HomeMy WebLinkAbout21- Forest Health Program Subaward Agreement - Sourdough Creek Fuels Reduction - Project CampaignFY22 – DNRC Forestry Subaward Page 1 of 8
FOREST HEALTH PROGRAM SUBAWARD AGREEMENT
Sourdough Creek Fuels Reduction - Project Campaign This Subaward Agreement (Subaward) is accepted by City of Bozeman, hereinafter referred to as the “Subrecipient,” Federal ID No. 81-601238, DUNS# 083705293, and represented by Brian Heaston, Project Engineer, PO Box 1230, Bozeman, Montana 59771-1230, telephone (406) 582-2280, according to the following terms and conditions. This Subaward, awarded and administered by the Montana Department of Natural Resources
and Conservation (DNRC), is consistent with the policies, procedures and objectives of the Cooperative Forestry Assistance Act of 1978, Public Law 95-313, as amended. This Subaward is awarded under federal grant #20-DG-11010000-024, Consolidated Payments Grant, executed
on 06/29/2020, from the United States Department of Agriculture (USDA) – Forest Service (USFS) and Catalog of Federal Domestic Assistance (CFDA) number 10.664, “Cooperative Forestry Assistance.”
SECTION 1. PURPOSE. The purpose of this Subaward is to establish mutually agreeable terms and conditions, specifications, and requirements to grant funds to the Subrecipient for the purpose of activities that increase public understanding of the importance of active, sustainable cross-boundary forest management that aims to reduce wildfire risks and increase forest health across the landscape/watersheds containing City of Bozeman’s municipal water source and infrastructure. Basis for this subaward is Forest Health Management Program which is administered through a partnership with the USFS and the DNRC. Permissible projects are those on non-federal lands. Projects can include any/all of the following: community/citizen education, wildland fire prevention programs, and monitoring.
FOR DNRC USE ONLY
Subaward # FHE-21-101
Maximum amount under this Subaward Agreement: $20,000.00 Amendment # N/A
Source of Funds Approved by
USDA FS Grant # 20-DG-11010000-024; CFDA # 10.664 Program EW
Fiscal LP
Legal MP
Fund Subclass Org Percent Amount Expiration Amendment
03283 555YS 50479 100% $20,000.00 See Sect. 2 N/A
Workers Comp: X N/A Attached Exempt Will be forwarded
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SECTION 2. TERM. This Subaward is effective on the date of last signature. The Subrecipient shall have until May 31, 2023 to complete the project and work described in Section 4, Project
Scope. The DNRC may, pursuant to Section 18, Agreement Extension, grant an extension for completion upon request and showing of good cause by the Subrecipient. Good cause is defined as external factors preventing the Subrecipient from completing the work, including, but
not limited to, pandemic, inadequate staff, delays experienced by federal, other collaborative partners or contractors, or prolonged inoperable weather conditions. A request for extension must be submitted in writing no less than thirty (30) days prior to the termination date if an extension is to be considered by the DNRC. SECTION 3. DNRC's ROLE. The DNRC is administering grant funds awarded by the USFS to ensure that the funds are used according to the intent and procedures of the Forest Health Grant Program. The DNRC will monitor project expenditures to assure payment eligibility. The DNRC assumes no responsibility for the Subrecipient's obligation to faithfully perform the tasks and activities required by this Subaward. The DNRC assumes no responsibility for verifying the right of the Subrecipient to conduct project activities. The Subrecipient is responsible for obtaining all appropriate permissions to conduct activities. The Subrecipient may contact the DNRC's liaison Erik Warrington, at (406) 542-4303, 2705 Spurgin Road, Missoula, Montana 59804 for guidance related to administration of the terms of this Subaward. All requests for
information and assistance shall be submitted to the DNRC liaison or his designee. SECTION 4. PROJECT SCOPE. (a) The Subrecipient must use the proceeds provided
pursuant to this Subaward to perform allowable activities under the Program. The key outcomes of the project are the support of landowner and community outreach
and engagement; development and promotion of media and material content which educates the audience on the important role healthy forests, intact watersheds, and fire adapted communities. The audience includes the general public, civic leaders, land
management agencies, as well as targeted materials for adjacent private forest landowners, and recreation users of the municipal watershed trail systems.
The project will utilize contracted professional services for campaign coordination and media development. Media content may include but is not limited to audio, visual, print, and social. The campaign is anticipated to run before, during, and up to the completion
of the City of Bozeman’s Sourdough Creek Fuels Reduction Project.
SECTION 5. PROJECT BUDGET. Subaward funds are allocated to the following budget categories:
Project Funding Summary:
Direct Costs
Subrecipient salary/wages/benefits $0
Operating Expenses $0
Contracted Services $20,000
Subtotal – Direct Costs $20,000
Indirect Costs (0.0%) $0
Total Subaward Amount $20,000
Match Required (none) $0
Total Project Funding: $20,000
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No match is required for this Subaward.
The indirect cost rate is shown above, expressed as a percentage of indirect costs to direct costs. Unless the rate has been formalized in a Negotiated Indirect Cost Rate Agreement
(NICRA) between the Subrecipient and its cognizant federal agency, the rate shown above is hereby approved by the DNRC for the term of this Subaward and may not be changed except via written amendment. Total payment for all purposes under this Subaward shall not exceed Twenty Thousand and no/100 Dollars ($20,000.00). Subrecipient shall follow all applicable procurement procedures as required in Section 12, Compliance with Applicable Laws, and the applicable Federal Office of Management and Budget (OMB) in the Code of Federal Regulations (CFR) 2 CFR 200 §§ 200.317 – 200.326. SECTION 6. AVAILABILITY OF SUBAWARD FUNDS. The Subrecipient acknowledges and understands that Subaward funds become available based on federal awards to DNRC. Costs incurred by the Subrecipient on or after May 1, 2021 may be, upon approval by the DNRC,
eligible for reimbursement or may be counted as match funds. The commitment by the DNRC to expend money is contingent upon the DNRC receiving funds
under the Cooperative Forestry Assistance Act of 1978, Public Law 95-313, as amended. No liability shall accrue to the DNRC or its officials in the event such funds are not appropriated or issued as authorized under this legislation. The DNRC may, at its sole discretion, issue a
temporary stop-work order, reduce the scope of project activities, or terminate this Subaward if appropriated funding is reduced or unavailable for any reason. The DNRC will provide Subrecipient at least 10 days’ notice for a stop-work order and at least 30 days’ notice if a reduction in scope or termination is determined to be necessary due to unavailability of funds. Until the DNRC notifies Subrecipient that obligated funds are unavailable, the DNRC will continue to comply with the terms of this Subaward, including the disbursement of funds for eligible expenses incurred by Subrecipient up to the specified date and time provided in a written notice. SECTION 7. DISBURSEMENTS. Subrecipient shall submit claims for disbursement of Subaward funds to the DNRC liaison, using the “Request for Disbursement of DNRC Grant
Funds / Financial Status Report” (Request) form, attached hereto as Appendix D and incorporated herein by reference. Documentation of reimbursable costs incurred and paid must be submitted with the request. Documentation may include, but is not limited to, itemized
receipts, vendor invoices, inspection certificates, transaction ledgers or other financial reports that clearly show expenditures, payroll records, copies of checks, bank statements, and other forms of proof of payment. The DNRC will determine whether documentation submitted
adequately supports the disbursement request and may require additional documentation before approving payment. Reimbursement of Subrecipient’s expenditures will only be made for expenses included in the Project Budget in Section 5, that are clearly and accurately supported by the Subrecipient's records. Subrecipient should seek timely reimbursement of claimed costs incurred under this Subaward.
A minimum of one Request must be submitted annually to the DNRC. The annual period begins on the Subaward date of last signature. In the event no reimbursable costs are incurred in an annual period, a Request for zero dollars ($0.00) listing current subaward balances must be
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submitted to the DNRC. Request for final disbursement of Subaward funds is due 30 days following the subaward termination date.
The DNRC may determine the method of submission for disbursement requests. Methods may include requiring paper versions by US Mail, e-mail or state FTP portal transmission for
electronic versions, or entry in a registered Subrecipient account in a grant management system. If a required submission method changes during the term of the Subaward, the DNRC will provide thirty (30) days’ notice. The DNRC may withhold up to ten percent (10%) of the total authorized subaward amount until both the project tasks (outlined in Section 1 and Section 4) and the Final Report (required by Section 8) are completed by the Subrecipient and approved by the DNRC. SECTION 8. REPORTS. The Subrecipient shall immediately notify the DNRC of developments that have a significant impact on the activities supported under this Subaward. Notification must be given in the case of problems, delays or adverse conditions that materially impair the ability of the Subrecipient to meet the objectives of the Subaward. The notification must include a statement on action taken or contemplated, and any assistance needed to resolve the situation including requests for scope and/or timeline modifications as provided for below in Section 16,
Assignment and Amendment. Quarterly progress reports for the periods ending each March, June, September and
December must be submitted to the DNRC during the term of this Subaward. Reports will provide status information for each project implementation objective. Project status information will include, at a minimum, the percentage completed, costs incurred, funds remaining, and
projected completion date. The Subrecipient shall report on total project costs, including grant-funded costs, Subrecipient-provided match, and match provided by other sources. Quarterly reports must be submitted to the DNRC by the last day of the next month following the close of the quarterly period. The first quarter closes December 31, 2021, and the report is due on or before January 31, 2022. The first quarterly should include all activities under this Subaward project to-date. The DNRC will review reports for completeness and accuracy, and will notify the Subrecipient if changes are necessary. No claims for disbursements will be honored by the DNRC until complete, accurate quarterly reports have been submitted by the Subrecipient. A suggested Quarterly Report format is attached hereto as Appendix B and incorporated herein by reference.
A Final Report that details the project status, results, accomplishments, and financial status will be submitted to the DNRC by the Subrecipient for approval upon project completion. Final
reports are due 30 days following the subaward termination date. Final disbursement of Subaward funds is contingent upon the DNRC’s receipt and approval of
the Final Report. A suggested Final Report format is attached hereto as Appendix C and incorporated herein by reference. The DNRC may determine the method of submission for all Quarterly and Final reports. Methods may include requiring paper versions by US Mail, e-mail or state FTP portal transmission for electronic versions, or entry in a registered Subrecipient account in a grant management system. If a required submission method changes during the term of the Subaward, the DNRC will provide thirty (30) days’ notice.
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SECTION 9. RECORDS AND AUDITS. The Subrecipient must maintain appropriate and adequate records showing complete entries of all receipts, disbursements, and other
transactions relating to this Subaward for three (3) years after the later of either the final Subaward payment or the termination or expiration of this Subaward. The DNRC, the Montana Legislative Audit Division, or the Montana Legislative Fiscal Division may, at any reasonable
time, audit all records, reports, and other documents that the Subrecipient maintains under or during the course of this Subaward to ensure compliance with its terms and conditions. SECTION 10. PROJECT MONITORING AND ACCESS FOR INSPECTION AND MONITORING. The DNRC or its agents may monitor and inspect all phases and aspects of the Subrecipient’s performance to determine compliance with this Subaward, including the adequacy of records and accounts. The Subrecipient shall accommodate requests for the DNRC access to the site and records with due consideration for safety, private property rights, and convenience of everyone involved. SECTION 11. EMPLOYMENT STATUS AND WORKER'S COMPENSATION. The DNRC is not an owner or general contractor for the project. The DNRC does not control the work activities or worksite of the Subrecipient or any contractors that might be engaged by the Subrecipient for completion of the project. The Subrecipient is independent from and is not an employee, officer,
or agent of the DNRC. The Subrecipient, its employees and contractors, are not covered by the DNRC’s Workers' Compensation Insurance. The Subrecipient is responsible for making sure that it and its employees are covered by Workers’ Compensation Insurance and that its
contractors are in compliance with the coverage provisions of the Workers’ Compensation Act. The Subrecipient shall ensure that all employees complete the I-9 form to certify they are
eligible for lawful employment under the Immigration and Nationality Act (8 USC 1324a). Subrecipient shall comply with regulations regarding certification and retention of the completed forms. SECTION 12. COMPLIANCE WITH APPLICABLE LAWS. The Subrecipient must comply with the requirements of the Federal Office of Management and Budget (OMB) guidance in subparts A through F of 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, And
Audit Requirements For Federal Awards, as adopted and supplemented by the USDA in 2 CFR Part 400. These regulations are available online at the following website: www.ecfr.gov. Subrecipient certifies that it will abide by all certifications and assurances set forth in USDA
Form AD-1048, “Certification Regarding Debarment, Suspension, Ineligibility & Voluntary Exclusion Lower Tier Covered Transactions,” this form having been signed, attached hereto as Appendix A, and incorporated herein by reference. Per the terms of the federal award, the
Subrecipient shall also require all second-tier subrecipients and contractors who will be paid with subaward funds to sign form AD-1048, and subrecipient shall keep completed forms on file.
If the amount of this contract, sub-contract, or sub-grant is in excess of $100,000, the Subrecipient will comply with all applicable standards, orders, or requirements issued under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR part 15).
All work performed under this Subaward must fully comply with all applicable federal, state, and local laws, rules, and regulations, including but not limited to, the Montana Human Rights Act, the Civil Rights Act of 1964, the Age Discrimination Act of 1975, the Americans with Disabilities
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Act of 1990, and Section 504 of the Rehabilitation Act of 1973. Any subletting or subcontracting by the Subrecipient subjects subcontractors to the same provision. In accordance with 49-3-
207, MCA, the Subrecipient agrees that the hiring of persons to perform this Subaward will be made on the basis of merit and qualifications and without discrimination based upon race, color, religion, creed, political ideas, sex, age, marital status, physical or mental disability, or national
origin of the persons performing this Subaward. It shall be the Subrecipient's responsibility to obtain all permits, licenses, or authorizations that might be required from government authorities for completion of the project. Procurement of labor, services, supplies, materials and equipment shall be conducted according to applicable federal, state, and local statutes. The DNRC’s signature on this Subaward does not guarantee the approval or issuance of any permits, licenses, or any other form of authorization to take action for which Subrecipient must apply with the DNRC or any other government entity and submit to the DNRC to fulfill the terms of this Subaward. TRAFFICKING IN PERSONS. Subrecipients under this award and the Subrecipient’s employees may not: (1) Engage in severe forms of trafficking in persons during the period of
time that the award is in effect; (2) Procure a commercial sex act during the period of time that the award is in effect; or (3) Use forced labor in performance of the award or subawards under the award.
NONDISCRIMINATION STATEMENT – PRINTED, ELECTRONIC, OR AUDIOVISUAL MATERIAL. The Subrecipient shall include the following statement, in full, in any printed
audiovisual material, or electronic media for public distribution developed or printed with any Federal funding.
In accordance with Federal law and U.S. Department of Agriculture policy, this
institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. (Not all prohibited bases apply to all programs.)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC
20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.
If the material is too small to permit the full statement to be included, the material must at minimum, include the following statement, in print size no smaller than the text:
“This institution is an equal opportunity provider.” SECTION 13. AGENCY RECOGNITION REQUIREMENTS Use of Agency Insignia. Subrecipient shall request in writing permission from the USFS Northern Region and receive written permission from the USFS before using the USFS insignia
on any published media, such as a webpage, printed publication, or audiovisual production. Subrecipient shall request in writing and receive written permission from the DNRC before using the DNRC insignia on any published media, such as a webpage, printed publication, or audiovisual production. Public Notices. Subrecipient is encouraged to give public notice of the receipt of this subaward
of federal grant funds and, from time to time, to announce progress and accomplishments. Press releases or other public notices should include and all notices of funding opportunities or solicitation for project participants must include a statement substantially as follows: “The
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funding for this project is derived in full [or in part] from a federal award of the U.S. Forest Service, Department of Agriculture, subawarded by the Montana Department of Natural
Resources and Conservation, Forestry Division.” Acknowledgment in Publications, Audiovisuals, and Electronic Media. Subrecipient shall
acknowledge USFS and DNRC support as appropriate in any publications, audiovisuals, and electronic media developed as a result of this subaward of USFS grant funds. Follow direction in USDA Supplemental 2 CFR 415.2. SECTION 14. COPYRIGHTING AND GOVERNMENT RIGHT TO USE. Subrecipient is granted
sole and exclusive right to copyright any publications developed as a result of this award. The
State of Montana and the USFS reserve a royalty-free, nonexclusive, and irrevocable right to
reproduce, publish, or otherwise use, and to authorize others to use the work for government purposes. This provision includes any right of copyright to which Subrecipient purchases
ownership with any federal contributions. No original text or graphics produced by the State of
Montana or the USFS shall be copyrighted. SECTION 15. FAILURE TO COMPLY. If the Subrecipient fails to comply with the terms and conditions of this Subaward, the DNRC may terminate this Subaward and refuse additional disbursements of subaward funds and take legal action to recover disbursed subaward funds. Such termination will become a consideration in the DNRC’s evaluation of future applications for subawards. SECTION 16. ASSIGNMENT AND AMENDMENT. The Subrecipient may not assign or transfer any portion of this Subaward without the DNRC’s express written consent. Amendments will be in writing, signed by both parties, and attached as an integral component of this Subaward. This
Subaward may be terminated by the mutual written consent of both parties. If this Subaward is terminated, the Subrecipient may not submit claims for reimbursement for costs incurred beyond the mutually agreed to termination date.
SECTION 17. MONTANA LAW AND VENUE. Any action or judicial proceeding for enforcement of the terms of this Subaward shall be instituted only in the courts of Montana and shall be
governed by the laws of Montana. Venue shall be in the First Judicial District, Lewis and Clark County, Montana. SECTION 18. AGREEMENT EXTENSION. This Subaward may, upon mutual written agreement between the parties and according to its terms, be extended. SECTION 19. INDEMNITY AND LIABILITY (HOLD HARMLESS / INDEMNIFICATION). Subrecipient agrees to be financially responsible for any audit exception or other financial loss to the DNRC and the State of Montana which occurs due to the negligence, intentional acts, or failure by Subrecipient and/or its agents, employees, subcontractors, or representatives to comply with the terms of this Subaward.
Subrecipient hereby agrees to defend, indemnify, and hold harmless the DNRC and the State of Montana and its agents from and against any and all claims, demands, or actions
for damages to property or injury to persons or other damage to persons or entities arising out of, or resulting from the performance of this Subaward or the results of this Subaward, provided such damage to property or injury to persons is due to the negligent act or
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omission, recklessness, or intentional misconduct of Subrecipient or any of its employees. This Subaward is not intended to relieve a liable party of financial or legal responsibility.
SECTION 20. INSURANCE REQUIREMENTS. General Requirements. The Subrecipient shall maintain for the duration of this Subaward, at its cost and expense, insurance against claims for
injuries to persons or damages to property, including liability, which may arise from or in connection with the performance of the work by the Subrecipient, agents, employees, representatives, assigns, or contractors. This insurance shall cover such claims as may be caused by any negligent act or omission.
Specific Requirements for Commercial General Liability. The Subrecipient shall purchase and maintain occurrence coverage with combined single limits for bodily injury, personal injury, and property damage of $750,000 per occurrence and $1,500,000 aggregate per year to cover such claims as may be caused by any act, omission, or negligence of the Subrecipient or its officers, agents, representatives, assigns or contractors. This Subaward consists of pages 1 – 8, plus the following appendices:
• Appendix A [Form AD-1048]
• Appendix B [Quarterly Report Format]
• Appendix C [Final Report Format]
• Appendix D [Request for Disbursement Form].
The Subrecipient hereby accepts this Subaward according to the above terms and conditions.
__________________ By: ______________________________________________ Date Subrecipient or Subrecipient’s Authorized Representative _____________________________________________ Printed Name
__________________ By: ______________________________________________
Date DNRC Authorized Representative
______________________________________________ Printed Name
DocuSign Envelope ID: E2F03E8C-0A39-4050-84EB-BB8CC2D55169
Jeff Mihelich
11/17/2021 | 2:54:58 PM PST
Erik Warrington
11/22/2021 | 2:59:01 PM PST
This form is available electronically. Form Approved – OMB No. 0505-0027
Expiration Date: 04/30/2022
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion AD-1048
Lower Tier Covered Transactions
The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. § 552a, as amended). This certification is required by the regulations
implementing Executive Order 12549, Debarment and Suspension, and 2 C.F.R. §§ 180.300, 180.335, Participants' responsibilities. The regulations were
amended and published on August 31, 2005, in 70 Fed. Reg. 51865-51880. Copies of the regulations may be obtained by contacting the Department of
Agriculture agency offering the proposed covered transaction.
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 0505-0027. The time required to
complete this information collection is estimated to average 15 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 provisions of appropriate criminal and
civil fraud privacy, and other statutes may be applicable to the information provided.
(Read instructions on page two before completing certification.)
A.The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this
transaction by any Federal department or agency;
B.Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this proposal.
ORGANIZATION NAME PR/AWARD NUMBER OR PROJECT NAME
NAME(S) AND TITLE(S) OF AUTHORIZED REPRESENTATIVE(S)
SIGNATURE(S) DATE
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and
institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender
expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior
civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or
incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact
the responsible agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program
information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint (https://www.ascr.usda.gov/filing-program-discrimination-complaint-usda-customer) and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442.
Appendix ADocuSign Envelope ID: E2F03E8C-0A39-4050-84EB-BB8CC2D55169
City of Bozeman FHE-21-101
Jeff Mihelich
11/17/2021 | 2:54:58 PM PST
City Manager
Instructions for Certification
(1)By signing and submitting this form, the prospective lower tier participant is providing the certification set out on page 1 in
accordance with these instructions.
(2)The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was
entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government, the department or agency with which this transaction originated
may pursue available remedies, including suspension or debarment.
(3)The prospective lower tier participant shall provide immediate written notice to the person(s) to which this proposal is submitted if
at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
(4)The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person,"
"primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out
in the Definitions and Coverage sections of the rules implementing Executive Order 12549, at 2 C.F.R. Parts 180 and 417. You
may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those
regulations.
(5)The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into,
it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible,
or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which
this transaction originated.
(6)The prospective lower tier participant further agrees by submitting this form that it will include this clause titled "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions," without
modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.
(7)A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction
that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its
principals. Each participant may, but is not required to, check the System for Award Management (SAM) database.
(8)Nothing contained in the foregoing shall be construed to require establishment of a system of records to render in good faith the
certification required by this clause. The knowledge and information of a participant is not required to exceed that which is
normally possessed by a prudent person in the ordinary course of business dealings.
(9)Except for transactions authorized under paragraph (5) of these instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension and/or debarment.
Form AD-1048 (REV 12/18)
Page 2 of 2
Appendix ADocuSign Envelope ID: E2F03E8C-0A39-4050-84EB-BB8CC2D55169
QUARTERLY REPORT FOR SUBAWARD AGREEMENT NUMBER: xxx - xx - xxx
Reporting period: Select Quarter , Select Year
Agreement termination date: Click to enter/select date
List Outreach Activities # Educational Programs
Completed
This Quarter this quarter this quarter
Enter Narrative Here. A narrative describing project progress, process, challenges, and other pertinent
information is required. If project includes multiple geographic areas, please provide a detailed
description of where project accomplishments occurred (e.g., 20 acres and 10 property assessments
completed in Gold Creek, 1 community meeting held in Potomac, etc.). Include before/after photos and
other representative information to support narrative.
Enter Summary Here. A summary of a monitoring review held with DNRC staff member, as applicable.
Appendix B
SUBAWARD AGREEMENT
SUGGESTED QUARTERLY REPORT FORMAT
Enter Name of Organization Here
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Subaward Agreement
FINAL REPORT FORMAT
Title Page:
1. Subrecipient’s name, address & telephone numbers.
2.Name, address, and telephone numbers of others who may be contacted concerning the
project if the primary contacts are not available.
3.Funding: Total project cost and amount of subaward.
Introduction:
Describe the project history, project location, and the purpose of the project.
Discussion and Results:
1.Document that project goals, objectives, and tasks identified in the Subaward have been
completed. Copy the project goals, objectives, and tasks verbatim. After listing each
goal, object, and task, document that they were completed. If any were not completed,
explain why. It is very important that you provide evidence that the agreement was
completed as agreed to in Section 4 of the Subaward, Project Scope.
2.Summarize any problems encountered and solutions adopted. What would you do
differently?
Public Benefits:
List the anticipated overall public benefits of the project as stated in the grant application. Were
these benefits realized? If not, explain why not.
Subaward Administration & Project Costs:
1. Budget
Include a summary of how the monies were spent by budget category and source of
funding. Was the project completed according to budget? Explain any cost overruns or
savings. Discuss any unbudgeted expenses that arose over the course of the project.
2.Matching Funds
Identify the matching funds that were to be spent according to the Subaward. Document
that these funds were spent. If not all matching funds were spent, explain why.
Appendix C
DocuSign Envelope ID: E2F03E8C-0A39-4050-84EB-BB8CC2D55169
Grant Agreement Number / Project Name
From (mm/dd/yy):To (mm/dd/yy):
Direct Costs:
Subrecipient Salary/Wages/Benefits $0.00
Operating Expenses $0.00
Payments to Landowners (Beneficiaries)$0.00
Contracted Services $0.00
SubTotal $0.00 $0.00 $0.00 $0.00 $0.00
Indirect Costs:$0.00
TOTAL $0.00 $0.00 $0.00 $0.00 $0.00
Date
Grant balance
remaining
(after this request)
Cumulative match
expenses to date
(if applicable)
Request for Disbursement of DNRC Grant Funds / Financial Status Report
Request for Reimbursement
Grantee Name
Period covered by this request:
Request for Advance
Grantee Representative / Preparer's Signature
Total Grant Budget
by category
(from grant agreement)
Funds received from
DNRC
(before this request)
Disbursement
amount
requested
Revised Aug 2015
Appendix D
DocuSign Envelope ID: E2F03E8C-0A39-4050-84EB-BB8CC2D55169