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USDA Forest Service OMB 0596-0217 <br />FS -1500-19 <br />MODIFICATION OF GRANT OR AGREEMENT <br />PAGE OF PAGES1 <br />1 12 <br />1. U.S. FOREST SERVICE GRANT/AGREEMENT NUMBER: <br />2. RECIPIENT/COOPERATOR GRANT or <br />3. MODIFICATION NUMBER: <br />19 -LE -11061700-009 (Kittitas County <br />AGREEMENT NUMBER, IF ANY <br />002 <br />Cooperative Law Enforcement <br />4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING <br />5. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING <br />GRANT/AGREEMENT (unit name, street, city, state, and zip + 4): <br />PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4) <br />Okanogan -Wenatchee National Forest <br />Okanogan -Wenatchee National Forest <br />215 Melody Lane <br />215 Melody Lane <br />Wenatchee, WA 98801 <br />Wenatchee, WA 98801 <br />6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, state, and zip + <br />7. RECIPIENT/COOPERATOR'S HHS SUB ACCOUNT NUMBER (For HHS <br />4, county), <br />payment use only): <br />County of Kittitas <br />Sheriff's Office <br />N/A <br />307 W. Umptanum Road <br />Ellensburg, WA 98926 <br />8. PURPOSE OF <br />MODIFICATION <br />CHECK ALL <br />This modification is issued pursuant to the modification provision in the grant/agreement <br />THAT APPLY: <br />referenced in item no. 1, above. <br />❑ <br />CHANGE IN PERFORMANCE PERIOD: <br />® <br />CHANGE IN FUNDING: Add CY21 funding in the amount of $47,960.00. <br />® <br />ADMINISTRATIVE CHANGES: Update ASC email address for invoicing. See Exhibit A — 2021 Annual Operating <br />Plan Section IV.A. Update U.S. Forest Service Grants & Agreements contact. See box 9. <br />OTHER (Specify type of modification): <br />Except as provided herein, all terms and conditions of the Grant/Agreement referenced in 1, above, remain unchanged and in full <br />force and effect. <br />9. ADDITIONAL SPACE FOR DESCRIPTION OF MODIFICATION (add additional pages as needed): <br />This modification is to add the 2021 Annual Operating and Financial Plan and update U.S. Forest Service Grants & Agreements contact <br />from Verellen to Underwood. <br />10. ATTACHED DOCUMENTATION (Check all that apply): <br />Revised Scope of Work <br />Exhibit A: 2021 Annual Operating and Financial Plan <br />® Other: Exhibit B: 2021 Specialized Equipment and Rates <br />11. SIGNATURES <br />AUTHORIZED REPRESENTATIVE: BY SIGNATURE BELOW, THE SIGNING PARTIES CERTIFY THAT THEY ARE THE OFFICIAL REPRESENTATIVES OF <br />THEIR RESPECTIVE PARTIES AND AUTHORIZED TO ACT IN THEIR RESPECTIVE AREAS FOR MATTERS RELATED TO THE ABOVE -REFERENCED <br />GRANT/AGREEMENT. <br />11. A. KITTITAS COUNTY SIGNATURE <br />1 I B. DATE <br />11. C. U.S. FOREST SERVICE SIGNATURE <br />11. D. DATE <br />SIGNED <br />SIGNED <br />(Signature of Signatory Official <br />(Signature of Signatory Official <br />11. E. NAME (type or print): <br />11. F. NAME (type or print), <br />CLAY MYERS <br />KRISTIN M. BAIL <br />11. G. TITLE (type or print): <br />11. H. TITLE (type or print): <br />Sheriff, Kittitas County <br />Forest Supervisor, Okanogan -Wenatchee National Forest <br />