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U.S. Department of AQrlculbn <br />Natural Resources Conservation Senllce <br />NRCS-CPA-41 <br />12/2018 <br />ENTITY APPLICATION for an AGRICULTURAL LAND EASEMENT (ALE) AGREEMENT <br />I Cl ear Form <br />Thia II an Entity Application for an Aa,lcultunal Land Eaaelllllllt (ALE) AgrMIMllt throuth the: (Select OIE} <br />D Aglfcultunal Conurvatton Enement Program -Agricultural Land EMement (ACEP-ALE) <br />IZ) Raglonal Conservatton Partne111hlp Program (RCPP) -ACEP-ALE <br />Entity Name: NEST Appllcatlon Number: <br />Forterre NW AGENCY USE <br />Entity Add ,_..: <br />Forterra NW <br />AppllallOn Date: <br />Entity Type: • State Govemnant <br />D Local GcMrnment <br />0 lndlan Tribe <br />EnlltyEmalt IZI Non-gal,wnmental Organtzallon ~ <br />adraper@forterra .org <br />En:.r:TlN Application Total AcNIII: <br />~4-3 12461 273.6 <br />T11lerone~ stat.: <br />(206 905-6956 WA <br />Land lllglbUlly Category for Ag ,_,.lllt (a.i.c:t Onti'): <br />D Hu prime, unique, or olhet proclucllve 1011 <br />D Contains Nstorlcal or archaeological resourcas I' <br />IZI Protecta grazing uses and rellflld c:onaervatlon values <br />D Furthara a state or looal government pollcy oon1lstant wlh Iha purposes of ACEP. Clla the state or local gowamment poBcy conalltent <br />wtth ACEP : <br />la thla a n appllcallon for • Gru•land of 8,-c:lal EnYlronmantal 81gnlflcllna (GSB) ALE AglNment: 0 Y• @No <br />This Is an Entity Appllcatlon for an ALE Agnteme11t, as establlahed by the Agrlcultural Act of 2014. <br />By signing and submitting this appllcatlon, you agree to comply with the requirement& of ACEP-ALE. <br />1. @ Y• [)o Do you have entity records Ntabllshad with Ille appropriate USDA service <br />center agency? · <br />If no, }'OCI must establish them with the appropriate USDA service center agency prior to submitting this <br />appllcstion. <br />2. A Dun & Bradetreet Data Unlven,1I Numbering Sys tem (DUNS) number and currant registration <br />In the System for Award Manag ement (SAM) Is required for recehrlng payment under an EIN. <br />If yau do not have 8 DUNS number Information is available at <br />hlfp:llfsdgov. dnb. comAvebfonn To register with SAM, go to hltDs:ltwww.sam.gov/ <br />DUNS Number: pooo2oe16 I <br />3. (21 Y• D No Do you have the authority and capablllty to acquire, manage. and enforce <br />agricultural land easements? <br />4. How many entity staff ant dedicated to monitoring and e•ament stewardshlp?p._ ______ _ <br />6 0 Ya @ No Are you an NRCS Certified Entity~? <br />6. 0 Y D No Are all parce P anoclamd with thfa appllcaQon subject to a written pending <br />offe,vi signed by the &llglblo ntlty for pwchu of an a gricultural land eaa&mentfll1 l)y an ellglble <br />entltf? <br />PAGE 1 of5