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HomeMy WebLinkAboutWashington State Department of Agriculture Contract Number: K2827 MC Contract#19-069 INTERAGENCY AGREEMENT BETWEEN WASHINGTON STATE DEPARTMENT OF AGRICULTURE AND MASON COUNTY AND ITS AGENT MASON COUNTY NOXIOUS WEED CONTROL BOARD THIS AGREEMENT is made and entered into by and between the Washington State Department of Agriculture (WSDA) and Mason County and its agent, Mason County Noxious Weed Control Board. IT IS THE PURPOSE OF THIS AGREEMENT to provide Mason County and its agent, Mason County Noxious Weed Control Board, funding for a project to control invasive knotweed species within the riparian corridors of Mason County. THEREFORE, IT IS MUTUALLY AGREED THAT: STATEMENT OF WORK Mason County through its agent, Mason County Noxious Weed Control Board, shall furnish the necessary personnel, equipment, material and/or service(s) and otherwise do all things necessary for or incidental to the performance of the work set forth in Attachment "A"which is attached hereto and incorporated herein. PERIOD OF PERFORMANCE Regardless of the date of signature and subject to its other provisions, this Agreement shall begin on July 1, 2019 and end on June 30, 2021, unless terminated sooner or extended by WSDA as provided herein through a properly executed amendment. PAYMENT Compensation for the work provided in accordance with this Agreement has been established under the terms of RCW 39.34.130. The parties have determined that the cost of accomplishing the work herein will not exceed $15,000.00. Only reasonable costs identified in Attachment "A", incurred directly related to the Mason County Knotweed Control and Eradication Program,will be reimbursed to Mason County under this Agreement. Payment for satisfactory performance of the work shall not exceed this amount unless the parties mutually agree in writing to a higher amount prior to the commencement of any work that will cause the maximum payment to be exceeded. Compensation for service(s)shall be as set forth in accordance with the budget in Attachment"B"which is attached hereto and incorporated herein. Projects in riparian habitats will begin at the farthest upstream infestation and continue downstream. This funding may not be used downstream of a landowner that has not given written permission for entry and treatment(Attachment C). Any deviation requires prior written permission from WSDA. BILLING PROCEDURE Mason County shall submit properly completed invoices quarterly to the WSDA Agreement administrator. Reference WSDA Contract Number K2827 on all invoices. Pa ment to Mason [j t3 eGEN lif D oi I 6 1019 Page 1 of6 Contract Number: K2827 County for approved and completed work will be made by warrant or account transfer by WSDA within 30 days of receipt of the properly completed invoice. If Contractor does not have an invoice template to request payment, Contractor can request a copy of a Certified State Invoice Voucher(Form A-19) from WSDA. Upon expiration of the Agreement, any claim for payment not already made shall be submitted within 30 days after the expiration date or the end of the fiscal year, whichever is earlier. In no case can this be more than 10 days past the end of the biennium. DUPLICATION OF BILLED COSTS The Contractor shall not bill the Agency for services performed under this contract, and the Agency shall not pay the Contractor, if the Contractor has been or will be paid by any other source, including grants, for that service. FUNDING CONTINGENCY In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way after the effective date of this Agreement and prior to completion of the work in this Agreement, the Agency may: a. Terminate this Agreement with 10 days advance notice. If this Agreement is terminated, the parties shall be liable only for performance rendered or costs incurred in accordance with the terms of this Agreement prior to the effective date of termination. b. Renegotiate the terms of the Agreement under those new funding limitations and conditions. c. After a review of project expenditures and deliverable status, extend the end date of this Agreement and postpone deliverables or portions of deliverables. Or, d. Pursue such other alternative as the parties mutually agree to writing. RECORDS MAINTENANCE The parties to this Agreement shall each maintain books, records, documents and other evidence that sufficiently and properly reflect all direct and indirect costs expended by either party in the performance of the services described herein. Documents must also support performance and costs of any nature expended in the performance of this Agreement. These records shall be subject to inspection, review or audit by personnel of both parties, other personnel duly authorized by either party, the Office of the State Auditor, and federal officials so authorized by law. All books, records, documents and other material relevant to this Agreement will be retained for six years after expiration of the Agreement and the Office of the State Auditor, federal auditors and any persons duly authorized by the parties shall have full access and the right to examine any of these materials during this period. If any litigation, claim or audit is started before the expiration of the six(6)year period, the records shall be retained until all litigation, claims, or audit findings involving the records have been resolved. Records and other documents, in any medium, furnished by one party to this Agreement to the other party,will remain the property of the furnishing party, unless otherwise agreed. The receiving party will not disclose or make available this material to any third parties without first giving notice to the furnishing party and giving it a reasonable opportunity to respond, consistent Page 2 of 6 Contract Number: K2827 with applicable laws. Each party will utilize reasonable security procedures and protections to assure that records and documents provided by the other party are not erroneously disclosed to third parties. RIGHTS IN DATA Unless otherwise provided, data that originates from this Agreement shall be"works for hire" as defined by the U.S. Copyright Act of 1976 and shall be owned by WSDA. Data shall include, but not be limited to, reports, documents, pamphlets, advertisements, books, magazines, surveys, studies, computer programs, films, tapes and/or sound reproductions. Ownership includes the right to copyright, patent, register, and the ability to transfer these rights. INDEPENDENT CAPACITY The employees or agents of each party who are engaged in the performance of this Agreement shall continue to be employees or agents of that party and shall not be considered for any purpose to be employees or agents of the other party. AGREEMENT ALTERATIONS AND AMENDMENTS This Agreement may be amended by mutual agreement of the parties. Such amendments shall not be binding unless they are in writing and signed by personnel authorized to bind each of the parties. SUBCONTRACTING "Subcontractor" means one not in the employment of a party to this Agreement, who is performing all or part of those services under this Agreement under a separate contract with a party to this Agreement. The terms"subcontractor" and "subcontractors" mean subcontractor(s) in any tier. Except as otherwise provided in the Agreement, the Contractor shall not subcontract any of the contracted services without the prior approval of the Agency. The Contractor is responsible to ensure that all terms, conditions, assurances and certifications set forth in this Agreement are included in any and all Subcontracts. Any failure of Contractor or its Subcontractors to perform the obligations of this Agreement shall not discharge Contractor from its obligations under this Agreement. TERMINATION FOR CONVENIENCE Either party may terminate this Agreement upon 30 days' prior written notification to the other party. If this Agreement is so terminated, the parties shall be liable only for performance rendered or costs incurred in accordance with the terms of the Agreement prior to the effective date of termination. TERMINATION FOR CAUSE If for any cause, either party does not fulfill in a timely and proper manner its obligations under this Agreement, or if either party violates any of these terms and conditions, the aggrieved party will give the other party written notice of such failure or violation. The responsible party will be given the opportunity to correct the violation or failure within 15 working days of receipt of written notice. If the failure or violation is not corrected, this Agreement may be terminated immediately upon receipt of written notice of the aggrieved party to the other. CONFLICT OF INTEREST WSDA may, by written notice to Mason County, terminate this Agreement if it is found after due notice and examination by the Director of the Department of Agriculture, and/or the designee Page 3 of 6 Contract Number: K2827 authorized in writing to act on the Director's behalf, that there is a violation of the State Ethics Law, chapter 42.52 RCW; chapter 42.23 RCW; or any similar statute involving Mason County in the procurement of or performance under this Agreement. Unless stated otherwise, the signatory of this Agreement is the Director's designee. In the event this Agreement is terminated as provided above, WSDA shall be entitled to pursue the same remedies against Mason County and its agent, Mason County Noxious Weed Control Board, as it could pursue in the event of a breach of the Agreement by Mason County or its agent, Mason County Noxious Weed Control Board. The rights and remedies of WSDA provided for in this clause shall not be exclusive and are in addition to any other rights and remedies provided by law. The existence of facts upon which the Director of the Department of Agriculture, and/or the designee authorized in writing to act on the Director's behalf, makes any determination under this clause shall be an issue and may be reviewed as provided in the "Disputes"clause of this Agreement. DISPUTES In the event that a dispute arises under this Agreement, it shall be determined by a Dispute Board in the following manner: Each party to this Agreement shall appoint one member to the Dispute Board. The members so appointed shall jointly appoint an additional member to the Dispute Board. The Dispute Board shall review the facts, agreement terms and applicable statutes and rules and make a determination of the dispute. The determination of the Dispute Board shall be final and binding on the parties hereto. GOVERNING LAW AND VENUE This Agreement shall be construed and interpreted in accordance with the laws of the state of Washington and the venue of any action brought under this Agreement shall be in Superior Court for Thurston County. ASSURANCES The parties agree that all activity pursuant to this Agreement shall be in accordance with all applicable federal, state and local laws, rules, and regulations as they currently exist or as amended. LICENSING, BONDING, INDUSTRIAL INSURANCE AND OTHER INSURANCE COVERAGE Mason County and its agent, Mason County Noxious Weed Control Board, shall ensure that all contractors hired to perform services under this Agreement shall comply with all applicable licensing and bonding requirements for the type of service to be performed, and with the provisions of Title 51, Industrial Insurance. Mason County and its agent, Mason County Noxious Weed Control Board, shall also ensure that all contractors provide proof of an adequate amount of commercial general liability insurance coverage for the activities to be performed under any subcontract. ORDER OF PRECEDENCE In the event of an inconsistency in the terms of this Agreement, or between its terms and any applicable statute or rule, the inconsistency shall be resolved by giving precedence in the following order: a. Applicable state and federal statutes and rules; b. Terms and conditions contained within this Contract; c. Plan of Work (Attachment A); d. Budget (Attachment B); Page 4 of 6 Contract Number: K2827 e. Permission to Enter Private Land and Waiver of Liability(Attachment C); and f. Any other provisions of the Agreement, including material incorporated by reference. ASSIGNMENT Mason County and its agent, Mason County Noxious Weed Control Board, are responsible for ensuring that all terms, conditions, assurances and certifications set forth in this Agreement are carried forward to any subcontracts. In no event shall the existence of any subcontract operate to release or reduce the liability of Mason County and its agent, Mason County Noxious Weed Control Board,to WSDA for any breach in the performance of Mason County and its agent Mason County Noxious Weed Control Board's duties. WAIVER A failure by either party to exercise its rights under this Agreement shall not preclude that party from subsequent exercise of such rights and shall not constitute a waiver of any other rights under this Agreement. Waiver of any default or breach shall not be deemed to be a waiver of any subsequent default or breach. Any waiver shall not be construed to be a modification of the terms of this Agreement unless stated to be such in writing signed by an authorized representative of the party and attached to the original Agreement. SEVERABILITY If any term or condition of this Agreement is held invalid, such invalidity shall not affect the validity of the other terms or conditions of this Agreement. ALL WRITINGS CONTAINED HEREIN This Agreement contains all the terms and conditions agreed upon by the parties. No other understandings, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties hereto. Page 5 of 6 Contract Number: K2827 CONTRACT MANAGEMENT The Agreement administrator for each of the parties shall be responsible for and shall be the contact person for all communications and billings regarding the performance of this Agreement. The Agreement administrator for WSDA is: Jonathan Still, Knotweed Coordinator Washington State Dept. of Agriculture Plant Protection Division PO Box 42560 Olympia, Washington 98504-2560 (360) 280-6363 jstill@agr.wa.gov The Agreement administrator for Mason County is: Patricia Grover, Coordinator Mason County Noxious Weed Control Board 303 N. 4th Street Shelton, Washington 98584 (360)427-9670 ext. 592 Fax: (360)427-7264 patriciaq( co.mason.wa.us All communications between the parties relating to this Agreement and any billings and payments will be directed to those persons. Either party may change administrators by notifying the other in writing. IN WITNESS WHEREOF, the parties have executed this Agreement. STATE OF ASHINGTON MASON COUNTY DEPT. OF A RICU,LT RE By:`'_ >c.--L By: Title: .. t,. Title: al ll�i 1�' a/a,Snu ,�tvhnfy mr�;S,ti; neki J Date: Date: t,trte5'i- (cl .)Ul Page 6 of 6 Contract Number: K2827 ATTACHMENT A Plan of Work Mason County and its agent Mason County Noxious Weed Control Board Project for Knotweed Control July 1, 2019 to June 30, 2021 County Knotweed Control Criteria: Mason County through its agent, Mason County Noxious Weed Control Board, will conduct control work on knotweed infestations located within the riparian corridors of Mason County. The control of any knotweed species not located in a riparian corridor requires written permission from the WSDA knotweed coordinator prior to any treatments or work completed. Treatment of these areas will utilize funding allotted by the state legislature for control of knotweed species during the 2020-2021 state fiscal biennium. Control shall include field survey directly associated with areas to be treated. Minimum work specifications: workers will be hired or contracted to treat knotweed infestations known or discovered in the area identified above. Mason County knotweed control employees or contractors will use an integrated weed management approach, in conjunction with the best management practice for the control of invasive knotweed species. Projects in riparian habitats will begin at the farthest upstream infestation and continue downstream. This funding may not be used downstream of a landowner that has not given written permission for entry and treatment (Attachment C). Funding stops where permission stops. All control methods will be employed consistent with the laws, rules and regulations of Washington State, Mason County, the Noxious Emergent Plant Management Environmental Impact Statement(EIS) first published in November 1993, and all subsequent amendments to the EIS. Mason County, or subcontractors to Mason County, must enter into a contract with WSDA under which Mason County, or subcontractors to Mason County, act as limited agents to carry out noxious and quarantine weed control for WSDA under the"Aquatic Noxious Weed Control National Pollutant Discharge Elimination System Waste Discharge General Permit" (NPDES permit) prior to the performance of any activity pursuant to this Agreement that discharges herbicides directly into streams or rivers, or indirectly into streams, rivers, estuaries, wetlands, along lake shorelines, or in other wet areas. Herbicide treatments may only occur at times allowed under provisions of the NPDES permit and must comply with conditions specified in such permit. The crew will work closely with the county noxious weed coordinator and the WSDA Knotweed Control Coordinator, and be active in the field from July 1, 2019 to June 30, 2021, as allowed by the variable growth season of knotweed and any required preparation or conclusion times. Work will only take place on property for which the Mason County Noxious Weed Control Board has obtained prior written permission for entry and treatment, utilizing the permission form provided by WSDA (Attachment C)or any applicable permission form approved by WSDA, from the landowner or tenant. Mason County Noxious Weed Control Board will also provide access to these properties for the WSDA Knotweed Control Coordinator. Changes made to any permission form must be approved by WSDA prior to the performance of any work on that property undertaken under terms of this Agreement. Page 1 of 2 Contract Number: K2827 Work Crew and Work Hours: The knotweed control crew will work or be under contract with the county noxious weed control board during the specified period, dedicating their time to controlling knotweed in the project area. The control crew will have one crew leader who will be responsible for coordinating the crew's work, and who will maintain ongoing contact with the county noxious weed coordinator and the WSDA Knotweed Control Coordinator. Equipment: The knotweed control crew will use all available tools for control, including manual controls and herbicide applications, to control knotweed infestations in Mason County. The control crew may use equipment provided by other agencies, provided the county noxious weed coordinator and the WSDA Knotweed Control Coordinator agree to the usage of the equipment and materials. Program Needs Provided by WSDA: WSDA may furnish the knotweed control crew with herbicide, public information fliers, public notification signs, and other equipment as the WSDA Knotweed Control Coordinator deems necessary. All unexpended items remain the property of WSDA. Expenditures: The funds provided for the county knotweed control crew will primarily go towards salaries and benefits, travel, supplies and equipment expenses for the crewmembers. All supplies furnished by WSDA will be used in Washington State and under the supervision of county personnel. An inventory list will be furnished to WSDA upon request. Items such as computer programs, models, food and beverage, or other costs not specified in this document will not be reimbursed unless the expenditure is specifically authorized in advance in writing by WSDA. Coordination: The Mason County Knotweed Control Program will be coordinated with state, local and private control efforts. Deliverables: The county noxious weed coordinator will submit a written report to the WSDA Agreement administrator, documenting the work conducted in Mason County, as follows: A season ending report is due December 1, 2019 and December 1, 2020, which will include the following: date(s) of control activities, map of project area(s), the type of control conducted, difficulties encountered, solid acres of knotweed treated, acres of knotweed protected, number of river miles worked, number of landowners assisted, and photo documentation of selected sites, including before and after treatment photos. The county noxious weed coordinator will supply WSDA with all geographic information system data that is generated as a result of this Agreement. Final payment under this Agreement will not be made until the season ending report is accepted by WSDA. These deliverables are separate from and in addition to any reporting requirements associated with limited agent status under WSDA's Aquatic Noxious Weed Control NPDES General Permit coverage. Page 2 of 2 Contract Number: K2827 ATTACHMENT B Budget Mason County and its agent Mason County Noxious Weed Control Board Knotweed Control Project July 1, 2019 to June 30, 2021 Total payment to Mason County and its agent Mason County Noxious Weed Control Board will not exceed $15,000.00 in fiscal biennium 2019 (i.e., July 1, 2019 through June 30, 2021). 1. Salaries and benefits $12,800.00 2. Supplies, equipment, and travel $1,560.00 3. Indirect(can not exceed 5% of salaries and benefits) $640.00 TOTAL: $15,000.00 Reimbursement for travel expenditures shall not exceed allowable costs as set forth in Washington State travel regulations, contained in the Office of Financial Management State Administrative and Accounting Manual, Chapter 10, Section 90. Page 1 of 1 Contract Number: K2827 ATTACHMENT C Permission to Enter Private Land and Waiver of Liability Mason County and its agent Mason County Noxious Weed Control Board Project for Knotweed Control PERMISSION TO ENTER PRIVATE LAND AND WAIVER OF LIABILITY THIS AGREEMENT INCLUDES PERMISSION TO ENTER PRIVATE PROPERTY AND A WAIVER OF CERTAIN CLAIMS OF LIABILITY. READ CAREFULLY BEFORE SIGNING. This Permission to Enter Private Land and Waiver of Liability is made between the Mason County Noxious Weed Control Board, hereafter referred to as "the Board," and hereafter referred to individually or collectively as,"the property owner(s)." INTRODUCTION 1. The control and eradication of noxious weeds on public and private lands is in the public interest and the presence of invasive knotweeds(Polygonum spp.)on private lands threatens wildlife habitat and provides a source for renewed infestation of other private and public lands. Effective eradication of knotweeds requires concerted effort on both public and private lands to protect our natural resources. 2. The Board and its agents desire to perform activities to eradicate and/or control knotweed on public and private lands within Mason County. These activities are authorized and carried out under one or more of the following chapters: 17.04 RCW, 17.06 RCW, 17.10 RCW,and 17.24 RCW. 3. The property owner(s)is/are the sole owner of property located at in Mason County,Washington,hereafter referred to as"the property." 4. The property owner(s)is/are interested in and benefited by the eradication and/or control of knotweed on the property. 5. The property owner(s) and the Board desire to memorialize an agreement for the purpose of eradication and/or control of knotweed on the property. AGREEMENT 1. Permission. In consideration of the benefits described above,the property owner(s) grant permission to the Board and its agents, contractors, cooperators and employees to enter onto the property from July 1, 2019 to December 31, 2023 to perform activities to eradicate and/or control knotweed on the property. The property owner(s) acknowledge and agree that these activities may include the application of herbicide to the property. The property owner(s) also grant permission to agents, contractors, cooperators and employees of the Washington State University and/or the Washington State Department of Agriculture to enter onto the property from July 1, 2019 to December 31, 2023 for the purpose of monitoring and evaluating the success of knotweed eradication and/or control activities. 2. Expiration and Revocation. The Board and its agents, contractors, cooperators and employees are permitted to enter the property on all of the above dates and until December 31, 2023, or until this permission is revoked, whichever occurs first. The property owner(s) may revoke this permission by Contract Number: K2827 presenting a written letter of revocation to the Board. The revocation is effective five (5) business days after receipt by the Board. 3. Liability Waiver. The purpose of entry onto the property is to perform activities to eradicate and/or control knotweed. The property owner(s)expressly agree to hold harmless the Board,the Washington Department of Agriculture(WSDA), and the agents,contractors, cooperators and employees of the Board,or WSDA,and to waive any claim of liability against the Board, WSDA, and the agents, contractors, cooperators and employees of the Board, or WSDA, for any injury, damage, or harm which is the logical and intended consequence of activities properly performed to eradicate and/or control knotweed. The Board and its agents,contractors,cooperators and employees agree to waive any claim of liability against the landowner for any injury, damage, or harm which is not the consequence of the landowner's negligence. As to any other act or omission of either party under this agreement, each party shall be responsible for its own acts or omissions and those of its officers, employees and agents under this agreement. No party to this agreement shall be responsible to the other for the acts or omissions of entities or individuals not a party to this agreement. 4. Entire Agreement. This Permission to Enter Private Land and Waiver of Liability contains the entire agreement between the parties with regard to the matters set forth herein. 5. Applicable Law. This Permission to Enter Private Land and Waiver of Liability shall be construed and interpreted according to the laws of the State of Washington. BY THE SIGNATURE BELOW, THE PROPERTY OWNER(S) DECLARE THAT THE TERMS OF THIS PERMISSION TO ENTER PRIVATE LAND AND WAIVER OF LIABILITY HAVE BEEN COMPLETELY READ AND FULLY UNDERSTOOD AND VOLUNTARILY ACCEP IED AND EXPRESSLY WAIVE ANY CLAIM THAT THIS PERMISSION TO ENTER PRIVATE LAND AND WAIVER OF LIABILITY IS NOT FAIRLY AND KNOWINGLY MADE. Property Owner(s)/Legal Representative: Property Owner(s)Mailing Address: Street City County Zip Telephone Number(s): (PRINT)Name of property owner Signature of property owner Date (PRINT)Name of property owner Signature of property owner Date (PRINT)Name of property owner Signature of property owner Date (PRINT)Name of authorized representative, Signature of authorized representative, Date Mason County Noxious Weed Control Board Mason County Noxious Weed Control Board Contact information for the Mason County Noxious Weed Control Board: Patricia Grover,(360)427-9670 ext.592 303 N.4th Street Shelton,WA 98584 toUSDA Forest Service OMB 0596-0217 FS-1500-19 MC Contract 19-084 MODIFICATION OF GRANT OR AGREEMENT PAGE OF P CiES 3 1 3 I.U.S.FOREST SERVICE GRANT/AGREEMENT NUMBER: 2.RECIPIENT/COOPERATOR GRANT or 3.MODIFICATION NUMBER: 16-PA-11060900-006 AGREEMENT NUMBER,IF ANY: 03 4.NAME/ADDRESS OF U.S.FOREST SERVICE UNIT ADMINISTERING 5.NAME/ADDRESS OF U.S.FOREST SERVICE UNIT ADMINISTERING GRANT/AGREEMENT(unit name,street,city,state,and zip+4): PROJECT/ACTIVITY(unit name,street,city,state,and zip+4): Amy Verellen Susan Piper,Forest Wildlife Biologist and Terrestrial Grants Management Specialist Program Manager 215 Melody Lane Olympic National Forest Wenatchee, WA 98801 1835 Black Lake Blvd. SW Email: amy.verellen@usda.gov Olympia, WA 98512 Email: susan.piper@usda.gov 6.NAME/ADDRESS OF RECIPIENT/COOPERATOR(street,city,state,and zip+ 7.RECIPIENT/COOPERATOR'S HHS SUB ACCOUNT NUMBER(For HHS 4,county): payment use only): Patricia Grover Same Mason County Noxious Weed Control Board 303 N.4th Street Shelton, WA 98584 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. 1,above. CHANGE IN PERFORMANCE PERIOD: ® CHANGE IN FUNDING:Additional funding in the amount of$21,263.88. ® ADMINISTRATIVE CHANGES:Change Grants Management Specialist from Sarah Russell to Amy Verellen.See box 4. OTHER(Specify type of modification):Update U.S.Forest Service email addresses for Susan Piper(see box 5) and Albuquerque Service Center(see box 9). 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): IV.THE U.S.FOREST SERVICE SHALL: A.PAYMENT/REIMBURSEMENT.The U.S.Forest Service shall reimburse the County for the U.S.Forest Service's share of actual expenses incurred,not to exceed$21,263.88,as shown in the Financial Plan.In order to approve a Request for Reimbursement,the U.S. Forest Service shall review such requests to ensure payments for reimbursement are in compliance and otherwise consistent with the terms of the agreement.The U.S.Forest Service shall make payment upon receipt of County's annual invoice.Each invoice from the County shall display the total project costs for the billing period,separated by U.S.Forest Service and the County'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 County'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. The County'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 the County 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 U.S.Forest Service payments to date. 8. Statement that the invoice is a request for payment by"reimbursement". 9. If using SF-270,a signature is required. ts+ USDA Forest Service OiShcf 0596-0217 FS-I500-19 10,Invoice Number,if applicable. The invoice must be forwarded to: ENIA IL:SM.FS.asc_ga@usda.gov FAX: 877-687-4894 POSTAL:USDA Forest Service Albuquerque Service Center Payments—Grants&Agreements 10I B Sun Ave NE Albuquerque,NM 87109 Send a copy to:Susan Piper(susan.piper a,usda.gov) L.LIMITATION OF FUNDS.U.S.Forest Service funds in the amount of S2 1,263.88 and all remaining funds are currently available for performance of this instrument through September 30,2021.The U.S.Forest Service's obligation for performance of this instrument beyond is contingent upon the availability of appropriated funds from which payment can made.There is no legal liability on the part of the U.S.Forest Service for any payment may arise for performance tinder this instrument beyond this amount until the County receives notice of availability to be confirmed in a written modification by the U.S.Forest Service. 10.ATTACHED DOCUMENTATION(Check all that apply): Revised Scope of Work Revised Financial Plan ❑ Other: 11. SIGNATURES r1U 11IOt21210 REPRESENTAriVj;:By SIGNATURE BELOW,TiIE SIGNING PARTuis CE R'EIFY TI TAT TIIEY ARE THE OFFICIAI.REPRESENTATIVES OF 'THEIR RFSPta"rIVti PARTIES AND AErIiumr.Fn'1T)ACT IN TI9GIR RESPECTIVE AREAS FOR MATTERS RELATED TOTIIE ABOVE-REFERENCED GRANTIA(IREEMENF. I I.:\ MASON CC INTY SIGNATURE I I.D.DATE I LC.U.S.I [SY ERVILiSR Nil IRE I I.D.DATE SIGNET) /I SIGNED D (Signature or Sig :miry Official) (Signature I Signatory Official) I I.E NAME Hype or print):KEVIN SHUTTY 11 F.NAME Hype or print) RE FA LAFORD it r. lTrt.t(type or print)'County Commissioner Chair turn-mu(type or print):Forest Supervisor,Olympic N.F. 12.C&A REVIEW I'_.A.The authority and format of this modification tt3(E6-PA-I 1060900-006)have been reviewed and approved I2.B.DATE for signature bv: AMY D. VERELLEN U.S.Forest Service Grants&Agreements Specialist Burden Statement According to the Paperwork Reduction Act of 1995,an agency may not conduct or sponsor,and a person is not required to respond to a collection of information unless i1 displays a valid OMB control number.The valid OMB control number for this information colection is 059E-0217 The time required to complete this information collection is estimated to average 30 minutes per response.including the lane for reviewing instructions,searching existing data sources.gathering and maintaining the data needed and completing and reviewing the collection of information Thetis Department of Agriculture(USDA)prohibits discrimination in at)as programs and activities an the basis of race.color.national origin,age,disability,and where applicable,sex,marital status familial status parental status,religion,sexual orientation,genetic information,political belinfs,reprisal.or because at or part of an individuals income is derived from any pubic orive USDA Forest Service OMB 0596-0217 FS-1500-19 assistance.(Not all prohibited bases apply to all programs.)Persons with disabilities who require alternative means for communication of program information(Braille,large print,audiotape, etc.)should contact USDA's TARGET Center at 202-720-2600(voice and TDD). To file a complaint of discrimination,write USDA,Director,Office of Civil Rights,1400 Independence Avenue,SW,Washington,DC 20250-9410 or call toll free(866)632-9992(voice).TDD users can contact USDA through local relay or the Federal relay at(800)877-8339(TDD)or(866)377-8642(relay voice).USDA is an equal opportunity provider and employer. U.S. Forest Service OMB 0596-0217 FS-1500-17B USFS Agreement No.: 16PA11060900006 Mod.No.: 3 Cooperator Agreement No.: Agreements Financial Plan (Short Form) Financial Plan Matrix: Note:All columns may not be used.Use depends on source and type of contribution(s). FOREST SERVICE CONTRIBUTIONS COOPERATOR CONTRIBUTIONS r � f ! (b) c) (d) ask 4 Cash COST ELEMENTS -- ,' to Noncash In-Kind (e) Direct Costs Z 4,t4f Cooperator Total Salaries/Labor $3,622.70 $17,782.50 S4,323 St $0.00 S26,328.85 Travel S0.00 5510.40 S280.00 $0.00 S790.40 Equipment $0.00 $0.00 S660.00 $0.00 S660.00 Supplies/Materials $0.00 S273.31 $350.00 $0.00 $623.31 Printing $0.00 $0.00 $0.00 $0.00 S0.00 Other $0.00 $0.00 S720.00 $0.00 S720.00 Other S0.00 Subtotal S3,622.70 $18,566.21 S6,933.65 50.00 $29,122.56 Coop Indirect Costs $2.697.67 $1,007.46 $3,705.13 FS Overhead Costs $362.27 S362.27 Total $3,98497 $21,263.88 S7,941.11 $0.00 Total Project Value: $33,189.96 Note: This Financial Plan may be used when: (1) No program income is expected and (2) The Cooperator is not giving cash to the FS and (3) There is no other Federal funding Matching Costs Determination Reimbursement Calculation Total Forest Service Share= (f) Forest Service reimbursement percent(as%of expenses directly incurred by the Cooperator-i.e.,Cooperator's (a+b)_(e)_(f) 76.07% non-cash contributions only that are subject to Forest Service reimbursement) (b)-(b+c)_(i) (i) 72.81% Total Cooperator Share (g) Cooperator non-cash contributions not reimbursed by Forest Service (j) (c)+ b+c)=0) (c+d) (e)_(g) 23.93% 27.19% Reimbursable Amount=Total actual cost incurred to date(sum of cost elements from the Cooperator's Total(f+g)_(h) (h) invoice as prescribed in agreement provision and multiplied by 100.00% 72.81%I(i)minus any previous Forest Service payments,not to exceed the subtotal amount listed in column(b).) Page 1 VVORKSHEET FOR FS Non-Cash Contribution Cost Analysis, Column (a) Salaries/Labor Standard Calculation Job Description Cost/Day #of Days Total Invasive Plant Program Coordinator $362.27 10.00 $3,622.70 Total Salaries/Labor $3,622.70 Travel Standard Calculation Travel Expense Employees Cost/Trip #of Trips Total $0.00 Total Travel $0.00 Equipment Standard Calculation Piece of Equipment #of Units Cost/Day #of Days Total $0.00 Total Equipment $0.00 SupplicafMateriais Standard Calculation Supplies/Materials #of Items Cost/Item Total $0.00 Total Supplies/Materials $0.00 Printing) Standard Calculation Paper Material #of Units Cost/Unit Total Total Printing $0.00 Other Expenses Standard Calculation Item #of Units Cost/Unit Total $0.00 Total Other $0.00 Forest ServfcemtOverhead Costs Current Overhead Rate Subtotal Direct Costs Total 10.00% $3,622.70 $362.27 Total FS Overhead Costs $362.27 TOTAL COST $3,984.97 WORKSHEET FOR FS Cash to the Cooperator Cost Analysis, Column (b) Salaries/Labor Standard Calculation Job Description Cost/Day #of Days Total MCNWCB Coordinator $304.55 30.00 $9,136.50 Crewmember $172.92 50.00 $8,646.00 Total Salaries/Labor $17,782.50 Travel Non-Standard Calculation Travel to/from worksite 880 miles X 0.58/mile $510.40 Total Travel $510.40 Supplies/Materials Standard Calculation Supplies/Materials #of Items Cost/Item Total PPE, herbicide, hand pruners, heavy garbage bags,etc. $273.31 Total Supplies/Materials $273.31 Other Expenses Standard Calculation Item #of Units Cost/Unit Total Total Other $0.00 Subtotal Direct Costs $18,566.21 Cooperator Indirect Costs Current Overhead Rate Subtotal Direct Costs Total 14.53% $18,566.21 $2,697.67 Total Coop.Indirect Costs $2,697.67 TOTAL COST $21 ,263.88 WORKSHEET FOR Cooperator Non-Cash Contribution Cost Analysis, Column (c) Salaries/Labor Standard Calculation Job Description Cost/Day #of Days J _Total MCNWCB Coordinator $304.55 10.00 $3,045.50 Office Manager $313.03 6.00 $1,878.15 Total Salaries/Labor I $4,923.65! Travel Standard Calculation Travel Expense Employees Cost/Trip #of Trips Total Vehicle Use/Mileage 1 $28.00 10.00 $280.00 Total Travel $280.00 Equipment Standard Calculation Piece of Equipment #of Units Cost/Day #of Days Total Non-Standard Calculation Backpack Sprayers 3.00 $140.00 $420.00 Misc. Small tools 3.00 $80.00 $240.00 Total Equipment $660.00 Supplies/Materials Non-Standard Calculation PPE/Field Supplies- 1st aid kits, vests, garbage bags, spill kit, safety glasses,weather equip, etc. $250.00 Office Supplies $100.00 Total Supplies/Materials $350.00 Other Expenses Non-Standard Calculation Storage building-$60/month x 12 months $720.00 Total Other $720.00 Subtotal Direct Costs $6,933.65 Cooperator Indirect Costs Current Overhead Rate Subtotal Direct Costs Total 14.53% $6,933.65 $1,007.46 Total Coop. Indirect Costs $1,007.46 TOTAL COST $7,941 .11