| Agreement Financial Plan |
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| PROJECT NAME: |
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| USFS AGREEMENT NO: |
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Mod No: |
00 |
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| PARTNER AGREEMENT NO: |
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| 1. Financial Plan Matrix: |
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FOREST SERVICE CONTRIBUTIONS |
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PARTNER CONTRIBUTIONS |
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FSDefaultUser:
(a) Forest Service Non-Cash Contribution: Forest Service employee salaries, travel, equipment, supplies, etc., provided toward completion of the project. Total Forest Service indirect cost (overhead) is also included in this column. All the costs listed here are an expense to the Forest Service.
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FSDefaultUser:
(c) Forest Service Obligation to Pay Cooperator Expenses: This is the maximum Forest Service funding to be obligated under the agreement for advance or reimbursement of the Forest Service share of cooperator expenses. This is an expense to the Forest Service. Paynment for Services not contributed by Cooperator in exceeding product value.
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FSDefaultUser:
(b) Value of Forest Products appraised by the FS.
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FSDefaultUser:
Cooperator Services for Exchange Contribution. Cooperator contributions may consist of employee salaries, overhead, travel provided, and/or equipment and supplies purchased and provided for use in the performance of service work (stewardship items). These services are an expense to the Cooperator, and are exchanged for product value.
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FSDefaultUser:
Cooperator Noncash Contribution. Cooperator noncash contributions may consist of employee salaries, overhead, travel provided, and/or equipment and supplies purchased and provided for use in the project. These costs are an expense to the Cooperator, and are not reimbursed by the FS.
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FSDefaultUser:
(e) Value of Cooperator In-Kind Contribution: Cooperator non-cash contributions provided toward completion of the project for which the Cooperator has incurred no expense. These contributions can be made from the Cooperator or through the Cooperator by other entities and include such items as volunteer labor, donated materials, equipment, supplies, etc. These values are not reimbursable and can only be used to satisfy the Cooperator's matching requirement.
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FSDefaultUser:
(f) Cash Contribution to the Forest Service: Cooperator cash contribution provided to the Forest Service for use in completing the project. This is an expense to the Cooperator. Display by Cost Element where these funds will be expended. Be sure to cite a collection authority in the Agreement if this column is used.
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USDA Forest Service:
UNHIDE COLUMNS L-Q FOR THIRD PARTY CONTRIBUTIONS! To unhide, highlight columns L-R. Then choose format, column, unhide.
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(b)
Cash to Partner
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(c)
Appraised Value of Forest Product
Non-Cash |
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(d)
Services Exchanged for Product Value (2) |
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(g)
Cash *(3) |
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(h) |
(i) |
(j) |
(k) |
(l) |
(m) |
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(a) |
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(e) |
(f) |
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THIRD PARTY |
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| COST ELEMENTS |
Non-Cash |
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Non-Cash |
In-Kind |
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Cash |
Non-Cash |
In-Kind |
(n)
Total |
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FSDefaultUser:
(g) Third Party Cash Contribution Non-Federal: Cash contribution provided to the Cooperator from Non-Federal organization(s) for use in the project. Display these contributions by Cost Element expenditures.
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FSDefaultUser:
(h) Third Party Cash Contribution Federal: Cash contributions provided to the Cooperator from Federal agency(ies) for use in the project. Display these contributions by Cost Element expenditures.
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FSDefaultUser:
(i) Third Party Non-Cash Contribution Non-Federal: Non-cash contribution provided to the Cooperator from Non-Federal organization(s) for use in the project. Display these contributions by Cost Element Expenditures.
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FSDefaultUser:
(j) Third Party Non-Cash Contribution Federal: Non-cash contribution provided to the Cooperator from Federal agencie(s) for use in the project. Display these contributions by Cost Element Expenditures.
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FSDefaultUser:
(k) Third Party In-Kind Contribution Non-Federal: In-kind contribution provided to the Cooperator from Non-Federal organization(s) for use in the project. Display these contribtuions by Cost Element Expenditures.
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FSDefaultUser:
(l) Third Party In-Kind Contribution Federal: In-kind contribution provided to the Cooperator from Federal agencie(s) for use in the project. Display these contributions by Cost Element Expenditures.
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| Direct Costs: |
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Non-Fed |
Federal |
Non-Fed |
Federal |
Non-Fed |
Federal |
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| Salaries/Labor |
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*(5) |
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$0.00 |
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| Travel |
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*(5) |
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$0.00 |
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| Equipment |
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*(5) |
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$0.00 |
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| Supplies |
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*(5) |
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$0.00 |
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| Materials |
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*(5) |
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$0.00 |
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| Printing |
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*(5) |
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$0.00 |
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Planned service work to be contracted - This cost element can be replaced with a cost element unique to your agreement.
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*(5) |
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*(4) |
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$0.00 |
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Planned service work to be contracted - This cost element can be replaced with a cost element unique to your agreement.
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*(5) |
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*(4) |
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$0.00 |
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Planned service work to be contracted - This cost element can be replaced with a cost element unique to your agreement.
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*(5) |
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*(4) |
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$0.00 |
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| Product Value |
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Appraisal for timber reported on an FS2400-17 or bid value as applicable.
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Cash Product Value equals Residual Receipts paid to the government by the cooperator. Once agreement has been closed, excess money will move from residual receipts to retained receipts.
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*(6) |
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$0.00 |
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| Subtotal |
$0.00 |
$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
$0.00 |
$0.00 |
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$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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| Indirect Costs |
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*(5) |
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$0.00 |
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| Total |
$0.00 |
$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
$0.00 |
$0.00 |
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$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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| Total Forest Service Contributions: |
$0.00 |
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Total Partner & Third Party Contribution less Exchanged Services (Col D): |
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$0.00 |
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| (1) See Tab D Financial Plan Crosswalk for service work to be paid for by the FS |
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| (2) See Tab D Financial Plan Crosswalk for service work exchanged for product appraised value. Partner reimbursed by sale of product. |
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| (3) See Tab D Financial Plan Crosswalk for service work to be paid for with Partner cash contribution (collection for CWKV, BD, and coop funds [RM, SRR, etc.] not allowed) |
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| (4) See Tab D Financial Plan Crosswalk for contributed service work (Rows 20-22*, Columns E-M). |
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| (5) Enter in TSA amounts in Column B that are also included in Tab D Financial Plan Crosswalk and Appendix E Schedule of Items and Specifications |
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(6) Residual Receipts: Column G Partner Cash – Receipts paid to FS by Partner – Moved to retained receipts once agreement closed
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| If indirect costs (column B, row 29) will be reimbursed and/or exchanged for product (column D, row 29) the total dollar amount of indirect costs can be prorated between all lines of services listed in Column B and/or Column D on Tab D - Financial Plan Crosswalk and in Appendix E - Schedule of Items and Specifications. |
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| Orange fields identify all service work, by unit price, and must equal Appendix E - Schedule of Items and Specifications. Tab D Financial Plan Crosswalk identifies how total services are funded . |
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| Green fields identify possible TSA data figures. |
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| Matching Costs Determination |
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| Total Forest Service Share = |
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(p) |
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| (a+b+c)/(n) = (p) |
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#DIV/0! |
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| Third Party Contribution-- Federal = |
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(q) |
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| (i+k+m)/(n) = (q) |
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#DIV/0! |
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| Total Federal Share = |
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(r) |
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| (p+q) = (r) |
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#DIV/0! |
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| Total Partner Share |
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(s) |
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| [(e+f+g+h+j+l) / (n) = (s) |
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#DIV/0! |
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(t) |
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| Total (r+s) = (t) |
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#DIV/0! |
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| 2. Cost Analysis: |
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Use the following section to show additional information that supports the lump sum figures provided above. The following Cost Analysis boxes, (a)-(m), should provide a cost analysis of the corresponding matrix columns, (a)-(m), above, e.g. matrix column (a) FS Non-Cash Contribution should be analyzed under block (a), below, and matrix column (b) Obligation to Pay Partner Costs should be analyzed under block (b), below, etc. Furthermore, each cost analysis box, below, should have clear labels indicating which cost element, above, that is being analyzed, e.g. Salary/Labor = hrs or days x rate; Travel = miles x rate or months x FOR rate, days x per diem rate; Equipment Use = hrs or days x rate; Supplies & Materials--list of items and estimated cost; Printing = estimated cost per item; Indirect Cost = Direct cost x current indirect rate. |
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If necessary, add additional sheets for cost analysis. To compress any unwanted portion(s) of this section, highlight the section to be hidden, then select "Format", "Row", and "Hide" from the toolbar. |
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FS Non-Cash Contributions ONLY:
EXAMPLE Column (a): Salary GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (a) |
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| FS Non-Cash Contribution |
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The amount the FS will be reimbursing above the contributed product in Column C.
EXAMPLE Column (c): Salary: GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel: 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (b) |
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| FS Cash to Partner |
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The Forest Service appraised value or higher bid value of product provided to Cooperator in exchange for their services.(1) See Appendix E Schedule of Items for service work and include services in Tab D Funding Breakdown to identify all services to be paid for by the FS
Column (c) |
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| Value of Forest Products to Reimburse Partner |
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Cooperators services in the amount they will provide to receive product of same amount in Column C. Costs in rows 14 through 19 should be prorated to costs in rows 20 through 26.
EXAMPLE Column (d): Salary: GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel: 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (d) |
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| Services for exchange |
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FSDefaultUser:
Cooperator Non-Cash Contributions ONLY:
EXAMPLE Column (d): Salary: GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel: 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (e) |
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| Partner Non-Cash Contribution |
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Cooperator In-Kind Contributions ONLY:
EXAMPLE Column (e): Salary: GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel: 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (f) |
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| Partner In-Kind Contribution |
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FSDefaultUser:
Cooperator Cash Contributions ONLY:
EXAMPLE Column (f): Salary: GS 11 Biologist @ 40 hrs x $25.02/hr = $1,000.80, GS 5 Crew Leader @ 80 hrs x $12.79/hr = $1,023.20, GS 3 Crew 3 x 80hrs x $10.19/hr = $2445.60; Travel: 12 round trips x 50 miles x $.375/mi. = $225; Indirect Cost: $4,694.60 x 19.2% = $901.36
Column (g) |
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| Partner Cash Contribution |
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FSDefaultUser:
"The funding shown in this column is funding being sought from several sources for adequate fuding to make this project viable. It will be used to cover contract costs. If outside funding sources are obtained, this Stewardship Agreement will be modified to reflect that in this Financial Plan."
Column (h) |
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| Partner 3rd Party Cash-Non Fed. |
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| Column (i) |
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| Partner 3rd Party Cash-Fed. |
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| Column (j) |
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| Partner 3rd Party Non-Cash Non-Fed. |
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| Column (k) |
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| Partner 3rd Party Non-Cash Fed. |
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| Column (l) |
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| Partner 3rd Party In-Kind Non-Fed. |
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| Column (m) |
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| Partner 3rd Party In-Kind Fed. |
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| 3. Instructions: Use this form in conjunction with FSH 1509.11 Chapter 70 |
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| Use cost elements that apply to the particular project. The cost elements listed are examples of those commonly used. Delete those that don't apply. Value assessed for volunteer labor should be commensurate with local labor rates for similar work. Donated materials, equipment and supplies should be valued at rates and prices available in the current local market. |
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| (a) Forest Service Non-Cash Contribution: Forest Service employee salaries, travel, equipment, supplies, etc., provided toward completion of the project. Total Forest Service indirect cost (overhead) is also included in this column. All the costs listed here are an expense to the Forest Service. |
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| (b) Forest Service Cash to Pay Partner Expenses: This is the maximum Forest Service funding to be obligated under the agreement for advance or reimbursement of the FS share of partner expenses. This is an expense to the Forest Service. |
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| (c) Appraised or Bid Value of Forest Products: Per 36 CFR 223.60 appraisal establishing value of forest products that can be exchanged for stewardship items (project work) provided by Partner. If Partner subcontracts removal and obtains bids, this amount should be used to value products for exchange. |
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| (d) Partner services exchanged for product value. Stewardship service work performed by Partner in exchange for forest product. |
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| (e) Partner Non-Cash Contribution: Partner employee salaries, travel, equipment, supplies, etc., provided toward completion of the project. Total Partner indirect cost (overhead) is also included in this column. All the costs listed here are an expense to the Partner. |
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| (f) Value of Partner In-Kind Contribution: Partner contributions provided toward completion of the project for which the Partner has incurred no expense. These contributions can be made from the Partner or through the Partner by other entities and include such items as volunteer labor, donated materials, equipment, supplies, etc. These values are not reimbursable and can only be used to satisfy the Partner's matching requirement. |
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| (g) Partner Cash to the FS: Required cash deposits per Appendix F-Timber Removal Specifications. This is an expense to the Partner. |
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| (h) Third Party Cash Contribution Non-Federal: Cash contribution provided to the Partner from Non-Federal organization(s) for use in the project. Display these contributions by cost element expenditures. |
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| (i) Third Party Cash Contribution Federal: Cash contributions provided to the Partner from Federal agency(ies) for use in the project. Display these contributions by cost element expenditures. |
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| (j) Third Party Non-Cash Contribution Non-Federal: Non-cash contribution provided to the Partner from Non-Federal organization(s) for use in the project. Display these contributions by cost element expenditures. |
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| (k) Third Party Non-Cash Contribution Federal: Non-cash contribution provided to the Partner from Federal agencie(s) for use in the project. Display these contributions by cost element expenditures. |
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| (l) Third Party In-Kind Contribution Non-Federal: In-kind contribution provided to the Partner from Non-Federal organization(s) for use in the project. Display these contributions by cost element expenditures. |
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| (m) Third Party In-Kind Contribution Federal: In-kind contribution provided to the Partner from Federal agencie(s) for use in the project. Display these contributions by cost element expenditures. |
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| (n) Total Project Value: The sum of all the values provided toward the project. This figure reflects the true estimated cost of the project. |
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Burden Statement |
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| 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 it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-New. The time required to complete this information collection is estimated to average XX minutes/hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. |
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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). |
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| 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. |
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