OMB Control No. 0412-0520; Expiration Date: 10/31/2010

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<tbody>
<tr class="odd">
<td colspan="16"><h1
id="contractor-employee-biographical-data-sheet">CONTRACTOR EMPLOYEE
BIOGRAPHICAL DATA SHEET</h1></td>
</tr>
<tr class="even">
<td colspan="5"><p>1. Name <em>(Last, First, Middle)</em></p>
<p>     </p></td>
<td colspan="11"><p>2. Contractor’s Name</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="5" rowspan="2"><p>3. Employee’s Address <em>(include ZIP
code)</em></p>
<p>     </p></td>
<td colspan="3"><p>4. Contract Number</p>
<p>     </p></td>
<td colspan="8"><p>5. Position Under Contract</p>
<p>     </p></td>
</tr>
<tr class="even">
<td colspan="3"><p>6. Proposed Salary</p>
<p>     </p></td>
<td colspan="8"><p>7. Duration of Assignment</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="3"><p>8. Telephone Number <em>(include area code)</em></p>
<p>     </p></td>
<td colspan="2"><p>9. Place of Birth</p>
<p>     </p></td>
<td colspan="11"><p>10. Citizenship (<em>If non-U.S. citizen, give visa
status)</em></p>
<p>     </p></td>
</tr>
<tr class="even">
<td colspan="16"><p>11. Names, Ages, and Relationship of Dependents to
Accompany Individual to Country of Assignment</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="6"><strong>12. EDUCATION</strong> <em>(include all college
or university degrees)</em></td>
<td colspan="10"><strong>13. LANGUAGE PROFICIENCY</strong> <em>(see
Instruction on Page 2)</em></td>
</tr>
<tr class="even">
<td colspan="2">NAME AND LOCATION OF INSTITUTION</td>
<td colspan="2">MAJOR</td>
<td>DEGREE</td>
<td>DATE</td>
<td colspan="6">LANGUAGE</td>
<td colspan="3"><p>Proficiency</p>
<p>Speaking</p></td>
<td><p>Proficiency</p>
<p>Reading</p></td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td colspan="2">     </td>
<td>     </td>
<td>        </td>
<td colspan="6">     </td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td colspan="2">     </td>
<td>     </td>
<td>     </td>
<td colspan="6">     </td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td colspan="2">     </td>
<td>     </td>
<td>     </td>
<td colspan="6">     </td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="16"><strong>14. EMPLOYMENT HISTORY</strong></td>
</tr>
<tr class="odd">
<td colspan="16"><ol type="1">
<li><p>Give last three (3) years. List salaries separate for each year.
Continue on separate sheet of paper if required to list all employment
related to duties of proposed assignment.</p></li>
<li><p>Salary definition – basic periodic payment for services rendered.
Exclude bonuses, profit-sharing arrangements, commissions, consultant
fees, extra or overtime work payments, overseas differential or
quarters, cost of living or dependent education allowances.</p></li>
</ol></td>
</tr>
<tr class="even">
<td rowspan="2">POSITION TITLE</td>
<td colspan="5" rowspan="2"><p>EMPLOYER’S NAME AND ADDRESS</p>
<p>POINT OF CONTACT &amp;TELEPHONE #</p></td>
<td colspan="7">Dates of Employment <em>(M/D/Y)</em></td>
<td colspan="3">Annual Salary</td>
</tr>
<tr class="odd">
<td colspan="4">From</td>
<td colspan="3">To</td>
<td colspan="3">Dollars</td>
</tr>
<tr class="even">
<td>     </td>
<td colspan="5">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="3">     </td>
</tr>
<tr class="odd">
<td>     </td>
<td colspan="5">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="3">     </td>
</tr>
<tr class="even">
<td>     </td>
<td colspan="5">     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="3">     </td>
</tr>
<tr class="odd">
<td colspan="16"><strong>15. SPECIFIC CONSULTANT SERVICES</strong>
<em>(give last three (3) years)</em></td>
</tr>
<tr class="even">
<td rowspan="2">SERVICES PERFORMED</td>
<td colspan="5" rowspan="2"><p>EMPLOYER’S NAME AND ADDRESS</p>
<p>POINT OF CONTACT &amp;TELEPHONE #</p></td>
<td colspan="5">Dates of Employment <em>(M/D/Y)</em></td>
<td colspan="3" rowspan="2"><p>Days at</p>
<p>Rate</p></td>
<td colspan="2" rowspan="2"><p>Daily Rate</p>
<p>In Dollars</p></td>
</tr>
<tr class="odd">
<td>From</td>
<td colspan="4">To</td>
</tr>
<tr class="even">
<td>     </td>
<td colspan="5">     </td>
<td>     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td>     </td>
<td colspan="5">     </td>
<td>     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
</tr>
<tr class="even">
<td>     </td>
<td colspan="5">     </td>
<td>     </td>
<td colspan="4">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="16"><strong>16. CERTIFICATION: To the best of my knowledge,
the above facts as stated are true and correct.</strong></td>
</tr>
<tr class="even">
<td colspan="10">Signature of Employee</td>
<td colspan="6"><p>Date</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="16"><strong>17. CONTRACTOR'S CERTIFICATION</strong> <em>(To
be signed by responsible representative of Contractor)</em></td>
</tr>
<tr class="even">
<td colspan="16">Contractor certifies in submitting this form that it
has taken reasonable steps (in accordance with sound business practices)
to verify the information contained in this form. Contractor understands
that USAID may rely on the accuracy of such information in negotiating
and reimbursing personnel under this contract. The making of
certifications that are false, fictitious, or fraudulent, or that are
based on inadequately verified information, may result in appropriate
remedial action by USAID, taking into consideration all of the pertinent
facts and circumstances, ranging from refund claims to criminal
prosecution.</td>
</tr>
<tr class="odd">
<td colspan="9">Signature of Contractor’s Representative</td>
<td colspan="7"><p>Date</p>
<p>     </p></td>
</tr>
</tbody>
</table>

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| ##                                                                    |
|                                                                       |
| ## INSTRUCTION                                                        |
|                                                                       |
| > Indicate your language proficiency in block 13 using the following  |
| > numeric Interagency Language Roundtable levels (Foreign Service     |
| > Institute Levels). Also, the following provides brief descriptions  |
| > of proficiency levels 2, 3, 4, and 5. "S" indicates speaking        |
| > ability and "R" indicates reading ability. For more in-depth        |
| > description of the levels refer to USAID Handbook 28 or superseding |
| > policy directive.                                                   |
|                                                                       |
| 2.  Limited working proficiency                                       |
|                                                                       |
| > S Able to satisfy routine special demands and limited work          |
| > requirements.                                                       |
| >                                                                     |
| > R Sufficient comprehension to read simple, authentic written        |
| > material in a form equivalent to usual printing or typescript on    |
| > familiar subjects within familiar contexts.                         |
|                                                                       |
| 3.  General professional proficiency                                  |
|                                                                       |
| S Able to speak the language with sufficient structural accuracy and  |
| vocabulary to participate effectively in most formal and informal     |
| conversations on practical, social, and professional topics.          |
|                                                                       |
| > R Able to read within a normal range of speed and with almost       |
| > complete comprehension of a variety of authentic prose material on  |
| > unfamiliar subjects.                                                |
|                                                                       |
| 4.  Advanced professional proficiency                                 |
|                                                                       |
| > S Able to use the language fluently and accurately on all levels    |
| > normally pertinent to professional needs.                           |
| >                                                                     |
| > R Able to read fluently and accurately all styles and forms of the  |
| > language pertinent to professional needs.                           |
|                                                                       |
| 5.  Functional native proficiency                                     |
|                                                                       |
| > S Speaking proficiency is functionally equivalent to that of a      |
| > highly articulate well-educated native speaker and reflects the     |
| > cultural standards of a country where the language is natively      |
| > spoken.                                                             |
| >                                                                     |
| > R Reading proficiency is functionally equivalent to that of the     |
| > well-educated native reader.                                        |
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| ##                                                                    |
|                                                                       |
| ## PAPERWORK REDUCTION ACT INFORMATION                                |
|                                                                       |
| > The information requested by this form is necessary for prudent     |
| > management and administration of public funds under USAID           |
| > contracts. The information helps USAID estimate overseas logistic   |
| > support and allowances, the educational information provides an     |
| > indication of qualifications, the salary information is used as a   |
| > means of cost monitoring and to help determine reasonableness of    |
| > proposed salary.                                                    |
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| ##                                                                    |
|                                                                       |
| ## PAPERWORK REDUCTION ACT NOTICE                                     |
|                                                                       |
| > Public reporting burden for this collection of information is       |
| > estimated to average thirty minutes per response, including the     |
| > time for reviewing instructions, searching existing data sources,   |
| > gathering and maintaining the data needed, and completing and       |
| > reviewing the collection of information. Send comments regarding    |
| > this burden estimate or any other aspect of this collection of      |
| > information, including suggestions for reducing this burden, to:    |
| >                                                                     |
| > United States Agency for International Development                  |
|                                                                       |
| Office of Acquisition and Assistance                                  |
|                                                                       |
| Policy Division (M/OAA/P)                                             |
|                                                                       |
| > Washington, DC 20523-7100;                                          |
| >                                                                     |
| > and                                                                 |
| >                                                                     |
| > Office of Management and Budget                                     |
| >                                                                     |
| > Paperwork Reduction Project (0412-0520)                             |
| >                                                                     |
| > Washington, DC 20503                                                |
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