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HomeMy WebLinkAboutC20-349 US Forest Service Modification USDA Forest Service OMB 0596-0217 FS-1500-19 MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES 1 13 1.U.S. FOREST SERVICE GRANT/AGREEMENT NUMBER: 20-RO-11021500-018 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 Contact: Erica Borum 900 Grand Avenue Glenwood Springs, CO 81601 Telephone: (970) 945-3277 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 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: John Harris P.O. Box 250 Eagle, CO 81631 Telephone: (970) 328-3542 Email: john.harris@eaglecounty.us 7. RECIPIENT/COOPERATOR’S HHS SUB ACCOUNT NUMBER (For HHS payment use only): Eagle County Admin Contact: Nicole Trujillo P.O. Box 250 Eagle, CO 81631 Telephone: (970) 328-3540 Email: nicole.trujillo@eaglecounty.us 8.PURPOSE OF MODIFICATION CHECK ALL THAT APPLY: This modification is issued pursuant to the modification provision in the agreement referenced in item no. 1, above. CHANGE IN PERFORMANCE PERIOD: Expiration date remains the same. CHANGE IN FUNDING: Obligates additional U.S. Forest Service funds in the amount of $49,920.00 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: N/A OTHER (Specify type of modification): Incorporates mandatory provisions, operating and financial plans, see 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): 10. ATTACHED DOCUMENTATION (Check all that apply): Exhibit A: Operating Plan – Modification No. 1 Exhibit C: Financial Plan – Modification No. 1 Other: Exhibit B “Project Details” and Mandatory Provisions DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 C20-349 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- 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 Director Eagle County, State of Colorado 11.H. TITLE (type or print): Forest Supervisor, White River National Forest 11.A. EAGLE COUNTY SIGNATURE 11.B. DATE SIGNED (Signature of Signatory Official) 11.E. NAME (type or print): KATHY CHANDLER-HENRY 11.G. TITLE (type or print): County Commission Chair Eagle County, State of Colorado ATTEST: ______________________________________________________ Clerk of the Board of County Commissioners Date County of Eagle, State of Colorado, a Body Politic and Corporate Through its Authorized Agents and Representative 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: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 9/10/2020 9/24/2020 9/24/2020 9/25/2020 9/25/2020 USDA Forest Service OMB 0596-0217 FS-1500-19 MODIFICATION No. 1 MANDATORY PROVISIONS: PAYMENT/REIMBURSEMENT. The U.S. Forest Service shall reimburse Cooperator for the U.S. Forest Service’s share of actual expenses incurred, not to exceed $49,920.00, as shown in the Financial Plan. The U.S. Forest Service shall make payment upon receipt of Cooperator’s annual invoice. Each invoice from Cooperator must display the total project costs for the billing period. Each invoice must include, at a minimum: 1) Cooperator’s name, address, and telephone number 2) U.S. Forest Service agreement number 3) Invoice date 4) Performance dates of the work completed (start and end) 5) Total invoice amount for the billing period The invoice must be forwarded to: SM.FS.asc_ga@usda.gov U.S. Forest Service Albuquerque Service Center Payments – Grants & Agreements 101B Sun Ave NE Albuquerque, NM 87109 Email: SM.FS.asc_ga@usda.gov FAX: 877-687-4894 Send a copy to: Erica Borum at erica.borum@usda.gov LIMITATION OF FUNDS. U.S. Forest Service funds in the amount of $49,920.00 are currently available for performance of this agreement. The U.S. Forest Service’s ability to provide additional funding is contingent upon the availability of appropriated funds from which payment can be made. There is no legal liability on the part of the U.S. Forest Service for any payment above this amount until the Cooperator receives notice of availability confirmed in a written modification by the 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 at www.sam.gov. 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. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 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: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 Exhibit A Operating Plan Road Maintenance NFR 600.1 and 700.1 I. GENERAL PROJECT DESCRIPTION: The U.S. Forest Service and Eagle County have determined that there is a need to prepare the roadbed and place dust abatement materials (Magnesium Chloride) on high use Schedule A roads in specified locations on the following road segment(s): • NFR 600.1 (Coffee pot road) • NFR 700.1 (Red Sandstone-Muddy Pass) See EXHIBIT B “Project Details” for specific locations and quantities. The U.S. Forest Service and Eagle County have determined that there is a need to place additional road base on high use Schedule A roads, in specified locations on the following road segment(s): • NFR 700.1 (Red Sandstone-Muddy Pass) See EXHIBIT B “Project Details” for specific locations and quantities. II. PROJECT LOCATION A. NFR 600.1; between MP 1.70 and 6.97 (beginning at parking area switchback) B. NFR 700.1; between MP 0.00 and 24.56 (beginning at Hwy. 131) III. PROJECT SPECIFICS A. THE U.S. FOREST SERVICE SHALL: • Reimburse the County for project costs incorporated in the attached Financial Plan. • Coordinate application timing with U.S. Forest Service prior to commencement of project work. • Provide a technical and administrative contact for the project (see Contact Info below III. D.). • Partial payments may be made upon submission of an invoice from the County, or after complete execution of this road project agreement. B. THE COOPERATOR (EAGLE COUNTY) SHALL: • Agree to perform work as described in EXHIBIT B “Project Details” • Provide all necessary materials, labor and equipment to perform the work • Be responsible for providing and implementing all necessary erosion control materials and safety precautions, including traffic control. • Be responsible for ensuring all personnel on site follow all applicable Federal, State and local safety, fire and environmental regulations. • Perform work in a manner to preserve and protect roads and appurtenances, and prevent erosion damage to roads, streams, and other Forest values. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 • Provide a load tickets to the project manager for tracking quantity of aggregate hauled from commercial source(s). • Notify U.S. Forest Service White River Project Manager of 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. SPECIFICATIONS FOR TRAFFIC CONTROL and CONTROL OF NOXIOUS WEEDS TRAFFIC CONTROL: This work consists of controlling and protecting public traffic adjacent to and within the project. Perform work in a manner that ensures the safety and convenience of the public and protects improvements and facilities adjacent to the site. Accommodate public traffic on roads adjacent to and within the project until the project is accepted by the U.S. Forest Service. 1. Maintaining roadways during work: a. Maintain a dust-free traveled way such that visibility and air quality are not affected. This work shall be considered incidental to the project. b. Maintain the roadways in a safe and acceptable condition, during work and during periods when work is not in progress. 2. Limitations on Construction Operations: a. Operate equipment in the direction of Traffic, where applicable. b. Any staging areas shall be as designated by the U.S. Forest Service Roads Manager. 3. Accommodating Traffic During Work: a. Traffic control plan shall conform to the current edition of the Manual on Uniform Traffic Control Devises (MUTCD). b. Closures up to 2 hours are allowed. c. Coordination with the White River NF Project Manager will be required. 4. Temporary Traffic Control: a. This work consists of furnishing, maintaining, relocating and moving temporary traffic control devices for the control and protection of traffic through the project. b. All traffic control devices shall conform to the current edition of the MUTCD. c. All devices and signs shall be type III, VII, VIII retro-reflecting sheeting. d. Flaggers, if required, shall be certified by American Traffic Safety Services Association (ATTSA), National Safety Council (NSC), a state agency, or other acceptable organization. Use type III, VII or VIII retroreflective sheeting on flagger panels. Do not use flags. 5. Traffic and Safety Supervisor: a. Provide a traffic and safety supervisor who is certified by a state highway agency or other acceptable certification program. Furnish the supervisor’s name, address, and 24-hour telephone number prior to the start of the work. At all times, during the project, including periods of suspension and shutdown, perform all of the following: b. Implement traffic control plan. c. Ensure the condition and placement of traffic control devices in use. d. Immediately correct deficiencies. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 NOXIOUS WEEDS: For work on National Forest System lands, use a washing system that traps all wash water and either stores it for removal from National Forest System lands or recycles the water for continued use. If the equipment recycles the water, provide adequate filters for seed removal. Dispose of the filter material and removed seeds in an approved manner. Do not mix soaps, detergents, or other chemicals with the wash water. 1. Washing: a. Wash the sides, tips, and undercarriages of all construction equipment. Remove all seeds, plant, plant fragments, dirt, and debris from the construction equipment. 2. Inspection: a. Inspect the washed construction equipment, including the undercarriage, to ensure that the washing removed the dirt, debris, and seeds from the construction equipment. Rewash the construction equipment as necessary or as directed. C. TERM OF OPERATING PLAN: The project road agreement is executed as the date of last signature and is effective through the life of the signed agreement. This operating plan may be modified by mutual agreement at any time under the effective life of the signed 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. 20-RO- 11021500-018 Modification 001 and this Operating Plan “Road Maintenance NFR 600.1 and 700.1” for the project work shown above. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 EXHIBIT B PROJECT DETAILS Title Pages 1. Estimate of Quantities 1 2. Project Work Summary 1 NOTES: 1. When requested by either party, and agreed upon by both parties, work locations on NFR 600.1 and NFR 700.1 shall be modified. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 ESTIMATE OF QUANTITIES for 2021 Road Maintenance NFR 600.1 and 700.1 Pay Item Description Pay Unit Units Notes Road Number: 600.1 700.1 1000 Supply, haul and place magnesium chloride Gallon 10500 21000 Magnesium chloride application @ 3500 gal./mile. 1002 Supply, haul, place and compact CDOT Class 6 Road Base (spot surfacing at locations between MP 6.39 and 21.00) Ton 0 940 Supply, haul, place and compact @ 1025 tons/ mile; 0.92 miles of 14' ft. road with 3" compacted surface course. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 PROJECT WORK SUMMARY for 2021 Road Maintenance NFR 600.1 and 700.1 Road 600.1 - Coffeepot Termini MP 1.70 - 6.97 (beginning at parking area switchback) Station or Mile Post Description Pay Item Notes 1.87 - 6.97 Supply, haul and place magnesium chloride at graveled locations between 1.87 and 6.97. 1000 Magnesium chloride application not to exceed 3 miles. Road 700.1 - Red Sandstone-Muddy Pass Termini MP 0.00 - 21.00 (beginning at Hwy. 131) Station or Mile Post Description Pay Item Notes 0.00 - 6.39 Supply, haul and place magnesium chloride at graveled locations between 0.00 and 6.39 1000 Magnesium chloride application not to exceed 5 miles. 6.39 - 21.00 Supply, haul, place and compact CDOT Class 6 Road Base (spot surfacing at locations between MP 6.39 and 21.00) 1002 Supply, haul, place and compact @ 1025 tons/ mile; 0.92 miles of 14' ft. road with 3" compacted surface course. DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 EXHIBIT C FINANCIAL PLAN Attachment:EXHIBIT C USFS Agreement No.:Mod. No.:001 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 $780.60 $0.00 $0.00 $0.00 $780.60 Travel $0.00 $0.00 $0.00 $0.00 $0.00 Equipment $24.00 $0.00 $0.00 $0.00 $24.00 Supplies/Materials $15.50 $0.00 $0.00 $0.00 $15.50 Printing $0.00 $0.00 $0.00 $0.00 $0.00 Other $0.00 $49,920.00 $0.00 $0.00 $49,920.00 Other $0.00 Subtotal $820.10 $49,920.00 $0.00 $0.00 $50,740.10 Coop Indirect Costs $0.00 $0.00 $0.00 FS Overhead Costs $98.41 $98.41 Total $918.51 $49,920.00 $0.00 $0.00 $50,838.51 (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) 100.00% Total Project Value: (e) Total 0.00% Agreements Financial Plan (Short Form) 20-RO-11021500-018 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 DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40 USDA Forest Service OMB 0596-0217 FS-1500-19 BUDGET SUMMARY OF CASH TO COOPERATOR for 2021 Road Maintenance NFR 600.1 and 700.1 Pay Item Description Pay Unit Units Cost/ Unit Total Cost (Cash to Cooperator) Notes Road Number: 600.1 700.1 1000 Supply, haul and place magnesium chloride Gallon 10500 21000 $0.60 $18,900.00 Magnesium chloride application @ 3500 gal./mile. 1002 Supply, haul, place and compact CDOT Class 6 Road Base (spot surfacing at locations between MP 6.39 and 21.00) Ton 0 940 $33.00 $31,020.00 Supply, haul, place and compact @ 1025 tons/ mile; 0.92 miles of 14' ft. road with 3" compacted surface course. TOTAL $49,920.00 DocuSign Envelope ID: 4C6E9581-6AD2-42C8-87E7-8FBA81417F40