Mod 004 - Laserfiche WebLink

Home Browse Search

~ ~ USD,-\ Forest Sc:rvice OMB 0596-0217 FS -1500-19 I P,-\GE OF PAGES MODIFICATION OF GRANT OR AGREEMENT I 1 I 3 I. u.s. FOREST SER\/[CE GRANT 'AGREEMENT NUMBER! 2. REC IPIENT.·C OOPERATOR GRANTor 3. tv lODlFIC A nON NU MBER: 14-LE-I1061720-011 (Kittitas County AGREEMENT NUMBER. IF ANY: 004 Cooperative Law Enforcement) 4. NA..tvlE,'AODR ESS OF U S. FORES T SERVICE UNIT ADMINISTERIN G 5 NAlvIE/ADDR ESS OF U.S. FORE ST SERVICE UN IT AD M IN IS TERfNG GRANT/AGR EE MENT (unit name, street, city, state, and zip + 4): PROJ ECT/ACTIVITY (unit name, street, city, state , and zip + 4): Amy Verellen Laurence Olson, Patrol Captain Okanogan-Wenatchee National Forest Okanogan-Wenatchee National Forest 215 Melody Lane 215 Melody Lane Wenatchee, WA 98801 Wenatchee, WA 98801 Telephone: (509) 664-9231 Telephone: (509) 664-9236 FAX: (509) 664-9281 FAX: (509) 664-9283 EMAIL: 8ve re ll cnut fs.h:d.us EMAIL : iwo ison (ct1fs.feci.us 6. NAME /ADDRESS OF RECIPIEN T/C OOPERATOR (street. city, state, and zip + 7. RE C IPI ENT/COOPERATOR'S HHS SUB ACCOUNT NUMB ER (F or HHS 4, county): payment use only): Kittitas County Sheriff's Office N /A 307 W. Umptanum Road Ellensburg, W A 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. 1j above. D CHANGE IN PERFORMANCE PERIOD: C8J CHANGE IN FUNDING: Add CY funding in the amount of$47,960.00 C8J ADMINISTRATIVE CHANGES: Update contacts from Michael Kujala to Laurence Olson (block 5) C8J 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): This modification is to add the 2018 Annual Operating and Financial Plan with attached marine rates and update contacts . The following provisions are updated to reflect this modification: A. PA YMENTIREIMBURSEMENT. The U.S. Forest Service shall reimburse the Cooperator for the U.S. Forest Service's share of actual expenses incurred, not to exceed $47,960.00, as shown in the Financial Plan for this modification. The U.S. Forest Service shall make payment upon receipt of the Cooperator's monthly invoice. Each invoice from the Cooperator shall display the total project costs for the billing period, separated by U.S. Forest Service and the Cooperator's 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 the Cooperator'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. Cooperator'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, separated by the U .S . Forest Service and Cooperator share with in-kind contributions displayed as a separate line item. 6 . Display all costs, both cumulative and for the billing period, by separate cost element as shown on the financial plan. 7, Cumulative amount of the U .S. Forest Service payments to date. 8. Statement that the invoice is a request for payment by 'reimburs ement'.