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NRC-HQ-84-15-E-0002 NRC-HQ-84-1 5-T-0001Table of Contents

SECTION A

A.1 PRICE/COST SCHEDULE ........................................... .................. 4

TASK ORDER TERMS AND CONDITIONS

A.2 TASK/DELIVERY ORDER PERIOD OF PERFORMANCE (SEP 2013) ................. 5A.3 STATEMENT OF WORK ............................................................... 5A.4 NRCB050 CONSIDERATION AND OBLIGATION- TASK ORDERS .................... 10A.5 52.232-22 LIMITATION OF FUNDS (ARP 1984)....................................... 10A.6 BRANDING (AUG 2011)..................................................... ,.......... 12A.7 ELECTRONIC PAYMENTS (SEP 2014) ................................................ 12A.8 BILLING INSTRUCTIONS FOR LABOR HOUR/TIME AND MATERIALS TYPE

CONTRACTS (MAY 2015) .............................................................. 12

3 of 17

NRC-H Q-84-1 5-E-0002 NRC-H Q-84-15-T-0001

A.1 PRICE/COST SCHEDULE

Clin. ..--!'Base Year -•091•3012015- 03131120•16 ." Est" ... ' . LABOR ::;.:~.EST.. TOTAL i

00001 Program Management0$.000002 Project Management

00003 SR OD Consultant

[00004 JR OD Consultant

00005 SR OD Coach .O 00

SOTHER DIRECT COSTS

0000"6- Assessment I nstruments/Misc Supplies -] NTE

Cost Not-to-Exceed (NTE) .__NTE_

00007. Travel (For Base and Option years) NTE

.TOTAL ODCj OTL'S1MATEDP•RI CE. - -T• ;! $157,010.00/!;i

......... '•.O..ption. Year. I,,1..04I.!)i20-i6 - D•31,3112:0:7.•:,,• :.Est.b:•-;. t::_ lABOiR -.:••i •EST. TOTAL•:

10001 Program Management 0 w.• "$

10002 Project Management r•

10003 SR CD Consultant

10004 JR CD Consultant10005 SR OD Coach •$

SUBTOTAL

OTHER DIRECT COSTS10006 Assessment Instruments/Misc Supplies NTE

TOTAL ODC

T O TA L ES TIM ATED P• R IGE - -!!!•,t.:•.:ii:•ti;•"•.... " $291,419..60

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NRC-HQ-84-15-E-0002 NRC-.HQ-84-1 5-T-0001

20002 Project Management Ii-

20003 SR OD Consultant

20005 SR OD Coach 0$

GRAND TOTAL: $748.81 9.60

TASK ORDER TERMS AND CONDITIONS

NOT SPECIFIED IN THE CONTRACT

A.2 NRCFO32 TASK/DELIVERY ORDER PERIOD OF PERFORMANCE (SEP 2013)

The period of performance for this task order is 09/30/2015 - 03/31/2017. Option year one is being exercised at thetime of award of this task order.

Base: 09/30/2015 - 03/31/2016Period 1: 04/01/2016 -03/31/2017Period 2: 04/01/2017 - 03/31/2018

A.3 STATEMENT OF WORK.

1. PROJECT TITLE

Engagements services for the Nuclear Regulatory Commission (NRC).

2. BACKGROUND

OD is defined as a planned effort to increase an organization's-effectiveness and health through interventions Inthe organization's human processes, and using behavioral science knowledge. For the last 15 years, the NRC hascontracted for OD consultants to support the agency mission and to improve its effectiveness. Consultants have

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NRC-HQ-84- 15-E-0002 NRC-HQ-84- 15-T-000 Iprovided service such as supporting office change management efforts, working with specific units or groups toimprove the work environment, enhance organizational performance and resolve conflicts.

3. SCOPE

The contractor shall perform the following work under this task order:

* Support the agency's efforts to create and sustain a work environment, that produces positive work outcomes andcollaboratively engages its internal and external stakeholders;

* Build the agency's internal capacity to sustain a diverse, inclusive, high-performing workforce;• Maintain and enhance the professionalism of its employees;* Build public confidence and trust in the NRC;* Enhance communications, interpersonal skills, and cognitive self-awareness to improve behaviors that support

NRC values and continue developing a positive organizational culture;* Enable the professional staff to meet new challenges confronting them in their positions;* Support employees who are preparing for management and supervisory responsibilities; and* Enhance individual and group performance by addressing cultural and environmental issues through role modeling

during all stages of 0D engagements.* Provide planning and facilitation support for change management efforts, improving engagement, and

organizational performance issues.

4. SPECIFIC TASKS

Task 1 - Organization Development Services

The contractor shall be required to provide 00 services that enhance a work unit's performance and support ahumanistic, healthy, and effective NRC work culture.

Standard

When requested in writing by the NRC contracting officer representative (COR), the contractor shall perform anyor all of the following activities as identified for the intervention:

a. Upon request, hold client entry meetings to identify engagement scope.b. Prepare an engagement letter and high-level project plan for proposed work.c. Conduct data gathering from the client system, including leaders and staff.d. Present concise, aggregated data to the client in the form of survey feedback.e. Conduct and lead 00 engagements that reflect the client data gathered, address the key drivers and goals

as identified by the client.f. Provide client coaching within the context of an 00 engagement as outlined in the initial client engagement

subtask order.g. Administer and interpret individual developmental assessment tools such as the Myers-Briggs Type

Indicator (MBTI), Strength Deployment Inventory (SDI), and 360 degree assessment.h. Design and provide training as a part of an 00 engagement or as part of interpreting developmental

assessments.

Task 2 -- Develop Participant Materials

The contractor shall develop participant materials that address the client's needl when providing an 00engagement, including training, coaching, off-sites and assessments.

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NRC-HQ-84-15-E-0002 NRC-HQ-84-1 5-T-O001

Standard

When requested in writing by the NRC OCOR, the contractor shall perform any or all of the following activities andprovide appropriate deliverables:

a. Develop training materials and job aids, such as manuals or hand-outs or other media (e.g. slides).b. Develop and conduct group presentations. Assessment Instruments (online or paper and pencil).c. Analyze and prepare written reports summarizing the results of the participant materials used.

Task 3 - Evaluation Tools

The contractor shall develop and implement a clearly defined, cyclical and measureable evaluation process that

includes a generic assessment tool for each client OD engagement.

Standard

When requested in writing by the NRC OCOR, the contractor shall perform any or all of the following activities andprovide appropriate deliverables:

a. Get consensus from the client on key drivers and expected and observable outcomes. "What does successlook like?"

b, Develop metrics and evaluations for the pre-and post-client engagement.c. Develop a participant evaluation for trainings, retreats or any other specific and significant group activity

within the larger CD engagement.d, As part of the Contract Annual Report, prepare a Level 3 Kirkpatrick Assessment 1 of all CD client

engagements conducted at the end of the base year.

5. DELIVERABLES AND DELIVERY SCHEDULE

The contractor shall provide any of the following deliverables to the NRC OCR asappropriate for each intervention or workshop and summaries in Appendix E of the base SCW.

Deliverables related to Task 1 - Organization Development Services

* Client Entry meeting minutes.• CD Engagement Memorandum and Project Plan for each engagement as described in Appendix B of the base

SCW - IDIQ.* Final data gathering questions.* Survey feedback of data gathered.* Draft and final agenda for proposed client interventions and workshops as described in Appendix B of the base

SCW - IDIQ.* Process agenda for large engagements (as agreed upon by contractor and OCOR).* CD Engagement report and assessment of the results that outlines the outcomes achieved, interventions

conducted and provides overriding group themes that support or hinder achievement of the outcomes.

Deliverables Task 2 - Develop Participant Materials

* Written reports.

1 Level 3 measures behavior - capability to perform the learned skills while on the job.

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NRC-HQ-84- 15-E-0002 NRC-HQ-84-1I5-T-000 1* Training material and aids, slides, or Web-based materials (e.g. for surveys).* Materials for proposed OD engagements including self-assessment tools and surveys.* Assessments of the results from the evaluation materials and surveys used during the engagement.

Deliverables Task 3 - Evaluation Tools

* Using the standard evaluation process of assessment tools, pre-and post-client intervention evaluation inconnection with an OD service, Such as the MBTI indicator, a 360 degree survey instrument, or other appropriatetools and materials.

* Surveys (online or other).* Assessment report.

Additional Deliverables

*The Contractor shall provide a list of consultants and their resumes is to the COR within 20 days after contractaward and will be updated regularly as new consultants join or others no longer work for the contractor.Consultant updates will be submitted to the COR prior to being assigned to work at the NRC.

*Reports. The contractor shall electronically submit to the COR, no later than the tenth of each month, asapplicable, the following:

oA Monthly Progress Report showing all 00 engagement currently scheduled, with appropriate annotationas to OD title, date, location (whether Headquarters, TTC or Region), name of OD facilitator, and workorder number, if known. The NRC COR will not approve invoices for payment before receiving themonthly report.

oWithin 20 working days after completing an OD engagement, the contractor shall submit to the CO, COR,and the requesting office, a written OD service report on the results and recommendations of the 00engagement. The NRC COR will not approve invoices for payment before receiving the 00 servicereport.

o An Annual Report, listing all OD services completed for the calendar year (CY) and outcomes thatresulted from such engagements, is due within 10 working days after each CY.

o A final assessment report is due within 60 working days after completion of the contract. This report shallcomment on the value of the OD services to the NRC and to participants, as reflected in their overallevaluation comments.

6. REQUIRED LABOR CATEGORIES

Base Contract: September 30, 2015 - March 31, 2016CONTRACT LABOR ESTIMATED LEVEL OFCATEGORY EFFORT

Senior 00 Consultant 450

Junior 00 Consultant 100

Project Management 75

Total 625

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NRC-HQ-84- 15-E-0002 NRC-HQ-84- 15-T-0001I

Option Year 1: April 1, 2016- March 31, 2017CONTRACT LABOR ESTIMATED LEVELCATEGORY OF EFFORTSenior OD Consultant 900

Junior 00 Consultant 200

Project Management 130

Total 1230

Option Year 2: April 1, 2017 - March 31, 2018CONTRACT LABOR ESTIMATED LEVELCATEGORY OF EFFORTSenior OD Consultant 900

Junior OD Consultant 200

Project Management 130

Total 1230

7. GOVERNMENT-FURNISHED PROPERTY

Facilities: The Government will provide appropriate facilities for condu'cting OD meetings and other related activitiesat NRC headquarters and each of its four regions, the TTC, and other specified locations as outline in the SOW andupon request of the contractor for use during the provision of contract services.

Equipment: The Government will provide equipment as needed including items such as easels and flip charts;name and tent cards; DVD Player, VCR (if needed); VTCILCD video camera equipment; TV monitors andmicrophones; blank DVDs, CDs, or tapes; overhead projector; writing pens and paper; highlighters; dry erasemarkers; painter's tape for attaching participants' flip chart work sheets to special wall boards; etc.

Computer Access: The Government will provide access to the NRC internal website as required by this task order.Access is dependent on the contractors maintaining, at a minimum, an NRC IT-i level clearance.

At the end of this contract/order, disposition of GFP shall be in accordance with FAR 52.245-1, GovernmentProperty.

8. PLACE OF PERFORMANCE

All coaching sessions will be conducted at NRC facilities (Headquarters and/or Regions).

9. TRAVEL

Travel will be reimbursed in accordance with FAR 31.205-46, "Travel costs" and the General ServicesAdministration's Federal Travel Regulations at: http://www.qisa..qov/p~ortal/content/1 04790

Travel to the regional offices or technical training center to support 00 engagements in those locations is authorizedas required. The travel budget will be specified in the project plan for each engagement and will not exceed theamount allocated in the base SOW.

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NRC-HQ-84-1 5-E-0002 N•RC-HQ-84-1 5-T-0001

A.4 NRCB050 CONSIDERATION AND OBLIGATION-TASK ORDERS

(a) The Based and Exercised ceiling of this order for services is $448,429.60 and the Base and All Options of thisorder is $748,819.60.

(b) The amount presently obligated with respect to this order is $163,789.00. The obligated amount shall, at no time,exceed the order ceiling as specified in paragraph (a) above. When and if the amount(s) paid and payable to theContractor hereunder shall equal the obligated amount, the Contractor shall not be obligated to continue performanceof the work unless and until the Contracting Officer shall increase the amount obligated with respect to this order, inaccordance with FAR Part 43 - Modifications. Any work undertaken by the Contractor in excess of the obligatedamount specified above is done so at the Contractor's sole risk and may not be reimbursed by the Government.

(d) The Contractor shall comply with the provisions of FAR 52.232-22 - Limitation of Funds, for incrementally-fundeddelivery orders or task orders.

A.5 52.232-22 LIMITATION OF FUNDS (APR 1984)

(a) The parties estimate that performance of this contract will not cost the Government more than (1) the estimatedcost specified in the Schedule or, (2) if this is a cost-sharing contract, the Government's share of the estimated costspecified in the Schedule. The Contractor agrees to use its best efforts to perform the work specified in the Scheduleand all obligations under this contract within the estimated cost, which, if this is a cost-sharing contract, includes, boththe Government's and the Contractor's share of the cost.

(b) The Schedule specifies the amount presently available for payment by the Government and allotted to thiscontract, the items covered, the Government's share of the cost if this is a cost-sharing contract, and the period ofperformance it is estimated the allotted amount will cover. The parties contemplate that the Government will allotadditional funds incrementally to the contract up to the full estimated cost to the Government specified in theSchedule, exclusive of any fee. The Contractor agrees to perform, or have performed, work on the contract up to thepoint at which the total amount paid and payable by the Government under the contract approximates but does notexceed the total amount actually allotted by the Government to the contract

(c) The Contractor shall notify the Contracting Officer in writing whenever it has reason to believe that the costs itexpects to incur under this contract in the next 60 days, when added to all costs previously incurred, will exceed 75percent of (1) the total amount so far allotted to the contract by the Government or, (2) if this is a cost-sharing contract,the amount then allotted to the contract by the Government plus the Contractor's corresponding share. The noticeshall state the estimated amount of additional funds required to continue performance for the period specified in theSchedule.

(d) Sixty days before the end of the period specified in the Schedule, the Contractor shall notify the ContractingOfficer in writing of the estimated amount of additional funds, if any, required to continue timely performance under thecontract or for any further period specified in the Schedule or otherwise agreed upon, and when the funds will berequired.

(e) If, after notification, additional funds are not allotted by the end of the period specified in the Schedule or anotheragreed-upon date, upon the Contractor's written request the Contracting Officer will terminate this contract on thatdate in accordance with the provisions of the Termination clause of this contract. If the Contractor estimates that thefunds available will allow it to continue to discharge its obligations beyond that date, it may specify a later date in itsrequest, and the Contracting Officer may terminate this contract on that later date.

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NRC-HQ-84-1 5-E-0002 NRC-HQ-84-1 5-T-0001

(f) Except as required by other provisions of this contract, specifically citing and stated to be an exception to thisclause--

(1) The Government is not obligated to reimburse the Contractor for costs incurred in excess of the total amountallotted by the Government to this contract; and

(2) The Contractor is not obligated to continue performance under this contract (including actions under theTermination clause of this contract) or otherwise incur costs in excess of--

(i) The amount then allotted to the contract by the Government or;

(ii) If this is a cost-sharing contract, the amount then allotted by the Government to the contract plus theContractor's corresponding share, until the Contracting Officer notifies the Contractor in writing that the amountallotted by the Government has been increased and specifies an increased amount, which shall then constitute thetotal amount allotted by the Government to this contract.

(g) The estimated Cost shall be increased to the extent that (1) the amount allotted by the Government or, (2) if thisis a cost-sharing contract, the amount then allotted by the Government to the contract plus the Contractor'scorresponding share, exceeds the estimated cost specified in the Schedule. If this is a cost-sharing contract, theincrease shall be allocated in accordance with the formula specified in the Schedule.

(h) No notice, communication, or representation in any form other than that specified in paragraph (f)(2) of thisclause, or from any person other than the Contracting Officer, shall affect the amount allotted by the Government tothis contract. In the absence of the specified notice, the Government is not obligated to reimburse the Contractorforany costs in excess of the total amount allotted by the Government to this contract, whether incurred during thecourse of the contract or as a result of termination.

(i) When and to the extent that the amount allotted by the Government to the contract is increased, any costs theContractor incurs before the increase that are in excess of--

(1) The amount previously allotted by the Government or;

(2) If this is a cost-sharing contract, the amount previously allotted by the Government to the contract plus theContractor's corresponding share, shall be allowable to the same extent as if incurred afterward, unless theContracting Officer issues a termination or other notice and directs that the increase is solely to cover termination orother specified expenses.

(j) Change orders shall not be considered an authorization to exceed the amount allotted by the Governmentspecified in the Schedule, unless they contain a statement increasing the amount allotted.

(k) Nothing in this clause shall affect the right of the Government to terminate this contract. If this contract isterminated, the Government and the Contractor shall negotiate an equitable distribution of all property produced orpurchased under the contract, based upon the share of costs incurred by each.

(I) If the Government does not allot sufficient funds to allow completion of the work, the Contractor is entitled to apercentage of the fee specified in the Schedule equaling the percentage of completion of the work contemplated bythis contract.

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NRC-HQ-84- 15-E-0002 NRC-HQ-84-1I5-T-O0001

A.6 BRANDING (AUG 2011)

The Contractor is required to use the official NRC branding logo or seal on any publications, presentations, products,or materials funded under this contract, to the extent practical, in order to provide NRC recognition for its involvementin and contribution to the project. If the work performed is funded entirely with NRC funds, then the contractor mustacknowledge that information in its documentation/presentation.

Access the following websites for branding information and specifications:http://www~internal.nrc.Qov/ADM/branding/ and Management Directive and Handbook 3.13 -

(internal NRC website): http://www.internal.nrc.q ov/p olicyfdirectives/toc/md3.13.htm

(external public website): http://pbadupws. nrc.qov/docs/ML1 122/ML1 12280190.prdf

A.7 ELECTRONIC PAYMENT (SEP 2014)

The Debt Collection Improvement Act of 1996 requires that all payments except IRS tax refunds be made byElectronic Funds Transfer. Payment shall be made in accordance with FAR 52.232-33, entitled "Payment byElectronic Funds-Central Contractor Registration". To receive payment, the contractor shall prepare invoices inaccordance with NRC's Billing Instructions. Claims shall be submitted on the payee's letterhead, invoice, or on theGovernment's Standard Form 1034, "Public Voucher for Purchases and Services Other than Personal," and StandardForm 1035, "Public Voucher for Purchases Other than Personal - Continuation Sheet." The preferred method ofsubmitting invoices is electronically to: NRCPayments~nrc..qov. If the contractor submits a hard copy of the invoice, itshall be submitted to the following address:

NRC PaymentsU.S. Nuclear Regulatory CommissionOne White Flint North11555 Rockville PikeMailstop 03-El17ARockville, MD 20852-2738

A.8 BILLING INSTRUCTIONS FOR LABOR HOUR/TIME AND MATERIALS TYPE CONTRACTS (MAY2015)

General: During performance and through final payment of this contract, the contractor is responsible for theaccuracy and completeness of data within the System for Award Management (SAM) database and for any liabilityresulting from the Government's reliance on inaccurate or incomplete SAM data.

The contractor shall prepare invoices/vouchers for reimbursement of costs in the manner and format described herein.FAILURE TO SUBMIT INVOICESNOUCHERS IN ACCORDANCE WITH THESE INSTRUCTIONS WILL RESULT INREJECTION OF THE INVOICE/VOUCHER AS IMPROPER.

Standard Forms: Claims shall be submitted on the payee's letterhead, invoice/voucher, or on the Government'sStandard Form 1034, "Public Voucher for Purchases and Services Other than Personal," and Standard Form 1035,"Public Voucher for Purchases Other than Personal--Continuation Sheet."

Electronic InvoiceNoucher Submissions: The preferred method of submitting vouchers/invoices is electronically tothe U.S. Nuclear Regulatory Commission, via email to: NRCPavments~nrc.qov.

Hard-Copy InvoiceNoucher Submissions: If you submit a hard-copy of the invoice/voucher, a signed original and- 12 - of 17

NRC-HQ-84-1I5-E-0002 NRC-HQ-84-1I5-T-000 1supporting documentation shall be submitted to the following address:

NRC PaymentsU.S. Nuclear Regulatory CommissionOne White Flint North11555 Rockville PikeMailstop O3-E17ARocky/lle, MD 20852-2738

Purchase of Capital Property: ($50,000 or more with life of one year or longer)

Contractors must report to the Contracting Officer, electronically, any capital property acquired with contract fundshaving an initial cost of $50,000 or more, in accordance with procedures set forth in NRC Management Directive (MD).

Agency Payment Office: Payment will continue to be made by the office designated~in the contract in Block 12 of theStandard Form 26, or Block 25 of the Standard Form 33, whichever is applicable.

Frequency: The contractor shall submit claims for reimbursement once each month, unless otherwise authorized bythe Contracting Officer.

Format: Invoices/Vouchers shall be submitted in the format depicted on the attached sample form entitled"lnvoice/Voucher for Purchases and Services Other Than Personal". Alternate formats are permissible only if theyaddress all requirements of the Billing Instructions. The instructions for preparation and itemization of theinvoice/voucher are included with the sample form.

Task Order Contracts: The contractor must submit a separate invoice/voucher for each individual task order withdetailed cost information. This includes all applicable cost elements and other items discussed in paragraphs (a)through (q) of the attached instructions. In addition, the invoice/voucher must specify the contract number, and theNRC-assigned task/delivery order number.

.Billingq of Costs after Expiration of Contract: If costs are incurred during the contract period and claimed after thecontract has expired, you must cite the period during which these costs were incurred. To be considered a properexpiration invoice/voucher, the contractor shall clearly mark it "EXPIRATION INVOICE" or "EXPIRATION VOUCHER".

Final invoices/vouchers shall be marked "FINAL INVOICE" or "FINAL VOUCHER".

Currency: Invoices/Vouchers must be expressed in U.S. Dollars.

Supersession: These instructions supersede previous Billing Instructions for Time-and-Materials/Labor-Hour TypeContracts (MAY 2013).

INVOICE/VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL(SAMPLE FORMAT - COVER SHEET)

1. Official A gency Billing Office

NRC PaymentsU.S. Nuclear Regulatory CommissionOne White Flint North11555 Rockville PikeMailstop O3-E17ARockville, MD 20852-2738

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NRC-HQ-84-1 5-E-0002 NRC-HQ-84-1 5-T-0001

2. Invoice/Voucher Information

a. Payee's DUNS Number or DUNS+4. The Payee shall include the Payee's Data Universal Number (DUNS) orDUNS+4 number that identifies the Payee's name and address. The DUNS+4 number is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the Payee to identify alternative Electronic Funds Transfer(EFT) accounts for the same parent concern.

b. Payee's Name and Address. Show the name of the Payee as it appears in the contract and its correct address.Where the Payee is authorized to assign the proceeds of this contract in accordance with the clause at FederalAcquisition Regulation (FAR) 52.232-23 Assiqnment of Claims, the Payee shall require as a condition of any suchassignment, that the assignee shall register separately in the System for Award Management (SAM) database athttp://sam.qov and shall be paid by EFT in accordance with the terms of this contract. See FAR 52.232-33 Paymentby Electronic Funds Transfer-System for Award Manaqement.

c. Taxpayer Identification Number. The Payee shall include the Payee's taxpaYer identification number (TIN) used bythe Internal Revenue Service (IRS) in the administration of tax laws. (See IRS Web site:http://wwvw.irs.qov/lndivid uals/InternationaI-Taxpayers/Taxpayer-ldentification-Numbers-(TI N)).

d. Contract Number. Insert the NRC contract number (including Enterprise-wide Contract (EWC)), GSA FederalSupply Schedule (FSS), Governmentwide Agency Contract (GWAC) number, or Multiple Agency Contract (MAC)number, as applicable.

e. Task Order Number. Insert the task/delivery order number (If Applicable). Do not include more than one taskorder per invoice or the invoice may be rejected as improper.

f. Invoice/Voucher. The appropriate sequential number of the invoice/voucher, beginning with 001 should bedesignated. Contractors may also include an individual internal accounting number, if desired, in addition to the 3-digitsequential number.

g. Date of Invoice/Voucher. Insert the date the invoice/voucher is prepared.

h. Billingq period. Insert the beginning and ending dates (day, month, year) of the period during which costs wereincurred and for which reimbursement is requested.

i. Labor Hours Expended. Provide a general summary description of the services performed and associated laborhours utilized during the invoice period. Specify the Contract Line Item Number (CLIN) or SubCLIN, as applicable,and information pertaining to the contract's labor categories/positions, and corresponding authorized hours.

j. Property. For contractor acquired property, list each item with an initial acquisition cost of $50,000 or more andprovide: (1) an item description, (2) manufacturer, (3) model number,(4) serial number, (5) acquisition cost, (6) date of purchase, and (7) a copy of the purchasing document.

k. Ship~pinq. Insert weight and zone of shipment, if shipped by parcel post.

I. Charges for freigqht or express shipments. Attach prepaid bill if shipped by freight or express.

m. instructions. include instructions to consignee to notify the Contracting Officer of receipt of shipment.

n. For Indefinite Delivery contracts, the final invoice/voucher shall be marked "FINAL INVOICE" or "FINALVOUCHER".

o. Direct Costs. Insert the amount billed for the following cost elements, adjustments, suspensions, and total

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NRC-HQ-84- 15-E-0002 NRC-HQ-84-1I5-T-0001Iamounts, for both the current billing period and for the cumulative period (from contract inception to end date of thisbilling period).

(1) Direct (Burdened) Labor. This consists of salaries and wages paid (or accrued) for direct performanceof the contract itemized, including a burden (or load) for indirect costs (i.e., fringe, overhead, General andAdministrative, as applicable), and profit component, as follows:

Labor Hours Burdened CumulativeCategory Billed Hourly Rate Total Hours Billed

(2) Contractor-acquired property ($50,000 or more). List each item costing $50,000 or more and having alife expectancy of more than one year. List only those items of equipment for which reimbursement isrequested. For each such item, list the following (as applicable): (a) an item description, (b) manufacturer, (c)model number, (d) serial number, (e) acquisition cost, (f) date of purchase, and (g) a copy of the purchasingdocument.

(3) Contractor-acquired property (under $50,000), Materials, and Supplies. These are equipment otherthan that described in (2) above, plus consumable materials and supplies. List by category. List items valuedat $1,000 or more separately. Provide the item number for each piece of equipment valued at $1 ,000 or more.

(4) Materials Handling Fee. Indirect costs allocated to direct materials in accordance the contractor's usualaccounting procedures.

(5) Consultant Fee. The supporting information must include the name, hourly or daily rate of theconsultant, and reference the NRC approval (if not specifically approved in the original contract).

*(6) Travel. Total costs associated with each trip must be shown in the following format:

Start Date Destination Costs

From To From To $

(Must include separate detailed costs for airfare, per diem, and other transportation expenses. All costs must

be adequately supported by copies of receipts or other documentation.)

(7) Subcontracts. Include separate detailed breakdown of all costs paid to approved subcontractors duringthe billing period.

p. Total Amount Billed. Insert columns for total amounts for the current and cumulative periods.

q..Adjustments. Insert columns for any adjustments, including outstanding suspensions for unsupported or

unauthorized hours or costs, for the current and cumulative periods.

r. Grand Totals.

3. Sample Invoicel~oucher Information

Sample Invoice/Voucher Information (Supporting Documentation must be attached)

This invoice/voucher represents reimbursable costs for the billing period from through.____

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(1)(2)(3)

(4)

(5)(6)(7)

Direct burdened laborGovernment property ($50,000 or more)Government property, Materials, andSupplies (under $50,000 per item)Materials Handling FeeConsultants FeeTravelSubcontracts

Total Direct Costs:

NRC-HQ-84.-1 5-E-0002 NRC-HQ-84-1 5-T-0001Amount Billed

Current Period Cumulative (a) Direct Costs

$___ $__$___ $__

$___ $__$___ $__$___ $__$___ $__$___ $__

$___$.__

(b) Total Amount Billed $______$

(c) Adjustments (+/-) $. ____$.

(d) Grand Total $. ____$

(The invoice/voucher format provided above must include information similar to that ii

ensure accuracy and completeness.)

SAMPLE SUPPORTING INFORMATION

The budget, information provided below is for format purposes only and is illustrative.

Cost Elements:

1 ) Direct Burdened Labor - $4,800

ncluded below in the following to

LaborHours Burdened CumulativeCategqory Billed Rate Total Hours BilledSenior Engineer I 100 $28.00 $2,800 975Engineer 50 $20.00 $1,000 465Computer Analyst 100 $10.00 $1,000 320

$4,800 1,760 hrs.

Burdened labor rates must come directly from the contract.

2) Government-furnished and contractor-acqiuired property ($50,000 or more) - $60,000

Prototype Spectrometer - item number 1000-01 = $60,000

3) Government-furnished and contractor-acq uired property (under $50,000), Materials, and

Supplies - $2,000

10 Radon tubes @$110.00 = $1,1006 Pairs Electrostatic gloves @ $150.00 = $ 900

$2,0004) Materials Handlinq Fee - $40

(2% of $2,000 in item #3)

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NRC-HQ-84-15-E-0002 NRC-HQ-84-1 5-T-0001

5) Consultants' Fee - $100

Dr. Carney - 1 hour fully-burdened @ $100 = $100

6) Travel - $2,640

(i) Airfare: (2 Roundtrip trips for 1 person @ $300 per r/t ticket)

Start Date End Date Days From Too Cost4/1/2011 4/7/20 11 7 Philadelphia, PA *Wash, D.C. $3007/1/2011 7/8/20 11 8 Philadelphia, PA Wash, D.C. $300

(ii) Per Diem: $136/day x 15 days = $2,040

7) Subcontractinci - $30,000

Company A = $10,000Company B = $20,000

$30,000

(EX: Subcontracts for Companies A & B were consented to by the Contracting Officer by letter dated6/15/2011.)

Total Amount Billed $99,580Adjustments (+/-) - 0Grand Total $99,580

4. Definitions

Material/handlinq costs. When included as part of material costs, material handling costs shall include only costsclearly excluded from the labor-hour rate. Material handling costs may include all appropriate indirect costs allocatedto direct materials in accordance with the contractor's usual accounting procedures.

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