HomeMy WebLinkAbout080910_ca02
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO:
Board of Commissioners
FROM:
WSU Jefferson County Extension
DATE:
August 9, 2010
RE:
4-H Stewardship Program
STATEMENT OF ISSUE:
A USDA Forest Service project whereby 4-H youth, with adult supervision complete deferred
maintenance in campgrounds and along trails and in wildlife and fishery habitat projects.
ANALYSIS:
This provides opportunities and stipends for Jefferson County youth and provides Forest Service,
Title II funding for the 4-H Coordinator.
FISCAL IMPACT:
None. Grant funded.
RECOMMENDATION:
We request that three originals of this contract be approved and signed by the Jefferson County
BOCC.
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FS Agreement No.
lO-CS-II060900-023
CHALLENGE COST SHARE AGREEMENT
Between The
JEFFERSON COUNTY
A POLmCAL SUBDIVISION OF THE STATE OF WASHINGTON
BY AND THROUGH JEFFERSON COUNTY WASHINGTON 4-H STEWARDSHIP
And The
USDA, FOREST SERVICE
OLYMPIC NATIONAL FOREST
This CHALLENGE COST SHARE AGREEMENT is hereby made and entered into by and
between the Jefferson County, A political subdivision of the State of Washington, by and
through Jefferson County Washington 4-H Stewardship, hereinafter referred to as "4-H
Program," and the USDA, Forest Service, Olympic National Forest hereinafter referred to as the
"U.S. Forest Service," under the authority: Secure Rural Schools and Community Self-
Determination Act of 2000, Public Law 106-393, 16 U.S.C. 500, as reauthorized and amended
by the Emergency Economic Stabilization Act of2008, Energy Improvement and Extension Act
of2008, and Tax Extenders and Alternative Minimum Tax relief Act of 2008, Section 601(a) in
division C of Pub. L. 110.
Title: 4-H Stewardship Program
L PURPOSE:
The pwpose of this agreement is to document the cooperation between the parties to
complete deferred maintenance projects in campgrounds and along trails, to engage the
local community in forest stewardship deferred maintenance projects, and to complete
wildlife and fishery habitat enhancement projects in acco,rdance with the following
provisions and the hereby incorporated Operating and Financial Plan, attached as Exhibit
A.
II. STATEMENT OF MUTUAL BENEFIT AND INTERESTS:
Participating in deferred maintenance projects on the Olympic National Forest will provide
learning and education opportunities for local youth in Jefferson and Mason Counties ages 13-16
It will encourage stewardship of National Forest Lands and develop to leadership qualities in the
4-H youth.
In Consideration of the above premises, the parties agree as follows:
IlL 4-H PROGRAM SHALL:
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A. LEGAL AUTHORITY. 4-H Program shall have the legal authority to enter into this
agreement, and the institutional, managerial, and ftnancial capability to ensure proper
planning, management, and completion of the project, which includes funds sufficient
to pay the nonfederal share of project costs, when applicable.
B. USE OF GOVERNMENT OWNED VEIDCLES. U.S. Forest Service vehicles may
be used for official U.S. Forest Service business only in accordance with FSH
7109.19, ch. 60, the requirements established by the region in which performance of
this agreement takes place, and the terms of this agreement
C. BUILDING AND COMPUTER. ACCESS BY NON-U.S. FOREST SERVICE
PERSONNEL. 4-H Program may be granted access to U.S. Forest Service facilities
and/or computer systems to accomplish work described in the Operating Plan or
Statement of Work. All non-govermnent employees with unescorted access to U.S.
Forest Service facilities and computer systems must have background checks
following the procedures established by USDA Directives 3500 series. Those granted
computer access must fulftll all U.S. Forest Service requirements for mandatory
security awareness and role-base advanced security training, and sign all applicable
U.S. Forest Service statements of responsibilities.
D. Provide a trained crew leader and assistant crew leader to train, and supervise the 4-H
participants while performing trail and campground maintenance, habitat
enhancement projects, and community engagement projects as directed by the Hood
Canal District appropriate U.S. Forest Service personnel.
E. Ensure the crew leader and assistant crew leader are available; 5 days each season, to
work with Forest Service employees to prepare and coordinate projects for the youth
crews.
F. Recruit and select 12 applicants ages 13-16 to participate 6 Saturdays in both spring
and fall in the 4-H Stewardship Program, insure selected enrollees are current
members of 4-H, meet the age requirements of the program, and complete the
necessary forms to participate in the Stewardship Program.
G. Provide proof of, and maintain, a comprehensive liability policy of not less than
$1,000,000 per occurrence and property damage. .
H. Mason County Forestry 4-H will provide up to 10 youth and 2 leaders, for one week in
July, to work with the Backcountry Horsemen of Washington (BCHW) to improve and
repair facilities in LeBar Horse Camp.
I. Work will mainly be concentrated in the Quilcene area of the Hood Canal Ranger
District, with the exception of the ftsh habitat enhancement project located near
Hoodsport n the SF Skokomish River Area and the Mason County 4-H project listed
above.
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J. Provide a stipend to each 4-H Stewardship participant for each full day they actively
engage in the assigned work projects.
K. Be responsible for obtaining any necessary licenses and permits, and complying with
any Federal, State and municipal laws, codes, and regulations applicable to the
performance of the work.
L. Provide a list of 4-H Stewardship participants, and their addresses, who work on U.S.
Forest Service projects over the course of each fiscal year.
M. Provide vehicles to transport tools, equipment, gear, and 4-H Stewardship participants
from the Hood Canal Ranger Station in Quilcene to and from the project sites.
N. Be responsible for nightly storage of a U.S. Forest Service radio in a secure location.
The radio will only be used for official business while working on NFS lands. The 4-
H Stewardship program leaders will be responsible for following FS radio protocol as
provided in training.
O. Fall Projects include:
(1) Fish Fling (fish habitat enhancement project SF Skokomish River Area.
(2) Wildlife Day
(3) Trails Day - Silver Lake or Lower Big Quilcene Trail Drainage cleanont.
(4) Watershed Cleanup Volunteer Event
(5) Campground Clean up at Falls View Campground
(6) Table Plan and leafraking at Seal Rock Campground (Nov).
P. Spring Projects Include:
(I) Campground Maintenance - Seal Rock and Falls View
(2) Wildlife Day
(3) Trails Day
(4) Watershed Cleanup Volunteer Event (Earth Day)
(5) Campground maintenance and preparation
(6) Campground -Table Plank installation and preparation.
IV. THE U.S. FOREST SERVICE SHALL:
A. PA YMENT/REIMBURSEMENT. The U.S. Forest Service shall reimburse 4-H
Program for the U.S. Forest Service's share of actual expenses incurred, not to exceed
$66,364.00, as shown in the Financial Plan. The U.S. Forest Service shall make
payment upon receipt of 4-H Program's monthly invoice. Each invoice from 4-H
Program must display the total project costs for the billing period, separated by U.S.
Forest Service and 4-H Program share. In-kind contributions must be displayed as a
separate line item and must not be included in the total project costs available for
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reimbursement The final invoice must display 4-H Program's full match towards the
project, as shown in the financial plan, and be submitted no later than 90 days from
the expiration date.
Each invoice must include, at a minimum:
1. 4-H Program's 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
6. Statement that the invoice is a request for payment by 'reimbursement'
7. Ifusing SF-270, a signature is required.
8. Invoice Number, if applicable
The invoice must be sent by one of three methods (email is preferred):
EMAIL: asc...Bl1@fs.fed.us
FAX: 877-687-4894
Send a copy to:
POSTAL: USDA Forest Service
Albuquerque Service Center
Payments - Grants & Agreements
101BSunAveNE
Albuquerque, NM 87109
Susan Graham
Hood Canal Ranger District
P.O. Box 280
Quilcene, W A 98376
B. Provide specifications, equipment, and on the ground delineation of all work projects
as agreed to in the Financial Project Plan.
C. Provide guidance and direction for the crew leader and assistant crew leader when
they are assisting the U.S. ,Forest Service with approved projects.
D. Designate the Hood Canal Ranger District Recreation Manager and/or appropriate
U.S. Forest Service personnel the lead contact for the purpose of agreement
execution, to include, but not limited to, resolution of work assignments, collection
and reimbursement of funds owed to PNTA, and coordination of work assignments.
E. Forest Service will distribute and collect 4-H applications as provided by the 4-H
program.
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F. Issue to the 4-H Stewardship Program, U.S. Forest Service Radio equipment, and authorize 4-
H Crew Leaders to use the equipment and FS radio frequencies to maintain commuuications
while working on Olympic National Forest Lands. The U.S. Forest Service will provide
radio use training.
V. IT IS MUTUALLY UNDERSTOOD AND AGREED BY AND BETWEEN THE
PARTIES THAT:
A. PRINCIPAL CONTACTS. Individuals listed below are authorized to act in their
respective areas for matters related to this instrument.
PrinciDal Coouerator Contacts:
CooDerator Prol!ram Contact CooDerator Administrative Contact
Name: Pamela Roberts Name: Laurie Meyer
Address: 201 W. Patison Address: 201 W. Patison Street
City, State, Zip: Port Hadlock, W A 98339 City, State, Zip: Port Hadlock, W A 98339
Telephone:360-379-56l0,ext.207 Telephone: 360-379-5610, ext. 206
Email: orobertsCaliefferson.wsu.edu Emil: Imever@2co.iefferson.wa.us
PrinciDal U.S. Forest Service Contacts:
U.S. Forest Service Program Manager
Contact
Name: Susan Graham
Address: P.O. Box 280
City, State, Zip: Quilcene, WA 98376
Telephone: 360-877-1046
FAJ{:360-877-1069
Email: ses.fed.us
U.S. Forest Service Administrative
Contact
Name: Colleen Brower
Address: P.O. Box 280
City, State, Zip: Quilcene, W A 98376
Telephone: 360-765-2259
FAJ{:360-765-2202
Email: cbrowerfs.fed.us
B. NON-LIABILITY. The U.S. Forest Service does not assume liability for any third
party claims for damages arising out of this instrument.
C. NOTICES. Any communications affecting the operations covered by this agreement
given by the U.S. Forest Service or 4-H Program are sufficient only if in writing and
delivered in person, mailed, or transmitted electronically bye-mail or fax, as follows:
To the U.S. Forest Service Program Manager, at the address specified in the
agreement.
To 4-H Program, at 4-H Program's address shown in the agreement or such other
address designated within the agreement.
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Notices are effective when delivered in accordance with this provision, or on the
effective date of the notice, whichever is later.
D. PARTICIPATION IN SIMILAR ACTIVITIES. This agreement in no way restricts
the U.S. Forest Service or 4-H Program from participating in similar activities with
other public or private agencies, organizations, and individuals.
E. ENDORSEMENT. Any of 4-H Program's contributions made under this agreement
do not by direct reference or implication convey U.S. Forest Service endorsement of
4-H Program's products or activities.
F. USE OF U.S. FOREST SERVICE INSIGNIA. In order for 4-H Program to use the
U.S. Forest Service insignia on any published media, such as a Web page, printed
publication, or audiovisual production, permission must be granted from the U.S.
Forest Service's Office of Communications. A written request must be submitted and
approval granted in writing by the Office of Communications (Washington Office)
prior to use of the insignia.
G. NON-FEDERAL STATUS FOR COOPERATOR PARTICIPANT LIABILITY. 4-H
Program agree(s) that any of their employees, volunteers, and program participants
shall not be deemed to be Federal employees for any purposes including Chapter 171
of Title 28, United States Code (Federal Tort Claims Act) and Chapter 81 of Title 5,
United States Code (OWCP), as 4-H Program hereby willingly agree(s) to assume
these responsibilities.
Further, 4-H Program shall provide any necessary training to 4-H Program's
employees, volunteers, and program participants to ensure that such personnel are
capable of performing tasks to be completed. 4-H Program shall also supervise and
direct the work of its employees, volunteers, and participants perfonning under this
agreement.
H. 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 instrument, or benefits that may arise therefrom, either directly or
iridirectly.
I. NONDISCRIMINATION. 4-H Program shall comply with all applicable Federal
statutes relating to nondiscrimination. This includes all applicable requirements of all
other Federal laws, regulations, and policies. These include but are not limited to Title
VI of the Civil Rights Act of 1964 as amended, which prohibits discrimination on the
bases of race, color and national origin; Title IX of the Education Amendments of
1972 which prohibits discrimination based on sex in educational programs and
activities; Age Discrimination Act of 1975, as amended, prohibiting age
discrimination; and 504 of the Rehabilitation Act of 1973 as amended, which
prohibits discrimination on the basis of disability.
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J. ELIGffiLE WORKERS. 4-H Program shall ensure that all employees complete the
1-9 form to certify that they are eligible for lawful employment under the Immigration
and Nationality Act (8 use 1324a). 4-H Program shall comply with regulations
regarding certification and retention of the completed forms. These requirements also
apply to any contract awarded under this instrument.
K. STANDARDS FOR FINANCIAL MANAGEMENT.
1. Financial Reporting
4-H Program shall provide complete, accurate, and current financial disclosures of
the project or program in accordance with any financial reporting requirements, as
set forth in the financial provisions.
2. Accounting Records
4-H Program shall continuously maintain and update records identifying the source
and use of funds. The records shall contain information pertaining to the
agreement, authorizations, obligations, unobligated balances, assets, outlays, and
income.
3. Internal Control
4-H Program shall maintain effective control over and accountability for all U.S.
Forest Service funds, real property, and personal property assets. 4-H Program
shall keep effective internal controls to ensure that all United States Fedeml funds
received are sepamtely and properly allocated to the activities described in the
agreement. 4-H Program shall adequately safeguard all such property and shall
ensure that it is used solely for authorized pwposes.
4. Sonrce Docnmentation
4-H Program shall support all accounting records with source documentation.
These documentations include, but are not limited to, cancelled checks, paid bills,
payrolls, contract and subgrantlcontract documents, and so forth.
L. AVAILABILITY OF FUNDS. U.S. Forest Service funds in the amount of $66,364.00
are currently available for performance of this instrument through 12-31-2012. 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 12-31-2012.until funds are made
available to the U.S. Forest Service for performance and until4-H Program
receive(s) notice of availability to be confirmed in a written modification by the U.S.
Forest Service.
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M. PROGRAM INCOME - PARTNERSHIP AGREEMENTS.
1. 4-H Program shall apply the standards set forth in this Provision to account for
program income earned under the agreement.
2. If any program income is generated as a result of this agreement, the income
must be applied using the deduction alternative. The deduction alternative
means that program income must be deducted from total allowable costs to
detennine the net allowable costs, unless otherwise approved by the signatory
official. Program income must be used for current costs unless the Federal
agency authorizes otherwise. Program income which 4-H Program did not
anticipate at the time of the award must be used to reduce the Federal agency and
4-H Program's contributions rather than to increase the funds committed to the
project.
3. Unless the terms and conditions of the agreement provide otherwise, 4-H
Program shall have no obligation to the U.S. Government regarding program
income earned after the end of the project period.
4. Costs incident to the generation of program income may be deducted from gross
income to detennine program income, provided these costs have not been
charged to the agreement and they comply with the Cost Principles, if applicable.
N. OVERPAYMENT. Any funds paid to 4-H Program 4-H Program in excess of
the amount entitled under the terms and conditions of this agreement constitute a debt
to the Federal Govemment. The following must also be considered as a debt or debts
owed by 4-H Program to the U.S. Forest Service:
- Any interest or other investment income eamed on advances of agreement funds; or
- Any royalties or other special classes of program income which, under the
provisions of the agreement, are required to be returned;
If this debt is not paid according to the terms of the bill for collection issued for the
overpayment, the U.S. Forest Service may reduce the debt by:
1. Making an administrative offset against other requests for reimbursement.
2. Withholding advance payments otherwise due to 4-H Program.
3. Taking other action permitted by statute (31 U.S.C. 3716 and 7 CFR, Part 3,
Subpart B).
Except as otherwise provided by law, the U.S. Forest Service may charge interest on
an overdue debt.
O. INSTRUMENT CLOSEOUT. 4-H Program shall close out the instrument within
90 days after expiration or notice of termination.
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Any unobligated balance of cash advanced to 4-H Program must be immediately
refunded to the U.S. Forest Service, including any interest earned in accordance with
7 CPR 3016.21, 7 CFR 3019.22, or other relevant law or regulation.
Within a maximum of90 days following the date of expiration or termination of this
instrument, all financial performance and related reports required by the terms of the
instrument must be submitted to the U.S. Forest Service by 4-H Program.
If this instrument is closed out without audit, the U.S. Forest Service reserves the
right to disallow and recover an appropriate amount after fully considering any
recommended disallowances resulting from an audit which may be conducted later.
P. PROGRAM PERFORMANCE REPORTS 4-H Program 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.
4-H Program shall submit semi-annual performance reports to the U.S. Forest Service
Program Manager. These reports are due 30 days after the reporting period. The
final performance report shall be submitted either with 4-H Program's final payment
request, or separately, but not later than 90 days from the expiration date of the
agreement.
Q. RETENTION AND ACCESS REOUIREMENTS FOR RECORDS. 4-H Program
shall retain all records pertinent to this instrument for a period of no less than 3 years
from the expiration or termination date. As used in this provision, "records" includes
books, documents, accounting procedures and practice, and other data, regardless of
the type or format. 4-H Program shall provide access and the right to examine all
records related to this instrument to the U.S. Forest Service Inspector General, or
Comptroller General or their authorized representative.
If any litigation, claim, negotiation, audit, or other action involving the records has
been started before the end of the 3-year period, the records must be kept until all
issues are resolved, or until the end of the regular 3-year period, whichever is later.
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Records for nonexpendable property acquired in whole or in part, with Federal funds
must be retained for 3 years after its ftnal disposition.
4-H Program shall provide access to any project site(s) to the U.S. Forest Service or
any of their authorized representatives. The rights of access in this section shall not
be limited to the required retention period but shall last as long as the records are
kept.
R. FREEDOM OF INFORMATION ACT (FOIA). Public access to agreement records
must not be limited, except when such records must be kept conftdential and would
have been exempted from disclosure pursuant to Freedom of Information regulations
(5 U.S.C. 552).
S. PUBLIC NOTICES. It is the U.s. Forest Service's policy to inform the public as
fully as possible of its programs and activities. 4-H Program islare encouraged to
give public notice of the receipt of this instrument and, from time to time, to
announce progress and accomplishments. Press releases or other public notices
should include a statement substantially as follows:
"Watershed Cleanup Event of the U.S. Forest Service, Department of Agriculture
will be organized, promoted, and administered by the 4-H Stewardship Program to
encourage local stewardship of National Forest Lands. n
4-H Program may call on the U.S. Forest Service's Office of Communication for
advice regarding public notices. 4-H Program is/are requested to provide copies of
notices or announcements to the U.S. Forest Service Program Manager and to U.S.
Forest Service's Office of Communications as far in advance of release as possible.
T. FUNDING EOUlPMENT. Fedeml funding under this instrument is not available for
reimbursement of 4-H Program's purchase of equipment Equipment is deftned as
having a fair market value of $5,000 or more per unit and a useful life of over one
year. Supplies are those items that are not equipment
U. 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
administmtion of the U.S. Forest Service as would other National Forest
improvements. No part of this instrument entitles 4-H Program to any interest in the
improvements, other than the right to use them under applicable U.S. Forest Service
regulations.
V. CONTRACT REOUIREMENTS. Any contract under this agreement must be
awarded following 4-H Program's established procurement procedures, to ensure
free and open competition, and avoid any conflict of interest (or appeamnce of a
conflict). 4-H Program must maintain cost and price analysis documentation for
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potential U.S. Forest Service review. 4-H Program is/are encouraged to utilize
small businesses, minority-owned fIrms, and women's business enterprises.
Additionally, federal wage provisions (Davis-Bacon or Service Contract Act) are
applicable to any contract developed and awarded under this instrument where all or
part of the funding is provided with U.S. Forest Service funds. Davis-Bacon wage
rates apply on all public works contracts in excess of$2,000 and Service Contract Act
wage provisions apply to service contracts in excess of$2,500.
W. GOVERNMENT-FURNISHED PROPERTY. 4-H Program may only use U.S.
Forest Service property furnished under this agreement for performing tasks assigned
in this agreement. 4-H Program shall not modify, cannibalize, or make alterations to
U.S. Forest Service property. A separate document, Form AD-lO?, 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
ftxture 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, 4-H Program shall not be liable
for loss, damage, destruction, or theft to the Government property furnished or
acquired under this contract, except when anyone of the following applies---
a. The risk is covered by insurance or 4-H Program is/are 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 4-H Program's managerial personnel. 4-H
Program's managerial personnel, in this clause, means 4-H Program's
directors, officers, managers, superintendents, or equivalent representatives
who have supervision or direction of all or substantially all of 4-H Program's
business; all or substantially all of 4-H Program's operation at anyone plant
or separate location; or a separate and complete major industrial operation.
2. 4-H Program shall take all reasonable actions necessary to protect the
Govermnent property from further loss, damage, destruction, or theft. 4-H
Program 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. 4-H Program shall do nothing to prejudice the Government's rights to recover
against third parties for any loss, damage, destruction, or theft of Government
property.
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4. Upon the request of the Grants & Agreements Specialist, 4-H Program shall, at
the Government's expense, furnish to the Government all reasonable assistance
and cooperation, including the prosecution of suit and the execution of
instruments of assignment in favor of the Government in obtaining recovery.
x. U.S. FOREST SERVICE ACKNOWLEDGED IN PUBLICATIONS.
AUDIOVISUALS AND ELECTRONIC MEDlA. 4-H Program shall acknowledge
U.S. Forest Service support in any publications, audiovisuals, and electronic media
developed as a result of this instrument.
Y. NONDISCRIMINATION STATEMENT - PRINTED. ELECTRONIC. OR
AUDIOVISUAL MATERIAL. 4-H Program shall include the following statement,
in full, in any printed, audiovisual material, or electronic media for public distribution
developed or printed with any Federal funding.
"In accordance with Federal law and u.s. Department of Agriculture policy, this
institution Is prohibited from discriminating on the basis of race, color, national origin,
sex, age, or dlsabl/ity. (Not all prohibited bases apply to all programs.)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights,
Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC
20250-9410 or call (202) 720-5964 (voice and TOD). USDA is an equal opportunity
provider and employer."
If the material is too small to permit the full statement to be included, the material
must, at minimum, include the following statement, in print size no smaller than the
text:
"This institution is an equal opportanity provider. "
Z. REMEDIES FOR COMPLIANCE RELATED ISSUES. If 4-H Program materially
fail(s) to comply with any term of the instrument, whether stated in a Federal statute
or regulation, an assurance, the agreement, or elsewhere, the U.S. Forest Service may
take one or more oftbe following actions:
1. Temporarily withhold cash payments pending correction of the deficiency by 4-H
Program or more severe enforcement action by the U.S. Forest Service;
2. Disallow (that is, deny both use of funds and matching credit for) all or part of
the cost of the activity or action not in compliance;
3. Wholly or partly suspend or terminate the current instrument for 4-H Program's
program;
4. Withhold further awards for the program, or
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S. Take other remedies that may be legally available, including debarment
procedures under 7 CFR part 3017.
AA. TERMINATION BY MUTUAL AGREEMENT: This instrument may be
tenninated, in whole or part, as follows:
1. When the U.S. Forest Service and 4-H Program 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 4-H Program to 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.
If, in the case of a partial termination, the U.S. Forest Service determines that the
remaining portion of the instrument will not accomplish the purposes for which the
instrument was made, the U.S. Forest Service may terminate the instrument in its
entirety.
Upon termination of an instrument, 4-H Program shall not incur any new obligations
for the terminated portion of the instrument after the effective date, and shall cancel
as many outstanding obligations as possible. The U.S. Forest Service shall allow full
credit to 4-H Program for the United States Federal share of the non-cancelable
obligations properly incurred by 4-H Program up to the effective date of the
termination. Excess funds must be refunded within 60 days after the effective date of
termination.
BB. ALTERNATE DISPUTE RESOLUTION - PARTNERSHIP AGREEMENT. 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 fmding.
CC. DEBARMENT AND SUSPENSION. 4-H Program shall immediately inform the
U.S. Foreat 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 of2 CFR Part 180. Additionally, should 4-H Program 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.
DD. COPYRIGHTING. 4-H Program is/are granted sole and exclusive right to
copyright any publications developed as a result of this agreement. This includes the
right to publish and vend throughout the world in any language and in all media and
Page 13 of 15
'C, l' " ~
1m
USDA, Forest Service
OMU 0596-02171
PiS-lSOO-IO
fonns, in whole or in part, for the full term of copyright and all renewals thereof in
accordance with this instrument.
No original text or graphics produced and submitted by the U.S. Forest Service shall
be copyrighted. The U.S. Forest Service reserves a royalty-free, nonexclusive, and
irrevocable right to reproduce, publish, or otherwise use, and to authorize others to
use the work for federal goveroment purposes. This right must be transferred to any
sub-agreements or subcontracts.
This provision includes:
. The copyright in any work developed by 4-H Program under this agreement
. Any right of copyright to which 4-H Program purchase(s) ownership with any
federal contributions.
EE. PUBLICATION SALE. 4-H Program may sell any publication developed as a
result of this agreement. The publication may be sold at fair market value, which is
initially defined in this agreement to cover the costs of development, production,
marketing, and distribution. After the costs of development and production have been
recovered, fitir market value is defined in this agreement to cover the costs of
marketing, printing, and distribution only. Fair market value must exclude any in-
kind or federal goveroment contributions from the total costs of the project.
FF. MODIFICA nONS. Modifications within the scope of this instrument 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.
00. COMMENCEMENT/EXPIRA nON DATE. This instrument is executed as of the
date of the last signature and is effective for fIVe (5) years, at which time it will
expire. .
HR. AUTIIORlZED 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 instrument. In
witness whereof, the parties hereto have executed this instrument as of the last date
written below.
DAVID SULLIVAN, Chairman
Jefferson Board of County Commissioners
Date
DALE HOM, Forest Supervisor
U.S. Forest Service, Olympic National Forest
Date
Page 140f15
APPI'6"'Sa as te ferm enly:
~ 4}3'alla
Jefferson Co. Prosecu r's omce
.-
i- ~
1m
USDA, Forest Service
OMB 0596-02171
FS.1500-IO
The authority and format of this instrument have been reviewed and approved for
signature.
1 ,oR '"
{ 4tlt~~~--
COLLEEN BROWER
U.S. Forest Service Grants & Agreements
Specialist
7/28/2010
Date
Burden Statement
According to the Paperwork Reduction Act of 1995. an agency _ not conduct or sponsor, and a person is not required to respond to a
coI1ectino ofinfonnation unless it displays a valid OMB control number, The valid OMB control number for this infonnation collection is 0596-
0217, The time tequired to complete this infunnation collection is estimated III avemge 4 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data naaded, and complating and reviewing the collection of
information.
The U.S, Department of Agriculture (USDA) prohibits _inlIlion in all its programs and activitWs on the basis ofmce, color, national origin,
age, disability, and where applitahle, sex, mari1al-. fiuniIial-. perantal-. religion, sexual nrientation, genatic infunnation, political
beliefl, reprisal. or because 811 or pert of an individual's inccme is derived from any public assis1ance, (Not wI prohibited bases apply to wI
programs,) Persons with disabilities who require 81teroalive meens for communication of program _on (Braille, large print. audiotape,
etc,) should co-. USDA's TARGET Cantor at 202-72().2600 (voil:e and IDD),
To llIe a complaint of disorimination, write USDA, Directcr, Office of Civil Rights. 1400 Indepandence Avenue, SW, Wesbington, DC 20250-
9410 or call1llll free (866) 632-9992 (voice), IDD users can ~ USDA lbrough lcosJ relay or the Federal relay at (800) 877-8339 (IDD) cr
(866) m-8642 (relay voice), USDA is an equal opportunify provider and employer,
Page 15 ofl5
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WORKSHEET FOR
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. costIday x # of days=total, where the total is calculatad automaticaliy.
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 costIday
x # of days, costa 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.
Job Desc' tion Total
KurlAluzas $1,336.00
Marc McHenry $718.00
Jennifer Fujii $1,920.00
Eric Fosse $268.00 4.00 $1,072.00
Susan Graham $272.00 4.00 $1,088.00
.
ITotal SalarleslLabor
$6,134.00 I
ITotal Travel
$260.001
Icurrent Overhead Rate ISubtotal Direct Costs I
7.10% $6,384.00
Total FS Overhead Costs
ITotal
~..;l. ...
Use this worksheet to perform the cost enalysis 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 delated or lines may be hidden, if not applicable. Line items may be
added or deleted as needed. The Standard Calculation sections provide a standardized formule for
daterming 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
oostIday 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/contracl= $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.
""'\{~~~~~~~j~l8rr:-"'
Sfandardicaldutatlon
Job Descri tion
Director/Coordinator
Bookkeeper
1 Crew Chief (Mason County)
2 Crew Chiefs (Jefferson County)
12 Youth Stipends (FaIQ
12 Youth Stipends ~SPrinl1)
INon-standal'd.calll\llatlon
Payroll taxes (crew chiefs) @ 11%
Payroll taxes (youth) @ 11%
ITotal SalarleslLabor I
Total
$12,000.00
$2,000.00
$6,480.00
$13,600.00
$7,200.00
$7,200.00
I
1910
950
$51,340.001
CostIDa # of D s
$300.00 40.00
$160.00 12.50
$120.00 54.00
$400.00 34.00
$600.00 12.00
$600.00 12.00
Standa.rd CalculatlC!!1 .
Travel ense Em I
Fuel for the van @ .50/mlle
(Multiple year/multiple projects)
CoslITri
#ofTri
Total
$5,500.00
$0.00
$0.00
$0.00
$0.00
I
I Non-Stan!lard Clllculatllm
ITotal Travel
$5.500.001
Total
$0.00
$0.00
$0.00
!. -: ~> ,.....
I Non-StandlU'll Calculation.
$0.00
I
ITotaI Equlpmant
$0.001
5tandIU'llCalculatlon,"
Su lIesIMaterials
Misc. supplies (multiple years)
safety equipment, shovels. gloves, raingear
toner, paper
Costlltem
Total
$5.524.00
$0.00
$0.00
$0.00
I
I Non.:.standlU'll Calculatldn
$5.624.001
ITotal SupplleslMaterlals I
n. n ,o..
Standard Calculation, '.
Pa er Meterial
CostlUnlt
Total
I
$0.00
$0.001
I Non.:.standard Calculation
ITotal Prlntlng
. .$1'
StandlU'llCalcufatlon
Item # of Units
Training
Experts In stewardship and watershed Issues
INon.:.standard Calculatlon
CostlUnlt
Total .
$4,000.00
$0.00
$0.00
I
ITotal Other
$4.000.001
I;.," .~~~_It~_WS[f[~~
ITotal
I
$0.00
$0.001
I Current Overhead Rete I Subtotal Direct Costs
$66,364.00
ITotal Coop. Indirect Costs I
t-...... ~...
WORKSHEET FOR
Usa this worksheet to perform the cost analysis that supports the lump sum figures provided in the matrix.
NOTE: This workshaat auto populates the relevant and applicable metrix cells.
Cost element sections may be deleted or lines may be hidden, if not applicable. Une items may be added or
deleted as needed. The Standard Calculation sections provide a standardized formula for datermlng a line item's
cost, e.g. costIday 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 costIday 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 ligures.
~~tI'd'ri!'" ,''"' ' "
W"C-'h1'1i}!!"C';" rt!
''_'__ ____ .,5,,',.>'1- "r)!:',,;_-;Hi
$1,600.00
$1,600.00
$0.00
$0.00
$0.00
(Total Salarlesllabor
$3,200.001
ITotal Travel
I
$O.oot
.
~.. -w t,.
'~
ITotal equipment
$0.001
$1,000.00
100.00
$24,000.00
$1,000.00
$100.00
$0.00
ITotaI SuppllesIMaterlals
$25,100.00 I
ITotal Printing
Item
Challenge Course leadership training
~ii!~ijl. .
ITotal Other
$400.001
lIirr~~
I Current Overhead Rate I Subtotal Direct Costs
$29,200.00
ITotal Coop. Indirect Costs I
ITotal
I
$0.00
$0.001
.
#/~/:<.
,~''-
to,
WORKSHEET FOR
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 sectlons may be deleted or lines may be hidden, if not applicable. Une 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. costIday 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. insteed of salaries being calculated by costIday x # of days, costs
may be calculated simply by a contracted value that Is not dependent on deys worked, such as 1 employee
x $1,200/contrect= $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.
ITotal SalarleslLabor
$0.001
$1,200.00
$1,200.00 I