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FS-1500-18 (VER. XX/XX) OMB No. 0596-0217 |
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| Cooperator Agreement # |
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| Collection Agreement Financial Plan |
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| Cooperator and FS Contributions |
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| COST ELEMENTS and related data |
Cooperator Contribution |
FS Non-Cash Contribution |
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| Line Item Cost Subtotals |
Subtotal |
Subtotal |
Combined Subtotals |
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| PERSONNEL |
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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 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
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$0.00 |
$0.00 |
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$0.00 |
$0.00 |
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$0.00 |
$0.00 |
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$0.00 |
$0.00 |
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| Subtotal, Personnel: |
0.00 |
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$0.00 |
$0.00 |
$0.00 |
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| TRAVEL |
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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 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
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| Subtotal, Travel: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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| EQUIPMENT |
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| Name and Type of Equipment: |
Unit Cost |
Quantity |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
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| Subtotal, Equipment: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
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| SUPPLIES |
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| Name and Type of Supplies: |
Unit Cost |
Quantity |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
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$0.00 |
$0.00 |
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| Subtotal, Supplies: |
$0.00 |
0 |
$0.00 |
$0.00 |
$0.00 |
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| CONTRACTUAL |
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| Describe Contracts that will most likely result from this project: |
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$0.00 |
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$0.00 |
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$0.00 |
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| Subtotal, Contractual: |
$0.00 |
$0.00 |
$0.00 |
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| OTHER |
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| Describe Other Costs of the Project: |
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$0.00 |
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$0.00 |
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$0.00 |
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| Subtotal, Other: |
$0.00 |
$0.00 |
$0.00 |
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| TOTAL DIRECT CHARGES |
$0.00 |
$0.00 |
$0.00 |
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OVERHEAD ASSESSMENT
(if applicable, see FSH 1909.13) |
Insert Rate Here: |
ccoppenbarger:
Insert Rate Here.
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$0.00 |
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| Total Party Costs |
$0.00 |
$0.00 |
$0.00 |
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| COST ELEMENTS SUBJECT TO NATIONAL PASS-THROUGH RATES |
Cooperator Contribution |
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| TOTAL CHARGES |
$0.00 |
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OVERHEAD ASSESSMENT
(if applicable, see FSH 1909.13) |
Insert Rate Here: |
ccoppenbarger:
Insert Rate Here.
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$0.00 |
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| Total Pass-Through Costs |
$0.00 |
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| TOTAL PROJECT COSTS |
$0.00 |
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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 Response to this collection of information is Mandatory (Title VIII of IIJA). The time required to complete this information collection is estimated to average 4 hours per response, including the time for reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
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To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, DC 20250-9410, or call toll free at (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.
The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 522) govern the confidentiality to be provided for information received by the Forest Service. |
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