SH16-002 USFS Agreement - Laserfiche WebLink

Home Browse Search

USD.A Forest Service OMB 0596-0217 FS -1500-19 I PAGE OF PAGES MODIFICATION OF GRANT OR AGREEMENT 1 1 9 1. U.S. FOREST SERVICE GRANT'AGREEMENT NUMBER: 2. RECIPtENT./COOPERATOR GRANT or 3. MODIFICATION NUMBER: 14 -LE -11061720-01 1 (Kittitas Law Enforcement) AGREEMENT NUMBER, IF ANY: 002 4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADIWINISTERING 5. NA!vIE/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING GRANT/AGREEMENT (unit name, street, city, state, and zip + 4): PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4): De Ette Stofleth Robert Moelder, Patrol Captain Okanogan -Wenatchee National Forest Okanogan -Wenatchee National Forest 215 Melody Lane 215 Melody Lane Wenatchee, WA 98801 Wenatchee, WA 98801 6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip + 7. RECIPIENT/COOPERATOR'S HHS SUB ACCOUNT NUMBER (For HHS 4, county): payment use only): Kittitas County Sheriff's Office 307 W. Umptanurn Road N/A Ellensburg, WA 98926 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. 1, above. El CHANGE IN PERFORMANCE PERIOD: ®' CHANGE IN FUNDING: Add CY funding in the amount of $47,960.00 , 0 ADMINISTRATIVE CHANGES: ® OTHER (Specify type of modification): See item no. 9, below. 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 following provisions are updated to reflect this modification: 1) PAYMENT/REIMBURSEMENT . The U.S. Forest Service shall reimburse Kittitas County Sheriff's Office for the U.S. Forest Service's share of actual expenses incurred, not to exceed $47,960.00, as shown in the Financial Plan. The U.S. Forest Service shall make payment upon receipt of Kittitas County Sheriff's Office's monthly invoice. Each invoice from Kittitas County Sheriffs Offic shall display the total project costs for the billing period, separated by U.S. Forest Service and Kittitas County Sheriff's Offic share. In-kind contributions must be displayed as a separate line item and must not be included in the total project costs available for reimbursement. The final invoice must display Kittitas County Sheriff's Office'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. Kittitas County Sheriff's Offices'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. If using 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_ga@fs.fed.us FAX: 877-687-4894 POSTAL: USDA Forest Service Albuoueraue Service Center