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U.S. Forest Service OMB 0596-0217
<br />FS-1500-18
<br />Forest Service Agreement #
<br />Subtotal Subtotal Combined
<br />Subtotals
<br /># of
<br />Days $/Day
<br />24.00 $121.20 $2,908.80 $2,908.80
<br />24.00 $137.67 $3,304.10 $3,304.10
<br />34.30 $168.72 $5,787.10 $5,787.10
<br />$0.00 $0.00
<br />82.30 $12,000.00 $0.00 $12,000.00
<br />Vehicle
<br />Mileage
<br />Cost or
<br />Airfare
<br />Cost
<br /># of
<br />Trips
<br />PerDiem
<br />and
<br />Lodging
<br />$0.00 $0.00
<br />$0.00 $0.00
<br />$0.00 0 $0.00 $0.00 $0.00 $0.00
<br />Unit
<br />Cost Quantity
<br />$0.00 $0.00
<br />$0.00 $0.00
<br />$0.00 0 $0.00 $0.00 $0.00
<br />$0.00
<br />$0.00
<br />$0.00 $0.00 $0.00
<br />$12,000.00 $0.00 $12,000.00
<br />Insert
<br />Rate
<br />Here:0.0%$0.00
<br />$12,000.00 $0.00 $12,000.00
<br />$12,000.00
<br /> Burden Statement
<br />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
<br />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
<br />information collection is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
<br />maintaining the data needed, and completing and reviewing the collection of information.
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<br />where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part
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<br />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
<br />(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
<br />equal opportunity provider and employer.
<br />Cooperator
<br />Contribution
<br />FS Non-Cash
<br />Contribution
<br />Line Item Cost Subtotals
<br />COST ELEMENTS and related data
<br />Forestry Aid (Fouts)
<br />Resource Specialists (List all personnel):
<br />GS 4 1001
<br />17-CO-11061700-017 Cooperator Agreement #
<br />Collection Agreement Financial Plan
<br />Cooperator and FS Contributions
<br />PERSONNEL
<br />SUPPLIES
<br />TRAVEL
<br />Subtotal, Personnel:
<br />Subtotal, Travel:
<br />Office Clerk (Dyer)
<br />Explanation of trips:
<br />From Where/To Where/For Whom
<br />TOTAL PROJECT COSTS
<br />OTHER
<br />Describe Other Costs of the Project:
<br />OVERHEAD ASSESSMENT
<br />(if applicable, see FSH 1909.13)
<br />TOTAL DIRECT CHARGES
<br />Subtotal, Other:
<br />Total Party Costs
<br />Name and Type of Supplies:
<br />Subtotal, Supplies:
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