Form 4120-6 Cooperative Range Improvement Agreement

Print

Reset

FORM APPROVED
OMB NO. 1004-0019
Expires: October 31, 2016

Form 4120-6
(May 2014)

FOR BUREAU OF LAND MANAGEMENT USE ONLY

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.
of

1. I, (We)

of
of
of

and

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)

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 or 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)

$ 0.00

(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 be deemed abandoned and title thereto will
thereupon vest in the United States.

(Continued on page 3)

(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 be 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 inthe 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 (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 of changes in law, regulation, of
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
burro 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

State of

(Signature)

(Date)

(Signature)

(Date)

(Signature)

(Date)

(Signature)

(Date)

(Title)

(Signature)

(Date)

(Date)

District/Field Office

By

(Signature)

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 and 43 CFR 2.48(d) require that you be furnished the following information in connection with the information requested by this form.
AUTHORITY: 43 U.S.C. 315, 43 U.S.C. 1752, 43 U.S.C. 1904 and subpart 4120 permit collection of the information requested by this form.
PRINCIPAL PURPOSE: The BLM will use the information you provide to develop a cooperative agreement for the construction, use, and maintenance of range
improvements on its public lands. The information will be used to document specific participation of each cooperator on the range improvement(s) to be accomplished under the
cooperative agreement.
ROUTINE USES: In accordance with the Bureau of Land Management’s (BLM) System of Records Notice published in the Federal Register on December 29, 2010 [Bureau
of Land Management’s Range Management System—Interior, LLM-2; Notice To Amend an Existing System of Records; Privacy Act of 1974; as Amended], names and
addresses provided by the applicant on this form will be publicly available in reports on the BLM public website.
EFFECT OF NOT PROVIDING INFORMATION: Submission of the requested information is necessary to obtain or retain a benefit. Failure to submit all the requested
information or to complete this form may result in delay or rejection and/or denial of your application.
The Paperwork Reduction Act requires that you be furnished the following information in connection with the information requested by this form: BLM collects this
information to authorize range improvements on public lands. Response to this request is required in order to obtain or retain a benefit. You do not have to respond to this or
any other Federal agency-sponsored information collection unless it displays a valid OMB Control Number.
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., Room 2134LM, Washington, D.C.
20240.

(Form 4120-6, page 4)