Form 10-912 UPARR REHABILITATION AND INNOVATION AGREEMENT

OMB No. 1024-0089

Expires 8/31/2010

UNITED STATES DEPARTMENT OF THE INTERIOR

NATIONAL PARK SERVICE

URBAN PARK AND RECREATION RECOVERY PROGRAM GRANT

REHABILITATION AND INNOVATION AGREEMENT

NPS 10-912

Applicant Name Grant Number

Administering Agency

Grant Title

[ ] Rehabilitation [ ] Innovation [ ] Eligible [ ] Discretionary

Grant Expiration Date

Proposal Scope (description of individual site or project basis, with identification of each site):

Grant Cost

Total Cost $________________ The following are hereby incorporated into this

agreement:

UPARR Request %________ $________________

1. General Provisions

State Match %________ $________________

2. UPARR Grants Manual (NPS-37)

Local Match %________ $________________

3. Project Applications and Attachments

Other %________ $________________

4. OMB Circular A-102

Appropriation FY________ $________________

5. Title 43, Code of Federal Regulations

FY________ $________________

6. 36 CFR Chapter I, Part 72

7. __________________________________

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Grant Agreement No.:_______________________

The United States of America, represented by the Director, National Park Service, United States Department of the Interior, and the Grants Recipient above (hereinafter referred to as the Grantee), mutually agree to perform this agreement in accordance with Title X, Urban Park and Recreation Recovery Program, 16 USC 2501, 92. Stat. 3538 (1978), and with the terms, promises, conditions, plans, specifications, estimates, procedures, project proposals, maps and assurances attached hereto and hereby made a part of hereof.

The United States of America hereby promises, in consideration of the promises made by the Grantee herein, to obligate to the grantee the amount of money referred to above and to tender to the Grantee that portion of the obligation which is required to pay the United States share of the costs of the above Grant based upon percentage of assistance. The Grantee hereby promises in consideration of the promises made by the United States herein, to execute the Grant described above in accordance with the terms of this agreement.

The following special Grant terms and conditions were added to this agreement before it was signed by the parties hereto:

In witness whereof, the parties hereto have executed this agreement as of the date entered below.

THE UNITED STATES OF AMERICA GRANTEE

By_______________________________________ ____________________________________

(Signature) (Government Name)

__________________________________________ ____________________________________

(Title) (Signature)

National Park Service

____________________________________________ ____________________________________

(Date) (Name)

____________________________________

(Title)

PAPERWORK REDUCTION ACT STATEMENT: This information collection is authorized by the Urban Park and Recreation Recovery Act (16 U.S.C. 2501 et seq.). Your response is required to obtain or retain a benefit. We use this information to document the proposal scope and grant costs as well as the legal obligations of each party. Your response is not required unless a currently valid OMB control number is displayed. We estimate that it will take 1 hour to complete this form, including the time necessary to review instructions, gather data, and review the form. You may direct comments regarding the burden estimate or any other aspect of the form to State and Local Assistance Programs, National Park Service, 1849 C Street, NW. Mail Stop 2225, Washington, DC 20240.

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