FS-1500-NEW09 Memorandum of Understanding

OMB 0596-New

FS-1500-NEW9

FS Agreement No.	0X-MU-11XX
Cooperator Tax ID No.
Cooperator Agreement No.

MEMORANDUM OF UNDERSTANDING

BETWEEN

     

AND

UNITED STATES DEPARTMENT OF AGRICULTURE

FOREST SERVICE

     

This MEMORANDUM OF UNDERSTANDING is hereby made and entered into by and between the      , hereinafter referred to as      , and United States Department of Agriculture Forest Service,      , hereinafter referred to as Forest Service.

1. PURPOSE:

     

2. STATEMENT OF MUTUAL BENEFIT AND INTERESTS:

     

3. FOREST SERVICE SHALL:

1.      

4.       SHALL:

1.      

5. IT IS MUTUALLY UNDERSTOOD AND AGREED BY AND BETWEEN THE PARTIES THAT:

1. FREEDOM OF INFORMATION ACT (FOIA). Any information furnished to the Forest Service under this instrument is subject to the Freedom of Information Act (5 U.S.C. 552).

2. PARTICIPATION IN SIMILAR ACTIVITIES. This instrument in no way restricts the Forest Service or the Cooperator(s) from participating in similar activities with other public or private agencies, organizations, and individuals.

3. COMMENCEMENT/EXPIRATION/TERMINATION. This MOU takes effect upon the signature of the Forest Service and       and shall remain in effect for       from the date of execution. This MOU may be extended or amended upon written request of either the Forest Service or       and the subsequent written concurrence of the other(s). Either the Forest Service or       may terminate this MOU with a 60-day written notice to the other(s).

4. RESPONSIBILITIES OF PARTIES. The Forest Service and       and their respective agencies and office will handle their own activities and utilize their own resources, including the expenditure of their own funds, in pursuing these objectives. Each party will carry out its separate activities in a coordinated and mutually beneficial manner.

5. PRINCIPAL CONTACTS. The principal contacts for this instrument are:

Forest Service Project Contact	Cooperator Project Contact
   	     
     	     
     	     
     	     
     	     
Phone:      	Phone:      
FAX:      	FAX:      
E-Mail:      	E-Mail:      

Forest Service Administrative Contact	Cooperator Administrative Contact
     	     
     	     
     	     
     	     
     	     
Phone:      	Phone:      
FAX:      	FAX:      
E-Mail:      	E-Mail:      

6. NON-FUND OBLIGATING DOCUMENT. Nothing in this MOU shall obligate either the Forest Service or       to obligate or transfer any funds. Specific work projects or activities that involve the transfer of funds, services, or property among the various agencies and offices of the Forest Service and       will require execution of separate agreements and be contingent upon the availability of appropriated funds. Such activities must be independently authorized by appropriate statutory authority. This MOU does not provide such authority. Negotiation, execution, and administration of each such agreement must comply with all applicable statutes and regulations.

7. ESTABLISHMENT OF RESPONSIBILITY. This MOU is not intended to, and does not create, any right, benefit, or trust responsibility, substantive or procedural, enforceable at law or equity, by a party against the United States, its agencies, its officers, or any person.

8. AUTHORIZED REPRESENTATIVES. By signature below, the cooperator certifies that the individuals listed in this document as representatives of the cooperator are authorized to act in their respective areas for matters related to this agreement.

THE PARTIES HERETO have executed this instrument.

     		USDA FOREST SERVICE
     		     
		     

      DATE		      DATE
     		     

The authority and format of this instrument has been reviewed and approved for signature.

      DATE

FS Agreements Coordinator

BURDEN AND NONDISCRIMINATION STATEMENTS

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The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on 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 beliefs, reprisal, or because all or part of an individual’s income is derived from any public 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.