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GUIDELINES FOR SUBMITTING NDI 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 (fmoapinv@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.
Submitting an invoice to cover a full year is acceptable but quarterly invoicing is encouraged.
INFORMATION REQUIRED:
1. Invoice/Voucher number
2. US Department, Bureau, or Establishment and Location
3. Date Voucher prepared
4. Contract Number
5. Payee name and address
6. DUNS
7. EIN
8. Item Number
9. Date of Delivery
10. Supplies and Services
11. Quantity
12. Unit Price
13. Amount
14. Total
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LINK TO FORM: http://www.gsa.gov/portal/forms/download/115462
DETAILED INSTRUCTIONS (See page 6 for each item listed below):
1. 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.
2. 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
3. A current date must be added indicating when the invoice was prepared.
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4. Enter your state specific purchase order number in the block for CONTRACT NUMBER. The
purchase order number can be found on page 3 in the far right hand corner for NDI data
purchase.
Example: 200-2012-M-30986
5. Enter Payee’s name and address (state/jurisdiction)
6. 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.
7. 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.
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8. For the item number and date of order, use the CLIN/ITEM number. It can be found on page 3 of
16 of the purchase order.
9. The Date of Delivery is the same as the Period of Performance or PoP. Please see your purchase
order for the Period of Performance. If you are not invoicing for all four quarters of data
included in the data collection period, please do *not* use the entire date range.
10. Articles or Service should specifically indicate for what data you are requesting payment.
Examples:
1
st
Quarter:
NDI Data Months: January - March 2012
Performance Period: April - June 2012
All data months:
NDI Data Months: January 2012 - December 2012
Performance Period: April 16, 2012 - April 15, 2013
11. The quantity is the number of quarters you are requesting payment. For example, if you are
requesting payment for one quarter, enter such in this field:
QTY / UNIT
1 Quarter
12. The unit price is the amount for each quarter of death data. This information can also be found
on page 3 of your NDI purchase order. This amount is entered under the Unit Price on the
invoice.
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13. The Amount is the Quantity multiplied by the Unit Price.
14. The Total represents the grand total of the voucher OR the sum of all Amounts.
Example: Using the figures from instruction 13 above your total for 1 quarter would be the
same as the Amount, $12,912.75.
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.
QTY / UNIT
UNIT PRICE
AMOUNT
1 Quarter
$12,912.75
$12,912.75
4 Quarters
$12,912.75
$51,651.00
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Standard Form 1034
Revised October 1987
Department of the Treasury
1 TFM 4-2000
PUBLIC VOUCHER FOR PURCHASES AND SERVICES
OTHER THAN PERSONAL
VOUCHER NO.
REQ #1
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION
REQ #2
DATE VOUCHER PREPARED
REQ #3
SCHEDULE NO.
CONTRACT NUMBER AND DATE
REQ #4
PAID BY
REQUISITION NUMBER AND DATE
PAYEE'S NAME AND ADDRESS
REQ #5
DATE INVOICE RECEIVED
DISCOUNT TERMS
PAYEE'S ACCOUNT NUMBER
REQ #6
SHIPPED FROM TO WEIGHT
GOVERNMENT B/L NUMBER
REQ #7
NUMBER AND DATE
OF ORDER
DATE OF
DELIVERY
OR SERVICE
ARTICLES OR SERVICES
(Enter description, item number of contract or Federal supply schedule,
and other information deemed necessary)
QUAN-
TITY
UNIT PRICE
AMOUNT
COST
PER
(1)
REQ #8
REQ
#9
REQ #10
REQ
#11
REQ
#12
REQ #13
(Use continuation sheet(s) if necessary) (Payee must NOT use the space below) TOTAL
REQ #14
PAYMENT:
PROVISIONAL
COMPLETE
PARTIAL FINAL
PROGRESS
ADVANCE
APPROVED FOR
=$
EXCHANGE RATE
=$1.00
DIFFERENCES
BY 2
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
1. When stated in foreign currency, insert name of currency.
2. 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.
3. 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 disbursing 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.
