HomeMy WebLinkAboutC22-421 USDA Forest Service_grant 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 -
REFERENCED GRANT/AGREEMENT.
11.A. 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): JE))6+52//11.F. NAME (type or print): SCOTT G. FITZWILLIAMS
11.G. TITLE (type or print): &RXQW\0DQDJHU,
Eagle County&RORUDGR
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:
______________________________________
ALEX SPECHT
U.S. Forest Service, Grants & Agreements Specialist
12.B. DATE
SIGNED
MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES
1 2
1. U.S. FOREST SERVICE GRANT/AGREEMENT
NUMBER:
21-CO-11021500-006
2. RECIPIENT/COOPERATOR GRANT or
AGREEMENT NUMBER, IF ANY:
3. MODIFICATION NUMBER:
2
4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
GRANT/AGREEMENT (unit name, street, city, state, and zip + 4):
White River National Forest
900 Grand Ave, Glenwood Springs, CO 81601
5. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING
PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4):
White River National Forest
900 Grand Ave, Glenwood Springs, CO 81601
6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip
+ 4, county):
Eagle, County of
500 Broadway, Eagle, Colorado 81631-5178
7. RECIPIENT/For HHS
payment use only):
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: Extends the Expiration Date to December 31, 2024.
CHANGE IN FUNDING:
ADMINISTRATIVE CHANGES: Adds Mike Beach as the U.S. Forest Service Program Manager Contact. PO Box
190, Minturn, CO 81645, Telephone: 970-827-5159, Email: michael.beach@usda.gov.
OTHER (Specify type of modification): Incorporates mandatory provisions, operating and financial plans 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):
The purpose of Modification No. 2 is to update the FS Program Manger contact and extend the agreement expiration to 12/31/2024 to
provide additional time to complete work on identified activities and projects incorporated to the agreement that were delayed due to
labor shortages.
10. ATTACHED DOCUMENTATION (Check all that apply):
DocuSign Envelope ID: 214F62D4-E241-4D66-BAB6-DC3CA24004A4
12/22/2022
USDA Forest Service OMB 0596-0217
FS-1500-19
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DocuSign Envelope ID: 214F62D4-E241-4D66-BAB6-DC3CA24004A4
