Statement of Work s11

Attachment 1 FWS Agreement No: 6XXXX-A- JXXX

CHALLENGE COST SHARE AGREEMENT (CCSA) STATEMENT OF WORK

I. BACKGROUND

II. PURPOSE AND OBJECTIVES

III. RESPONSIBILITIES OF THE PARTIES A. The Service will:

B. The Recipient will:

IV. REPORTING and/or DELIVERY REQUIREMENTS The cooperator will forward to the Service Project Officer a final report summarizing all project accomplishments under this award no later than 60 days after the completion of project. The Service Project Officer shall provide a final report of all parties to the Challenge Cost Share Coordinator at the end of the Fiscal Year.

V. CONTRIBUTIONS OF THE PARTIES AND FINANCIAL ADMINISTRATION A. The Cooperator shall provide contributions valued at $______and the Service shall provide contributions valued at $______toward the total project cost of $______.

B. [Insert here an explanation of whether any Service funds will be provided to the Cooperator, or if there will be no exchange of funds at all. Use the samples at the end of this document for basic ideas to fill within these brackets. These samples are for guidance only and should be deleted from the end of this document before application packet is submitted.]

VI. CERTIFICATION ADDENDUM

By signature on page one, Cooperator affirms that no less than 50 percent of the total cost of the project will be contributed by Cooperator and that no portion of the Cooperator’s contribution is of Federal origin. Cost-share value can be derived from labor, materials, equipment, land, water, in-kind services, and/or cash.

VII. PAYMENT PROVISIONS, if applicable VIII. FINANCIAL STATUS REPORTING, if applicable IX. TERMS AND CONDITIONS, if applicable X. MODIFICATIONS XI. SPECIAL PROVISIONS, if applicable XII. TERMINATION

(Details in section VII through XII will be provided by CGS). Attachment 1 FWS Agreement No: 4XXXX-A-JXXX Page 2 of 2 SAMPLES FOR V. CONTRIBUTION OF THE PARTIES AND FINANCIAL ADMINISTRATION

Sample 1: The Service shall reimburse Cooperator for not more than $______[Service funding] of actual and reasonable costs incurred in completion of this project. Cooperator shall invoice the Service [specify either monthly or upon completion of project] for their costs by submitting to the Service Project Officer an itemized statement with receipts for actual cash expenses.

Sample 2: The Service will fulfill its obligation of the cost-share by means of employee services and third-party acquisitions. Service employee salaries and equipment use will be charged to this agreement’s charge code; and the purchase of [specify items to be purchased, if any] will be accomplished through third-party acquisitions utilizing this agreement’s charge code. The Cooperator will fulfill its cost-share obligation by sending a certified check, cashier’s check, or money order payable to the “United States of America” in the amount of (U.S.) $______to the Service Project Officer identified in section V below upon signing this agreement. These funds will be used to offset costs associated with this project.

Sample 3: There will be no exchange of funds between the parties under this agreement. The Service will fulfill its cost-share obligation by means of employee services and purchases of supplies and/or services from others. Service employee salaries and equipment use will be charged to this agreement’s charge code; and the purchase of [specify items to be purchased, if any] will be accomplished through third-party acquisitions utilizing this agreement’s charge code. The Cooperator will fulfill its cost-share obligation by contributing [specify in-kind service, purchase of materials, salaries, etc.].