HomeMy WebLinkAboutbocc.con.163.2017-BOCC t SDA Forest Sc-nioe CONTRACT#1“.19/ OMB 0596-0217
FS-1500-19
MODIFICATION OF GRANT OR AGREEMENT PAGE OF PAGES
13
I.U.S FOREST SERVICE GRANTIAC,REE%LENT NUMBER: -'.RECIPIENT/COOPERATOR GRANT or 3_MODIFICATION NUMB172:
1 5-CS-1 1021200-008 AGREEMENT NUMBER.IF ANY: 001
N/A
4.NAMFJADDRESS OF U S.FOREST SERVICE UNIT MAIN'S r FIRING S.NANIEJADDRFSS OF U.S.FOREST SERVICE UNIT ADMINISTERING
GRANT/AGREEMENT(unit name.sine.cit).'use.and rip.3 t: PROJECT/ACTIVITY(unit name...Hem city.Atte.and zip+4*:
Rick Maestas Jim Fiorelli
Grants and Agreements Specialist Leadville Ranger District
PSICC 810 Front St
USDA,Forest Service Leadville,CO 80461
2840 Kachina Drive
Pueblo,CO 81008 Clark Woolley
WRNF—Aspen and Sopris R.D.
620 Main St. PO Box 309
Carbondale,CO 81623
6.NAME/ADDRESS OF RECIPIENT/COOPERATOR(Muret.city.state.and zip+ 7 RECIPIENT/COOPERATOR'S HHS SUB ACCOUNT NUMBER(For HHS
J,county): payment uce only):
NA
Independence Pass Foundation(IPF)
Karin Teague, PO BOX 1700,Aspen.CO 81612
Lake County
Dolores Semsack,506 Harrison Ave,Leadville,CO
80461
Pitkin County
Brian Pettet, 76 Service Center Road. Aspen,CO 81611
8.PURPOSE OF MODIFICATION
CHECK ALL This modification is issued pursuant to provision no.
THAT APPLY:
CHANGE IN PERFORMANCE PERIOD:
CHANGE IN FUNDING:Additional funding for FY 2017 will be collected from Independence Pass Foundation(IPF).
Pitkin,and Lake Counties. Total amount collected$13,300
® ADMINISTRATIVE CHANGES: Change Principal Contacts G.R.Fielding to Brian Pettet,Martha Moran to Clark
Woolley and Mike Bordogna to Dolores Semsack. Sec the AOP attached Exhibit B.Section IV.
OTHER: Add the FY 2017 Annual Operating Plan(AOP)
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 this Modification No.002 is to continue to have a working arrangement between the U.S.Forest Service,Independence
Pass Foundation(IPF),Pitkin,and Lake Counties,in our mutual effort to protect and restore the designated State section of Top of Rockic.
National Scenic Byway from Twin Lakes to Aspen,Colorado-Independence Pass. One of the main goals is to work together in
maintaining the facilities at the top of the Independence Pass. Also to include FY 2017 Annual Operating Plan,and financial plan.
Additional funds will be collected from IPF-$5,800.Pitkin County-$6,000 and Lake County$1.500 for a total amount of S13.300,these
monies will be utilized from the Cooperators to meet the FY20I7 costs.
"MI
IS USDA Forest Service OMB 0596-0217
L_ FS-1500-19
10. ATTACHED DOCUMF:Ni ATION (Check all that apply):
Revised Scope of Work
Revised Financial Plan FY 2017(Exhibit A)
Other: Annual Operating Plan 2017(Exhibit(?)
II. SIGNATURES
,t ittootll t)Ruta t/S)%1711:B1 SIGN 111 RI MUM,flit VGSIVt:r(BIOS(7R)ri t 111U 1111.1"%RI flit(Al I(1 U RLt'RISI\l t11‘1.5,OR I la]R REsptcmi
aRitES t\).tUT110RI7I7)fU tCI I\TIILIR RINPUC Ttt.tRE tS FOR\I.17llRS RELfE070 i1G..tBoVF-RFSERF'C1UGR% I/AWG' LUES).
I I.A.REeIY Cs P -OR SIGNATURE 11.B.DATE T I I.C.U.S.FORES .ERS'ICE SI 'ATURE I I.D.DATE
SIGNED SIGNED
• /piritiLd
JY ' b (Signature of SiLnatcm Official) 2-4.1/
1-7
�tI.E.NAME tope or print):K.ARIN TEAGUE — 11.F.NAME(t)pe or print):ERIN CONNELLY
11.G.TTFLE (npe or print): Eseculive Director.IPF 11.H. TITLE tope or print):Forest&Grassland Super.isor.PSICC
I 1 L RECIPIENT/COOPERATOR SIGNATL'RE I I.B.DATE 11 J.U.S.FOREST SERVICE SIGNATURE I I.D.DATE
SIGNED SIGNED
(Signature of Signatory Official)
(Signature of Signator Official)
I I.L.NAME(t)pe or print):SCOTT C.FITL WILLIAMS.
1 I.K.NAME(rye or print):MIKE BORDOGNA
I I.N TITLE(rcpt or print):Forest Supervisor
I IM TITLE (t)pe or print): County Commissioner.Lake Count) USDA.White Ricer National Forest
11.0.RECIPIENT/COOPERATOR SIGNATURE 11.P.DATE.
SIGNED
(Signature of Signator Official)
1 I Q.NAME(t)pe or print):BRIAN PETTET
I I.R TITI F (t)pt or print): Count Engineer,Pitkin Count)
ISI SDA Pure.:Sei' c OM1)039611217
FS-I 500-19
10. ATTACHED DOCUMENTATION(Check all that apph):
• Res iced Score of Work
0 ' Rel ised I Irian(IA Plan IV 2017(I thibit A) — —-. —
Ottic: mix
- ArnuaI() ing Plar 2(11'(Exhibit H1
—_...— — _
.— 11. SIGNATURES
At flkst-iu RI rwis14i t191 I, 714 VILA 111 RI lMltra.rl ii SR.\Ir4P lR lll_lQ RIO♦ 11111 Ii81 Uri .+tit 1l MI Ainftr Sf til%MI.% WI/It RICK(Mt
P 0011 1'3 Ni 11101071x,70 U:1%MI IR RFSPbl1I1 Ut11S 1oit NI\T71RC RI 11111)10 Ila• lfinl-Rfilit'.tIAli%NT/St.li 1%0NI
114 RFCIPIFXT((XtPIRATOR SIC.NATI LITE 1 11 0 D4T1 . I l C US FOREST SERVICE SIGNATURE I I I) DATE
SIG\E D 1 SIGN/D
IStiznaiury of Stptato,r)Offtcii'i (S.ttnat:frc of Squalo,f)ti1 a9
11 E NAME(t)pc or meal.KARIN TI AGUE. 11 f NAMF ove cr prmil ERIN(ON\E1 1 Y
11 G T1TI1 (t.pe or prat) I secutne threctot.IPF I I II TTTI.F itpc n pnral Forest&Grassland Supen ism.PSICC
II 1 REOPIENi 4tX)PIRATUR SIGNATURE i I I1 DATE 4-11) .S FOREST SERVICE SIGN Alt RL 11 D.1)41(
SIGNED SIGN(D
r
iStgnatorctlfSignalcx,official) --- - "%/ /% r. -
tSigna:ure of Site Mfirali r!/c281/b
ill NAME ttypeorp:cut SCOTT G FITLTA1ELIA\1S• - --
11
—II K NAA1F ft•pc of printf MIKE BORN/CNA —
11 N TITLE(I'peofpr.txl IoresiSup_nl4er —�— —
I I M TITLE (t)pe.•r prat). (cOrt)C ommvssiener,I ale Count) USDA.White liner National Faro
I!0 RC( IPIFN I ((POPI RAI OR SIG\All RT. 1 I I.P.DA11.
SIGN!I)
(S ie+tnlurc of',wow,'. 11III,tai) i
CI
-Ii (/`..:%ME ('pcorprint).BRIAN:P11IL1 --
I I R TITt E (h pr or prim) Count,Engineer,Pill n Count
7
"Mr
6 1 USDA Forfar Son‘ce 0148 459641217j
FS-1500-19
10. ATTACHE!)DOCUMENTATION(Cbcck all that appl ):
_._._ ._ _ Rev.ned Scope., o EVork .
- -— . —
Rolrscc1 ii: F 1 2017(Exhibit A)
——
Other Amon/Operating Nor 1)17 MAMA 133
II. SIGNATURES
11,IHURVI;I RIM/4%I%OM;BY NIGSUI Rf 11111111V.11111.S1):QV)r MIAS tIL*1111 un,URA VD IIR IX I KW R.MINI NI 130 i>ew lig 1s(Kivu mi
r%curs tun%I 11,113,11)II)U I pc VOIR intivreet.1 *%.I FUR 1.1‘1 1110.at.:;Dr)snug vs/ye-tun imeocat tvIrmaim
I A RECIPIENPCOOPERATOR SIGNATURE JIB DATE tic I,S I ORE5T SERVICE SIGNATURC I I.O.DA1 I
SICNI 0 SKATO
IStr-tatorc a Cei„T.a:.+,DITtosI/ (See.r.a lc of t;pular?Oinciel
--,
I I F NAME ti”%c or priaq KARIN TEAOLIE I I.F.NAME(opc or pont) LRIN CONNFI.I Y
I I G.17TLE rs,pe ce•prim): E•tcythe airector.11.1* II.H. Tall.(t,pc or prim) Foreq&(Irz•Jand Sttp:rvitor.1SIC c —
II.I. RECIPIFN f PC TOR SIGNAL LIRE 11.0.. SI(NI-D
DATE
OM
SIGNED ' J U S.FOR r c7 SERVICE SILI.NA MIZE 11.0.DATI:
li _... 14--
(Sionstase of SIignsecollfileial)
D.-.2-- 7 (sird
ILL L NAI.IE(t:tpe or prim).SCOTT C; IIT/WILLIAMS.
II K NAME(t pc or print).14WrE-4iORIK)(A:A cpeLe 1SottQi.,r_
II N. lEft E ope or prit)...rarer Soper%hoe
II M MIS Ogre or grin* Court)Ctxnnt:ssioner.Lake Count, USDA.%Tile River National forest
II 0,. .CIPII.NPf CR IOR SIGNATURE - II.r.DATE
MrANI I)
.Irtator,Offocie) *Cr,/4
Ii Q.NAMI (ope or print):BRIAN ITT fET
I I.R P.TITI I' (t,pc or prim): C.obros!--Cuttiruxr.Ihtkia coma.
--e-‘44.w..-1‘...` ,.c•ve_cs`u. ._
2
I:SDA Forst Service OMB 0596-0217
FS-1500.19
12. ( &. RFV1F11
I.: N. Theaulhorils and format of this modification have been reniened and approved for si:Nnaturc b):
RICK MAESTAS
U.S.Forest Service Grants&Agreements Specialist
Burden Statement
Aaadrg to the Paperwork Reduction Ad of 1995.an agency may not oondud or sponsor,and a person is not required to respond to a collection of information unless it displays a vaid pub
control number The ward OW control number for this information collection is 0595 0217 The lire revered to complete the information collection is estimated to average 30 nhiuies per
response.including the time for reviewing instructors,searching ezising data sources galherirg and maintaining the data needed and completing and reviewing the collection of ruination
The U S.Department of Agriculture(USDA)prohibits doannination in slits programs and activities on he bass of race.color,national origin.age,disability.and where applicable.sec marital
status,fameal stabs.parental status.rMgion,sexual orientation,genetic nkxrnaion,pond beliefs,reprisal,or because al or part of an ndmiduars income is derived from any public
assistance (Not all prohibited bases apply to ail programs) Persons wilt disabilities who require alternative means fix communication of program information(Braille.large print auaotape
etc)should contact USDA's TARGET Center at 202.720.2600(voice and TDD I
To file a complaint of drscrimrnabon.write USDA.Director.Office of CMI 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(TDO)or(856)377-8642(relay voice) USDA is an equal opportunity provider and employer.
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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 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 S1,200/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 I
Standard Calculation
Job Description CosUDay #of Days I Total
Leadville Recreation Staff(GS-11) $388 5 51.940.00
Clarke W (GS-11) $347.00 3.00 51.041.00
Michelle M (GS-9) $254.07 5.00 $1.270.35
Seasonal (GS-3) $120_00 16.00 $1.920.00
Todd Parker $352.00 2.00 S704.00
Non-Standard Calculation
Total Salaries/Labor L $6,875.35
Travel
Standard Calculation
Travel Expense 'Employees ICost/Trip #of Trips Total
LDV vehicle 1 $10.00 16.00 $160.00
Non-Standard Calculation
Total Travel $160.00_
Equipment
Standard Calculation
Piece of Equipment #of Units Cost/Day #of Days Total
LDV vehicle FOR 1 00 S10.00 10.00 $100.00
$0.00
Non-Standard Calculation
Total Equipment $100.00
Supplies/Materials
Standard Calculation
Supplies/Materials #of Items Cost/Item Total
$0.00
Non-Standard Calculation
Total Supplies/Materials I $0.00
Printing
Standard Calculation
Paper Material #of Units [Cost/Unit Total
S0.00
Non-Standard Calculation
Total Printing $0.00
Other Expenses
Standard Calculation
Item #of Units Cost/Unit [ Total
Contract Cleaning/Pumping
$4,900 from the PSICC
Leadville RD and S5.900
from White River Aspen RD 1 00 $10,800 00 S10.800.00
$0.00
Non-Standard Calculation
Total Other I $10.800.00
Subtotal Direct Costs $17,935.35
Forest Service Overhead Costs
Current Overhead Rate [Subtotal Direct Costs [ Total
8.00% $17.935.35 $1,434.83
'Total FS Overhead Costs [ [ $1,434.83
TOTAL COST $19,370.18
WORKSHEET FOR
Cooperator Non-Cash Contribution Cost Analysis, Column (d)
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 S1.200/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 Cost/Day 1#of Days (Total
Lake County $300.00 1 00 S300 00
Pitkin county $300.00 1.00 S300.00
IPF- Karin Teague $300.00 6 00 S1.800 00
Non-Standard Calculation
Total Salaries/Labor I L 52,400.00
Travel
Standard Calculation
Travel Expense 'Employees Cost/Trip 1#of Trips (Total
S0.00
Non-Standard Calculation
Total Travel 50.00
Equipment
Standard Calculation
Piece of Equipment 1#of Units ICost/Day #of Days (Total
IPF Vehicle 1 00 $25 00 5.00 5125.00
$0.00
Non-Standard Calculation
[total Equipment L 5125.00
Supplies/Materials
Standard Calculation
Supplies/Materials I#of Items Cost/Item Total
$0.00
Non-Standard Calculation
Total Supplies/Materials $0.00
Printing
Standard Calculation
Paper Material I#of Units [Cost/Unit [Total
SO 00
Non-Standard Calculation
S0.00
Total Printing $0.00
Other Expenses
Standard Calculation
[#of Units Cost/Unit [ Total
$000
$0.00
Non-Standard Calculation
Total Other
Subtotal Direct Costs $2,525.00
Cooperator Indirect Costs
Current Overhead Rate Subtotal Direct Costs [ Total
$2,525.00 $0.00
Total Coop. Indirect Costs $0.00
r----TOTAL COST $2,525.00
WORKSHEET FOR
Cash to FS Cost Analysis, Column (f)
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 51.200/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 Cost/Day 1#of Days Total
$0.00
Non-Standard Calculation
[Total Salaries/Labor I $0.001
Travel
Standard Calculation
Travel Expense !Employees 1CostTrip #of Trips Total
$0.00
Non-Standard Calculation
Total Travel $O.00I
Equipment I
Standard Calculation
Piece of Equipment 1#of Units ICost/Day 1#of Days I Total
S0_00
Non-Standard Calculation
Total Equipment $0.00
Supplies/Materials '
Standard Calculation
Supplies/Materials 1#of Items 1Cost/Item 'Total
$0.00
Non-Standard Calculation
Total Supplies/Materials $0.00
Printing
Standard Calculation
Paper Materia I#of Units ICosUUnit I 'Total
SO 00
Non-Standard Calculation
Total Printing J $0.00
Other Expenses
Standard Calculation
Item #of Units Cost/Unit Total
Lake County- Funding for the
cleaning/pumping contract to 1.00 51,500.00 S1.500.00
the U S Forest Service
Pitkin County-Funding for the
cleaning/pumping contract to 1.00 56,000.00 S6.000.00
the U.S. Forest Service
IPF-Funding for the
cleaning/pumping contract to 1.00 $5,800.00 $5,800.00
the U.S. Forest Service
$0.00
Non-Standard Calculation
Total Other � $13,300.00
Subtotal Direct Costs $13,300.00
Forest Service Overhead Costs
Current Overhead Rate Subtotal Direct Costs Total
$13,300.00 $0.00
Total FS Overhead Costs $0.00
TOTAL COST $13,300.00
155-11021200-008
Exhibit B
Modification No.002
2017 Annual Operating Plan
2017 ANNUAL OPERATING PLAN
I. GENERAL PROJECT DESCRIPTION:
The Independence Pass partners will jointly share in the operation and maintenance of the Independence
Pass facilities.
II.PROJECT SPECIFICS:
A.PSICC SHALL:
1. Provide Jim Fiorelli as the project contact for Independence Pass summer operations.
2.Provide patrolling which entails making sure trash is picked up and that the Restrooms are being kept
up during open season for Independence Pass. The month the Leadville Ranger District will provide
this sen ice will be May and June.
3. Upon request,provide partnership with interpretive/educational information and subject matter on
Independence Pass to be used for supplemental information.
4. Monitor the effectiseness of this agreement for future operations.
5.Provide approximate funding for PSICC's share in the amount of$4,900 for the summer restroom
operations.
6. Be responsible for awarding the toilet pumping contract.
7.Act as the Designated Contracting officer's Representative for the toilet pumping contract. This entails
collecting the funding and administering the contract.
B.WHITE RIVER FOREST SERVICE SHALL:
1.Provide Clark Woolley as the project contact for Independence Pass.
2. Provide patrolling which entails making sure trash is picked up and restrooms are being cleaned during
open season for Independence Pass. The months the Aspen-Sopris Ranger District will provide this
service in July and August.
3.Monitor the effectiveness of this agreement for future operations.
4.Provide approximate funding for White River's share in the amount of$5,900 for the summer restroom
operations.
C.IPF SHALL:
I.Provide Karin Teague as the project contact for the summer programs at Independence Pass.
2.Provide to the U.S. Forest Service not to exceed$5,800 for IPF's share of the summer toilet operations.
3.Provide patrolling which entails making sure trash is picked up and restrooms being cleaned during
open season for Independence Pass. The months IPF will provide this service will be from September
and until the Pass is closed for the season.
D.PITKIN COUNTY SHALL:
1. Provide Brian Pettet as the project contact for Independence Toilet project at Independence Pass.
2. Provide to the U.S. Forest Service not to exceed$6,000 for Pitkin County's share of the summer toilet
operations.
E.LAKE COUNTY SHALL:
1.Provide Dolores Semsack as the project contact for Independence Toilet project at Independence Pass.
2.Provide to the U.S. Forest Service not to exceed$1,500 for Lake County's share of the summer toilet
operations.
1
15-CS-11021200-008
Exhibit B
Modification No 002
2017 Annual Operating Plan
F.ALL PARTIES SHALL:
I.A pm and post-season meeting +ill be held to discus monitoring results of patrolling.alternatives_
successes and challenges.
III.TERM OF ANNUAL OPERATING PLAN: The project work will be completed during the
period starting date of final signature of this agreement and ending 09/30/2017.
IV.PRINCIPAL CONTACTS. The principal contacts for this instrument are:
US.Forest Service Aspen-Sopris Project US.Forest Service Leadville RD Project
Contact Contact
Clark Woolley Jim Fiorelli
Aspen—Sopris Ranger District Leadville Ranger District
620 Main St. 810 Front Street
Carbondale,CO 81623 Leadville,CO 80461
Phone: 970-963-2266/970-404-3155 Phone: 719-486-7411
FAX: 970-963-1012 FAX: 719-468-0928
E-Mail:cmwoolley@fs.fed.us E-Mail:jfiorelli@fs.fed.us
Pitkin County Project Contact Lake County Project Contact
Brian Pettet Dolores Senvsack
Engineer Lake County Commissioner
76 Service Center Road 506 Harrison Ave.
Aspen,CO 81611 Leadville,CO 80461
Phone: 970-920-5390 Phone: 719-486-4101
FAX: 970-920-5374 FAX: 719-486-4103
E-Mail: brian.pettet@pitkincounty.com E-Mail:dsemsack(Pco.lake.co.us
Independence Pass Foundation Project U.S.Forest Service Admin Contact-PSICC
Contact
Karin Teague Rick Maestas
Executive Director Grants and Agreements Specialist
PO Box 1700 2840 Kachina Drive
Aspen,CO 81612 Pueblo,CO 81008
Phone: 970-274-9690 Phone: 719-553-1443
E-Mail: director@independencepass.org FAX: 719-553-1435
E-Mail: rmaestas02@fs.fed.us
2
15-CS-11021200-008
Exhibit B
Modification No.002
2017 Annual Operating Plan
V.SPECIAL BILLING REQUIREMENTS:
ADVANCE BILLING
I.)Bill IPF$5,800.00 prior to commencement of work for deposits sufficient to cover the estimated costs
for the specific payment period. Overhead will not be assessed as the incoming funds will be passed thru
to the restroom pumping costs.
Billing Method:A single lump sum advanced bill
Billing shall be sent to: Karin Teague—Independence Pass Foundation(IPF)
PO Box 1700
Aspen,CO 81612
2.)Bill Pitkin County$6,000.00 prior to commencement of work for deposits sufficient to cover the
estimated costs for the specific payment period. Overhead will not be assessed as the incoming funds will
be passed thru to the restroom pumping costs.
Billing Method: A single lump sum advanced bill
Billing shall be sent to: Brian Pettet, Pitkin County
76 Service Center Road
Aspen.CO 81611
3.)Bill Lake County$1,500.00 prior to commencement of work for deposits sufficient to cover the
estimated costs for the specific payment period. Overhead will not be assessed as the incoming funds will
be passed thru to the restroom pumping costs.
Billing Method: A single lump sum advanced bill
Billing shall be sent to: Delores Semsack/Kayla Marcella, Lake County
POBox 964 .
Leadville,CO 80461
3
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it l- Ek .e, CONTRACT
# 05-2
USDA Fames Sarna✓ OMB 0596-0217
FS-1500.19
PAGE OF
MODIFICATION OF GRANT OR AGREEMENT PAGES
1 3
I US FOREST SERVICE GRANTAGREEMENT 7 RECIPIENT/COOPERATOR GRANT nr 3 MODIFICATION NUMBER
NUMBER AGREEMENT NUMBER.If ANY I
19-C0-11021500-014
4 NAMEADDRESS OPUS FOREST SERVKE UNIT ADMINISTERING t NAME/ADDRESS OF US FOREST SERVICE UNIT ADMINISTERING
GRANLAOREEMENTIumi name prim my siaie.and rips II PROJECT:ACTIVITY(uml name Nreet,ciy%tee anLp Hl
White River National Forest Program Contact: White River National Forest Partnership Contact:
Shelly Grail,Recreation Manager Clark M.Woolley
620 Main St. 900 Grand Avenue
Carbondale,CO 81623 Glenwood Springs,CO 81601
Telephone 970-404-3155 Telephone:970-945-3227
E-Mail:urailfafs.fed,us E-Mail:crprwoollehfs fed us
6 NAMEADDRESS OF RECIPIENT COOPERATOR Jami IA).mm and asp i RECIPIENTCOOPFRATOR'S NNS SUB ACCOUNT NUMBER(Fre HHS
+ county) Menem use only)
Pitkin County Program Contact:
Brian Pellet
Director of Pitkin County Public Works
76 Service Center Road
Aspen,CO 81611
Telephone 970-920-5392
E-Mail:bnanoettet@Ditkincounty.com
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. I.above.
• CHANGE IN PERFORMANCE PERIOD'
• CHANGE IN FUNDING'N/A
▪ ADMINISTRATIVE CHANGES Revive Billing Method,sec Section III,Letter A of the Agreement
• 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).
10. ATTACHED DOCUMENTATION(Check all that apply):
Scope of Work Remains the Same
111YJ��YII Financial Plan Remains the Same
Other See attached revised billing method
11. SIGNATURES
AUTHORIffO REPRESENTATIVE:By SIGNATURE BELOW,THESIGNING PARTIES CERTIFY THAT THEY ARE THE OFFICIAL REPRESENTATIVES
OF THEIR RESPE WE! TIES AND AUTHORIZED TO ACT IN IHEHC RESPECTIVE AREAS FOR MATTERS RELATED TOTHE ABOVE-
RE FERENCS C ANT/AGREEMENT
It 1/PI WIN 'SIGNATURE IIB DATE II S FOREST SERVICE SIGNATURE II DATE
SIGNED
12271 a SIGNED
f)alnW SepmunOfficial) immure nfSirmmry al)
II E NAME pipe or mini) BRIAN PETTET n F NSMElip rpm COTT G FITZWILLIAMS
JIG TITLE owe nr pnnn Director Illi TITL E nrpc or print) Forest Supervisor
Pitkin County Public Works
-
USDA Fon.r Sow Pt Ohl B 039e-0217
5rA
rs-i5Ul1 reJ
12.G&A REVIEW
12 A 1 he authorits and format of this modification have been rodeo ed and appraised for signature by: 12 B DATE
SW FD
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CLARK NI WOOLLEY /�
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45
USDA roro,r Sen u. OMB OS4 -B27
FS.6nn.w
Reined Proru mn
III. THE U.S.FOREST SERVICE SHALL,:
A ADVANCE BILLING The U.S. Forest Service shall bill the Cooperator pnoi to commencement of work for
deposits sufficient to cover the estimated costs for the specific payment period.U S Forest Service overhead rate
will not assessed as the project is of mutual interest to the parties
Billing Method I Initial lump sum advance payment total.525,000.00(Initiated by PS on Date of Signatures)
2 Final lump sum advance payment initiated by FS on July 15th total-525,000 00
Total S50000 00
Pitkin County Public Works
Alt Brian Pettet
76 Service Center Road
Aspen,CO 81611
i Email hrian pettet apitkmcounty corn _