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USDA Forest Service OMB 0596-0217 <br />FS -1500-19 <br />MODIFICATION OF GRANT OR AGREEMENT <br />1 U.S. FOREST SERVICE GRANT/AGREEMENT 2. RECIPIEN <br />NUMBER: AGREEMEN <br />16 -CO -11061700-100 (Cie Elum <br />District Visitor_ Services) <br />4. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING <br />GRANT/AGREEMENT (unit name, street, city, stale, and zip + 4): <br />DeEtte Stofleth, Grants Management Specialist <br />Okanogan -Wenatchee National Forest <br />215 Melody Lane <br />Wenatchee, WA 98801 <br />Phone: 509-664-9315 <br />Email: dInstolli thfrt, ls, Ced. tls <br />6. NAME/ADDRESS OF RECIPIENT/COOPERATOR (street, city, stale, and <br />zip + 4, county): <br />Kittitas County <br />205 W 5th Ave, Suite 108 <br />Ellensbura, WA 98926 <br />T/COOPERATOR GRANT or <br />T NUMBER, IF ANY: <br />PAGE OF <br />PAGES <br />1 2 <br />3. MODIFICATION NUMBER: <br />1 <br />5. NAME/ADDRESS OF U.S. FOREST SERVICE UNIT ADMINISTERING <br />PROJECT/ACTIVITY (unit name, street, city, state, and zip + 4): <br />Barry Collins <br />Cie Elum Ranger District <br />803 W. 2nd Street <br />Cie Elum, WA 98922 <br />Phone: 509-852-1070 <br />Email: bcol1inserr'f's.1' d.us <br />7. RECIPIENT/COOPERATOR'S HITS SUB ACCOUNT NUMBER (For <br />HHS payment use only): <br />N/A <br />8. PURPOSE OF MODIFICATION <br />CHECK ALL <br />THAT APPLY: <br />This modification is issued pursuant to the modification provision in the grant/agreement <br />referenced in item no. 1, above. <br />® <br />CHANGE 1N PERFORMANCE PERIOD: Extending the expiration date from 07/04/2017 to 10/31/2017 <br />❑ <br />CHANGE 1N FUNDING: <br />❑ <br />ADMINISTRATIVE CHANGES: <br />❑ <br />OTHER (Specify type of modification): <br />Except as provided herein, all terms and conditions of the Grant/Agreement referenced in I, above, remain unchanged and in full force <br />and effect. <br />9. ADDITIONAL SPACE FOR DESCRIPTION OF MODIFICATION (add additional pages as needed): <br />Modification #1 is to extend the expiration date to continue visitor services. <br />10. ATTACHED DOCUMENTATION (Check all that apply): <br />Revised Scope of Work <br />Revised Financial Plan <br />Other: <br />11. SIGNATURES <br />AUTHORIZED REPRESENTATIVE: BY SIGNATURE BELOW, THE SIGNING PARTIES CERTIFY TI4AT THEY ARE THE OFFICIAL <br />REPRESENTATIVES OF THEIR RESPECTIVE PARTIES AND AUTHORIZED TO ACT IN THEIR RESPECTIVE AREAS FOR MATTERS RELATED <br />TO <br />THE ABOVE -REFERENCED GRANT/AGREEMENT. <br />11. A. KITTITAS COUNTY. SIGNATURE <br />1 I. B. DATE <br />I l.C_ i1.S. I REST SERVICE=SIC= A+TURE <br />I I.D. <br />SIGNED <br />AI <br />DATE <br />SIGNED <br />"A// 6 <br />(Signature Signatory Official) <br />ignatory Official) <br />of <br />(Signature <br />I I.E. NAME (type or print): t <br />I I.F. NAME (type or print): <br />OBIE O'BRIEN �`� <br />MICHAEL R. WILLIAMS <br />1 I .G. TITLE (type or print): <br />I I.H. TITLE (type or print): <br />Chairman of the Board, Kittitas County Commissioners <br />Okanogan- Wen atch ee National Forest, Forest Supervisor <br />