| Forest Service Agreement # |
|
Cooperator Agreement # |
|
|
| Collection Agreement Financial Plan |
|
| Cooperator and FS Contributions |
|
| COST ELEMENTS and related data |
Cooperator Contribution |
FS Non-Cash Contribution |
|
|
|
| Line Item Cost Subtotals |
Subtotal |
Subtotal |
Combined Subtotals |
|
| PERSONNEL |
|
|
ccoppenbarger:
Examples of positions are:
Forest Planner
NEPA Coordinator
Heritage Resources/CR
Fisheries Biologist
Transportation Planner
Logging Systems
Wildlife Biologist
Geologist
Recreation Planner
Hydrologist
Botanist
Resource Specialists (List all personnel): |
# of Days |
$/Day |
|
|
|
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
| Subtotal, Personnel: |
0.00 |
|
$0.00 |
$0.00 |
$0.00 |
|
| TRAVEL |
|
Explanation of trips:
From Where/To Where/For Whom |
ccoppenbarger:
Compute by multiplying miles x current mileage rate, then enter number in cell.
OR
Insert total airfare: one-way or round-trip, as applicable.
Vehicle Mileage Cost or Airfare Cost |
# of Trips |
PerDiem and Lodging |
|
|
|
|
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
|
|
$0.00 |
$0.00 |
|
| Subtotal, Travel: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
|
| EQUIPMENT |
|
| Name and Type of Equipment: |
Unit Cost |
Quantity |
|
|
|
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
| Subtotal, Equipment: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
|
| SUPPLIES |
|
| Name and Type of Supplies: |
Unit Cost |
Quantity |
|
|
|
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
$0.00 |
|
$0.00 |
|
|
|
|
|
$0.00 |
$0.00 |
|
| Subtotal, Supplies: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
|
| CONTRACTUAL |
|
| Describe Contracts that will most likely result from this project: |
|
|
|
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
|
| Subtotal, Contractual: |
$0.00 |
$0.00 |
$0.00 |
|
| OTHER |
|
| Describe Other Costs of the Project: |
|
|
|
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
|
|
|
|
$0.00 |
|
| Subtotal, Other: |
$0.00 |
$0.00 |
$0.00 |
|
| TOTAL DIRECT CHARGES |
$0.00 |
$0.00 |
$0.00 |
|
OVERHEAD ASSESSMENT
(if applicable, see FSH 1909.13) |
Insert Rate Here: |
ccoppenbarger:
Insert Rate Here.
|
$0.00 |
|
|
|
| Total Party Costs |
$0.00 |
$0.00 |
$0.00 |
|
| COST ELEMENTS SUBJECT TO NATIONAL PASS-THROUGH RATES |
Cooperator Contribution |
|
|
|
|
|
| TOTAL CHARGES |
$0.00 |
|
OVERHEAD ASSESSMENT
(if applicable, see FSH 1909.13) |
Insert Rate Here: |
ccoppenbarger:
Insert Rate Here.
|
$0.00 |
|
| Total Pass-Through Costs |
$0.00 |
|
| TOTAL PROJECT COSTS |
$0.00 |
|
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 it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0217. The time required to complete this information collection is estimated to average 45 minutes 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.
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.
|
|