Standing Corn Agreement Form

STANDING CORN ROW AGREEMENT

Winter Season of Trunk Highway Drift Plow Route # Reference Post Protection Identification to

County Truck Station Township Sectio Townshi Range Name n p ¼

Participant(s) agree(s) to leave standing corn rows along Trunk Highway by refraining from harvesting acres of corn stalks setback feet back from the Right of Way until . (date) After this date, the farm operator may remove the standing corn rows without notification from MnDOT. In consideration for this service, the Minnesota Department of Transportation (MnDOT) agrees to pay Participant(s) according to Section 1 Payment Formula below provided that MnDOT certifies that the terms and conditions contained in this Contract have been met.

PAYMENT FORMULA

(Round all numbers to the second decimal point)

a) Acres of corn left standing =

Length ft. X width ft. ÷ 43,560 ft.2

= acres (Round to the second decimal point.)

b) Multiply line (a) above by $ per acre

= $ (For total payment made under this agreement)

Appropriate payment is to be made after final inspection on or before April 30, .

FARM OPERATOR INFORMATION

Final Standing Corn Row Agreement.docx (Rev. 4-25-2017) 1 DATAName: PRACTICES Addres s:Books, records, documents, and accounting procedures and practices of the landowner relevant to the agreement shall be subject to examination by the contracting department or agency and the legislative auditor.City: State: PARTICIPANTS-SIGNATURES Zip: By signing below, Participant(s) agree(s) to the terms and conditions in this Contract and that the information I have providedPhone: is the amount on line (b) of the Payment Formula.

Participant(s)E-Mail: may receive a W-9 verification form requiring further information to register as a vendor with the State of Minnesota. Participant(s) will receive a 1099 form, which reports the amount received from the State of Minnesota from this Contract within the calendar year.

Participant(s) has/have read and understands the terms and conditions of this Contract and agrees to its term and conditions.

Farm Operator Signature Date

Area Maintenance Engineer Signature Date

(with delegated authority) LENGTH OF THIS AGREEMENT IS ONE WINTER SEASON.

Inspected and Approved for Payment (To be signed in spring after services verified and complete)

(Signature) (Date)

...... TO BE COMPLETED BY THE MNDOT DISTRICT BUSINESS OFFICE Purchase Order No. Vendor No. & Location No. Category

FUND: FIN DEPT ID: APPROP ID:

ACCOUNT: PROJECT ID: SOURCE TYPE:

TAXABLE: NO

This signed form serves as the Use the vendor number as the Note to Business Office: invoice invoice number

STANDING CORN ROW BLOWING SNOW CONTROL PROJECT LOCATION AND PLAN

Please draw the standing corn rows on the grid below to dimension their length and location from the roadway. NORTH

Final Standing Corn Row Agreement.docx (Rev. 4-25-2017) 3