Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC21-282 USFSDocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
U�5
USDA Forest Service OMB 0596-0217
FS-1500-19
PAGE OF PAGES
MODIFICATION OF GRANT OR AGREEMENT
1
1 13
1. U.S. FOREST SERVICE GRANT/AGREEMENT
2. RECIPIENT/COOPERATOR GRANT or
3. MODIFICATION NUMBER:
NUMBER:
AGREEMENT NUMBER, IF ANY:
3
18-PA-11021500-013
4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
5. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
GRANT/AGREEMENT (unit name, street, city, state, and zip + 4):
PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4):
Rocky Mountain Region - Center of Excellence
White River National Forest
900 Grand Avenue, Glenwood Springs, CO 81601
900 Grand Avenue, Glenwood Springs, CO 81601
6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip
7. RECIPIENT/COOPERATOR'S HHS SUB ACCOUNT NUMBER (For HHS
+ 4, county):
payment use only):
Eagle, County of
3289 Cooley Mesa, Gypsum, CO 81637
8. PURPOSE OF
MODIFICATION
CHECK ALL
This modification is issued pursuant to the modification provision in the grant/agreement
THAT APPLY:
referenced in item no. 1, above.
CHANGE IN PERFORMANCE PERIOD:
CHANGE IN FUNDING: Obligates an additional U.S. Forest Service funds in the amount of $3,000.00 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: Update FS Admin Contact: Alex Specht 900 Grand Ave. Glenwood Springs, CO
81601. alex.s echt usda. ov
OTHER:
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 3 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):
®
Exhibit A — Operating Plan
®
Exhibit B - Financial Plan
®
Other: Incorporates mandatory provisions.
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
U�5
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 GRANVAGREEMENT.
I I.A. EAGLE, COUNTY OF SIGNATURE
I I.B. DATE
I I.C. U.S. FOREST SERVICE SIGNATURE
I I.D. DATE
DocuSigned by:
SIGNED1-�(,4:F1]hWiWWMS
DocuSigned by:
SIGNED
ti S�ra
8/25/2021
24/2021
�1
(Signature of Si
i 328424
(SignatureofSi nat 2AFF9424...
I I.E. NAME (type or print): JEFF SHROLL
I I.F. NAME (type or print): SCOTT G. FITZWI)_,I,IAMS
I I.G. TITLE (type or print): County Manager, Eagle,
I I.H. TITLE (type or print): Forest Supervisor,
County of
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:
12.B. DATE
M Digitally signed by DAVID
DAVI D GRAHAGRAHAM
SIGNED
Date: 2021.07.01 15:58:08-06'00'
DAVE GRAHAM
U.S. Forest Service, Grants & Agreements Specialist
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.
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
U�5
USDA Forest Service OMB 0596-0217
FS-1500-19
18-PA-11021500-013
Exhibit A
Modification No. 3: Operating Plan
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.
Method
Utilize various ground pesticide application equipment (backpack, UTV, horse or truck mounted sprayers)
to 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.
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
Days
Cost Per Day
Cost
($100/hr.)
or
See Map - dependent
upon the severity of the
$800
$3,000
weed infestations
3.75 Days
Total Estimate:
3.75 Days
$800
$3,000
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
U�5
USDA Forest Service OMB 0596-0217
FS-1500-19
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 $3,000.00 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 120 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_gagusda.gov
FAX: 877-687-4894
POSTAL: USDA Forest Service
Albuquerque Service Center
Payments — Grants & Agreements
101 B Sun Ave NE
Albuquerque, NM 87109
Send a copy to: elizabeth.robertskusda.gov and stephen.elzingagusda.gov
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
U�5
USDA Forest Service OMB 0596-0217
FS-1500-19
LIMITATION OF FUNDS. U.S. Forest Service funds in the amount of $3,000.00 are currently available for
performance of this instrument through the performance period of the agreement through December 31, 2021. 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 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.
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 120 days from the expiration date of the
agreement.
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
co
O
O
O
LO
N
O
Q
00
O
Z
a)
E
(D
a)
O
Q
U)
LL
CO
Z)
m
L
x
w
C
a)
E
L
U
m
C
R
CO
O LL
d O
3 �
o
O O t
N
3 C
O X :; w
y L
R y 0
IL m a
o N
C r0+ ate+
O
E L
LL sm— Q c
N Im O y
t () i
~ O t t
GiZHH
.r
O
Z ...
E
0
LL
0
t
c
FL
t4
C
<4
LL
to
c
O
m
m
Q
LL
O
O
O
O
O
O
O
O
O
O
O
b4
64
64
N
69
O�
N
00
�O
CD
a) �
bs
64
64
64
�F—
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
Z
b4
64
64
64
64
64
64
69
64
O
�
� Y
m
H
Z
O
U
o
0
0
0
0
0
0
0
0
0
O
o
0
0
0
0
0
0
0
0
0
00
N
01
M
M
M
W
V
69
64
69
64
CAN
�
'
O
O
Z
O
U
cn
o
0
0
0
0
0
0
0
0
0
Z
O
O
O
O
O
O
O
O
O
O
L
O
6FJ
6Fi
69
6F3
6Fi
69
O
6F3
O
O
O
3
ca
r
m
c*
�O Q
U O
N
~
Z
U
o
L
O
a
U
W
R
O
O
O
O
O
O
O
O
O
O
O
O
O
Go!�
11�
't
C�
't
W
N
O
O
00
U
y4
64
�
� C
O
W
I
Z
O
LL
F
U
0
U
Z
L
U
U
W
)
L
O
O
(B
U
O
(6
w
�
�.
0)a�
J
O
J
N
L
w
U
(n_
E
aD
o
cu
c
—
a)
H
L
n3
>
Q
'7
Q
y-
L
L
O
Q
O
0
OUDUHLUU)0-
=
Q
C
;
_
;
0
u)Ui
O
P
0
0
�M
O
LC,
I
—CO
L
�
o
LO
O
C
E
a)
a
0
N
N
O
U
cy
t
v
�'
tv
II
c
a)
U_
co
n
L
II
Q II
II
L
O
O
+
LL .I.
U .I.
�
E
F
Fu
LI
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
WORKSHEET FOR
FS Non -Cash Contribution Cost Analysis, Column a
Use this worksheet to perform the cost analysis that supports the lump sum figures provided in the
matrix. NOTE: This worksheet auto populates the relevant and applicable matrix cells.
Cost element sections may be deleted or lines may be hidden, if not applicable. Line items may be
added or deleted as needed. The Standard Calculation sections provide a standardized formula for
determining a line item's cost, e.g. cost/day x # of days=total, where the total is calculated automatically.
The Non -Standard Calculation sections provide a write-in area for line items that require a calculation
formula that is other than the standardized formulas, e.g. instead of salaries being calculated by
cost/day x # of days, costs may be calculated simply by a contracted value that is not dependent on
days worked, such as 1 employee x $1,200/contract= $1,200. Be sure to review your calculations when
entering in a Non -Standard Calculation, and provide a brief explanation of units used to make
calculation, e.g. '1 month contract,' on a line below the figures.
Salaries/Labor
Standard Calculation
Job Description I Cost/Day 1# of Days I ITotal
District Program Mgr. $290.00 10.00 $2,900.00
Range Technician(s) $150.00 10.00 $1,500.00
Forest Program Mgr. $395.00 1.00 $395.00
$0.00
$0.00
I Non -Standard Calculation I
site survey/NEPA/Project
Total Salaries/Labor
Travel
Standard Calculation
Travel Expense Em
Cost/Trip 1# of Trips
otal
$0.00
$3,000.00
$7,795.00
Gov. Vehicle 2.00 $27.50 20.00 $1,100.00
$0.00
Non -Standard Calculation
Total Travel I 1 $1,100.00
Equipr
Standard Calculation
Piece of Equipment
# of Units (Cost/Dav (Miles
Total
$0.00
$0.00
$0.00
$0.00
Non -Standard Calculation
spray equipment/trailer 1.00 $100.00 22.50 $2,250.00
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
Total Equipment $2,250.00
Supplies/Materials
Standard Calculation
Supplies/Materials 1# of Items Cost/Item ITotal
Herbicide and spray supplies 1.00 $3,000.00 $3,000.00
$0.00
Non -Standard Calculation
Total Supplies/Materials $3,000.00
Printing
Standard Calculation
Paper Material 1# of Units Cost/Unit I ITotal
Non -Standard Calculation
Total Printing $0.00
Other Expenses
Standard Calculation
Item 1# of Units Cost/Unit I ITotal
Non -Standard Calculation
Total Other $0.00
Subtotal Direct Costs 1 $14,145.00
Forest Service Overhead Costs
Current Overhead Rate ISubtotal Direct Costs I I ITotal
12.00% $14,145.00 $1,697.40
Total FS Overhead Costs 1 1 $1,697.40
TOTAL COST 1 $155842.40
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
WORKSHEET FOR
FS Cash to the Cooperator Cost Analysis, Column b
Use this worksheet to perform the cost analysis that supports the lump sum figures provided in the
matrix. NOTE: This worksheet auto populates the relevant and applicable matrix cells.
Cost element sections may be deleted or lines may be hidden, if not applicable. Line items may be
added or deleted as needed. The Standard Calculation sections provide a standardized formula for
determining a line item's cost, e.g. cost/day x # of days=total, where the total is calculated
automatically. The Non -Standard Calculation sections provide a write-in area for line items that require
a calculation formula that is other than the standardized formulas, e.g. instead of salaries being
calculated by cost/day x # of days, costs may be calculated simply by a contracted value that is not
dependent on days worked, such as 1 employee x $1,200/contract= $1,200. Be sure to review your
calculations when entering in a Non -Standard Calculation, and provide a brief explanation of units
used to make calculation, e.g. '1 month contract,' on a line below the figures.
Salaries/Labor
ndard Calculation
Job Description I Cost/Day 1# of Days I ITotal
County Crews $800.00 3.75 $3,000.00
$0.00
$0.00
$0.00
$0.00
I Non -Standard Calculation I
Total Salaries/Labor 1 1 $3,000.00
Travel
Standard Calculation
Travel Expense lEmployees
Cost/Trip
1# of Trips I
ITotal
Non -Standard Calculation
Total Travel 1
Equipment
$0.00
Standard Calculation
Piece of Equipment 1# of Units
I Cost/Day
1# of Days I
ITotal
Non -Standard Calculation
Total Equipment
Supplies/Materials
$0.00
Standard Calculation
Supplies/Materials 1
1# of Items
Cost/ltem
ITotal
Non -Standard Calculation
Total Supplies/Materials
Printing
$0.00
Standard Calculation
Paper Material
1# of Units
Cost/Unit I
ITotal
Non -Standard Calculation
Total Printing
Other Expenses
$0.00
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
Standard Calculation
Item 1# of Units Cost/Unit I ITotal
Non -Standard Calculation
Total Other
Subtotal Direct Costs 1 $3,000.00
Cooperator Indirect Costs
Current Overhead Rate ISubtotal Direct Costs I I ITotal
$3,000.00 $0.00
Total Coop. Indirect Costs 1 $0.00
TOTAL COST 1 $3,000.00
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
WORKSHEET FOR
Cooperator Non -Cash Contribution Cost Analysis, Column(c)]
Use this worksheet to perform the cost analysis that supports the lump sum figures provided in the matrix.
NOTE: This worksheet auto populates the relevant and applicable matrix cells.
Cost element sections may be deleted or lines may be hidden, if not applicable. Line items may be added
or deleted as needed. The Standard Calculation sections provide a standardized formula for determining a
line item's cost, e.g. cost/day x # of days=total, where the total is calculated automatically. The Non -
Standard Calculation sections provide a write-in area for line items that require a calculation formula that is
other than the standardized formulas, e.g. instead of salaries being calculated by cost/day x # of days,
costs may be calculated simply by a contracted value that is not dependent on days worked, such as 1
employee x $1,200/contract= $1,200. Be sure to review your calculations when entering in a Non -Standard
Calculation, and provide a brief explanation of units used to make calculation, e.g. '1 month contract,' on a
line below the figures.
Salaries/Labor
Standard Calculation
Job Description I JCost/Day J# of Days I ITotal
Project planning $290.00 5.00 $1,450.00
Project monitoring $290.00 2.00 $580.00
Project implementation $290.00 10.00 $2,900.00
$0.00
Non -Standard Calculation
County salaries $3,500.00
Total Salaries/Labor $8,430.00
Travel
Standard Calculation
Travel Expense IEmDlovees Cost/Trip 1# of Trips I ITotal
vehicle expense 4.00 $27.50 25.00 $2,750.00
$0.00
$0.00
$0.00
$0.00
Non -Standard Calculation
Total Travel 1 1 $2,750.00
Equipment
alculation
JPiece of Equipment J# of Units JCost/mile J# of miles I ITotal
Equipment and Trailer 26 $10.00 25 $6,500.00
$0.00
$0.00
$0.00
$0.00
Non -Standard Calculation
spray equipment/trailer $3,000.00
C21-282
DocuSign Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
Total Equipment 1 1 $9,500.00
Supplies/Materials
IStandard Calculation I
(Supplies/Materials 1 1# of Items ICost/Item ITotal
Herbicide and spray supplies 1.00 $3,000.00 $3,000.00
$0.00
$0.00
$0.00
Non -Standard Calculation
Total Supplies/Materials 1 1 $3,000.00
Printing
Standard Calculation
Paper Material 1# of Units Cost/Unit I ITotal
Non -Standard Calculation
Total Printing $0.00
Other Expenses
Standard Calculation
Item 1# of Units Cost/Unit I ITotal
Non -Standard Calculation
Total Other 1 $0.00
Subtotal Direct Costs 1 $23,680.00 7
Cooperator Indirect Costs
Current Overhead Rate ISubtotal Direct Costs I I ITotal
0.00% $23,680.00 $0.00
Total Coop. Indirect Costs $0.00
TOTAL COST 1 $23,680.00
C21-282
cuZUSn Envelope ID: 201 B8047-BA63-481 D-A627-01232268E7CA
P-1 a A A -wax -&A
Rou H G ra m d
,ADO LISP
------------ ------------
ry
mvcqy
a
SUM Fn i I
Eaglt-GypSum
*sage
Wolcott
Peak
HuK04�d
..L. . I. h&I-Q SPI i rig "injum-Red Cliff
Eagle -CourLty weaver weeCodf CL-uh
Re nJ Air OTI 1 6
Avon town
va
409agi a town VAIIII Gult
ar
Rom h CJLJ Edwards P" CIU6
Gy RARCb 7:d!i.
+ t4awn IGUV Volil j u Hal oil
L EJall purl
Gyp-Num ( 'riL-k
RaFw h A!FpurL
6 Hum t4:Fwm
E!d Glift Lawn
ja6zon
(41" mtO
Gold Dust Peak& AL A Notch Mountain
mouni M thcLA f4O30 FDLF.1
"6IYii
(A269 Fay.)
A WhImy Pack
(4"1 Mir.)
r
Pitkim
LEGEND = Rmbwd HIOWAY.41PIA
W-R- Vryrd7- &221111m � V"r-rr*4
wynt-v wpt 4L. Fd*dkLM Fe4eqA
C21-282 % dcff cxmu:6v + %min
A N6u MELrrL sm'D kmA -4� h-umparh
Lake
6 iAwm mapsat.vorld.com