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USDA Forest Service OMB 0596-0217 <br />FS -1500-19 <br />The invoice shall be forwarded to: <br />EMAIL: SM.FS. ea(i�usda.gov <br />FAX: 877-687-4894 <br />POSTAL: USDA Forest Service <br />Albuquerque Service Center <br />Payments — Grants & Agreements <br />10113 Sun Ave NE <br />Albuquerque, NM 87109 <br />Send a copy to: <br />Shirley Tutino <br />Okanogan -Wenatchee National Forest <br />215 Melody Lane <br />Wenatchee, WA 98801 <br />shirley.tutino cr,usda.eov <br />* $47,960.00 reflects the $39,552.60 added in Modification 4 and $8,407.40 added in Modification 3 to fund Calendar Year 2022 <br />10. ATTACHED DOCUMENTATION (Check all that apply): <br />❑ Revised Scope of Work <br />❑ Revised Financial Plan <br />❑ Other: 2022 Annual Operating and Financial Plan <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 />GRANVAGREEMENT. <br />11. A KITTITAS COUNTY SIGNATURE <br />I l B. DATE <br />11. C. U.S. FOREST SERVICE SIGNATURE <br />1 I, 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 />11, L U.S FOREST SERVICE SIGNATURE <br />11. J. DATE <br />Digitally signed by <br />SIGNED <br />ALEXANDER LOMVARDIAS <br />Date: 2022.04.04 09:59:12 <br />-07'00' <br />(Signature of Signatory Official) <br />11. K. NAME (type or print): ALEX LOWARDIAS <br />11. P. TITLE (type or print): Special Agent in Charge <br />