Form 4120-6 Cooperative Improvement Agreement

Grazing Management (43 CFR Subpart 4120)

4120-6_5-2008 Revised 5-25-10 for CLittle

Cooperative Range Improvement Agreement (43 CFR Subpart 4120)

OMB: 1004-0019

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FORM APPROVED
OMB NO. 1004-0019
Expires: May 31, 2010
FOR BUREAU OF LAND MANAGEMENT USE ONLY

Form 4120-6
(May 2008)

UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT

State. . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Office . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Project Number(s)

COOPERATIVE RANGE IMPROVEMENT AGREEMENT

Project Name(s)

INSTRUCTIONS - Cooperator(s) to receive original, and one copy each to the
District/Field Office case or lease file and District/Field Office project file.
1. I, (We)

Reset

of
of
of

and

of

hereinafter called cooperator(s) and the United States of America, by the Bureau of Land Management, hereinafter called the BLM, for and in consideration
of the mutual benefits hereunder, and in accordance with the Taylor Grazing Act (43 U.S.C. 315, 315a-r), as amended, the National Soil Conservation Act
(16 U.S.C. 590a(3)), as amended, the Federal Land Policy and Management Act (43 U.S.C. 1701, et seq.), and the Public Rangelands Improvement Act (43
U.S.C. 1904) do enter into this cooperative agreement for the construction and/or maintenance of range improvements, installation of conservation works or
establishment of conservation practices, hereinafter referred to collectively as improvements, for the benefit of the public lands and of the cooperator(s).
2. The improvement(s) known as the

will be

is (are)

are located upon:

1/4, Sec(s).

T,

Meridian, County of

R,

, State of

,
,

3. IT IS MUTUALLY AGREED:
(a)

The parties hereto will furnish labor, materials, and equipment as required, the total cost of value not to exceed the amount listed below for each
of the parties respectively for the initial construction and/or installation of the improvements indicated in paragraph 2.

NAME(S) OF COOPERATOR(S)

TOTAL
COST OR VALUE

ITEMS
$

BUREAU OF LAND MANAGEMENT

AGGREGATE COST
(Continued on page 2)

$

(b) Upon notice from the BLM, cooperator(s) will promptly supply labor,
materials, and equipment as specified in paragraph 3 (a) as required.
Contributed materials in excess of the amount required must be returned
to the contributor. Equipment contributed must be returned promptly
following completion of the work. Work will be conducted under the
supervision and direction of the BLM and must be pursued with
diligence until completed.
4. (a) The cooperator(s) will be liable, jointly and severally, for the
repair and maintenance of the improvements following completion, in
good and serviceable condition. The cooperator(s), without further notice
from the BLM must do the necessary work promptly. If work is not
performed as necessary, the BLM will notify the cooperator(s) and
specify a period within which to complete the work as required.
(b) In event the cooperator(s) default in the repair and maintenance of
the improvements the BLM may do or cause such work to be done for
and in behalf of the cooperator (s); and the necessary cost and expense
thereof will become a charge and obligation upon and must be paid by
the cooperator(s). It is further understood in case of default that any
grazing permit or lease may be canceled and may not be renewed or
extended or any transfer of grazing preference may not be approved
unless and until all charges and costs owed by the cooperator(s) are paid;
and provided that the BLM may pursue such other remedies, legal or
administrative, as may be authorized.
(c) Repair and maintenance, as herein required, will mean normal
upkeep and maintenance necessary to preserve, protect, and prolong the
useful life of the improvements, but will not include major repairs where
the damage is due to floods, earthquakes, or other acts of God, or fire not
the result of fault or negligence of the cooperator(s) as determined by the
BLM.
5. IT IS FURTHER AGREED
(a) This agreement does not convey right, title, or interest in any lands
or resources held by the United States.
(b) Title to permanent or nonstructural improvements authorized by
this agreement is held by the United States of America. The actual
amount of the cooperator's(s') funds, materials, and the value of the labor
contributed to the construction of the range improvement(s) authorized by
this agreement is listed in Section 3 of this agreement and documents their
respective interest in the agreement.
(c) The improvements may be removed, in whole or in part, during the
term of this agreement or any extension thereof, by mutual consent of the
parties or by direction of the BLM; such removal must be made by the
cooperator(s), or by the BLM at its option. During the course of
salvaging material, the United States assumes no responsibility for the
protection or preservation of said material. Upon removal of the
improvements, any salvageable materials, after deducting an amount to
compensate for the actual cost of removal, will be available for
distribution to the parties then subject to this agreement in proportion to
the actual amount of their respective contributions to the initial
construction of the improvements. The parties must take possession and
remove their portion of the salvaged materials within one hundred and
eighty (180) days after first notification in writing that such material is
available; upon failure to do so within the time allowed, the materials will

(Continued on page 3)

be deemed abandoned and title thereto will thereupon vest in the
United States.
(d) In the event lands containing improvements described under (b) above
are devoted to another public purpose which precludes grazing, including
disposal, the cooperator(s) will been entitled to reasonable compensation for
the adjusted value of the cooperator’s(s’) interest to the improvements.
6. Applications by the cooperators(s) to transfer the grazing preference
and/or permitted grazing use embracing the lands upon which the
improvements are constructed or in connection with which they are used,
will evidence assignment of interest in this Cooperative Agreement to the
transferee. [Before the transferee will be recognized as successor in interest
hereunder, the transferee will be required by the BLM to accept an
assignment of this agreement and agree to be bound by the provisions
respecting the use and maintenance of the improvements.]
7. The cooperator’s(s’) use of the improvements will be in conformance with
any special conditions, the grazing permit(s) or lease(s), and regulations of
the Secretary of the Interior.
8. This agreement will not accord to cooperator(s) any preference,
privilege, or consideration with respect to any grazing permit or lease not
expressly provided herein or in the rules and regulations governing such
grazing permit or lease.
9. Items 2, 3, and 4 (a) of this agreement may be modified or canceled by
written agreement of the parties, which agreement will become a part
hereof.
10. This agreement is subject to the provisions of Executive Order No.
11246 of September 24, 1965, as amended, which sets forth the
nondiscrimination clauses. A copy of this order may be obtained from the
BLM.
11. This agreement will remain in effect indefinitely from date of signature
unless (1) otherwise designated under item 14. Special Conditions, or (2)
terminated by mutual written consent of parties, or (3) terminated by the
BLM after notice in writing because of the cooperator’s(s’) default or violation,
or (4) terminated by the BLM after notice in writing because the
improvements are not compatible with adopted land use plans, or (5)
terminated renegotiated, or modified by the BLM following consultation
with the parties involved, as a result or changes in law regulation, or
national BLM policy.
12. Any water right acquired on or after August 21, 1995 to use water on
public lands associated with this improvement will be held in the name of
the United States, if permitted under State Law. Co-application or joint
ownership by permittees or lessees of water rights for purposes of livestock
water will be allowed where State Law permits the practice.
13. Any water developed, improved, or impounded under this cooperative
agreement will be available for wildlife and free roaming wild horse and
burros use and other authorized public use to the extent that such use is
consistent with the multiple-use management objectives for the area.

(Form 4120-6, page 2)

14. Special Conditions

COOPERATOR(S)

THE UNITED STATES OF AMERICA

____________________________________________________________
(Signature)
(Date)

State of ___________________________________________________

____________________________________________________________
(Signature)
(Date)

District/Field Office _________________________________________

____________________________________________________________
(Signature)
(Date)

By _______________________________________________________
(Signature)

____________________________________________________________
(Signature)
(Date)

____________________________________________________________
(Title)

____________________________________________________________
(Signature)
(Date)

____________________________________________________________
(Date)

Title 18, U.S.C., Section 1001, makes it a crime for any person knowingly and willfully to make to any department or agency of the United States any false,
fictitious, or fraudulent statements or representations as to any matter within its jurisdiction.
(Continued on page 4)

(Form 4120-6, page 3)

LOCATION PLAT
Sec.

, T.

, R.

Scale

,

Mer.

inches equals one mile
NOTICES

The Privacy Act of 1974 and the regulation in 43 CFR 2.48(d) provide that you be furnished the following information in connection with information required by this
application.
AUTHORITY: 43 U.S.C. 315, 315a-r, 43 U.S.C. 1701; 43 U.S.C. 1904.
PRINCIPAL PURPOSE: The information is to be used to authorize and document participation for construction, use and maintenance of range improvements.
ROUTINE USES: (1) Identify applicants share or interest in an improvement placed on Public Lands. (2) Documentation for public information in support of notations made on
land status record for the management, disposal, and use of public lands and resources. (3) Transfer to appropriate Federal agencies when concurrence is required prior to granting
a permit to use public lands. (4) Transfer to the U.S. Department of Justice in the event of litigation involving the records or the subject matter of the records. (5) Transfer, in the
event there is indicated a violation or potential violation of a statute, regulation, rule, order, permit, lease, or agreement whether civil, criminal or regulatory in nature, to the
appropriate agency or agencies, whether Federal, State, local or foreign, charged with the responsibility of investigation or prosecuting such violation or charged with enforcing
or implementing the statute, rule, regulation, order, permit, lease, or agreement violated or potentially violated.
EFFECT OF NOT PROVIDING INFORMATION: If you do not file this application and furnish the requested information, you will not be authorized to place improvements on
the public lands. If the improvement is placed without proper authorization, you will be liable for damages and immediate removal of the facility.
The Paperwork Reduction Act of 1995 requires us to inform you that:
Information is being collected to develop a cooperative agreement for the construction, use, and maintenance of range improvements on its public lands.
Information will be used to document the specific participation of each cooperator on the range improvement(s) to be accomplished under the cooperative agreement. By
signature, each cooperator agrees to participate in the manner specifically described in the agreement.
Response to this request is required to obtain a benefit.
The BLM would like you to know that unless this form contains a currently valid OMB Control Number, you are not required to submit this information to the BLM or its
designated agents.
BURDEN HOURS STATEMENT: Public reporting burden for this form is estimated to average 2 hours per response, including the time for reviewing instructions, gathering
and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior,
Bureau of Land Management (1004-0019), Bureau Information Collection Clearance Officer (WO-630), 1849 C Street, N.W., Mail Stop 401 LS, Washington, D.C. 20240.
(Form 4120-6, page 4)


File Typeapplication/pdf
File TitleMicrosoft Word - BLM_4120-6__
AuthorBLM
File Modified2010-05-18
File Created2006-11-21

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