    |        |      |      |      |
| > Address of   |       |      | (f\) |        |      |      |      |
| > person to    |       |      | E    |        |      |      |      |
| > notify in    |       |      | ffec |        |      |      |      |
| > the event of |       |      | tive |        |      |      |      |
| > an improper  |       |      | D    |        |      |      |      |
| > invoice or,  |       |      | ate: |        |      |      |      |
| > in the case  |       |      |      |        |      |      |      |
| > of payment   |       |      | \    |        |      |      |      |
| > by method    |       |      | (g\) |        |      |      |      |
| > other than   |       |      | T    |        |      |      |      |
| > Electronic   |       |      | otal |        |      |      |      |
| > Funds        |       |      | E    |        |      |      |      |
| > Transfer, to |       |      | stim |        |      |      |      |
| > whom payment |       |      | ated |        |      |      |      |
| > is to be     |       |      | Cost |        |      |      |      |
| > sent.        |       |      | of   |        |      |      |      |
| >              |       |      | Con  |        |      |      |      |
| > VIN:         |       |      | trac |        |      |      |      |
| >              |       |      | t/Or |        |      |      |      |
| > DUNS or      |       |      | der: |        |      |      |      |
| > DUNS+4:      |       |      |      |        |      |      |      |
|                |       |      | \    |        |      |      |      |
|                |       |      | (h\) |        |      |      |      |
|                |       |      | T    |        |      |      |      |
|                |       |      | otal |        |      |      |      |
|                |       |      | F    |        |      |      |      |
|                |       |      | ixed |        |      |      |      |
|                |       |      | -Fee |        |      |      |      |
|                |       |      | (if  |        |      |      |      |
|                |       |      | appl |        |      |      |      |
|                |       |      | icab |        |      |      |      |
|                |       |      | le): |        |      |      |      |
|                |       |      |      |        |      |      |      |
|                |       |      | \    |        |      |      |      |
|                |       |      | (i\) |        |      |      |      |
|                |       |      | Two  |        |      |      |      |
|                |       |      | -Way |        |      |      |      |
|                |       |      | Ma   |        |      |      |      |
|                |       |      | tch: |        |      |      |      |
|                |       |      |      |        |      |      |      |
|                |       |      | > T  |        |      |      |      |
|                |       |      | hree |        |      |      |      |
|                |       |      | -Way |        |      |      |      |
|                |       |      | > Ma |        |      |      |      |
|                |       |      | tch: |        |      |      |      |
|                |       |      |      |        |      |      |      |
|                |       |      | \    |        |      |      |      |
|                |       |      | (j\) |        |      |      |      |
|                |       |      | Of   |        |      |      |      |
|                |       |      | fice |        |      |      |      |
|                |       |      | of   |        |      |      |      |
|                |       |      | A    |        |      |      |      |
|                |       |      | cqui |        |      |      |      |
|                |       |      | siti |        |      |      |      |
|                |       |      | ons: |        |      |      |      |
|                |       |      |      |        |      |      |      |
|                |       |      | \    |        |      |      |      |
|                |       |      | (k\) |        |      |      |      |
|                |       |      | Cen  |        |      |      |      |
|                |       |      | tral |        |      |      |      |
|                |       |      | P    |        |      |      |      |
|                |       |      | oint |        |      |      |      |
|                |       |      | of   |        |      |      |      |
|                |       |      | D    |        |      |      |      |
|                |       |      | istr |        |      |      |      |
|                |       |      | ibut |        |      |      |      |
|                |       |      | ion: |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(l\) This     |       |      |      |        |      |      |      |
| inv            |       |      |      |        |      |      |      |
| oice/financing |       |      |      |        |      |      |      |
| request        |       |      |      |        |      |      |      |
| represents     |       |      |      |        |      |      |      |
| reimbursable   |       |      |      |        |      |      |      |
| costs for the  |       |      |      |        |      |      |      |
| period from to |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| Expenditure    | Cumul |      | Am   |        | Cost | Cont | Vari |
| Category\*     | ative |      | ount |        | at   | ract | ance |
|                | Perce |      | Bi   |        | Co   |      |      |
| A              | ntage |      | lled |        | mple | Am   | H    |
|                | of    |      |      |        | tion | ount |      |
|                | E     |      |      |        |      |      |      |
|                | ffort |      |      |        | F    | G    |      |
|                | /Hrs. |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
|                | Negot | Ac   | \    | \(n\)  |      |      |      |
|                | iated | tual | (m\) | Cumu   |      |      |      |
|                |       |      |      | lative |      |      |      |
|                | B     | C    | Cur  |        |      |      |      |
|                |       |      | rent | E      |      |      |      |
|                |       |      |      |        |      |      |      |
|                |       |      | D    |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(o\) Direct   |       |      |      |        |      |      |      |
| Costs:         |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(1\) Direct   |       |      |      |        |      |      |      |
| Labor          |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(2\) Fringe   |       |      |      |        |      |      |      |
| Benefits       |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(3\)          |       |      |      |        |      |      |      |
| Accountable    |       |      |      |        |      |      |      |
| Property       |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(4\)          |       |      |      |        |      |      |      |
| Materials &    |       |      |      |        |      |      |      |
| Supplies       |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(5\) Premium  |       |      |      |        |      |      |      |
| Pay            |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(6\)          |       |      |      |        |      |      |      |
| Consultant     |       |      |      |        |      |      |      |
| Fees           |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(7\) Travel   |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(8\)          |       |      |      |        |      |      |      |
| Subcontracts   |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(9\) Other    |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| Total Direct   |       |      |      |        |      |      |      |
| Costs          |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(p\) Cost of  |       |      |      |        |      |      |      |
| Money          |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(q\) Indirect |       |      |      |        |      |      |      |
| Costs          |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(r\) Fixed    |       |      |      |        |      |      |      |
| Fee            |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(s\) Total    |       |      |      |        |      |      |      |
| Amount Claimed |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(t\)          |       |      |      |        |      |      |      |
| Adjustments    |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| \(u\) Grand    |       |      |      |        |      |      |      |
| Totals         |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+
| I certify that |       |      |      |        |      |      |      |
| all payments   |       |      |      |        |      |      |      |
| are for        |       |      |      |        |      |      |      |
| appropriate    |       |      |      |        |      |      |      |
| purposes and   |       |      |      |        |      |      |      |
| in accordance  |       |      |      |        |      |      |      |
| with the       |       |      |      |        |      |      |      |
| contract.      |       |      |      |        |      |      |      |
|                |       |      |      |        |      |      |      |
| \_\_\_\_\_\_   |       |      |      |        |      |      |      |
| \_\_\_\_\_\_\_ |       |      |      |        |      |      |      |
| \_\_\_\_\_\_\_ |       |      |      |        |      |      |      |
| \_\_\_\_\_\_\_ |       |      |      |        |      |      |      |
| \_\_\_\_\_\_   |       |      |      |        |      |      |      |
| \_\_\_\_\_\_\_ |       |      |      |        |      |      |      |
| \_\_\_\_\_\_\_ |       |      |      |        |      |      |      |
|                |       |      |      |        |      |      |      |
| (Name of       |       |      |      |        |      |      |      |
| Official)      |       |      |      |        |      |      |      |
| (Title)        |       |      |      |        |      |      |      |
|                |       |      |      |        |      |      |      |
| \* Attach      |       |      |      |        |      |      |      |
| details as     |       |      |      |        |      |      |      |
| specified in   |       |      |      |        |      |      |      |
| the contract   |       |      |      |        |      |      |      |
+----------------+-------+------+------+--------+------+------+------+