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HomeMy WebLinkAboutC23-228 USDA Forest Service_noxious weeds 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 OF 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 Government
11.H. TITLE (type or print): Forest Supervisor,
White River National Forest
MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES
1 9
1.U.S. FOREST SERVICE GRANT/AGREEMENT
NUMBER:
22-GN-11021500-037
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
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/COOPERATOR’S HHS SUB ACCOUNT NUMBER (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:
CHANGE IN FUNDING: Incorporates U.S. Forest Service funding in the amount of $10,000.00.
ADMINISTRATIVE CHANGES:
OTHER (Specify type of modification):
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 incorporates additional U.S. Forest Service funding to contribute to Eagle County’s collaborative efforts related to
the control and eradication of noxious weeds and invasive plants on public and private lands, within the watersheds in and adjacent to
Eagle County, and on the White River National Forest.
10. ATTACHED DOCUMENTATION (Check all that apply):
Exhibit A – Operating Plan
Exhibit B – Financial Plan
Other:
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
7/17/20237/17/2023
USDA Forest Service OMB 0596-0217
FS-1500-19
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
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, c olor, 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.
ALEX SPECHT Digitally signed by ALEX SPECHT
Date: 2023.06.20 14:24:04 -06'00'
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
USDA Forest Service OMB 0596-0217
FS-1500-19
WRNF FS Agreement No. 22-GN-11021500-037
Modification No. No. 1
Exhibit A
Operating Plan
Goal
Modification No. 1 includes additional U.S. Forest Service funding to contribute to the County’s collaborative
efforts related to the control and eradication of noxious weeds and invasive plants on public and private lands,
within the watersheds in and adjacent to the 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
- Utilize County Crews or Contactors for noxious weed control efforts.
- Evaluate/monitor treatment effectiveness.
- Evaluate treatment effectiveness.
Treatment Areas
- Proposed project areas may include:
o U.S. Forest Service Roads/Lands, Campgrounds, and Trailheads within the County
- 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 District Weed Program Manager, no later than September 30th annually.
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.
SCHEDULE OF ITEMS:
Item Number Description
1 Sylvan Fire Roads/Trails
2 Lake Christine Fire Area
3 Other National Forest System Lands
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
USDA Forest Service OMB 0596-0217
FS-1500-19
THE U.S. FOREST SERVICE SHALL PROVIDE THE FOLLOWING:
PAYMENT/REIMBURSEMENT. The U.S. Forest Service shall reimburse the County for the U.S. Forest
Service's share of actual expenses incurred, not to exceed $10,000.00 as shown in the Financial Plan. In order to
approve a Request for Reimbursement, the Forest Service shall review such requests to ensure payments for
reimbursement are in compliance and otherwise consistent with the terms of the agreement. The Forest Service
shall make payment upon receipt of the County’s annual invoice. Each invoice from the County shall display the
total project costs for the billing period, separated by Forest Service and the County 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 County’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. County 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 County 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 an electronic copy to: elizabeth.roberts@usda.gov
THE COOPERATOR SHALL:
PROGRAM MONITORING AND PROGRAM PERFORMANCE REPORTS. Remains the Same.
FINANCIAL STATUS REPORTING. Remains the Same.
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
U.S. Forest Service OMB 0596-0217
FS-1500-17B
Attachment:Exhibit B
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 $4,625.00 $0.00 $0.00 $0.00 $4,625.00
Travel $0.00 $0.00 $0.00 $0.00 $0.00
Equipment $1,000.00 $0.00 $0.00 $0.00 $1,000.00
Supplies/Materials $4,000.00 $0.00 $0.00 $0.00 $4,000.00
Printing $0.00 $0.00 $0.00 $0.00 $0.00
Other $0.00 $10,000.00 $0.00 $0.00 $10,000.00
Other $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $9,625.00 $10,000.00 $0.00 $0.00 $19,625.00
Coop Indirect Costs $0.00 $0.00 $0.00
FS Overhead Costs $693.75 $693.75
Total $10,318.75 $10,000.00 $0.00 $0.00
$20,318.75
(a+b) ÷ (e) = (f)
Total Cooperator Share
(c+d) ÷ (e) = (g)
Total (f+g) = (h)
Total Project Value:
(e)
Total
0.00%
Agreements Financial Plan (Short Form)
22-GN-11021500-037
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)
100.00%
Page 1
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
Standard Calculation
Job Description Cost/Day # of Days Total
FS Program Managers $400.00 5.00 $2,000.00
District Biologists $350.00 7.50 $2,625.00
$0.00
$0.00
$0.00
Non-Standard Calculation
Total Salaries/Labor $4,625.00
Standard Calculation
Travel Expense Employees Cost/Trip # of Trips Total
$0.00
Non-Standard Calculation
Total Travel $0.00
Piece of Equipment # of Units Cost/Day # of Days Total
$0.00
Total Equipment $0.00
FS Non-Cash Contribution Cost Analysis, Column (a)
Equipment
Travel
Salaries/Labor
Supplies/Materials
WORKSHEET FOR
Standard Calculation
Non-Standard Calculation
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
determing 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 formules, 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.
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
Supplies/Materials # of Items Cost/Item Total
$0.00
Total Supplies/Materials $0.00
Paper Material # of Units Cost/Unit Total
$0.00
Total Printing $0.00
Item # of Units Cost/Unit Total
$0.00
Total Other $0.00
Current Overhead Rate Total
15.00%$693.75
Total FS Overhead Costs $693.75
$4,625.00
Subtotal Direct Costs
Forest Service Overhead Costs
TOTAL COST $5,318.75
Printing
Other Expenses
Subtotal Direct Costs
$4,625.00
Non-Standard Calculation
Standard Calculation
Standard Calculation
Standard Calculation
Non-Standard Calculation
Non-Standard Calculation
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
Job Description Cost/Hour # of Hours Chemicals Total
$0.00
Total Salaries/Labor $0.00
Travel Expense Employees Cost/Trip # of Trips Total
$0.00
Total Travel $0.00
Piece of Equipment # of Units Cost/Day # of Days Total
$0.00
Total Equipment $0.00
Supplies/Materials # of Items Cost/Item Total
$0.00
Standard Calculation
Standard Calculation
Standard Calculation
Standard Calculation
WORKSHEET FOR
Non-Standard Calculation
Non-Standard Calculation
Non-Standard Calculation
Non-Standard Calculation
FS Cash to the Cooperator Cost Analysis, Column (b)
Salaries/Labor
Travel
Equipment
Supplies/Materials
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
determing 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 formules, 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.
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD
Total Supplies/Materials $0.00
Paper Material # of Units Cost/Unit Total
$0.00
$0.00
Total Printing $0.00
Item Cost/Unit # of Units Total
Spraying Crews (Contract)$10,000.00 1 $10,000.00
$0.00
Total Other $10,000.00
Current Overhead Rate Total
0.00%$0.00
$0.00
TOTAL COST $10,000.00
$10,000.00
Total Coop. Indirect Costs
Other Expenses
Subtotal Direct Costs
Cooperator Indirect Costs
Subtotal Direct Costs
$10,000.00
Non-Standard Calculation
Standard Calculation
Standard Calculation
Non-Standard Calculation
Printing
DocuSign Envelope ID: CCCCA6EA-CF39-4032-B502-F7B33C438ADD