Form FS-2400-009 Agreement to Modify Timber Sale or Integrated Resource T

Agreement to Modify Timber Sale or Integrated
Resource Timber Contract
FS-2400-0009 (REV. 11/2011)
(Ref. FSM 2450)

Contract Number:

OMB 0596-0225 (EXP. 05/2014)

Sale Name:

It is mutually agreed that the above designated timber sale contract, signed by
Name

Purchaser

of

, hereinafter called the
Business Name

and by

(1)

for the Unites States of America, as of

,
Name

the

th

day of

Contractor

Title

,

_________________
as
heretofore modified, be modified as follows:
________________

(2)

Continued on page 2

Pursuant to this mutual agreement, the Purchaser hereby agrees to cut and remove timber in strict accordance with all and
singular the terms and provisions of the aforesaid contract as herein modified. IN WITNESS WHEREOF, the parties hereto
have executed this modification of contract as of the

th

(3)

day of

,

.

By:
Signature of Approving Official

Name of Approving Official

Contracting Officer
Title of Approving Official
(4)

(Name of Purchaser )

(Street Address of Purchaser )

(City of Purchaser )

(State) (Zip Code)

(Signature of Purchaser )

IF CONTRACT IS TO OTHER THAN A CORPORATION
Two witnesses: (5)
(Name of First Witness)

(Name of Second Witness)

(Street Address of First Witness)

(Street Address of Second Witness)

(City of First Witness)

Signature of First Witness
File Code: 2450

(State) (Zip Code)

(City of Second Witness)

(State) (Zip Code)

Signature of Second Witness
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FS-2400-0009 (REV. 11/2011)
OMB 0596-0225 (EXP. 05/2014)

IF CONTRACT IS TO CORPORATION
I,
(6)

, certify that I am the
Name

Title

Secretary of the corporation named as Purchaser herein, that
Name

who signed this contract on behalf of the Purchaser , was then
Title

of said corporation; that said contract was duly signed for and in behalf of said corporation by authority of its governing body,
and is within the scope of its corporate powers.

Duly authorized

Title

Date

CORPORATE
SEAL

If the corporation has no corporate seal that fact shall be stated, in which case a scroll or
adhesive seal shall follow the corporate name.
MODIFICATION CONTINUED FROM PAGE 1

The signature
and addresses

(1) Select Purchaser if Modifying Timber Sale Contract. Select Contractor if modifying Integrated Resource Timber Contract.
(2) Check "as heretofore modified" if, and only if, the phrase is applicable.
(3) The date approving Forest Officer signs this form.
(4) If contracting party is a copartnership or LLC, the Purchaser's Name should be: XYZ Company, by John Doe, a member
of the firm. If contracting party is a corporation, Purchaser's Name should be XYZ Company, Inc., by John Doe, President
(or other officer or agent) and the seal of the corporation must be impressed or indicated. If contracting party is an individual,
enter their legal name.
(5) The signature and addresses of two witnesses are required if sale is to other than a corporation.
(6) The certificate must be completed if the purchaser is a corporation.

FS-2400-9: Public burden for this collection is estimated to be between 0.5 and 4 hours per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information. Under the Paperwork Reduction Act of 1995, an agency shall not conduct or sponsor, and no persons are required to
respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this collection
of information is 0596-0225.
File Code: 2450

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