National Aeronautics and Space Administration (NASA) 

Small Business Innovation Research (SBIR) Ignite Solicitation 

 

PHASE II PROPOSAL CERTIFICATIONS

Please read carefully the following certification statements. 

• The Federal Government relies on the information to determine whether the business is eligible for a Small 

 Business Innovation Research (SBIR/STTR) Program award. A similar certification will be used to ensure 

 continued compliance with specific program requirements during the life of the funding agreement. The definitions 

 for the terms used in this certification are set forth in the Small Business Act, SBA regulations (13 C.F.R. Part 

 121), the SBIR/STTR Policy Directive and also any statutory and regulatory provisions referenced in those 

 authorities. 

• If the Funding Agreement Officer believes that the business may not meet certain eligibility requirements at the 

 time of award, they are required to file a size protest with the U.S. Small Business Administration (SBA), who will 

 determine eligibility. At that time, SBA will request further clarification and supporting documentation in order to 

 assist in the verification of any of the information provided as part of a protest. If the Funding Agreement Officer 

 believes, after award, that the business is not meeting certain funding agreement requirements, the agency may 

 request further clarification and supporting documentation in order to assist in the verification of any of the 

 information provided. 

• Even if correct information has been included in other materials submitted to the Federal Government, any action 

 taken with respect to this certification does not affect the Government's right to pursue criminal, civil or 

 administrative remedies for incorrect or incomplete information given in the certification. Each person signing this 

 certification may be prosecuted if they have provided false information.

The undersigned has reviewed, verified and certifies that:

Selected Principal Investigator

1. During the performance of the award, the Principal Investigator/Project Manager will spend more than 

one half of his/her time (based on a 40 hour workweek) as an employee of the Awardee or has requested 

and received a written deviation from this requirement from the Funding Agreement Officer.

Yes No

If no, deviation percent approved in writing by Funding Agreement Officer:

If no, you are required to include a PDF of the written approval from the Funding Agreement Officer as 

part of your proposal package submission.
2. All Essentially Equivalent Work, or a portion of the work, proposed under this project (check 

applicable line):

a) Has not been submitted for funding to this agency or another Federal agency.

b) Has been submitted for funding to this Agency or another Federal agency but has not been funded 

under any other grant, contract, subcontract or other transaction.

c) A portion has been funded by another grant, contract, or subcontract as described in detail in the 

proposal and approved in writing by the Funding Agreement Officer.

If b) submitted for other Federal funding, provide information on essentially equivalent proposal 

submissions below, as applicable:

#1 Proposal Number

Proposal Title

Soliciting Agency

Submission Date

Anticipated Selection Announcement Date

#2 Proposal Number

Proposal Title

Soliciting Agency

Submission Date

Anticipated Selection Announcement Date

#3 Proposal Number
Proposal Title

Soliciting Agency

Submission Date

Anticipated Selection Announcement Date

2a. I will notify this agency immediately if all or a portion of the work authorized and funded under this 

awards is subsequently funded by another Federal agency. 

IMPORTANT: To be compliant with the solicitation requirements, the offeror must answer "Yes" to certify that 

they will notify this agency immediately if all or a portion of the work authorized and funded under this award is 

subsequently funded by another Federal agency.

Yes No

3. During performance of award, the Awardee will perform the applicable percentage of work (at least 

half (50%) of the research) unless a deviation from this requirement is approved in writing by the 

Funding Agreement Officer.

Yes No

If no, then provide the percent of deviation (must be approved in writing by Funding Agreement 

Officer):

If no, you are required to include a PDF of the written approval from the Funding Agreement Officer as 

part of your proposal package submission.

4. During performance of award, the R/R&D will be performed in the United States unless a deviation is 

approved in writing by the Funding Agreement Officer.

Yes No

If no, has a written waiver been provided by the Funding Agreement Officer?

Yes No

If no, you are required to include a PDF of the written approval from the Funding Agreement Officer as 

part of your proposal package submission.
5. During performance of award, the R/R&D will be performed at the Awardee's facilities by the 

Awardee's employees, except as otherwise indicated in the SBIR application and approved in the 

Funding Agreement.

Yes No

6. Do you plan to use NASA IP under the award? 

All topics listed in this solicitation have Technology Available (TAV) with NASA Intellectual Property. The use of 

the NASA IP is strictly voluntary. Refer to section 1.7 of the solicitation for additional information. To use NASA 

IP, you must complete a NASA Research License Application.

Yes No

If yes, you are required to include a PDF or Word document of your NASA Research License as part of 

your proposal package submission.

As described in section 3 of this solicitation, the offeror meets the following requirements completely:

7. All 10 parts of the proposal narrative are included in part order and the page limitation is met. 

IMPORTANT: The offeror must verify that they have included all 10 parts of the proposal narrative in part order 

and within the page limitation.

Yes No

8. Do you plan to use subcontractors/consultants?

Yes No

If yes, does the proposal white paper comply with the subcontractor/consultant limitation? (section 

3.6.3.4) 

IMPORTANT: You must answer "Yes" to be compliant with the solicitation requirements.

Yes No

9. Do you plan to use Federal facilities, laboratories, or equipment?

Yes No

If yes, identify the Federal facilities, laboratories, or equipment that you intend to use:

If yes, you are required to include a PDF or Word document of the letter of justification for use (section 

3.6.3.4) as part of your proposal package submission.

If yes, you are required to include a PDF or Word document of the signed statement of availability from 

the Government agency as part of your proposal package submission.

10. Are there any related Research and Development proposals and awards to your proposed effort?

Yes No
If yes, you are required to include a PDF or Word document of any supporting documentation on the 

related proposals or awards as part of your proposal package submission.

In accordance with ITAR, 22 CFR 120-130, as applicable:

11. The offeror understands and shall comply with export control regulations. 

IMPORTANT: The offeror must verify that they both understand and shall comply with export control regulations.

Yes No

12. There will be ITAR/EAR data in this work and/or deliverables.

Yes No

In accordance with 14 CFR 1230 and 1232, as applicable, indicate if any of the following will be used (must 

comply with Federal regulations):

13. Human Subject

Yes No

14. Animal Subject

Yes No

In accordance with FAR 52.223-13, FAR 52.223-3, 29 CFR 1910.1200(g) and the latest version of Federal 

Standard No. 313 as applicable, indicate if the following will be used (must comply with Federal regulations):

15. Does this proposed effort involve Toxic Chemicals?

Yes No

16. Does this proposed effort involve Hazardous Materials?

Yes No

17. Does this proposed effort relate to Renewable Energy?

Yes No

18. Does this proposed effort relate to Manufacturing?

Yes No

Disclosure permission:
19. Will you permit the Government to disclose the name, address, and telephone number of the

business official of your small business concern, if your proposal does not result in an award, to 

appropriate local and State-level economic development organizations that may be interested in 

contacting you for further information?

Yes No

PROPRIETARY NOTICE (if applicable, see sections 3.3 and 4.4)

18. This data shall not be disclosed outside the Government and shall not be duplicated, used, or disclosed

in whole or in part for any purpose other than evaluation of this proposal, provided that a funding agreement 

is awarded to the offeror as a result of or in connection with the 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 

and pursuant to applicable law. This restriction does not limit the Government's right to use information 

contained in the data if it is obtained from another source without restriction.

The data subject to this restriction are contained in the following pages of the proposal narrative:

Note: The Proposal Abstract form cannot contain proprietary data.

I understand that the information submitted may be given to Federal, State and local agencies for 

determining violations of law and other purposes.

I am an officer of the business concern authorized to represent it and sign this certification on its 

behalf. By signing this certification, I am representing on my own behalf, and on behalf of the 

business concern that the information provided in this certification, the application, and all other 

information submitted in connection with this application, is true and correct as of the date of 

submission. I acknowledge that any intentional or negligent misrepresentation of the information 

contained in this certification may result in criminal, civil or administrative sanctions, including 

but not limited to: (1) fines, restitution and/or imprisonment under 18 U.S.C. §1001; (2) treble 

damages and civil penalties under the False Claims Act (31 U.S.C. §3729 et seq.); (3) double 

damages and civil penalties under the Program Fraud Civil Remedies Act (31 U.S.C. §3801 et 

seq.); (4) civil recovery of award funds; (5) suspension and/or debarment from all Federal 

procurement and non-procurement transactions (FAR Subpart 9.4 or 2 C.F.R. part 180); and (6) 

other administrative penalties including termination of SBIR/STTR awards.

Name

Title

Business Name

Date