*Relevant Extramural SOP: *

*[Last revised: March 2, 2005]{.underline}*

(Delete this and everything above it when using the form. Do not fill
out online. See .)

[CONTRACT COMPLETION STATEMENT]{.underline}

[Contract Number Last Mod \# Amount ]{.underline}

Period of performance [ ]{.underline} to [ ]{.underline} Type [
]{.underline}

[I. The Contractor has completed the required deliveries and/or
performed]{.underline}

[ all services and the Government has inspected and accepted the
supplies ]{.underline}

[ and/or services. (Project Officer Certification, NIH
2582).]{.underline}

[II. The information below is required by FAR 4.804-5(b):]{.underline}

[ (1) Contract administration office name and address.]{.underline}

[ (2) Contracting office name and address.]{.underline}

[ Contract Management Program, NIAID, NIH ]{.underline}

[ 6700-B Rockledge Drive ]{.underline}

[ Room 3214, MSC 7612 ]{.underline}

[ Bethesda, MD 20892-7612 ]{.underline}

[ (5) Last call or order number. N/A ]{.underline}

[ (6) Contractor name and address.]{.underline}

[ (7) Dollar amount of excess funds, if any. ]{.underline}

[ (8) Voucher number and date, if final payment has been made,
or]{.underline}

[ (9) Invoice number and date, if the final approved invoice has been
]{.underline}

[ forwarded to OFM .]{.underline}

[ (10) All required contract administration actions have been fully and
]{.underline}

[ satisfactorily accomplished (see sections III & IV) .]{.underline}

[ (11) Name of Contracting Officer ]{.underline}

[ Signature: ]{.underline}

[ Date: ]{.underline}

[III. The following requirements pursuant FAR 4.804-5(a) have been met
for closure of the subject contract:]{.underline}

[ (1) Disposition of classified material is completed
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (2) Final patent report is cleared
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (3) Final royalty report is cleared
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (4) There is no outstanding value engineering proposal
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (5) Plant clearance is received
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (6) Property clearance is received (NIH-488)
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (7) All interim or disallowed costs are settled
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (8) Price revision is completed
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (9) Subcontracts are settled by the prime contractor
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**[
]{.underline}

[ (10) Prior year indirect cost rates are settled
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (11) Termination docket is completed
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (12) Contract audit is completed:]{.underline}

[ FASB Advisory Audit Report NIH 763-2
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ Desk Audit ]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (13) Contractor\'s closing statement is completed:]{.underline}

[ NIH 2582 ]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ NIH 1943 ]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (14) Contractor\'s final invoice has been submitted
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[ (15) Deobligation of excess funds is recommended NIH 1154-3
]{.underline}**[\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

[IV. Other Comments]{.underline}

[ Deobligate funds in the amount of ]{.underline}