NATIONAL SCIENCE FOUNDATION                                                                                                                                                 Attachment B-STTR
Program Solicitation:
Closing Date:                                             STTR PHASE I -- PROPOSAL COVER PAGE

TOPIC			EMPLOYER IDENTIFICATION NUMBER (EIN) OR  TAXPAYER IDENTIFICATION NUMBER (TIN)
PROPOSAL TITLE
NAME OF COMPANY			NAME OF RESEARCH INSTITUTION
NAME OF AFFILIATED COMPANIES (Parent, Subsidiary, Predecessor)
COMPANY ADDRESS (including Zip Code)			RESEARCH INSTITUTION ADDRESS (including Zip Code)
REQUESTED AMOUNT		PROPOSED DURATION        12 months		PERIOD OF PERFORMANCE
THE SMALL BUSINESS CERTIFIES THAT:					Y/N
1.  It is a small business as defined in the STTR solicitation
2.  It qualifies as a socially and economically disadvantaged business as defined in the STTR solicitation.  FOR STATISTICAL PURPOSES ONLY.
3.  It qualifies as a woman-owned business as defined in this solicitation.  FOR STATISTICAL PURPOSES ONLY.
4.  It will exercise management direction and control of the performance of the STTR funding agreement.
5.  NSF is the only Federal agency that has received this proposal (or an overlapping or equivalent proposal) from the small business concern.  If No, you must disclose overlapping or equivalent proposals and awards as required by the STTR Solicitation.
6.  It will perform _____percent of the work and the collaborating research institution will perform ______percent of the work as described in the proposal.
7.  The primary employment of the principal investigator will be with this firm at the time of award and during the conduct of the research.
8.  It will permit the government to disclose the title and technical abstract page, plus the name, address and telephone number of a corporate official if the proposal does not result in an award to parties who may be interested in contacting you for further information or possible investment.
9. It will comply with the provisions of the Civil Rights Act of 1964 ( P. L. 88-352) and the regulations pursuant thereto.
PRINCIPAL INVESIGATOR / PROJECT DIRECTOR
NAME			TITLE
SOCIAL SECURITY NO.		HIGHEST DEGREE / YEAR		E-MAIL ADDRESS
TELEPHONE NO.		FAX NO.		WEB ADDRESS
RESEARCH INSTITUTION INVESTIGATOR
NAME
SOCIAL SECURITY NO.			TELEPHONE NO.
COMPANY OFFICER (FOR BUSINESS AND FINANCIAL MATTERS)
PRESIDENT’S NAME		YEAR FIRM FOUNDED		NUMBER OF EMPLOYEES (Parent Co.) AVERAGE PREVIOUS 12 MO.  CURRENTLY

PROPRIETARY NOTICE:  See Part III, Subsection D.1 for instructions concerning proprietary information.
(Check Here        if proposal contains proprietary information.)
NOTE:  The signed Certification Page MUST be included immediately following this Cover Page with the original copy of the proposal only.

NSF FORM 1207 (STTR 12/97)                                  Proposal Page No. 1