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HomeMy WebLinkAboutC19-329 USDA - White River National Forest Modification USDA Forest Service OMB 0596-0217
FS-1500-19
11. SIGNATURES
AUTHORIZED REPRESENTATIVE: BY SIGNATURE BELOW, THE SIGNING PARTIES CERTIFY THAT THEY ARE THE OFFICIAL REPRESENTATIVES
OF THEIR RESPECTIVE PARTIES AND AUTHORIZED TO ACT IN THEIR RESPECTIVE AREAS FOR MATTERS RELATED TO THE ABOVE-
MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES
1 13
1. U.S. FOREST SERVICE GRANT/AGREEMENT NUMBER:
18-PA-11021500-013
2. RECIPIENT/COOPERATOR GRANT or
AGREEMENT NUMBER, IF ANY:
3. MODIFICATION NUMBER:
1
4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
GRANT/AGREEMENT (unit name, street, city, state, and zip + 4):
White River National Forest Program Contact:
Liz Roberts, Forest Ecologist
900 Grand Ave
Glenwood Springs, CO 81601
Telephone: 970 945-3257
FAX: 970 945-3266
Email: elizabeth.roberts@usda.gov
5. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4):
White River National Forest Admin Contact:
Clark M. Woolley, G&A Specialist
White River National Forest
900 Grand Avenue
Glenwood Springs, CO 81601
Telephone: 970-948-9803
Email: clark.woolley@usda.gov
6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip +
4, county):
Eagle County Program Contact:
Doug Riggins, Vegetation Management Lead
Eagle County Vegetation Management
3289 Cooley Mesa Road
Gypsum, CO 81637
PO Box 850
Eagle, CO 81631
Email: doug.riggins@eaglecounty.us
FAX: 970-328-3546
7. RECIPIENT/COOPERATOR’S HHS SUB ACCOUNT NUMBER (For HHS
payment use only):
Eagle County Contact:
Eagle County Attorney
500 Broadway
PO Box 850
Eagle, CO 81631
Email: atty@eaglecounty.us
FAX: 970-328-8699
8. PURPOSE OF MODIFICATION
CHECK ALL
THAT APPLY: This modification is issued pursuant to the modification provision in the grant/agreement
referenced in item no. 1, above.
CHANGE IN PERFORMANCE PERIOD: Remains the same.
CHANGE IN FUNDING: Obligates an additional U.S. Forest Service funds in the amount of $5,000.00 for cooperative
work and activities within the scope of the agreement. U.S. Forest Service funding beyond this fiscal year may be
carried forward to the next fiscal year and will be available through the term of this agreement.
ADMINISTRATIVE CHANGES: Incorporates Mandatory provisions.
OTHER: Incorporates Modification No. 1 Operating Plan and Financial Plan to the agreement.
Except as provided herein, all terms and conditions of the Grant/Agreement referenced in 1, above, remain unchanged and in full
force and effect.
9. ADDITIONAL SPACE FOR DESCRIPTION OF MODIFICATION (add additional pages as needed):
Modification No. 1 increases U.S. Forest Service funding within the scope of work and incorporates associated operating plan and
financial plan to this Agreement. See attached documents.
10. ATTACHED DOCUMENTATION (Check all that apply):
Scope of Work
Financial Plan
Other: Incorporates mandatory provisions.
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B
USDA Forest Service OMB 0596-0217
FS-1500-19
REFERENCED GRANT/AGREEMENT.
11.A. EAGLE COUNTY SIGNATURE
11.B. DATE
SIGNED
11.C. U.S. FOREST SERVICE SIGNATURE 11.D. DATE
SIGNED
(Signature of Signatory Official) (Signature of Signatory Official)
11.E. NAME (type or print): JEFF SHROLL 11.F. NAME (type or print): SCOTT G. FITZWILLIAMS
11.G. TITLE (type or print): County Manager
Eagle County
11.H. TITLE (type or print): Forest Supervisor,
White River National Forest
12. G&A REVIEW
12.A. The authority and format of this modification have been reviewed and approved for signature by:
______________________________________
CLARK M. WOOLLEY
U.S. Forest Service, Grants & Agreements Specialist
12.B. DATE
SIGNED
Burden Statement
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is 0596-0217. The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital
status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape,
etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call toll free (866) 632-9992 (voice). TDD users can contact USDA through local relay or the Federal relay at (800) 877-8339 (TDD) or (866) 377-8642 (relay voice). USDA is an equal opportunity provider and employer.
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B
9/26/2019 10/1/2019
10/1/2019
USDA Forest Service OMB 0596-0217
FS-1500-19
Modification No. 1
Operating Plan (2019-2020)
Goal
Control and eradication of noxious weeds and invasive plants on public and private lands, within Eagle County and
on the White River National Forest.
Objectives
- Coordinate a cooperative weed management program for consistent management on a landscape scale.
- Collaborate and treat Federal lands as well as county roads or county administered properties.
- Conduct treatments on County administered lands, targeting areas and species which will be complementary
to the County noxious weed control efforts.
- Conduct inventories of roadside noxious weed infestations.
Methods
- Utilizing various ground pesticide application equipment (backpack, UTV, horse or truck mounted sprayers)
treat all detected State of Colorado listed noxious weeds with Environmental Protection Agency approved
herbicides and ensure their labels are strictly adhered to.
- Evaluate/monitor treatment effectiveness.
- Evaluate treatment effectiveness.
Treatment Areas
- The areas to be treated under this agreement will be identified in annual project planning meetings with the
County Weed Program Manager.
- Proposed project areas may include:
o Forest Service Roads, Campgrounds and Trailheads within Eagle County
o Backcountry weed infestations as identified in each annual project planning meeting
o Other areas to be determined at the annual project planning meetings and as needed and identified
during routine monitoring.
- Acreage treated will be dependent upon the severity of the weed infestations.
Reporting
- A copy of the daily application records along with map locations of the weed infestations will be submitted
to the Eagle County Weed Program Manager, no later than September 30th annually.
Funding
- Cost of programing shall not exceed the stated amount in this agreement. If Coordinator does not request
the entire amount, any remaining funds may be carried forward to the next fiscal year and will be available
through the terms of this Agreement.
Identified Specific Projects
Area to be treated Acres # Days Cost Per Day
($100/hr.)
Cost
Areas to be identified at
the annual meeting TBD 6.25 Days
800 $5,000
Total Estimate: 6.25 Days $800 $5,000
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B
USDA Forest Service OMB 0596-0217
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Expected Results and Environmental Compliance
The results of this collaboration: 50-85% mortality of treated noxious weeds, resulting in each following year’s
herbicide input to decline. Mortality will be dependent upon the weed species treated. All environmental
compliance and permitting for the project have been completed.
MANDATORY PROVISIONS
PAYMENT/REIMBURSEMENT. The U.S. Forest Service shall reimburse the Cooperator for the U.S. Forest
Service's share of actual expenses incurred, not to exceed $5,000.00 as shown in the Financial Plan. The U.S.
Forest Service shall make payment upon receipt of the Cooperator’s quarterly invoice. Each invoice from the
Cooperator shall display the total project costs for the billing period, separated by U.S. Forest Service and the
Cooperator’s share. In-kind contributions must be displayed as a separate line item and must not be included in the
total project costs available for reimbursement. The final invoice must display the Cooperator’s full match towards
the project, as shown in the financial plan, and be submitted no later than 90 days from the expiration date.
Each invoice must include, at a minimum:
1. Cooperator name, address, and telephone number.
2. U.S. Forest Service agreement number.
3. Invoice date.
4. Performance dates of the work completed (start & end).
5. Total invoice amount for the billing period, separated by Forest Service and Cooperator share with
in-kind contributions displayed as a separate line item.
6. Display all costs, both cumulative and for the billing period, by separate cost element as shown on
the financial plan.
7. Cumulative amount of Forest Service payments to date.
8. Statement that the invoice is a request for payment by “reimbursement.”
9. If using SF-270, a signature is required.
10. Invoice Number, if applicable.
The invoice must be sent by one of three methods (email is preferred):
EMAIL: SM.FS.asc_ga@usda.gov
FAX: 877-687-4894
POSTAL: USDA Forest Service
Albuquerque Service Center
Payments – Grants & Agreements
101B Sun Ave NE
Albuquerque, NM 87109
Send a copy to: elizabeth.roberts@usda.gov and stephen.elzinga@usda.gov
AVAILABILITY OF FUNDS. U.S. Forest Service funds in the amount of $5,000.00 are currently available for
performance of this instrument through the performance period of the agreement. The U.S. Forest Service's
obligation for performance of this instrument beyond this date is contingent upon the availability of appropriated
funds from which payment can be made. No legal liability on the part of the U.S. Forest Service for any payment
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B
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may arise for performance under this instrument beyond the performance period or until funds are made available
to the U.S. Forest Service for performance and until the Cooperator receive(s) notice of availability to be confirmed
in a written modification by the U.S. Forest Service.
SYSTEM FOR AWARD MANAGEMENT REGISTRATION REQUIREMENT (SAM). The Cooperator shall
maintain current information in the System for Award Management (SAM) until receipt of final payment. This
requires review and update to the information at least annually after the initial registration, and more frequently if
required by changes in information or agreement term(s). For purposes of this agreement, System for Award
Management (SAM) means the Federal repository into which an entity must provide information required for the
conduct of business as a Cooperative. Additional information about registration procedures may be found at the
SAM Internet site (currently at https://www.sam.gov).
PERFORMANCE REPORTING. The Cooperator shall monitor the performance of the agreement activities to
ensure that performance goals are being achieved.
Performance reports must contain information on the following:
- A comparison of actual accomplishments to the goals established for the period. Where the output of the project
can be readily expressed in numbers, a computation of the cost per unit of output may be required if that
information is useful.
- Reason(s) for delay if established goals were not met.
- Additional pertinent information including, when appropriate, analysis and explanation of cost overruns or high
unit costs.
The Cooperator shall submit annual performance reports to the U.S. Forest Service Program Manager. These
reports are due 90 days after the reporting period. The final performance report shall be submitted either with the
Cooperator’s final payment request, or separately, but not later than 90 days from the expiration date of the
agreement.
PROHIBITION AGAINST INTERNAL CONFIDENTIAL AGREEMENTS. All non-Federal government entities
working on this agreement will adhere to the below provisions found in the Consolidated Appropriations Act, 2016,
Pub. L. 114-113, relating to reporting fraud, waste and abuse to authorities:
a. The Cooperator may not require its employees, contractors, or sub recipients eking to report fraud,
waste, or abuse to sign or comply with internal confidentiality agreements or statements prohibiting
or otherwise restricting them from lawfully reporting that waste, fraud, or abuse to a designated
investigative or law enforcement representative of a Federal department or agency authorized to
receive such information.
b. The Cooperator must notify its employees, contractors, or sub recipients that the prohibitions and
restrictions of any internal confidentiality agreements inconsistent with paragraph (a) of this
agreement provision are no longer in effect.
c. The prohibition in paragraph (a) of this agreement provision does not contravene requirements
applicable to any other form issued by a Federal department or agency governing the nondisclosure
of classified information.
d. If the Government determines that the Cooperator is not in compliance with this agreement
provision, it:
i. Will prohibit the Cooperator’s use of funds under this agreement, in accordance with sections
743, 744 of Division E of the Consolidated Appropriations Act, 2016, (Pub. L. 114-113) or
any successor provision of law; and
ii. May pursue other remedies available for the Cooperator's material failure to comply with
agreement terms and conditions.
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B
U.S. Forest Service OMB 0596-0217
FS-1500-17B
Page 1
Attachment:Financial Plan
USFS Agreement No.:Mod. No.:1
Cooperator Agreement No.:
Financial Plan Matrix:Note: All columns may not be used. Use depends on source and type of contribution(s).
(a) (b)(c)(d)
Cash
COST ELEMENTS Noncash to Noncash In-Kind
Direct Costs Cooperator
Salaries/Labor $9,995.00 $5,000.00 $8,430.00 $0.00 $23,425.00
Travel $1,100.00 $0.00 $2,750.00 $0.00 $3,850.00
Equipment $2,250.00 $0.00 $9,500.00 $0.00 $11,750.00
Supplies/Materials $3,000.00 $0.00 $3,000.00 $0.00 $6,000.00
Printing $0.00 $0.00 $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $16,345.00 $5,000.00 $23,680.00 $0.00 $45,025.00
Coop Indirect Costs $0.00 $0.00 $0.00
FS Overhead Costs $1,634.50 $1,634.50
Total $17,979.50 $5,000.00 $23,680.00 $0.00
$46,659.50
(a+b) ÷ (e) = (f)
Total Cooperator Share
(c+d) ÷ (e) = (g)
Total (f+g) = (h)
Total Project Value:
(e)
Total
50.75%
Agreements Financial Plan (Short Form)
18-PA-11021500-013
Note: This Financial Plan may be used when:
(1) No program income is expected and
(2) The Cooperator is not giving cash to the FS and
(3) There is no other Federal funding
FOREST SERVICE CONTRIBUTIONS COOPERATOR CONTRIBUTIONS
100.00%
(h)
(g)
Matching Costs Determination
Total Forest Service Share =(f)
49.25%
DocuSign Envelope ID: E59B4152-8978-40AC-AC43-9DB4FD173C3B