GUIDELINES FOR SUBMITTING VSCP INVOICES/VOUCHERS

General Guidelines for Submitting Invoices:

If you submit your invoice via E-mail, there is no need to mail a paper copy. You may send the single invoice attachment directly to OAS (cpbapinv@cdc.gov), and cc the DACEB procurements mailbox (daebproc@cdc.gov) and your state’s assigned COR/Vital Statistics Specialist (see task order for name and email address). Or you may send via mail/courier to CDC, PO Box 15580, Atlanta, GA 30333. But do not duplicate submissions.

Due to upgrades to the NCHS invoice imaging process, we ask that you submit only one invoice attachment per E-mail, to ensure vendor invoices are received and recorded properly in our system. E-mails submitted as a single file containing multiple invoices or emails submitted with multiple invoice attachments will not import properly due to our new system changes. Additional pages with the invoice, such as cover letters or associated paperwork, will not cause any issues; it is

only mandatory that the E-mail contains only one attachment, and that the attachment contains only

one invoice.

Please include the contract number and task order number in the subject line of the email. By submitting one invoice per email, clearly labeled in the subject line, you will ensure faster processing of vendor invoices and their subsequent payment.

Quarterly invoicing is encouraged, with the exception of the 4th quarter. The December payment includes final files as deliverables; all files must be closed before the this payment can be made.

INFORMATION REQUIRED:

Invoice/Voucher number
US Department, Bureau, or Establishment and Location
Date Voucher prepared
Contract Number
Payee name and address
DUNS
EIN
Item Number
Date of Delivery
Supplies and Services
Quantity
Unit Price
Amount
Total

LINK TO FORM: http://www.gsa.gov/portal/forms/download/115462

DETAILED INSTRUCTIONS (See page 6 for each item listed below):

Please use these instructions when completing invoices to avoid delay in payment. Invoice numbers cannot be duplicated. Please use consecutive invoice numbers. Public Vouchers submitted with an invoice must be numbered the same as the invoice. Do not use different numbers for the Public Voucher and the invoice.
US Department, Bureau, or Establishment and Location must show:
Centers for Disease Control & Prevention (CDC) Financial Management Office
P. O. Box 15580 Atlanta, GA 30333
A current date must be added indicating when the invoice was prepared.
The contract number (200-2012-50903) and the task order number (0001, 0002, 0003, 0004, 0005, 0006, 0007, etc.) must be included in the block below. Enter your state specific contract
number and task order number. Task order numbers can be found on page 3 in the far right hand corner for VSCP data purchase.

Example: 200-2012-50903 0001
Enter Payee’s name and address (state/jurisdiction)
The DUNS number is a unique nine digit identification number, for each physical location of your business. Dun & Bradstreet (D&B) provides a D-U-N-S Number. Enter this information in the block for the PAYEE’S ACCOUNT NUMBER.
The TIN/EIN number is the employer identification number, or EIN, and is also known as a taxpayer identification number, or TIN. Enter this information in the block for GOVERNMENT B/L NUMBER.
For the number and date of order, use the CLIN/ITEM number. It can be found on page 3 of 3 of the Task Order.
The Date of Delivery is the same as the Performance Period. Please see your task order for the Performance Period. If you are not invoicing for all months of data included in the data collection period, please do *not* use the entire date range.
Articles or Service should specifically indicate for what data you are requesting payment. Example: VSCP Data
Data Months January – March 2013
The quantity is the number of months you are requesting payment. For example, one quarter will equal three months:

QTY / UNIT
3 Months
The unit price is the monthly amount for all events (natality, mortality, infant, fetal deaths) and can also be found on page 3 of your task order. This amount is entered under the Unit price on
the invoice
The Extended Price is the Quantity multiplied by the Unit Price.

QTY / UNIT
UNIT PRICE
EXTENDED PRICE
3 Months
$20,258.00
$60,774.00
The Total represents the grand total of the voucher.

Example: Using the figures from instruction 13 above your total would be the same as the Extended Price, $60,774.00.

Note for issues with processed invoices or payment:

The NCHS goal for processing invoices is to have the payment made within 30 days of the date NCHS receives the invoice (not the date on the invoice). If it has been over 30 days since your invoice was submitted to NCHS, our suggestion is to send an E-mail to your state’s assigned Vital Statistics Specialist. Include a copy of the invoice and any necessary dates and information on it, including the original E-mail it was attached to, if available. Your Vital Statistics Specialist will look into it and let you know what they find out.

Standard Form 1034 Revised October 1987 Department of the Treasury 1 TFM 4-2000		PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL				VOUCHER NO. REQ #1
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION REQ #2			DATE VOUCHER PREPARED REQ #3			SCHEDULE NO.
			CONTRACT NUMBER AND DATE REQ #4			PAID BY
			REQUISITION NUMBER AND DATE
PAYEE'S NAME AND ADDRESS REQ #5
						DATE INVOICE RECEIVED
						DISCOUNT TERMS
						PAYEE'S ACCOUNT NUMBER REQ #6
SHIPPED FROM TO WEIGHT						GOVERNMENT B/L NUMBER REQ #7
NUMBER AND DATE OF ORDER	DATE OF DELIVERY OR SERVICE	ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)	QUANTITY	UNIT PRICE		AMOUNT
				COST	PER	(1)
REQ #8	REQ #9	REQ #10	REQ #11	REQ #12		REQ #13
(Use continuation sheet(s) if necessary) (Payee must NOT use the space below)				TOTAL		REQ #14
PAYMENT: PROVISIONAL COMPLETE	APPROVED FOR =$		EXCHANGE RATE =$1.00	DIFFERENCES

PARTIAL FINAL PROGRESS
	BY 2
ADVANCE

			Amount verified; correct for payment
	TITLE		(Signature or initials)
Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment. (Date) (Authorized Certifying Officer) 2				(Title)
ACCOUNTING CLASSIFICATION

P A I D B Y	CHECK NUMBER ON ACCOUNT OF U.S. TREASURY		CHECK NUMBER	ON (Name of bank)
	CASH DATE $		PAYEE 3
When stated in foreign currency, insert name of currency. If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise the approving officer will sign in the space provided, over his official title. When a voucher is receipted in the name of a company or corporation, the name of the person writing the company or corporate name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary", or "Treasurer", as the case may be.					PER
					TITLE

Previous edition usable NSN 7540-00-900-2234

PRIVACY ACT STATEMENT

The information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursi ng Federal money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

QTY / UNIT	UNIT PRICE	EXTENDED PRICE
3 Months	$20,258.00	$60,774.00