FS-2700-4h, Append Appendix B – Annual Granger-Thye Fee Offset Agreement

Authorization ID: #AUTH_ID# FS-2700-4h, App. B (09/2020)

Contact ID: #HOLDER_ID# OMB No. 0596-0082

Expiration Date: #EXPIRATION_DATE#

SPECIAL USE PERMIT FOR

CAMPGROUND AND RELATED GRANGER-THYE CONCESSIONS

APPENDIX B

Annual Granger Thye Fee Offset Agreement

AUTHORITY: Section 7 of the Granger-Thye Act, 16 U.S.C. 580d

<Reference FSH 2709.11 chapter 50>

This Annual Granger-Thye (GT) Fee Offset Agreement (agreement) is made by [name] (the holder) and the U.S. Department of Agriculture, Forest Service, [name] National Forest (the Forest Service), under section 7 of the G-T Act, 16 U.S.C. 580d, and clause IV.E of the special use permit issued to the holder on [date] (the permit). The total estimated annual land use fee is [amount]. [ ] percent of that land use fee may be offset by the cost incurred by the holder for the Government maintenance, reconditioning, renovation, or improvement (MRRI) projects listed below in accordance with this agreement. Additionally, [ ] percent of that fee may be offset by the cost incurred by the Forest Service for the Government MRRI projects under a separate collection agreement. Projects to be performed by the holder shall be completed by the date specified and within the holder’s fiscal year for the year the fee is due. The Forest Service may modify the projects and dates as necessary, after consultation with the holder.

1. Amount of Land Use Fee Subject to Offset. The actual cost of each project that is satisfactorily completed as determined by the Forest Service may be offset against the holder’s land use fee. Due dates and cost estimates for completion of each project are enumerated below. Examples of allowable costs include salaries and wages, materials and supplies, and subcontracts that are direct costs of a G-T fee offset project and indirect costs based on an approved indirect cost rate. The total cost for Government MRRI projects to be performed under this agreement shall not exceed the holder’s annual land use fee.

2. Projects and Project Costs Covered by This Agreement. Upon a determination by the Forest Service that a project has been satisfactorily completed by the holder, the holder shall submit documentation of its actual cost to the Forest Service and shall certify that the representations in that documentation are accurate and complete. The certification shall be signed and dated, and shall state that failure to sign the certification shall vitiate the fee offset claim. The Forest Service shall verify that documentation before giving any credit against the holder’s land use fee, and reserves the right not to grant any fee offset if any representations in the documentation are inaccurate or incomplete.

The holder shall perform the work itemized below under this agreement.

Description of Project	Due Date	Estimated cost	Completion Date	Actual Cost
[itemize projects]	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     
     	     	     	     	     

<USER NOTES FOR PARAGRAPH 3>

<Include paragraph 3 if the total estimated cost of Government MRRI projects to be performed under this agreement exceeds $2,000 and the holder is a private entity or a state or governmental entity that is contracting with a private entity to perform the Government MRRI projects. Otherwise delete paragraph 3, and re-number the remaining paragraph.>

3. Davis-Bacon Act Requirements. This agreement is subject to the Davis-Bacon Act, 40 U.S.C. 3141 et seq., and its implementing regulations at 29 CFR 5.5. These regulatory requirements are incorporated by reference into this agreement as if fully set forth in this agreement.

4. Documentation of Project Costs. Upon a determination by the Forest Service that a project has been satisfactorily completed by the holder, the holder shall submit documentation of its actual cost to the Forest Service and shall certify, using form FS-2700-4h, Appendix G, that the representations in that documentation are accurate and complete. The certification shall be signed and dated and shall state that failure to sign the certification shall vitiate the fee offset claim. The Forest Service shall verify that documentation before giving any credit against the holder’s land use fee and reserves the right not to grant any land use fee offset if any representations in the documentation are inaccurate or incomplete.

___________________________________________________________________________________

[NAME AND TITLE OF PERSON SIGNING ON BEHALF OF HOLDER, DATE

IF HOLDER IS AN ENTITY]

#HOLDER_NAME#

APPROVED:

___________________________________________________________________________________

#AUTHORIZED OFFICER NAME# DATE

#TITLE#

National Forest

USDA Forest Service

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 0596-0082. Response to this collection of information is mandatory. The authority to collect the information is the Organic Administration Act, 16 U.S.C. 551. The time required to complete this information collection is estimated to average 1 hour 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.

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 TYY) 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 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; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

The Privacy Act of 1974, 5 U.S.C. 552a, and the Freedom of Information Act, 5 U.S.C. 552, govern the confidentiality to be provided for information received by the Forest Service.

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