HomeMy WebLinkAboutbocc.con.241.2016 iTKIN Pitkin County
CouNTit Contract Cover Sheet
Please complete the Contract Cover Sheet when the contract is completed and signed by Contractor and Pitkin County
Project Manager.
Return all Contract Cover Sheets and Contracts/Change Orders/Amendments to Procurement
(procurement help@pitkincounty.com). Any contracts$50,000 and over will be routed for signatures to County Manager
and Attorney's Office(if required)by Procurement&Contracts Manager.
Contract Information
Contract Number 241-2016
Project Name Non-Funder Participating Agreement between Pitkin County and the
USDA,Forest Service WRNF
Contractor USDA,Forest Service WRNF
Budget Line Item 118.56.02140.82726
Additional Budget Line Item(s) Forest Service Agreement# 16-PA-11021501-049
and special notes to Finance
Contract Start Date 6/27/2016
Contract End Date 5/31/2019
Automatic Renewal Yes ❑ No®
If Construction: Retainage Click here to enter text.
If this is a new contractor,please request they complete and submit to Finance a W-9 Form.
Contact Information:
Department Open Space and Trails
Project Manager Gary Tennenbaum Project Manager 920-5355
Phone
Provide a brief description of the contract:
The agreement is to document the cooperation between the parties(Pitkin OST and FS-WRNF)to
collaborate in the maintenance,improvements, and operation of the Aspen Ranger Station's visitor
information center.This agreement provides for the interchange of services,equipment, supplies,and
technical assistance.No funds are exchanged between the parties.
Contract Value Summary:
Contract Amount NA
This Change order/Amendment amount(if applicable)
New Contract Total NA
Procurement Method:
None El Informal❑ Formal 0 Sole Source 0 Emergency 0 Contract Renewal 0
Contract Type:
Services/Maintenance 0 Construction 0 Goods,Equipment, Supplies 0
Change Order/Amendment 0 Other,please explain ® Exchange of services
ir...+3l.
NOTE: CLERKS OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHIVES RETAINAGE SCHEDULE.ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST.
pc' %-2j(,)
USDA,Forest Service orate 0596-0217
FS-1500-16
FS Agreement No. 16-PA-11021501-049
Cooperator Agreement No.
NON-FUNDED PARTICIPATING AGREEMENT
Between
PITKIN COUNTY
And The
USDA,FOREST SERVICE
WHITE RIVER NATIONAL FOREST
This PARTICIPATING AGREEMENT is hereby entered into by and between Pitkin County,
hereinafter referred to as "the Cooperator," and the USDA,Forest Service,White River National
Forest's Aspen Ranger District,hereinafter referred to as the"U.S. Forest Service,"under the
authority: The Cooperative Funds and Deposits Act of 1975 (16 U.S.C. 565a-1) and as amended.
Background: The U.S. Forest Service and the Cooperator share a mutual interest in operating the
visitor information center located at the Aspen Ranger Station to provide educational and
interpretive services to the Public. Section 426 of the Consolidated Appropriations Act of 2014
broadened the U.S. Forest Service's authority for working with Forest Service partners like
Pitkin County under the Cooperative Funds and Deposits Act(16 U.S.C. 565a-1). This
expanded authority improves the Agency's ability to engage new partners and to work with
existing partners. Under this expanded authority, the Agency can enter into this Agreement with
a local government agency to co-operate Forest Service facilities (including providing services to
the Public and employees to staff facilities) in public buildings such as the Aspen Ranger Station
for the sale or distribution of educational and interpretive materials,products,programs,and
services pertaining to National Forest System (NFS) lands, private lands,and lands administered
by other public entities. The expanded authority also allows for construction,maintenance,
and/or improvement of the Aspen Ranger Station where authorized interpretive and visitor
information services are conducted.
Title: The Aspen Ranger Station Visitor Information Program.
I. PURPOSE:
The purpose of this agreement is to document the cooperation between the parties to collaborate
in the maintenance,improvements, and operation of the Aspen Ranger Station's visitor
information center to provide interpretive and visitor information services to the Public
pertaining to NFS lands,private lands and lands administered by Pitkin County. This Agreement
provides for the interchange of services,equipment, supplies, and technical assistance in
accordance with the following provisions and the hereby incorporated Operating Plan, Financial
Plan, and Exhibits. No funds are exchanged between the parties.
Page 1 of 11
9 -0217
S USDA,Forest Sen ice OM FS51500-16
Q. MEMBERS OF U.S. CONGRESS. Pursuant to 41 U.S.C. 22, no United States
member of, or United States delegate to, Congress shall be admitted to any share or
part of this agreement, or benefits that may arise therefrom, either directly or
indirectly.
R. NONDISCRIMINATION. 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 a part of an individual's income is derived from any public
assistance program. (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 to USDA,
Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C.
20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an
equal opportunity provider and employer.
S. ELIGIBLE WORKERS. The Cooperator shall ensure that all employees complete
the I-9 form to certify that they are eligible for lawful employment under the
Immigration and Nationality Act(8 USC 1324a). The Cooperator shall comply with
regulations regarding certification and retention of the completed forms. These
requirements also apply to any contract awarded under this agreement.
T. AGREEMENT CLOSEOUT. Within 90 days after expiration or notice of
termination the Cooperator shall close out the agreement. Within a maximum of 90
days following the date of expiration or termination of this agreement, all reports
required by the terms of the agreement must be submitted to the U.S. Forest Service
by the Cooperator.
U. PROGRAM PERFORMANCE REPORTS. The parties to this agreement 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, if applicable.
- Reason(s) for delay if established goals were not met.
- Additional pertinent information.
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. See
Page 6 of 11
USDA,Forest Service OMB 0596-0217
FS-1500-16
attached Optional Project Performance Report, FS-1500-23, to assist the parties in
drafting and documenting the annual performance report.
V. RETENTION AND ACCESS REOUIREMENTS FOR RECORDS. The Cooperator
shall retain all records pertinent to this agreement for a period of no less than 3 years
from the expiration or termination date. As used in this provision, records include
books,documents, accounting procedures and practice, and other data, regardless of
the type or format. The Cooperator shall provide reasonable access and the right to
examine all records related to this agreement to the U.S. Forest Service, Inspector
General, or Comptroller General or their authorized representative upon prior written
request. The rights of access in this section must not be limited to the required
retention period but must last as long as the records are kept.
If any litigation,claim, negotiation, audit, or other action involving the records has
been started before the end of the 3-year period and so notified to Cooperator, the
records must be kept until all issues are resolved,or until the end of the regular 3-year
period,whichever is later.
Records for nonexpendable property acquired in whole or in part, with Federal funds
must be retained for 3 years after its final disposition.
W. FREEDOM OF INFORMATION ACT(FOIA). Public access to grant or agreement
records must not be limited,except when such records must be kept confidential and
would have been exempted from disclosure pursuant to Freedom of Information
regulations (5 U.S.C. 552). Requests for research data are subject to 2 CFR 215.36.
Public access to culturally sensitive data and information of Federally-recognized
Tribes may also be explicitly limited by P.L. 110-234,Title VIII Subtitle B §8106
(2008 Farm Bill).
X. TEXT MESSAGING WHILE DRIVING. In accordance with Executive Order(EO)
13513, "Federal Leadership on Reducing Text Messaging While Driving,"any and
all text messaging by Federal employees is banned: a)while driving a Government
owned vehicle(GOV)or driving a privately owned vehicle(POV)while on official
Government business; or b) using any electronic equipment supplied by the
Government when driving any vehicle at any time. All cooperators, their employees,
volunteers, and contractors are encouraged to adopt and enforce policies that ban text
messaging when driving company owned, leased or rented vehicles, POVs or GOVs
when driving while on official Government business or when performing any work
for or on behalf of the Government.
Y. PROPERTY IMPROVEMENTS. Improvements placed on National Forest System
land at the direction or with the approval of the U.S. Forest Service becomes property
of the United States. These improvements are subject to the same regulations and
administration of the U.S. Forest Service as would other National Forest
improvements. No part of this agreement entitles the Cooperator to any interest in the
Page 7 of 1 1
�+TS USDA,Forest Service OMB 0596-0217
FS-1500-16
improvements, other than the right to use them under applicable U.S. Forest Service
Regulations.
Z. REMEDIES FOR COMPLIANCE RELATED ISSUES. If the Cooperator materially
fail(s) to comply with any term of the agreement, whether stated in a Federal statute
or regulation, an assurance, or the agreement, the U.S. Forest Service may wholly or
partly suspend or terminate the current agreement.
AA. GOVERNMENT-FURNISHED PROPERTY. The Cooperator may only use U.S.
Forest Service property furnished under this agreement for performing tasks assigned
in this agreement. The Cooperator shall not modify, cannibalize, or make alterations
to U.S. Forest Service property. A separate document, Form AD-107, must be
completed to document the loan of U.S. Forest Service property. The U.S. Forest
Service shall retain title to all U.S. Forest Service-furnished property. Title to U.S.
Forest Service property must not be affected by its incorporation into or attachment to
any property not owned by the U.S. Forest Service, nor must the property become a
fixture or lose its identity as personal property by being attached to any real property.
Cooperator Liability for Government Property.
1. Unless otherwise provided for in the agreement, the Cooperator shall not be
liable for loss, damage, destruction, or theft to the Government property
furnished or acquired under this contract, except when any one of the following
applies:
a. The risk is covered by insurance or the Cooperator is otherwise reimbursed
(to the extent of such insurance or reimbursement).
b. The loss, damage, destruction, or theft is the result of willful misconduct or
lack of good faith on the part of the Cooperator's managerial personnel. The
Cooperator's managerial personnel, in this provision, means the Cooperator's
directors, officers, managers, superintendents, or equivalent representatives
who have supervision or direction of all or substantially all of the
Cooperator's business; all or substantially all of the Cooperator's operation at
any one plant or separate location; or a separate and complete major
industrial operation.
2. The Cooperator shall take all reasonable actions necessary to protect the
Government property from further loss, damage, destruction, or theft. The
Cooperator shall separate the damaged and undamaged Government property,
place all the affected Government property in the best possible order, and take
such other action as the Property Administrator directs.
3. The Cooperator shall do nothing to prejudice the Government's rights to recover
against third parties for any loss, damage, destruction, or theft of Government
property.
4. Upon the request of the Grants &Agreements Specialist, the Cooperator shall, at
the Government's expense, furnish to the Government all reasonable assistance
Page 8 of 11
0596-0217
[1+�S USDA,Forest Service OMBFS-1500--16
and cooperation,including the prosecution of suit and the execution of
agreements of assignment in favor of the Government in obtaining recovery.
BB. TERMINATION BY MUTUAL AGREEMENT. This agreement may be terminated,
in whole or part, as follows:
1. When the U.S. Forest Service and the Cooperator agree upon the termination
conditions, including the effective date and, in the case of partial termination, the
portion to be terminated.
2. By 30 days written notification by the Cooperator or by the U.S. Forest Service
setting forth the reasons for termination, effective date, and in the case of partial
termination,the portion to be terminated.
CC. ALTERNATE DISPUTE RESOLUTION. In the event of any issue of controversy
under this agreement, the parties may pursue Alternate Dispute Resolution procedures
to voluntarily resolve those issues. These procedures may include, but are not limited
to conciliation, facilitation, mediation, and fact finding.
DD. DEBARMENT AND SUSPENSION. The Cooperator shall immediately inform the
U.S. Forest Service if they or any of their principals are presently excluded, debarred,
or suspended from entering into covered transactions with the Federal Government
according to the terms of 2 CFR Part 180. Additionally, should the Cooperator or any
of their principals receive a transmittal letter or other official Federal notice of
debarment or suspension, then they shall notify the U.S. Forest Service without undue
delay. This applies whether the exclusion,debarment, or suspension is voluntary or
involuntary
EE. MODIFICATIONS. Modifications within the scope of this agreement must be made
by mutual consent of the parties,by the issuance of a written modification signed and
dated by all properly authorized, signatory officials,prior to any changes being
performed. Requests for modification should be made, in writing, at least 30 days
prior to implementation of the requested change. The U.S. Forest Service is not
obligated to fund any changes not properly approved in advance.
Page 9 of 1 1
ll�S USDA,Forest Service OMB 0596-0217FS-1500-16
FF. COMMENCEMENT/EXPIRATION DATE. This agreement is executed as of the
date of the last signature and is effective through May 31, 2019 at which time it will
expire. The expiration date is the final date for completion of all work activities under
this agreement.
GG. AUTHORIZED REPRESENTATIVES. By signature below, each party certifies that
the individuals listed in this document as representatives of the individual parties are
authorized to act in their respective areas for matters related to this agreement. In
witness whereof, the parties hereto have executed this agreement as of the last date
written below.
is2-1/1L•
GARY T NENBAUM, Assistant Director Date
Pitkin County, Colorado
SCOTT G. FITZWILLIAMS, Forest Supervisor Date
U.S. Forest Service, White River National Forest
The authority and format of this agreement have been reviewed and approved for
signature.
,d7 ‘/.2 3, 16
CLARK M. WOOLLE Date
U.S. Forest Service, Grants Management 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 4 hours per response,induding 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.
Page 10 of 11
0116 O596-0217
CI USDA,Forest Service FS-1500-16
FF'. COMMENCEMENT/EXPIRATION DATE. This agreement is executed as of the
date of the last signature and is effective through May 31, 2019 at which time it will
expire. The expiration date is the final date for completion of all work activities under
this agreement.
GG. AUTHORIZED REPRESENTATIVES. By signature below, each party certifies that
the individuals listed in this document as representatives of the individual parties are
authorized to act in their respective areas for matters related to this agreement. In
witness whereof, the parties hereto have executed this agreement as of the last date
written below.
GARY T NENBAUM, Assistant Director Date
Pitkin County, Colorado
SCOTT G. FITZWILLIAMS, Forest Supervisor 6 Dat
U.S. Forest Service, rhite�tiver National Forest
The authority and format of this agreement have been reviewed and approved for
signature.
C/..2 /
CLARK M.
WOOLLEDate
U.S. Forest Service, Grants Management 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 d splays a vai'd 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 4 hours per response,includng 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 or'.gin,age,dsabii:ty,and
where applicable,sex,marital status,familial status,parental status,religion,sexual orientation,genetic information,poPti al beliels,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(Brail'e,large print,audiotape,etc.)should contact USDA's TARGET Center at 202-720.2600(voce
and TDD).
To file a complaint of discrimination,write USDA,Director,Office of CMI Rights,1400 Independence Avenue,SW,Washington,DC 20250-9410 or call to'l 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.
Page 10 of 11
EXHIBIT A
Operating Plan
Goal
Provide the Public,including Pitkin County residents, with information regarding local
recreational opportunities, conservation education, and other interpretive services and programs.
Parties Agree to:
- Coordinate in the operation of the visitor information center located at the Aspen Ranger
Station.
- Collaborate to provide interpretive services and programs to the Public regarding
recreation and conservation.
- Visitor information center at the Aspen Ranger Station will be open during regular
business hours from 8:00 AM to 4:30 PM Monday—Friday.
- The Cooperator will provide visitor information services only.The Cooperator is not
responsible for managing the retail operation or sales of U.S. Forest Service products.
U.S. Forest Service is solely responsible for the management of the Rocky Mountain
Conservancy product sales and the sales of U.S. Forest Service products via the Point of
Sale System(POSS).
- The Special Use Permit signed and separate from this Agreement covers the Cooperator's
responsibility to cover costs of utilities associated with facility use which includes: City
of Aspen Electric, City of Aspen Water,Aspen Consolidated Sanitation, and SourceGas,
cleaning supplies,and other utilities utilized by the Cooperator. These costs are not
incorporated under this Agreement.
- All sales of items will be accounted for by the U. S. Forest Service.
- Agree to utilize space to maximize Public and partnership related activities within Pitkin
county and the surrounding areas.
Attachments
- Exhibit A: Operating Plan.
- Exhibit B: Identifies areas within Aspen Ranger Station that meet the requirements of
expanded authority.
- Exhibit B: Map of the Aspen Range Station.
- Exhibit C: Financial Plan.
- Exhibit D: Optional Project Performance Report, FS-1500-23.
Page 1 1 of 11
Exhibit B
Room Aspen RD Room description 806 North/South East/West Total Square Area Incorporated Area Incorporated
under Special Use in the Agreement
Number W.Hallam St.,Aspen,CO length length Footage
Permit*(Yes/No) (Yes/No)
1 SE corner office(Old Rec Staff Room) 14.25 15.67 223.30 Yes No
is Closet in room#1 5.00 3.67 18.35 Yes No
2 2nd in from East on south side(old DR 10.75 11.83 127.17 Yes No
rm)
2c Closet in room 2 3.66 1.58 5.78 Yes No
3 3rd in from East on South side(Old 18.33 11.58 212.26 Yes No
winter sports rm)
4 conference room 18.25 11.50 209.88 Yes No
5 coffee nook 3.17 4.00 12.68 Yes No
6 closet to west of coffee nook 3.17 3.33 10.56 Yes No
7 west door entryway 8.00 3.50 28.00 Yes No
8 main back hallway 3.17 51.25 162.46 Yes No
room next to west entryway(old recycle
9 3.75 5.42 20.33 Yes No
room)
10 men's restroom 6.17 10.17 62.75 Yes No
11 womens's restroom 6.17 6.17 38.07 Yes No
12 supply room nook across from copy room 4.17 1.92 8.01 Yes No
13 office space to SW of front office 5.67 11.67 66.17 Yes No
14 copier room 5.66 6.50 36.79 Yes No
15 utility room In back of copier 10.17 8.75 88.99 Yes No
16 large supply room to south of copier 4.17 6.58 27.44 Yes No
room
17 East Maroon Crew room 20.00 13.25 265.00 No No
18 Closet for Maroon crew room 6.83 10.17 69.46 No No
19 VIS back office area(radio,copier,etc) 9.25 10.67 98.70 No Yes
20 VIS front desk area and display area 20.47 21.00 429.87 No Yes
combined
21 public men's toilet 12.47 5.25 65.47 No Yes
22 public women's toilet 12.57 5.25 65.99 No Yes
23 front public entry way(estimated) 5.83 10.00 58.30 No Yes
2,411.76 1,358.97 718.33
*Sepecial use permit issued to Pitkin County Open Space 05/2016(Authorization ID:ASP856;Expires 05/31/2019)
1
Exhibit B
Aspen Ranger District Office
Floor plan: 806 W. Hallam St.
p
Z5 . Z
No.20 No.23
— - -l - 4. .
1 No. 19 No. 18
1 "—m---.
7.--- .
No. 17
No. 13 No. 14 No.10
r No. 15
No.9
z° No. 16 Z
zTT .
, ` I, t
0.11
No.8
No.6 11 No.5 V -�
, N
, i 6
Z
77
V
N ,
o
No. 2 z No.1
No.4 No.3 .
I
:
. _____ .
U.S. Forest Service OMB 0596-0217
Attachment C FS-1500-17C
USFS Agreement No.: 16-PA-11021501-049 Mod No. N/A
Cooperator Agreement No.:
This Financial Plan is an estimate of costs that
covers 3 years of contributions between the
Parties in sharing expenses related to operating
the Visitor Information Center at Aspen Ranger
Station (15 U.S.C.565a-1).
Agreements Financial Plan (Medium Form)
1. Financial Plan Matrix: Note: All columns may not be used. Use depends on source and type of contribution(s).
FOREST SERVICE CONTRIBUTIONS COOPERATOR CONTRIBUTIONS
Via).' (b) (c) (d) (e) (f)
Volunteer Cash
COST ELEMENTS .N01190#1 Labor to Noncash In-Kind Other Federal (g)
(Direct Costs) (In-Kind) Cooperator TOTAL
Salaries/Labor $40,487.42 $56,544.00 $0.00 $201,923.08 $0.00 $0.00 $298.954.50
Travel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Equipment $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Supplies/Materials $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Printing $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Other $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $40,487.42 $56.544.00 $0.00 $201,923.08 $0.00 $0.00 $298,954.50
Cooperator Indirect Costs $0.00 $0.00 $0.00
FS Overhead Assessment $3,238.99 $3.238.99
Gross Total $43,726.42 $56,544.00 $0.00 $201,923.08 $0.00 $0.00 $302.193.49
Matching Costs Determination
Total Forest Service Share= (h)
(a+b+c)/(g) =(h) 33.18%
Other Federal Contribution= (i)
(f)/(g) =(i) 0.00%
Total Federal Share= (j)
(h+i)= (j) 33.18%
Total Cooperator Share (k)
(d+e)/(g)= (k) 66.82%
Total (I)
(j+k)=(I) 100.00%
Page 1
WORKSHEET FOR
FS Non-Cash Contribution Cost Analysis Column
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 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 (Hours per DE Cost/Day 1#of Days 'Years Total
FS VIS Staff 8 $17.26 80.00 3 $33,138.46
FS SS Staff Officer 8 $30.62 10.00 3 $7,348.96
$0.00
$0.00
$0.00
(Non-Standard Calculation
(Total Salaries/Labor $40,487.42
Travel
Standard Calculation
,Travel Expense Employees Cost/Trip 1#of Trips I Total
$0.00
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
'Total Travel $0.00
Equipment
Standard Calculation
Piece of Equipment 1#of Units ICost/Day 1#of Days 1 (Total
$0.00
Non-Standard Calculation
(Total Equipment I I $0.00
Supplies/Materials
Standard Calculation
Supplies/Materials #of Items [Cost/Item Total
Costs accounted for in Rocky Mountain Concervancy agreement Agreement No. $0.00
16-00-11021500-035 $0.00
$0.00
$0.00
Non-Standard Calculation
Total Sueplies/Materials I $0.00
Printing
Standard Calculation
Paper Material #of Units Cost/Unit I (Total
$0.00
Non-Standard Calculation
(Total Printing J $0.001
Other Expenses
Standard Calculation
Item #of Years ICost/Unit per year Total
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
(Total Other L $0.00
Subtotal Direct Costs $40,487.42
Forest Service Overhead Costs
Current Overhead Rate [Subtotal Direct Costs I ( (Total
8.00% $40,487.42 $3,238.99
Total FS Overhead Costs I $3,238.99
TOTAL COST $43,726.42
WORKSHEET FOR
Volunteer Labor (In-Kind) Cost Analysis Column
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.
Salaries/Labor
Standard Calculation
Job Description 'Hours per Day Cost/Day* I#of Days 'Years [Total
FS Volunteer 8 $23.56 100.00 3 $56,544.00
*https://www.independentsector.org/volunteer_time $0.00
$0.00
$0.00
$0.00
(Non-Standard Calculation
[Total Salaries/Labor $56,544.00
Travel
Standard Calculation
Travel Expense Employees Cost/Trip I#of Trips I 'Total
$0.00
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
(Total Travel ( $0.001
Equipment
Standard Calculation
Piece of Equipment #of Units 'Cost/Day I#of Days I (Total
$0.00
(Non-Standard Calculation
Total Equipment $0.00
Supplies/Materials
Standard Calculation
Supplies/Materials I#of Items 'Cost/Item ITotal
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
(Total Supplies/Materials ( I $0.00
Printing
Standard Calculation
Paper Material #of Units ICost/Unit Total
$0.00
Non-Standard Calculation
(Total Printing _ $0.00
Other Expenses
Standard Calculation
Item #of Units Cost/Unit (Total
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
'Total Other $0.00
Subtotal Direct Costs $56,544.00
TOTAL COST $56,544.00
WORKSHEET FOR
Cooperator Non-Cash Contribution Cost Analysis Column
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.
Salaries/Labor
Standard Calculation
Job Description Hours Per D<Cost/Day 1#of Days (Years (Total
Front Desk Employee 8 $33.65 250.00 3 $201,923.08
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
Total Salaries/Labor I $201,923.08
Travel
Standard Calculation
Travel Expense JEmployees ICost/Trip #of Trips I Total
$0.00
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
ITotal Travel $0.001
Equipment
Standard Calculation
Piece of Equipment #of Units ICost/Day I#of Days I Notal
$0.00
Non-Standard Calculation
ITotal Equipment I $0.001
Supplies/Materials
Standard Calculation
Supplies/Materials I#of Items Cost/Item (Total
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
Total Supplies/Materials L $0.00
Printing
Standard Calculation
Paper Material I#of Units ICost/Unit I 'Total
$0.00
Non-Standard Calculation
$0.00
Lotal Printing $0.00
Other Expenses
Standard Calculation
Item #of Years Cost/Unit I Notal
$0.00
$0.00
$0.00
$0.00
Non-Standard Calculation
$0.00
(Total Other $0.001
Subtotal Direct Costs $201 ,923.08
Cooperator Indirect Costs
(Current Overhead Rate _Subtotal Direct Costs ITotal
$201,923.08 $0.00
(Total Coop. Indirect Costs J $0.001
TOTAL COST $201 ,923.08
U.S. Forest Service OMB 0596-0217
FS-1500-17C
Instructions: Use this form in conjunction with Forest Service Handbook(FSH) 1509.11, Ch. 70, Financial
Planning Requirements,for participating, challenge cost-share,joint venture, and cost-reimbursable
agreements. This form may be used for other types of Forest Service Manual 1580 agreements,when useful.
Choose one of the two(2)financial plan versions and complete. Use Version 1 (Financial Plan-Cash to
Coop)when you will have Cash to the Cooperator. Use Version 2(Financial Plan-Cash to FS)when you
have cash to the Forest Service. Users do not have to use or print versions/sheets that are not applicable to
their agreement.
The purpose of this form is to capture the total estimated value of the proposed agreement. Once the
agreement is approved, in writing, by the parties, then this financial plan becomes the financial estimates for
the agreement. This financial plan must display the parties'expected contributions to the agreement. These
contributions should be broken down by party contribution type(e.g., non-cash, in-kind, cash to cooperator),
see below for definitions, and cost elements (e.g., salaries, supplies, travel). Cost element values should be
the result of documented cost analysis on this form. Each financial plan version provides samples of cost
analysis calculations, see associated Excel comment balloons. Additional instructions are located on version
1 and 2 cost analysis tabs.
Definitions for the Matrix Column Headings:
(a) Forest Service Noncash Contribution: Forest Service noncash contributions may consist of employee
salaries, overhead (indirect), travel provided, and/or equipment and supplies purchased and provided to the
Cooperator for use in the project. These costs are an expense to the Forest Service, but do not include
funding for reimbursement of Cooperator expenses.
(b) Forest Service Volunteer Labor(In-Kind)Contribution: This is the value of volunteer labor donated for
completion of the project by the Forest Service for which the Forest Service has incurred no expense. Forest
Service volunteer agreements(either sponsored or individual)should be used to document the donated
services. The value of volunteer labor should be commensurate with local labor rates for similar work.
(c) Forest Service Cash to the Cooperator: This is the maximum amount of funding that will be reimbursed or
advanced to the Cooperator. This is an expense to the Forest Service.
(d) Cooperator Noncash Contribution: These are expenses the Cooperator incurs that are contributed to the
project in lieu of cash, but for which costs are incurred, such as employee salaries, overhead (indirect costs),
travel, equipment, supplies, and so forth. These do not include in-kind contributions from third parties, such
as donations from other entities or volunteer labor.
(e)Cooperator. In-Kind Contribution: In-kind contribution provided to the Cooperator from a third party
organization(s)for use in the project for which the Cooperator has incurred no expense. Value assessed for
volunteer labor and donated materials, equipment and supplies should be valued based on FSH 1509.11, Ch.
70. These values are not reimbursable and can only be used to satisfy the Cooperator's matching
requirement. Display these contributions by Cost Element Expenditures.
(f)Cooperator Cash to the Forest Service: These are Cooperator cash contributions actually transferred to
the Forest Service for use in completing the project. This is an expense to the Cooperator and does not
include in-kind contributions made to the Cooperator from other organizations. Display by Cost Element
where these funds will be expended. Be sure to cite a collection authority in the Agreement if this column is
used.
Include cash the Cooperator is transferring to the Forest Service for the project, that has been received as a
grants)from a non-Federal entity(ies).
(g)Cooperator, Other Federal Contribution: Contribution provided to the Cooperator from Federal agencie(s)
for use in the project. Display these contributions by Cost Element Expenditures.
U.S. Forest Service OMB 0596-0217
FS-1500-17C
(h)Total Project Value: The sum of all the values provided toward the project. This figure reflects the true
estimated cost of the project.
Definitions for Cost Allowability
(a)Allowable Cost: A cost, as recorded on the Agreements Financial Plan (Long, Medium, and Short)forms,
associated with an agreement,which meets the criteria for authorized expenditures specific in a cost principle
methodology. Generally, it meets the cost principle methodology, and is a cost the parties to an agreement
intend to charge, and must be: Reasonable for the performance of the award; Necessary and reasonable for
proper and efficient performance and administration of the agreement; Consistently treated as either a direct
or indirect cost; Generally, determined in accordance with generally accepted accounting principles (GAAP);
Net of all applicable credits(that is, less any future rebates from the purchase of goods or services); Separate
from a cost or from a cost-sharing/matching requirement of another Federal award or agreement, unless
otherwise permitted by Federal law or regulation;Adequately documented;Authorized or not prohibited by
Federal, State, or local laws and regulations; Compliant with limits or exclusions on types or amounts of costs,
as set forth in relevant Federal laws, agreement terms and conditions, or other governing regulations
(examples of such costs include: entertainment, alcohol, and taxes); and,Consistent with the agency's and
cooperator's internal policies, regulations, and procedures that apply to both Federal awards or agreements
and other cooperator activities.
(b)Allocable Cost:A cost, as recorded on the Agreements Financial Plan(Long, Medium, and Short)forms,
associated with an agreement, which in accordance with the relative benefit received by either party for the
award, is treated consistently with other costs incurred for the same purpose and in like circumstances, and if
it: Is incurred specifically for the award; Benefits both the award and other ancillary work, and the cost may be
distributed in reasonable proportion to the benefits received(an example of this type of cost is a piece of
equipment that is used for multiple projects);or Necessary to the overall operation of the organization,
although a direct relationship to any particular cost objective may not be shown.
(c) Reasonable Cost:A cost, as recorded on the Agreements Financial Plan (Long, Medium, and Short)
forms, associated with an agreement, that, in its nature and amount, does not exceed an amount that a
prudent person, under the circumstances prevailing at the time the decision was made, would incur. Other
factors to consider are:Whether the cost is of a type generally recognized as ordinary and necessary for the
entity's operation or agreement performance; The restraints or requirements imposed by factors such as
generally accepted, sound, business practices; arms-length bargaining; Federal and State laws and
regulations; and the terms and conditions of the agreement; Market prices or industry standard costs for
similar goods and services(that is, is the cooperator offering goods or services for an amount that exceeds
what is readily available in the marketplace);Whether individuals concerned acted with prudence under the
circumstances, considering their responsibilities to the entity; its members, employees, and clients; the public;
and the government;and Significant deviations from established practices of the governmental entity that
might unjustifiably increase costs charged to the agreement.
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 45 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.
(tea USDA Forest Service OMB 05 - 3
FS-1155 000-23
Optional Project Performance Report*
1.Recipient/Cooperator Name:
2.Agreement Number: 3.Project Title:
4.Reporting Period End Date: 5.Report Type: ❑Interim ❑Final
For each program/project in the agreement narrative,please provide brief information on the following:
6. Status Summary.:
7. What has been accomplished to date? Please provide a comparison of actual accomplishments to the objectives
established in the agreement narrative(quantify where possible):
8. Any problems encountered? Explain delays or changed costs or conditions that significantly impair the ability to
meet agreement objectives and timelines. If necessary,please work with the F.S.program manager for an extension of
the agreement period.
9. Any changes that you plan to propose? Please work with F.S.program manager to determine if a modification is
needed(e.g., a change is needed to the objectives or financial plan).
10. Briefly describe work to be performed during the next reporting period.
11. Any other comments considered of importance but not discussed above?
12. Signatures of 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.
•
tl l
toy Signature: Date:
e
tola' Name/Title: Phone:
*Note to Cooperator Project Lead: This optional form helps respond to the performance reporting required by the agreement.
ts
is
ta 4 Signature: Date:
Name/Title: Phone:
*Note to F. S.Program Manager:Please document this and any other monitoring activity in NRM or send to G&A Personnel.
Revised 11-25-13
al USDA Forest Service OMB 0596-0217
FS-1500-23
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 2 hours
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.
Revised 11-25-13
S
OMB 0596-0217
USDA Forest Service
FS-1500-23
INSTRUCTIONS FOR FORM FS-1500-23
1. Enter the recipient's or cooperator's name.
2. Enter the orginal U.S. Forest Service agreement number.
3. Enter the project's title.
4. Enter the type of report.
6-8. Provide information related to each program/project in the agreement narrative.
11. Self explanatory.
Revised 11-25-13