HomeMy WebLinkAboutC20-179 USDA Forest Service USDA Forest Service OMB 0596-0217
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MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES
1 11
1.U.S. FOREST SERVICE GRANT/AGREEMENT NUMBER:
17-RO-11021500-044
2. RECIPIENT/COOPERATOR GRANT or
AGREEMENT NUMBER, IF ANY:
3. MODIFICATION NUMBER:
3
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:
Erica Borum
900 Grand Ave.
Glenwood Springs, CO 81601
Telephone: 970-945-3277
FAX: 970-945-3266
Email: erica.borum@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
900 Grand Ave.
Glenwood Springs, CO 81601
Telephone : 970-945-9803
Email: clark.woolley@usda.gov
6.NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip +
4, county):
Eagle County Program Contact:
John Harris
P.O. Box 250
Eagle, CO 81631
Telephone: 970-328-3540
FAX: 970-328-3546
Email: john.harris@eaglecounty.us
7. RECIPIENT/COOPERATOR’S HHS SUB ACCOUNT NUMBER (For HHS
payment use only):
Eagle County Admin. Contact:
Nicole Trujillo
PO Box 250
Eagle, CO 81631
Telephone: 970-328-3540
FAX: 970-328-3546
Email: nicole.trujillo@eaglecounty.us
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: The Cooperative Forest Road Agreement, FS Agreement No. 17-RO-
11021500-044, expires on 7/24/2022.
CHANGE IN FUNDING: Obligates additional U.S. Forest Service funding in the amount of $20,000.00 for projects
within the scope of the agreement.
ADMINISTRATIVE CHANGES: Updates U.S. Forest Service email addresses.
OTHER (Specify type of modification): Mandatory provisions remain the same. Incorporates Road Project Agreement,
Operating Plan, Financial plan, and attachments.
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 incorporates Road Project Agreement No. 3 and increases U.S. Forest Service funding in the amount of $20,000.00
10. ATTACHED DOCUMENTATION (Check all that apply):
Scope of Work – Project Road Agreement No. 3 and Operating Plan (Exhibit A)
Financial Plan – Project Road Agreement No. 3 (Exhibit C), Figure 1.
Other: Project Details (Exhibit B)
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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-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): JOHN HARRIS 11.F. NAME (type or print): ): SCOTT G. FITZWILLIAMS
11.G. TITLE (type or print): Road and Bridge Division Manager
Eagle County, State of Colorado
11.H. TITLE (type or print): Forest Supervisor,
White River National Forest
11.I. EAGLE COUNTY SIGNATURE 11.J. DATE
SIGNED
(Signature of Signatory Official)
11.K. NAME (type or print): KATHY CHANDLER-HENRY
11.L. TITLE (type or print): County Commissioner Chair,
Eagle County, State of Colorado
ATTEST:
Clerk to the Board of County Commissioners
Eagle County, State of Colorado
Date
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.
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ROAD PROJECT AGREEMENT No. 3
Between
EAGLE COUNTY, STATE OF COLORADO
And The
USDA, FOREST SERVICE, WHITE RIVER NATIONAL FOREST
This Project Agreement (agreement) is hereby made and entered into by and between Eagle
County, State of Colorado, hereinafter referred to as “the County or Cooperator,” and the USDA,
Forest Service, White River National Forest, hereinafter referred to as the “U.S. Forest Service,”
as specified under the authority and provisions of the Cooperative Forest Road Agreement # 17-
RO-11021500-044 executed between the parties on July 24, 2017.
Project Title: MAGNESIUM CHLORIDE HAUL AND PLACEMENT
I. BACKGROUND:
The parties entered into a Forest Road Cooperative Agreement (Coop Agreement) on July 15,
2017. This Coop Agreement allows for the parties to cooperate in the planning, survey, design,
construction, reconstruction, improvement and maintenance of certain forest roads. The
Schedule A, which is attached to the Coop Agreement, identifies the maintenance responsibilities
of the parties to the specific road systems and may be revised as necessary. The process of
revising the Schedule A can be labor intensive and time consuming due to requiring extensive
valuations and several levels of formal review. Accordingly, formal revision of the Schedule A
does not readily lend itself to rapid response times, adjusting to limited funding opportunities and
a high degree of site condition specificity.
The Coop Agreement allows for specific Project Agreements between the parties with the intent
of completing work as expeditiously as available funds or work opportunities allow.
The Coop Agreement identifies numerous requirements for the development of Project
Agreements. These requirements include but are not limited to:
• The specific project (road) must be included in an approved U.S. Forest Service –
Cooperator plan (Schedule A).
• Mutual approval.
• The cost to be borne by each party.
• The amount of cooperative funds as set forth in the Project Agreement shall be the
maximum commitment of either party unless changed by a formal modification prior to
incurring any expense.
• Work must be completed in accordance with agreed upon standards.
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II. PURPOSE:
The purpose of this Project Agreement (agreement) is to document the parties’ cooperation in the
ROAD PROJECT AGREEMENT No. 3 titled MAGNESIUM CHLORIDE HAUL AND
PLACEMENT which focuses work on HAUL AND PLACEMENT OF MAGNESIUM
CHLORIDE on NFR 700.1 (RED SANDSTONE-MUDDY PASS) and NFR 600.1 (COFFEE
POT). The work is as described in the hereby incorporated Operating Plan (Exhibit A), Project
Details (Exhibit B) and (Financial Plan; Exhibit C), as attached.
III. THE COOPERATOR SHALL:
A. Perform in accordance with the Operating Plan (Exhibit A), Project Details (Exhibit B),
and (Financial Plan; Exhibit C), as attached
IV. THE U.S. FOREST SERVICE SHALL:
A. Perform in accordance with the Operating Plan (Exhibit A), Project Details (Exhibit B),
and (Financial Plan; Exhibit C), as attached.
B. PAYMENT/REIMBURSEMENT. The U.S. Forest Service shall reimburse Eagle
County for the U.S. Forest Service’s share of actual expenses incurred, not to exceed
$20,000.00, as shown in the Financial Plan. The U.S. Forest Service shall make payment
upon receipt of Eagle County’s quarterly invoice. Each invoice from Eagle County must
display the total project costs for the billing period.
Each invoice must include, at a minimum:
1. Eagle County’s name, address, and telephone number.
2. U.S. Forest Service agreement number.
3. Invoice date.
4. Performance dates of the work completed (start to end).
5. Total invoice amount for the billing period.
The invoice must be forwarded to:
EMAIL: SM.FS.asc_ga@usda.gov
FAX: 877-687-4894
POSTAL:
U.S. Forest Service
Albuquerque Service Center
Payments – Grants and Agreements
101B Sun Ave. NE
Albuquerque, NM 87109
FAX: 1-877-687-4894
Send a copy to: Erica Borum at erica.borum@usda.gov
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V. IT IS MUTUALLY AGREED AND UNDERSTOOD BY AND BETWEEN THE
PARTIES THAT:
A. In the event of a conflict between this Project Agreement and the Coop Agreement, the
latter shall take precedence.
B. FUNDING EQUIPMENT. Federal funding under this agreement is not available for
reimbursement of Cooperator’s purchase of equipment.
C. 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).
D. PROJECT TIMELINE: This Road Project Agreement is executed as the date of last
signature and is effective through the life of the signed Cooperative Forest Road
Agreement.
E. FINANCIAL PLAN: Attached is the Financial Plan for Modification No. 3 for activities
within the scope of the Agreement. Funding incorporated via modification may be carried
forward to the next fiscal year and will be available to spend through the term of this
Agreement.
F. ATTACHMENTS:
• Operating Plan (Exhibit A);
• Project Details (Exhibit B);
• Financial Plan (Exhibit C), Figure 1.
G. 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.
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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.
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ROAD PROJECT AGREEMENT No. 3
OPERATING PLAN (#2020-1)
MAGNESIUM CHLORIDE HAUL AND PLACEMENT
EXHIBIT A
I. GENERAL PROJECT DESCRIPTION:
The U.S. Forest Service and Eagle County have determined that there is a need to haul and place magnesium
chloride on NFR (National Forest Road) 700.1 (Red Sandstone-Muddy Pass), and NFR 600.1 (Coffee Pot).
This material is needed in order to maintain and protect the running surfaces on both roads.
Magnesium chloride haul and placement on NFR 700.1, and 600.1 includes, but is not limited to the following
activities:
• Hauling magnesium chloride to the work area locations on NFR 700.1; between MP 0.00 and 6.40 (not to
exceed 3.5 miles total), and on NFR 600.1; between MP 0.00 and 6.48 (not to exceed1.5 miles total).
• Preparing the existing roadbed for magnesium chloride placement.
• Spreading, shaping and compacting the aggregate road base material.
• Eagle County Road and Bridge Representative(s), and U.S. Forest Service Representatives Erica Borum,
and Bret Conant will conduct a pre-work site visit prior to commencement of the project.
• See Exhibit B for detailed work specifications, locations, descriptions, and quantities.
II. PROJECT LOCATION
A. NFR 700.1; between MP 0.00 and 6.40 (not to exceed 3.5 miles total), and on NFR 600.1; between MP 0.00
and 6.48 (not to exceed 1.5 miles total)
III. PROJECT SPECIFICS
A. THE U.S. FOREST SERVICE SHALL:
• Mark the work locations on the ground prior to commencement of project work.
• Provide on-site inspections at the discretion of the project manager and perform a final inspection.
• Provide a technical and administrative contact for the project (see Contact Info below III. D.).
B. THE COOPERATOR (EAGLE COUNTY) SHALL:
• Perform all agreed upon magnesium chloride haul and placement on NFR 700.1, and 600.1.
• Provide all necessary labor and equipment to perform the work outlined in Exhibit B.
• Perform work in a manner that preserves and protects roads and appurtenances, constructed features, and
other forest resources.
• Be responsible for providing and implementing all necessary measures to control erosion and prevent
sedimentation into stream channels.
• Be responsible for ensuring the safety of workers and the public, including traffic control.
• Be responsible for ensuring all personnel on site follow all applicable Federal, State and local safety, fire
and environmental regulations.
• Notify U.S. Forest Service project manager upon completion of field work. Following this, Cooperator
(or a representative) shall be available to participate in a final inspection by USFS White River
engineering staff. Cooperator is responsible for complying with deficiencies noted in final inspection.
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• Provide a load tickets to the project manager for tracking quantity of aggregate hauled from commercial
source(s).
C. TERM OF ANNUAL OPERATING PLAN: The project road agreement is executed as the date of last
signature and is effective through the life of the signed cooperative agreement. This operating plan may be
modified by mutual agreement at any time under the effective life of the signed cooperative agreement.
D. PRINCIPAL CONTACTS: The principal contacts for this instrument are:
U.S. Forest Service Project Manager Cooperator Project Contact
Erica Borum John Harris
900 Grand Ave. P.O. Box 250
Glenwood Springs, CO 81601 Eagle, CO 81631
Telephone: (970) 945-3277 Telephone: (970) 328-3540
FAX: (970) 945-3266 FAX: (970) 328-3546
Email: Erica.borum@usda.gov
Email: john.harris@eaglecounty.us
U.S. Forest Service Technical Contact
Bret Conant
900 Grand Ave.
Glenwood Springs, CO 81601
Telephone: (970) 945-3288
FAX: (970) 945-3266
Email: bret.conant@usda.gov
E. FINANCIAL PLAN: Attached is the Financial Plan identified as Exhibit C for Agreement No.17-RO-
11021500-044 and this Operating Plan (#2020-1) for the project work shown above.
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EXHIBIT B
PROJECT DETAILS
Title Pages
1. Estimate of Quantities 1
2. Project Work Listing 1
NOTES:
1. When requested by either party, and agreed upon by both parties, work locations on NFR 700.1 and NFR
600.1 shall be modified.
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MAGNESIUM CHLORIDE HAUL AND PLACEMENT
ESTIMATE OF QUANTITIES
Pay Item Description Pay Unit Units Notes
Road Number: 600.1 700.1
Project Length (miles): 1.50 3.50
BASE ITEM 1: Haul and place magnesium chloride on NFR 600.1 and 700.1
1000 Haul and place magnesium chloride Gallon 10500 24500
magnesium chloride
application
MAGNESIUM CHLORIDE HAUL AND PLACEMENT
Project Work Listing; BASE ITEM 1
Road 600.1 - Coffeepot
Termini MP 1.70 - 6.97
Length 5.27 miles, magnesium chloride application not to exceed 1.5 miles
Station or
Mile Post Description Pay Item Notes
1.70 - 6.97 Haul and place magnesium chloride at designated locations between 1.70
and 6.97. 1000
magnesium chloride
application not to
exceed 1.5 miles
Road 700.1 - Red Sandstone-Muddy Pass
Termini MP 0.00 - 6.39
Length 6.39 miles, magnesium chloride application not to exceed 3.5 miles
Station or
Mile Post Description Pay Item Notes
0.00 - 6.39 Haul and place magnesium chloride at designated locations between
0.00 and 6.39 1000
magnesium chloride
application not to
exceed 3.5 miles
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EXHIBIT C
FINANCIAL PLAN
Attachment:EXHIBIT C
USFS Agreement No.:Mod. No.:3
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 $1,536.34 $0.00 $0.00 $0.00 $1,536.34
Travel $320.00 $0.00 $0.00 $0.00 $320.00
Equipment $0.00 $0.00 $12,360.00 $0.00 $12,360.00
Supplies/Materials $0.00 $0.00 $0.00 $0.00 $0.00
Printing $0.00 $0.00 $0.00 $0.00 $0.00
Fuel Surcharge $0.00 $50.00 $0.00 $0.00 $50.00
NFR 700.1, and 600.1 $0.00 $19,950.00 $0.00 $0.00 $19,950.00
Subtotal $1,856.34 $20,000.00 $12,360.00 $0.00 $34,216.34
Coop Indirect Costs $0.00 $0.00 $0.00
FS Overhead Costs $185.63 $185.63
Total $2,041.97 $20,000.00 $12,360.00 $0.00
$34,401.97
(a+b) ÷ (e) = (f)
Total Cooperator Share
(c+d) ÷ (e) = (g)
Total (f+g) = (h)
100.00%
(h)
(g)
Matching Costs Determination
Total Forest Service Share =(f)
64.07%
Total Project Value:
(e)
Total
35.93%
Agreements Financial Plan (Short Form)
17-RO-11021500-044
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
Pay Item Description Pay Unit Units Notes
Road Number:600.1 700.1
Project Length (miles):1.50 3.50
1000 Haul and place magnesium chloride Gallon 10500 24500 $0.57 $19,950.00 magnesium chloride application
$50.00 Fuel Surcharge
$20,000.00TOTAL
MAGNESIUM CHLORIDE HAUL AND PLACEMENT
BUDGET SUMMARY OF CASH TO COOPERATOR
BASE ITEM 1: Haul and place magnesium chloride on NFR 600.1 and 700.1
Cost/ Unit
Total Cost
(Cash to
Cooperator)
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