Resolution No. 5667 Forestry Grant Exhibit A Agreement

City of Chandler — Regular Meeting (2023-04-13)

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Arizona Department of Forestry and Fire Management
Grant Agreement No.  CCG 22-103
Community Challenge Grant Program
This grant agreement (“Agreement”) is entered into by and between the (“Grantee”) Arizona
Department of Forestry and Fire Management (“State Forestry” or “State”) and (“Sub-grantee”),
City of Chandler (UEI #LCLUQVAP1WU4), pursuant to the Cooperative Forestry Assistance
Act of 1978, Public Law 95-313, as amended; Food, Agriculture, Conservation, and Trade Act of
1990, as amended, Public Law 101-624.
I.
PURPOSE OF AGREEMENT
State Forestry is a primary recipient of grant funds provided by the USDA Forest Service
to assist in the advancement of forest resources management; forest insect and disease
management, urban and community forestry, development and transfer of new and
improved fire control technologies, organization of shared fire suppression resources,
forestry resources planning, conservation of forest land, and achievement of a number of
other goals for the use and protection of forest lands. This agreement is a sub-award of
those federal grant funds authorized under Arizona Revised Statute 37-1302.
Subaward of Federal Award # 22-DG-11030000-008, dated 8/25/2022
The Federal Assistance Listing Number is 10.664, Cooperative Forestry Assistance, U.S.
Department of Agriculture, Forest Service.
II.
SCOPE OF WORK
Compensation is contingent upon Sub-grantee fulfilling the Scope of Work and project
commitments as identified in the Grant Application (Attachment A) and as amended by
the approved Detailed Project Plan (Attachment B).
III.
PROGRAMMATIC CHANGES
Sub-grantee shall obtain prior approval for any changes to the scope of objectives of the
approved project, key personnel, or transfer of substantive programmatic work to another
party.
IV.
TERM OF AGREEMENT
This Agreement shall be effective immediately upon signature by all parties and will
terminate on March  31, 2024 unless otherwise terminated or modified pursuant to the
terms herein.
V.
COMPENSATION AND MATCHING INVESTMENT
Grant funds may be utilized for up to 50% of the total cost of this program.
A contribution by the Sub-grantee for an additional Cost Share Match of 50% of the total
cost of the program is required (including contributions of third parties). Support
documentation outlining project costs including cost share match is required.
Compensation under this agreement shall be on a reimbursement basis, shall not exceed
the total eligible costs of the project, and total compensation (federal portion) shall not
exceed $40,000.00
______________________________________________________________________________
v.DFFM 10/2022
Page 1 of 6

Only costs for those project activities approved in (1) the initial award, or (2) approved
modifications thereto, are allowable. All payments are contingent upon the availability of
funds and reimbursement by the United States Department of Agriculture, Forest Service.
Reimbursement payments will be made to the Sub-grantee normally within ninety days
after receipt of the reimbursement request and required documentation.
VI.
ELIGIBLE COSTS
Eligible costs must be incurred during the Term of the Agreement, conform with the
General Provisions of this Grant Agreement (Attachment C) and all other provisions
identified herein, and be submitted to State Forestry along with detailed supporting
documentation. This is a reimbursable grant program. Support documentation must show
dates and amounts of all expenses (See Attachment D).
Reimbursement for purchase of Capital Equipment (equipment costing more than $5,000
per unit price) is NOT allowed under this agreement. Capital Equipment may only be used
as match with prior approval from State Forestry.
This is an award of Federal financial assistance and is subject to the Office of Management
and Budget (OMB) guidance in Subparts A through F of 2 CFR Part 200 as adopted and
supplemented by the USDA in 2 CFR Part 400. All Federal and Sub-grantee
matching/cost-share contributions are subject to applicable guidance. All project
expenditures are subject to the Single Audit act of 1984 and payments shall adhere to the
Federal Cash Management Improvement Act (CMIA).
VII.     ADMINISTRATIVE AND ACCOUNTING REQUIREMENTS
It shall be the responsibility of the Sub-grantee to establish and document both accounting
and administrative control procedures for their organization. Such procedures shall be
followed to ensure grant funds are being tracked and spent in accordance with all
applicable laws and within the terms of the grant agreement/award. Sub-grantee accepts
full liability for resources administered through the grant.
VIII.
AUDIT REQUIREMENTS
SINGLE AUDIT ACT OF 1984: All project expenditures are subject to the Single Audit
act of 1984 and all relevant Office of Management and Budget (OMB) guidance including
2 CFR 200, Subpart F. Sub-grantees are subject to audit if their share of federal financial
assistance is $750,000 or more for a single fiscal year. Federal financial assistance includes
reimbursements under this award and all other financial assistance originating from any
agency of the federal government during the Sub-grantee’s fiscal year. Sub-grantee will be
required annually to report compliance with this requirement.
ARS 35-181.03. Sub-grantee must also comply with applicable ARS 35-181.03 provisions
for financial and compliance audits.
In the event that an audit determines that unallowable costs have been charged to the grant
and funds have been disbursed to the Sub-grantee, then the Sub-grantee accepts full
liability and must pay back all costs incurred and deemed unallowable. Any audit
involving a Federally-funded grant shall provide a copy of the audit report to the Federal
Audit Clearinghouse within 30 days after receipt from the auditor or nine months from the
close of the sub-grantee’s fiscal year, whichever is earlier.
______________________________________________________________________________
v.DFFM 10/2022
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IX.
PROCUREMENT REQUIREMENTS
All procurement activities shall be in compliance with State, Federal, and local laws
including Office of Management and Budget (OMB) guidance in subparts A through F of
2 CFR Part 200, Subpart D as adopted and supplemented by the USDA in 2 CFR Part 400.
All Sub-grantees are responsible for developing, documenting, and adhering to their own
established procurement processes that include both administrative and accounting
controls.
X.
REPORTING REQUIREMENTS
Sub-grantee shall monitor the performance of the grant activities to ensure that
performance goals are being achieved. Sub-grantee shall provide detailed grant/project
accomplishments in quarterly reports to State Forestry no later than 30 days after the end
of each calendar quarter, or as requested by State Forestry. Quarterly performance reports
shall follow the format identified in Attachment E or as may be revised by State Forestry.
Reports (quarterly and final reporting) will contain information on the following: (1) A
comparison of actual accomplishments to the goals established for the period and for the
entire program or project, (2) Output of the project that can be readily expressed in
numbers, such as acres of forest treatment, number of citizens served, or other similar
activities. A computation of cost per unit of output may be required where applicable, (3)
Reason(s) for delay if established goals were not met. (4) Additional pertinent information
including, when appropriate, analysis and explanation of cost overruns or high unit costs.
(5) Before and after pictures (required for final report and optional for quarterly reporting).
(6) Mapping in the form of a pdf/paper map and matching shapefiles (if required for final
reporting, see Section XI below).
Financial/Reimbursement requests may be submitted as often as monthly. Reimbursement
requests shall follow the format as identified in Attachment E or as may be revised by
State Forestry. Reimbursement requests submitted with documentation (grant share or
match) that is older than 6 months will not be accepted without prior approval.
Cumulative match share must accrue proportionally with reimbursable costs. Each
reimbursement request must have the minimum required match share included and
documented (minimum cumulative match must reflect equal proportion to the cumulative
total amount). It is allowed to document match over the required match share in each
reimbursement request and to use this towards the total grant match requirement.
Financial/Reimbursement requests may be held for processing until quarterly
accomplishment/performance reports are current.
A final accomplishment report and all financial/reimbursement requests and required
documentation shall be provided at completion of the grant project, but no later than 30
days after the end of grant the term. Final financial reimbursement may be held until all
accomplishment reporting is complete and submitted to State Forestry.
All accomplishment and financial reports shall be submitted to the State Forestry contact
as identified below in Section XIII (PRINCIPLE CONTACTS).
Sub-grantee shall immediately notify State Forestry of developments that have a
significant impact on the activities supported under this grant. Also, notification shall be
given in case of problems, delays or adverse conditions that materially impair the ability to
______________________________________________________________________________
v.DFFM 10/2022
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meet the objectives of the agreement. This notification shall include a statement of the
action taken or contemplated, and any assistance needed to resolve the situation.
Any change to the original grant application scope of work or approved detailed project
plan must have prior written State approval. Incurring costs without prior written approval
may result in loss of funds reimbursed.
XI.
MAPPING (CHECK ONE)           _____ Required                 _X____ Not Required
Project Center Coordinates (in Decimal Degrees):
Latitude (y-coordinates) _____________     Longitude (x-coordinates) _____________
Center coordinates are required for all projects, regardless of mapping requirements. If the
project requires a mapping component, both a 1-page PDF map and matching GIS
(Geographic Information System) polygon data are required prior to project start date and
at the time of final accomplishment report submission. Data files (Shapefiles, File
Geodatabase, or KML polygons) created using GIS applications, must be submitted
showing treatment/project area(s) and their name(s) or parcel number(s). GIS acres must
match projected and actual treatment acres.
XII.
COMPLIANCE AND PERMITS
Grantee agrees that it is responsible for acquiring all permits required by applicable
federal, state, and local jurisdictions prior to treatment. Grantee also agrees that it is
responsible for adherence to all applicable statutes, regulations, ordinances, and codes
promulgated by applicable federal, state, and local jurisdictions, including but not limited
to environmental regulations concerning the presence, existence, discharge, emission, or
removal of any substances such as by-products, wastes, pollutants, and hazardous and
toxic materials.
XIII.
PRINCIPAL CONTACTS
NOTE: Principal contact should be one contact person responsible for overseeing all
elements of the grant project including but not limited to accounting, administrative and
field portions of the project.
Each party certifies that the individuals listed below are authorized to act in their
respective areas for matters related to this instrument.
Principal Sub-grantee Fiscal Contact:
Robert Steele,  Accounting Supervisor
175 S Arizona Ave
Chandler,  AZ 85225
480-782-2324
robert.steele@chandleraz.gov
Principal Sub-grantee Programmatic Contact:
Ryan McCartney,  Urban Forester
175 S Arizona Ave
Chandler,  AZ 85225
480-782-2748
ryan.mccartney@chandleraz.gov
______________________________________________________________________________
v.DFFM 10/2022
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Principal Arizona State Forestry Contact:
Megan Lasley, Conservation Education Coordinator
Arizona Department of Forestry and Fire Management
1110 W Washington Street, Suite 500
Phoenix, AZ 85007
(602) 206-9830
mlasley@dffm.az.gov
XIV.
NOTICES
Any and all reports, notices, requests or demands given or made upon the parties hereto,
pursuant to or in connection with this Agreement, unless otherwise noted, shall be
delivered in person, sent by electronic mail, or sent by United States Mail, postage
prepaid, to the parties at their respective addresses as set forth immediately below:
STATE FORESTRY
John Richardson
Assistant State Forester
Arizona Department of Forestry
and Fire Management
1110 West Washington, Suite 500
Phoenix, AZ 85007
602-771-1420
jrichardson@dffm.az.gov
SUB-GRANTEE
John Sefton, Jr.
Director
Community Services Department
City of Chandler
175 S Arizona Ave
Chandler,  AZ 85225
480.782.2707
John.Sefton@chandleraz.gov
XV.
AWARD CLOSEOUT
Sub-grantee shall close out the grant within 30 days after expiration or notice of
termination. If this award is closed out without audit, Arizona State Forestry and the U.S.
Forest Service reserve the right to disallow and recover an appropriate amount after fully
considering any recommended disallowances resulting from an audit which may be
conducted later.
XVI.
AUTHORITY
Sub-grantee shall have the legal authority to enter into this agreement, and shall have the
institutional, managerial, and financial capability to ensure proper planning, management,
accounting and completion of the project, which includes funds sufficient to pay the
nonfederal share of project costs, when applicable.
XVII. ATTACHMENTS
The following Attachments are part of this Agreement:
A.
Project Application
B.
Detailed Project Plan
C.
General Provisions
D.
Documentation of Expenses
E.
Quarterly Report and Reimbursement Format
Additional Certifications (require separate signatures):
______________________________________________________________________________
v.DFFM 10/2022
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AD1048
- USDA Form AD-1048 Debarment Certification
Lobbying
- USDA Lobbying Certification
XVIII. IN WITNESS WHEREOF, the parties agree to execute this agreement as of the last date
written below.
STATE FORESTRY
Arizona Department of Forestry
and Fire Management.
1110 West Washington, Suite 500
Phoenix, AZ 85007
ACCEPTED BY SUB-GRANTEE
City of Chandler
175 S Arizona Ave
Chandler,  AZ 85225
_________________________________
________________________________
Signature
Signature
_________________________________
________________________________
Print or Type Name
Print or Type Name
Arizona State Forester
________________________________
Title
Date: ____________________________
Date: ___________________________
____________________________
Signature
____________________________
Print or Type Name
Assistant State Forester for Forestry Programs
Date: _______________________
______________________________________________________________________________
v.DFFM 10/2022
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APPROVED AS TO FORM:
__________________________
City Attorney

ATTACHMENT A 
 
Project Application 
(Cover Sheet)

Applications: Managing Chandler’s Urban Forest
Profile
ryan.mccartney@chandleraz.gov
1. Application/Project Title
Managing Chandler’s Urban Forest
2. Org Name
City of Chandler
3. Program/Project Congressional District (check all that apply)
5, 9
4. Program/Project Legislative District (check all that apply)
12, 13
5. Tree City USA (Yes/No)
Yes
6. Fitting this year's theme
Chandler’s tagline is that the City is a “Community of Innovation” and is a core value to implement unique, creative, and cost-
effective solutions that promote a forward-thinking organization.  The Community Services Department’s Parks Operations and 
Maintenance Division has embraced this value by taking the first steps to create an Urban Forestry program to develop and 
implement policies and procedures. This implementation is related to, the promotion, and management of the Urban Forest.  A 
critical first step of any program is to understand what assets an organization contains in order to make management decisions.  
To reach this goal, Chandler’s project proposal is to complete a tree inventory of its park systems, develop a management plan, 
and implement a tree inventory data management software system by utilizing the latest innovative technology to manage the 
City’s Urban Forest.
7. Project Need & Justification
The Urban Forestry program is new to Chandler and does not currently have a tree inventory.  This project will utilize the 
information to make informed management decisions regarding Chandler’s tree assets and tree benefits.  This is an important 
aspect of the inventory to quantify the benefits trees provide residents to gather further support for the new program.  The 
information aligns with the State’s strategic goal of “people and communities receive maximum benefits from forests and trees".
8. Project Outcomes
Completed tree inventory – 1 complete inventory
This will be a total collection of approximately 20,000 trees, stumps, and vacant planting sites within public spaces managed by 
the Parks division
A Data management software system – 1 active system
This system will be provided by the contractor that organizes the tree inventory and provides a visual representation of tree 
assets in GIS mapping
Urban Forest Management Plan – 1 comprehensive plan
An internal guiding document analyzing inventory

9. Scope of Work
The Parks Division will hire a qualified company with experience in tree inventory data collection and urban forest management 
plan preparation specific to the climate of the southwest Sonoran Desert to complete a public tree inventory, a web-based tree 
inventory data management software system, and an Urban Forest Management Plan (UFMP).  Due to municipal financial 
practices and estimated costs of the project, the contractor will be selected via a Request for Proposal process to select a 
company that will be most advantageous to Chandler’s project goals.  After the committee has selected a company, the following 
work will be completed:
• A contractor will furnish all labor, material, and equipment necessary to perform a GIS-based tree inventory to collect GPS tree 
data points and various site attributes along public parks, facility grounds, and other Park’s maintained public property for 
approximately 20,000. Inventory data will be provided in multiple formats.
• A contractor will collect the tree inventory data and management program to provide a computerized software program to be 
used by City staff to manage the urban forest. The software system should organize the tree inventory and provide a visual 
representation of tree assets in GIS mapping. Capabilities should include a web-based, mobile app, or cloud feature to allow staff 
to view and update the inventory in the field through the use of a mobile device.
• A contractor will develop a comprehensive UFMP that creates a vision and strategy to care for the long-term urban forest. The 
plan will be based on the tree inventory data and provide an analysis of overall, important trends with an emphasis on the unique 
climate of the southwest desert. The urban forest composition on attributes such as maintenance needs, health, and diversity 
should also be discussed.
All stakeholders within Parks will be involved throughout the process to provide project oversight as well as QC to achieve 
expected outcomes.
10. Project Timeline
At the start of Fiscal Year ’24 (July 1, 2023), the RFP process will be publicly advertised to solicit qualified vendors to submit 
proposals once funding is secured in the new fiscal year.  After being open for 3-4 weeks, the RFP process takes approximately 1 
month to select a contractor for the services.  A kick-off meeting will be held with the contractor and field collection of the tree 
inventory would begin in September 2023.  The goal would be to have the contractor collect at least 500 sites per day (5 
days/week) to complete the field inventory by November 1, 2023.  This will provide the contractor with two months to process, 
and quality assure the data, upload it to the software system, and complete the management plan.  All deliverables are expected 
to be finalized by the end of December 2023 to meet the deadlines of the CCG.  This information will be provided to the 
contractor during the RFP process so that they are to meet the deadlines outlined in the proposal.  All reimbursable items and 
final reports will be delivered to DFFM in the 1st quarter of 2024.
Quarterly accomplishments:
• Quarter 3 – 2023:
Advertise and complete the RFP process to select a contractor to provide all services in this proposal
Hold kick-off meeting to discuss expectations and begin field data collection of tree inventory
• Quarter 4 – 2023
Complete collection of field data
Process and quality control of collected field data
Load inventory data in software
Complete UFMP
11. Collaborative Elements and Partners
Partners will consist of various City of Chandler staff and a qualified contractor.  City staff will be responsible for drafting the 
scope of the work for the project, ensuring that all items are accounted for that will provide the most useful inventory data for 
proper management of the Urban Forest.  City staff includes members of the parks, procurement, GIS, and financial divisions to 
plan the project, review scopes of work, evaluate quotes and proposals, and select a contractor to perform the services.  Parks 
staff will maintain constant contact with the contractor throughout the implementation of the project.
The contractor will review the scope of the work and provide suggestions to improve or find efficiencies within the project.  The 
contractor is expected to meet with City staff to understand project needs, train their staff on consistent data collection within the
confines of the scope of work, and clarify any items in question prior to implementation of the inventory process.

12. Results and Evaluation Plan
To complete the inventory, the City will hire a professional tree company with ISA-certified arborists. Parks staff will monitor the 
tree inventory in conjunction with the contracted project manager.  The City will request frequent reports to keep track of the 
project and ensure progress to reach deadlines. If progress is delayed which would result in not completing the project on time, 
discussions will be had with the contractor to bring in additional support. All data for the inventory will be downloaded and added 
to the data management software. By conducting the proposed tree inventory program, receiving an inventory software program,
and developing an urban forestry management plan, the City will be closer to achieving the goal of creating a sustainable and 
resilient urban forestry program within Chandler that serves to promote the benefits trees provide to the entire City in a proactive 
and equitable way.  By understanding Chandler’s Urban Forest composition and maintenance needs, this will allow the City to 
make informed management decisions such as mitigating risk to the public, planting and diversifying the tree species, and 
projecting budget requests.  This is a major step in going from a reactive to a proactive program to improve overall forest health 
that maximizes the benefits trees provide.  This project will set up the baseline to check for successes and failures over time.
The results of the project will be listed in the urban forest management plan and provide internal guidelines on how to best 
manage Chandler’s tree assets.  The management plan will be shared with City staff, and i-Tree Eco data will be available to 
educate the public on the benefits the trees provide.
13. Sustainability Plan
The City will include all stakeholders at the onset of the project, it ensures that a variety of expectations and needs are 
considered before implementation.  The selection process will evaluate the contractors’ services and products to create buy-in 
from the City staff utilizing the project deliverables.  Utilizing an intuitive, user-friendly data management software program, staff 
will be more inclined to keep the inventory updated. The use of third parties to perform subsequent inventories  will not require 
additional funding. This will allow Chandler to make management decisions that are based on accurate data.  Accurate data will 
assist in making business decisions to reach long-term goals such as creating an internal forestry crew to perform proactive 
maintenance, tracking urban tree canopy levels, and eventually creating an Urban Forest Master Plan for a City-wide vision of the 
program.
14. Project Budget Narrative and Financials
A tree inventory, software, and Urban Forest Management Plan quote was generated and sent to multiple vendors who perform 
the tasks within the scope.  Based upon the quotes received, The Community Services Department will submit a Business 
Decision Package request through the City's Budget process for one-time funding. 
The total estimated cost of the project is $102,000 based on quotes received from ArborPro and PlanIt Geo.  Quotes are available 
to show how Chandler arrived at this number.  The City will pay for the project from the Parks Operations and Maintenance 
operating budget funded through the City's General Fund and is asking for a grant match of up to $50,000 to support the total 
project cost.  Any costs above the 50% match will be paid for by the City.  Grant contingency funds are available and will cover 
the 50% match up front money if awarded.
Upload Budget Worksheet
CCG_Budget Worksheet.doc
Upload Letters of Partner Support (optional)
 
Upload Maintenance/Management Plan (optional)
City of Chandler - Tree Inventory Scope.docx
Average Score
0.00
# of Reviews
14
# of Denials
0
Applications: File Attachments

Upload Budget Worksheet
CCG_Budget Worksheet.doc
Upload Maintenance/Management Plan (optional)
City of Chandler - Tree Inventory Scope.docx

Page 1 of 1 
          
Community Challenge Grant Program  
Budget Attachment 
City of Chandler, AZ 
 
 
 
 
 
 
1 
Grant Contributors (Matching Share) 
 
Please specify each match contributor and the dollar amount of each contribution. 
Please DO NOT show grant requested funds in this table.  This is for matching share only. 
Contributors: 
(Please specify) 
City of 
Chandler 
      
      
      
      
      
TOTAL 
Dollars (Hard Match): 
$102,000 
$0 
$0 
$0 
$0 
$0 
$  102,000 
In-Kind (Soft Match): 
$0 
$0 
$0 
$0 
$0 
$0 
$   0 
TOTAL: 
$   0 
$   0 
$   0 
$   0 
$   0 
$   0 
$  102,000 
 
 
 
 
 
2 
Total Project Expense (break down your grant request and the matching share 
totals from block 1 above) 
 
Grant Share 
($ Amount 
Requested) 
Match (from block 1 above) 
TOTAL 
 
 
Dollars 
In-Kind 
 
Personnel / Labor: $0 
$0 
$0 
$   0 
Operating / Supplies: $0 
$0 
$0 
$   0 
Travel: $0 
$0 
$0 
$   0 
Contractual Services: $50,000 
$102,000 
$0 
$102,000 
Equipment: $0 
$0 
$0 
$   0 
Indirect Costs: $0 
$0 
$0 
$   0 
TOTAL: 
$   $50,000 
$   $102,000 
$   0 
$102,000 
 
 
A clear description of how the above grant funds will be spent shall be completed in the 
Scope of Work section of the online grant application.

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
City of Chandler Tree Inventory, Software, and Urban Forest Management 
Plan - Quote 
 
Project Description 
The City of Chandler, Parks Operations and Maintenance Division, is seeking quotes from 
qualified companies with experience in tree inventory data collection and urban forest 
management plan preparation specific to the climate of the southwest Sonoran Desert to 
consider a public tree inventory, a web-based tree inventory data management software 
system, and an Urban Forest Management Plan. 
 
Chandler’s Parks Operations and Maintenance Division are stewards of over 1,500 acres, 
containing 70 developed and undeveloped parks, 60 athletic and multi-use fields, 155 
ramadas, 95 playgrounds, 26 tennis courts, 9 pickleball courts, 35 sand volleyball courts, 60 
basketball courts, 2 disc golf courses, 2 racquetball courts, 1 cricket field, 63.4 miles of 
walking and biking trails, 4 dog parks, 26 restrooms, 1 archery range, 1 skate park, 1 BMX 
bike park, 2 urban fishing lakes, and many more specialty parks and trail areas.  
 
The City does not currently have a tree inventory and will utilize the information to make 
informed management decisions regarding Chandler’s tree assets. Information such as 
quantities, species, locations, overall health, and maintenance recommendations will be 
used to develop a comprehensive management plan to guide maintenance and planting 
opportunities as well as detail the benefits the trees provide the City’s residents. All data will 
be stored in a software system that will allow City staff to view and update tree attributes in 
real-time. The City estimates that 20,000 – 25,000 trees are contained on public property 
maintained by the Parks Division. 
 
Note:  This document is to only obtain quotes at this time to seek budget requests to perform 
these services in Fiscal Year ‘24 (starting July 2023). When pricing the requested line items, 
factor in any increase in costs for this period. 
 
SCOPE OF WORK FOR SERVICES 
 
1. DESCRIPTION 
Task 1 - Public Tree Inventory:  
CONTRACTOR shall furnish all labor, material, and equipment necessary to perform a 
GIS-based tree inventory to collect GPS tree data points and various site attributes 
along public parks, facility grounds, and other public property for approximately 20,000 
– 25,000 trees. The CONTRACTOR shall provide inventory data in Microsoft Access, 
Microsoft Excel, and ESRI shapefile formats and is compatible with i-Tree.

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
Tree inventory data may include, but is not limited to: 
• 
Tree Record – Unique ID, GPS location, and Park/Facility name 
• 
Genus and Species – Common and Scientific 
• 
Diameter at Breast Height (DBH) 
• 
Tree Condition – ANSI A300 Standards 
• 
Risk Rating – Based on target, the likelihood of failure, and consequences.  A risk 
rating system will be used to prioritize maintenance needs. 
• 
Tree Height – 10’ increments 
• 
Vigor Class (Describes the health condition of the tree in terms of vigor/function) 
• 
Structure Class (Describes the health condition of the tree in terms of 
structure/stability) 
• 
Crown Spread – Widest & narrowest width in 10’ increments 
• 
Identify, note diameter and location of all stumps within every park 
• 
Location Type – Park, Retention Basin, Facility, Other, Etc. 
• 
Access (Describes the ease in accessing a tree site for workers and vehicles) 
• 
Ground Type – Natural (bare ground), Turf (irrigated grass), Mulch (decomposed 
granite, bark, etc.), Other 
• 
Space Size – Narrowest width in feet 
• 
Concerns – Any general abiotic or biotic health concerns (remove hardware, 
planted too deep, cavity/decay, pest problem, etc.) 
• 
Overhead Utilities – Yes/No, distance from 
• 
Irrigation – Drip, Flood, Bubbler, Other 
• 
Maintenance Needs – ANSI A300 Standards (Maintenance Priority, Maintenance 
Task) 
• 
Additional Comments – Open field 
 
Maintenance Needs will include Stump Removal to remove existing stumps and Plant 
to indicate potential planting sites for Small, Medium, and Large growing trees. Planting 
sites will be limited to locations where it is obvious a tree previously existed and 
contains the presence of irrigation. 
 
It is expected that the CONTRACTOR hold a kick-off meeting with the CITY before 
fieldwork commencement to introduce the inventory team, and discuss safety, 
communication, project timelines, and project expectations. CONTRACTOR shall have 
a certified ISA Arborist on staff to provide quality control/quality assurance of inventory 
data. 
 
REFERENCES (See the following references for more information)  
• 
International Society of Arboriculture. (2013). Best management practices: Tree 
inventories. 
2nd 
edition. 
Prepared 
by 
Jerry 
Bond. 
http://www.isa-
arbor.com/store/product.aspx?ProductID=137

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
• 
International Society of Arboriculture. (2011). Best management practices: Tree 
risk assessment. Prepared by Thomas Smiley, et al. http://www.isa-
arbor.com/store/product.aspx?ProductID=324  
• 
International Society of Arboriculture. (2011). ANSI A300 Part 9: Tree, shrub, and 
other woody plant management—standard practices (Tree Risk Assessment a. 
Tree Structure Assessment). Prepared by Thomas Smiley, et al. http://www.isa-
arbor.com/store/product.aspx?ProductID=324  
 
Task 2 – Data Management Software System: 
CONTRACTOR shall collect the tree inventory data and management program to 
provide a computerized software program to be used by CITY staff to manage the 
urban forest. The software system should organize the tree inventory and provide 
a visual representation of tree assets in GIS mapping. Capabilities should include a 
web-based, mobile app, or cloud feature to allow staff to view and update the 
inventory in the field through the use of a mobile device. 
 
The software system may include capabilities such as issuing and tracking work orders, 
budget tracking, highlighting environmental benefits, calculating tree replacement 
values, 
resident 
requests, 
maintenance 
schedules, 
maintenance 
activities, 
photographing trees, and create various reports. 
 
A public viewing portal to be incorporated on the City’s webpage may be desired for 
educational purposes. The information would be limited to allow the public to view tree 
species and the benefits individual trees provide. 
 
CITY shall own all inventory data at end of any service or term agreement for the 
software subscription. 
 
 
 
Task 3 – Urban Forest Management Plan: 
CONTRACTOR, with input from CITY, will develop a comprehensive Urban Forest 
Management Plan (UFMP) that creates a vision and strategy to care for the long-term 
urban forest. The plan shall be based on the tree inventory data and provide an analysis 
of overall, important trends with an emphasis on the unique climate of the southwest 
desert. The urban forest composition on attributes such as maintenance needs, health, 
and diversity should also be discussed. 
 
Content to be included in the management plan shall include, but is not limited to: 
• 
Executive summary of UFMP in infographic form to promote publicly 
• 
Trends and analysis of urban forest composition 
• 
Management needs of the urban forest and general recommendations 
• 
i-Tree Eco benefits analysis of environmental items

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
• 
i-Tree Canopy or equivalent tree canopy assessment analysis 
• 
A multi-year budget and management recommendations 
• 
Potential pests and disease management 
• 
Prioritized planting plan with a recommended species list 
• 
Charts and graphs to highlight analysis findings 
• 
Appendices with applicable information 
• 
Photographs of the tree, as well as expected lifecycle and maintenance needs 
 
CONTRACTOR will gather input from CITY stakeholders to develop the UFMP.  
CONTRACTOR will provide digital and hard copies of the UFMP as final deliverables. 
 
2. Work Schedule 
CONTRACTOR shall provide Contract Administrator/designee with a proposed work 
schedule, as well as the name of the Supervisor(s) who will oversee the work 
performed, and a telephone number(s) by which to contact them. The work schedule 
shall reflect adequate time for completion of all routine work activities on a daily and 
weekly basis. Work shall be scheduled so that it will not disrupt the functions and 
normal day-to-day operations of the park or facility. 
 
The schedule shall identify the task, frequency of work, and the number of workers 
performing each task. The schedule shall delineate time frames for each task by day 
of the week. A clear and implemented schedule shall be provided to the Contract 
Administrator/designee at the beginning of each contract and updated as necessary. 
A new work schedule shall be provided whenever a schedule is delayed, altered, 
or amended by no later than the end of the current week. 
 
The schedule shall be subject to Contract Administrator/designee approval. 
Significant changes in the schedule shall be submitted in writing to the Contract 
Administrator/designee and accompanied by a proposed revised schedule before 
implementation. 
 
The CITY reserves the right to make minor adjustments in the schedule at any time 
to avoid conflict with park construction, maintenance operations, and recreation 
programs, or to better serve the CITY's needs. 
 
CONTRACTOR shall perform landscape maintenance activities from 6:00 a.m. to 5:00 
p.m., Monday through Friday unless otherwise specified and excluding weekends and 
holidays.  
 
3. Quality Control

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
CONTRACTOR shall establish a complete quality control program to assure the 
requirements of the contract are provided as specified. An ISA Certified Arborist shall 
provide oversight of inventory to ensure high quality and consistency of data. One copy 
of the CONTRACTOR's quality control program shall be provided to the Contract 
Administrator/designee. The program shall include but not be limited to the following: 
 
• 
Weekly updates on inventory collection 
 
• 
List of ISA Certified staff providing quality control or in-field data collection 
 
• 
Inventory arborist must be on-site regularly to field-check the data collected by 
other staff to assure adherence to CITY work specifications and national industry 
standards 
 
4. Quality Assurance 
The Contract Administrator/designee will monitor the CONTRACTOR's performance by 
random inspection of CITY landscaped areas to ensure CONTRACTOR compliance with 
the requirements of the contract. All employees shall conduct themselves in a 
professional and courteous manner.

City of Chandler 
650 E. Ryan Road, 
Chandler, AZ 85286 
480-782-2752 
 
 
 
5. Pricing 
Item for Quote 
Unit of 
Measure 
Cost per 
Unit 
Total Cost 
Task 1 – GIS Based Tree 
Inventory* 
Per Site 
 
$___________ 
 
$__________________ 
Task 1.1 – Inventory Attribute 
(Please Describe) 
Per Site 
 
$___________ 
 
$__________________ 
Task 1.2 – Inventory Attribute 
(Please Describe) 
Per Site 
 
$___________ 
 
$__________________ 
Task 2 – Data Management 
Software System 
Yearly 
Subscription 
 
$___________ 
 
$__________________ 
Task 3 – Urban Forest 
Management Plan** 
Plan Creation 
(Lump Sum) 
 
$___________ 
 
$__________________ 
Task 3.1 – Specialty UFMP 
Section 
Section Cost 
 
$___________ 
 
$__________________ 
Task 3.2 – Specialty UFMP 
Section 
Section Cost 
 
$___________ 
 
$__________________ 
Task 3.3 – Specialty UFMP 
Section 
Section Cost 
 
$___________ 
 
$__________________ 
Add Alt – Meetings and/or 
Presentations*** 
Hourly 
 
$___________ 
 
$__________________ 
Add Alt – Alternative Option 
(Please Describe) 
 
 
$___________ 
 
$__________________ 
Add Alt – Alternative Option 
(Please Describe) 
 
 
$___________ 
 
$__________________ 
 
 
 
 
Total Price 
 
 
 
$__________________ 
*Assuming 20,000 tree sites; if pricing changes with the total number of sites, list those 
costs. If any inventory attribute is above the base price, please include and describe 
** UFMP may contain different sections that are not included in the scope. Please add any 
pricing for sections not discussed and pricing options 
*** In case additional meetings are needed with project management staff or 
presentations are the desire of UFMP

Profile: ryan.mccartney@chandleraz.gov
Applicant Information
Tell us about you.
Linked Applicant
ryan.mccartney@chandleraz.gov
First name
Ryan
Last name
McCartney
Email
ryan.mccartney@chandleraz.gov
Title
Urban Forester
Company
City of Chandler
Company Website
https://www.chandleraz.gov/
City
Chandler
State
Arizona
Organization Information
Tell us about your organization.
Organization Name
City of Chandler
Employer Identification Number (EIN)
86-6000238
SAM Number
LCLUQVAP1WU4
Authorized Representative
Ryan McCartney
Business/Finance Representative
Robert Steele
Organization Address
Address
175 S Arizona Ave

Address 2
 
City
Chandler
State
Arizona
County
Maricopa
Congressional District/Region
5 & 9
Zip
85225
Phone
480-782-2000
Phone Extension
 
Fax
 
Authorized Representative (if different from above)
Name
 
Title
 
Email
 
Phone
 
Business/Finance Contact (if required)
Name
Robert Steele
Title
Accounting Supervisor
Email
robert.steele@chandleraz.gov
Phone
480-782-2324

ATTACHMENT B 
(Cover Sheet) 
 
Detailed Project Plan – Subject to State Approval 
(Include specific planned accomplishments, detailed project budget, and time line)

Arizona Department of Forestry and Fire Management – Project Budget Worksheet 
R11.10 
Project: Managing Chandler's Urban Forest 
Total Project Budget (by expense type) 
Budget Detail 
Grant Share 
($ Amount 
Requested) 
Match 
TOTAL 
Dollars 
In-Kind 
Administrative Labor: 
$0 
$0 
$0 
$   0 
Project Labor: 
$0 
$0 
$0 
$   0 
Travel: 
$0 
$0 
$0 
$   0 
Equipment: 
$0 
$0 
$0 
$   0 
Supplies: 
$0 
$0 
$0 
$   0 
Contractual: 
$40,000 
$62,128 
$0 
$62,128 
Other1: 
$0 
$0 
$0 
$   0 
Other2: 
$0 
$0 
$0 
$   0 
TOTAL: 
$40,000 
$62,128 
$   0 
$102,128 
Budget Narrative 
Provide a brief explanation of each budget item. Include an explanation for items 
that will be reimbursed by grant funds and those that will be provided as project 
match (add additional pages if needed).    
A scope of work was generated for a tree inventory, tree management software, and a management plan 
and sent to multiple vendors who perform the tasks within the scope. 
The total estimated cost of the project is $102,128 based on the average of quotes received from ArborPro 
and PlanIt Geo.   
Both contractors provided dollar amounts for three portions of the project that include the GIS inventory, 
the creation of the Management Plan, and the data management software system. 
ArborPro quoted $95,000 for the inventory, $4,500 for the Management Plan, and $2,250 for the software 
with a total amount of $101,750. 
PlanIt Geo quoted $68,000 for the inventory, $31,005 for the Management Plan, and $3,500 for the 
software with a total amount of $102,505. 
The City will pay for the project from the Parks Operations and Maintenance operating budget.  Any 
costs above the 50% match will be paid for by the City.  All reimbursable funding and project match will 
be used towards contractual expenditures.

Revised Timeline and Measurable Objectives for 2023 Urban & Community Forestry 
Grants CCG
Project Title: Managing Chandler's Urban Forest
Name of Applicant: City of Chandler 
Revised Timeline 
 Quarter 
Tasks Completed  
Quarter 3 - 2023 
ƒ
Advertise and complete the RFP process to select a contractor to provide all 
services in this proposal
ƒ
Hold kick-off meeting to discuss expectations and begin field data collection of tree 
inventory
ƒ
Quarter 4 - 2023
ƒ
Complete collection of field data
ƒ
Process and quality control of collected field data
ƒ
Load tree inventory data into management plan software
ƒ
Complete the urban forest management plan and provide copies to City
Quarter 1 - 2024
ƒ
 City to submit final reports and reimbursement requests 
to DFFM 
List of Anticipated Outcomes/Measurable Objectives 
o
Objectives include:
o
At the start of Fiscal Year ’24 (July 1, 2023), the RFP process will be publicly
advertised to solicit qualified vendors to submit proposals once funding is secured in
the new fiscal year.  After being open for 3-4 weeks, the RFP process takes
approximately 1 month to select a contractor for the services.  A kick-off meeting will
be held with the contractor and field collection of the tree inventory would begin in
September 2023.  The goal would be to have the contractor collect at least 500 sites
per day (5 days/week) to complete the field inventory by November 1, 2023.  This will
provide the contractor with two months to process, and quality assure the data,
upload it to the software system, and complete the management plan.  All
deliverables are expected to be finalized by the end of December 2023 to meet the
deadlines of the Community Challenge Grant.  This information will be provided to the
contractor during the RFP process so that they are to meet the deadlines outlined in
the proposal.  All reimbursable items and final reports will be delivered to DFFM in the
1st quarter of 2024.
o
Outcomes include:
o
Completed tree inventory – 1 complete inventory
o
This will be a total collection of approximately 20,000 trees, stumps, and vacant
planting sites within public spaces managed by the Parks division
o
A Data management software system – 1 active system
o
This system will be provided by the contractor that organizes the tree inventory and
provides a visual representation of tree assets in GIS mapping
o
Urban Forest Management Plan – 1 comprehensive plan
o
This will be an internal guiding document that analyzes inventory information to
proactively manage Chandler’s park trees

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 1 of 7  
ATTACHMENT C  
General Provisions  
  
COVENANT AGAINST CONTINGENT FEES  
The Sub-grantee warrants that it has not employed or retained any company or person, other than a bona fide 
employee working for the Sub-grantee, to solicit or secure this agreement, and that it has not paid or agreed 
to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage 
fee, gift, or any other consideration, contingent upon or resulting from the award or making of this agreement. 
For breach or violation of this warranty, the State shall have the right to annul this agreement without liability, 
or, in its discretion to deduct from the agreement price or consideration, or otherwise recover, the full amount 
of such fee, commission, percentage, brokerage fee, gift, or contingent fee.  
  
MODIFICATIONS  
Modifications within the scope of this award shall only be made by mutual consent of both parties, by issuance 
of a written amendment signed and dated by all properly authorized signatory officials prior to any changes 
being performed. Requests for modification shall be made, in writing, at least thirty (30) days prior to the 
implementation of the requested change.  Any change to the original grant application scope of work or 
approved detailed project plan must have prior written State approval.  Incurring costs without prior written 
approval may result in loss of funds reimbursed.  
  
EXTENSIONS  
Timely completion of this project is required. If this agreement is extended by mutual written consent of the 
parties, all terms, conditions and provisions of the original agreement shall remain in full force and effect and 
apply during any extension period. Any extension of time granted shall not constitute or operate as a waiver 
by the State of any of its rights herein. Extensions will only be considered and/or made if the Sub-grantee has 
demonstrated reasonable efforts to complete the grant project as defined in the original detailed project plan 
and has a clear and specific plan for completion of the project within the extended time period.    
  
RESPONSIBILITY FOR CLAIMS AND LIABILITIES  
The Sub-grantee agrees to assume all risk of loss to indemnify and hold the State, its officers, agents and 
employees, harmless from and against any and all liabilities, demands, claims, suites, losses, damages causes 
or action, fines or judgments, including costs, attorney’s and witnesses’ fees and expenses incident thereto, 
for injuries or death to persons and for loss of, damage to, theft of or destruction of any property including 
loss of use thereof arising out of or in connection with the performance of duties required by agreement, all 
whether or not authorized or agreed to by Sub-grantee.    
  
RETENTION OF RECORDS    
The Sub-grantee and any subcontractor shall maintain and store all documents, papers, accounting records; 
other evidence pertaining to costs incurred for this work, and shall make all such materials available at any 
reasonable time during the term of work and for five (5) years from the date of final payment to the Sub-
grantee. The Sub-grantee may be required to provide such records as necessary to any auditing agent. Inability 
to provide such records may result in unallowable costs to the grant and any funds disbursed to the Sub-
grantee may have to be paid back to the State and/or Federal government.    
  
COMPLIANCE WITH ARIZONA EXECUTIVE ORDERS 75-5 and 2009-09  
The Sub-grantee shall comply with Arizona Executive Order 75-5 and as amended by Arizona Executive 
Order 2009-09 relating to non-discrimination in employment by government contractors and subcontractors. 
These regulations are herein incorporated by reference and made a part of this agreement.

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 2 of 7  
ADMINISTRATIVE AND ACCOUNTING REQUIREMENTS   
It is the Sub-grantee’s responsibility to develop, document, administer and manage the grant in accordance 
with all applicable Federal and State laws.  Sub-grantee is subject to the OMB requirements and guidance in 
subparts A through F of 2 CFR 200 as adopted and supplemented by USDA in 2 CFR part 400.    
  
CFR (Code of Federal Regulations) – http://www.ecfr.gov. If grantee needs assistance in obtaining any of 
these documents in electronic or printed form, please contact your Arizona State Forestry representative.  
  
If any program income is generated as a result of this grant/agreement, the income earned during the term of 
this agreement shall be applied using the deductive method as described in 2 CFR 200.307 ; the deductive 
alternative is the preferred method, unless specifically authorized by the Signatory Official. Costs incident to 
the generation of program income may be deducted from gross income to determine program income 
provided these costs have not been charged to the award/agreement and they comply with the applicable Cost 
Principles.  
  
FREEDOM OF INFORMATION ACT  
Public access to grant or agreement records shall not be limited, except when such records must be kept 
confidential and would have been exempted from disclosure pursuant to “Freedom of Information” 
regulations (5 U.S.C. 552).  
  
MEMBERS OF U.S. CONGRESS  
Pursuant to 41 U.S.C. 22, no United States member of, or United States delegate to, Congress shall be 
admitted to any share or part of this award, or benefit that may arise there from, either directly or indirectly.  
  
TERMINATION FOR CONVENIENCE  
The Office of the State Forester, by written notice, may terminate this contract, in whole or in part, when it 
is deemed in the best interest of the State. If this agreement is so terminated, Sub-grantee will be compensated 
for work performed up to the time of the termination notification.  In no event shall payment for such costs 
exceed the current grant amount.  
  
TERMINATION BY MUTUAL AGREEMENT  
This award may be terminated, in whole or part, as follows:  
• 
When the State and Sub-grantee agree upon the termination conditions, including the effective date and, 
in the case of partial termination, the portion to be terminated.  
• 
By thirty (30) days written notification by the Sub-grantee to the State setting forth the reasons of 
termination, effective date, and in the case of partial termination, the portion to be terminated.  
• 
If, in the case of a partial termination, the State determines that the remaining portion of the award will 
not accomplish the purpose for which the award was made, the State may terminate the award in its 
entirety.  
Upon termination of an award, the Sub-grantee shall not incur any new obligations for the terminated portion 
of the award after the effective date, and shall cancel as many outstanding obligations as possible. The State 
shall allow full credit to the Sub-grantee for the United States Federal share of the noncancelable obligations 
properly incurred by the Sub-grantee up to the effective date of termination. Excess funds shall be refunded 
within sixty (60) days after the effective date of termination.

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 3 of 7  
CANCELLATION FOR CONFLICT OF INTEREST  
Pursuant to A.R.S. §38-511, the state, its political subdivisions or any department or agency of either may, 
within three years after its execution, cancel any contract, without penalty or further obligation, made by the 
state, its political subdivisions, or any of the departments or agencies of either if any person significantly 
involved in initiating, negotiating, securing, drafting or creating the contract on behalf of the state, its political 
subdivisions or any of the departments or agencies of either is, at any time while the contract or any extension 
of the contract is in effect, an employee or agent of any other party to the contract in any capacity or a 
consultant to any other party of the contract with respect to the subject matter of the contract.  
  
FEDERAL IMMIGRATION AND NATIONALITY ACT  
By entering into the Agreement, the Sub-grantee warrants compliance with the Federal Immigration and 
Nationality Act (FINA) and all other Federal immigration laws and regulations related to the immigration 
status of its employees. The Sub-grantee shall obtain statements from its contractors certifying compliance 
and shall furnish the statements to the Procurement Officer upon request. These warranties shall remain in 
effect through the term of the Contract. The Contractor and its subcontractors shall also maintain Employment 
Eligibility Verification forms (I-9) as required by the U.S. Department of Labor's Immigration and Control 
Act, for all employees performing work under the Grant. I-9 forms are available for download at 
USCIS.GOV.  
The State may request verification of compliance for any Sub-grantee, contractor or subcontractor performing 
work under the Grant. Should the State suspect or find that the Sub-grantee or any of its contractors are not 
in compliance, the State may pursue any and all remedies allowed by law, including, but not limited to: 
suspension of work, termination of the Agreement for default, and suspension and/or debarment of the Sub-
grantee or Contractor. All costs necessary to verify compliance are the responsibility of the Sub-grantee. The 
parties agree to comply with A.R.S. §41-4401, the provisions of which are hereby incorporated.  
  
ARBITRATION  
To the extent required by A.R.S. §12-1518, the parties agree to use arbitration, after exhausting applicable 
administrative review, to resolve disputes arising out of this agreement.   
  
ANTITRUST VIOLATIONS  
The Sub-grantee and the State recognize that in actual economic practice overcharges resulting from 
antitrust violations are in fact borne by the purchaser or ultimate user. Therefore, Sub-grantee acting as a 
vendor, hereby assigns to State any and all claims for such overcharges.  
  
SUSPENSION OR DEBARMENT  
Submittal of an offer or execution of a contract shall attest that the sub-grantee or contractor is not currently 
suspended or debarred.  If the Sub-grantee or any of its contractors become suspended or debarred, the Sub-
grantee shall immediately notify the State. The State may, by written notice to the Subgrantee, immediately 
terminate this Agreement if the State determines that the Sub-grantee or their contractors have been debarred, 
suspended or otherwise lawfully prohibited from participating in any public procurement activity, including 
but not limited to, being disapproved as a subcontractor of any public procurement unit or other governmental 
body.    
  
CONTRACTS AND SUBAWARDS TO DEBARRED AND SUSPENDED PARTIES  
Pursuant to Code of Federal Regulations 2 CFR part 180, grantees and sub grantees must not make an award 
or permit any award (subgrant or contract) at any tier to any party which is debarred or suspended or is 
otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 
12549, “Debarment and Suspension”. By entering into this agreement sub-grantee agrees to comply with all 
relevant codes including 2 CFR part 180, subpart C, “Responsibilities of Participants Regarding

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 4 of 7  
Transactions”. When entering into a covered transaction with another person at the next lower tier, sub-
grantee must verify that the person with whom you intend to do business is not excluded or disqualified. You 
do this by:  
(a) Checking the SAM Exclusions: System for Award Management (SAM) – www.sam.gov  
(b) Collecting a certification from that person  
(c) Adding a clause or condition to the covered transaction with that person.  
  
TITLE VI of CIVIL RIGHTS ACT of 1964  
Sub-grantee agrees to comply with Title VI of the Civil Rights Act of 1964 (P.L. 88-352, 42 U.S.C. 200d). 
In accordance with Title VI of that Act, no person in the United States shall, on the grounds of race, color or 
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to 
discrimination under any program or activity for which the applicant receives Federal financial assistance 
and Sub-grantee will immediately take any measures necessary to effectuate this agreement.  
  
UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT 
REGISTRATION REQUIREMENT (SAM)  
Sub-grantee shall maintain current information in the System for Award Management (SAM) until receipt of 
final payment. This requires review and update to the information at least annually after the initial registration, 
and more frequently if required by changes in information or award term(s). For purposes of this award, 
System for Award Management (SAM) means the Federal repository into which an entity must provide 
information required for the conduct of business as a Cooperative. Additional information about registration 
procedures may be found at the SAM Internet site at www.sam.gov .  
  
PUBLICATION REQUIREMENTS  
A. ACKNOWLEDGEMENT IN PUBLICATIONS. Sub-grantee shall acknowledge Arizona  
Department of Forestry and Fire Management and U.S. Forest Service support in any publications, 
audiovisuals, and electronic media developed as a result of this award, per 2 CFR 415.2.  
  
B. NONDISCRIMINATION STATEMENT IN PUBLICATIONS. Sub-grantee 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 basis 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) 7205964 
(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.”  
  
C. COPYRIGHTS.  No original text or graphics produced and submitted by the U.S. Forest Service 
shall be copyrighted. The U.S. Forest Service reserves a royalty-free, nonexclusive, and irrevocable 
right to reproduce, publish, or otherwise use, and to authorize others to use the work for federal 
government purposes. This right shall be transferred to any sub agreements or subcontracts. This

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 5 of 7  
provision includes the copyright in any work developed by Sub-grantee under this agreement. And any 
right of copyright to which Sub-grantee purchases ownership with any federal contributions.  
  
REPORTING OF SUBRECIPIENT EXECUTIVES  
Unless exempt from this requirement of 2 CFR 170, Sub-grantee agrees to report the names and total 
compensation of each of the sub-grantee’s five most highly compensated executives for the sub-grantee’s 
preceding completed fiscal year if:  
  
1. in the sub-grantee’s preceding fiscal year, the sub-grantee received—  
(A) 
80 percent or more of its annual gross revenues from Federal procurement contracts (and 
subcontracts) and Federal financial assistance subject to the Transparency Act, as defined at 
2 CFR 170.320 (and subawards); and  
(B) 
$25,000,000 or more in annual gross revenues from Federal procurement contracts (and 
subcontracts), and Federal financial assistance subject to the Transparency Act (and 
subawards); and  
2. The public does not have access to information about the compensation of the executives through 
periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 
U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986.   
  
TRAFFICKING IN PERSONS.  
Section 106 of the Trafficking Victims Protection Act of 2000 (TVPA), as amended (22 U.S.C. 7104(g)), 
include provisions applicable to federal support recipients. By entering into this agreement, you agree to 
terms set forth in the primary award from the US Forest Service as documented below.  This Agreement 
may be unilaterally terminated, without penalty, if a subrecipient is determined to have violated an 
applicable prohibition in this award term. (See 22 U.S.C. 7104 and 2 CFR175 for more details)  
  
A. Provisions applicable to a Recipient that is a private entity.  
1. You as the Recipient, your employees, subrecipients under this award, and subrecipients' 
employees may not-  
(i) 
Engage in severe forms of trafficking in persons during the period of time that the 
award is in effect;  
(ii) 
Procure a commercial sex act during the period of time that the award is in effect; or  
(iii) 
Use forced labor in the performance of the award or subawards under the award.  
  
2. This award may be unilaterally terminated, without penalty, if you or a subrecipient that 
is a private entity -  
(i) 
Is determined to have violated a prohibition in paragraph A.1 of this award term; or  
(ii) 
Has an employee who is determined by the agency official authorized to terminate 
the award to have violated a prohibition in paragraph A.1 of this award term 
through conduct that is either-  
a. Associated with performance under this award; or  
b. Imputed to you or the subrecipient using the standards and due process 
for imputing the conduct of an individual to an organization that are 
provided in 2 CFR part 180, "OMB Guidelines to Agencies on 
Government wide Debarment and Suspension (Nonprocurement)".

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 6 of 7  
  
B. Provision applicable to a recipient other than a private entity. This award may be unilaterally 
terminated, without penalty, if a subrecipient:  
1. Is determined to have violated an applicable prohibition in paragraph A.1 of this award 
term; or  
2. Has an employee who is determined by the agency official authorized to terminate the 
award to have violated an applicable prohibition in paragraph A.1 of this award term 
through conduct that is either-  
(i) Associated with performance under this award; or  
(ii) 
Imputed to the subrecipient using the standards and due process for imputing 
the conduct of an individual to an organization that are provided in 2 CFR part  
180, "OMB Guidelines to Agencies on Government wide Debarment and  
Suspension (Nonprocurement)."  
  
C. Provisions applicable to any recipient.  
1. You must inform us immediately of any information you receive from any source alleging 
a violation of a prohibition in paragraph A.1 of this award term.  
2. Our right to terminate unilaterally that is described in paragraph A.2 or B of this section:  
(1) Implements section I06(g) of the Trafficking Victims Protection Act of  
2000 (TVPA), as amended (22 U.S.C. 7104(g)), and  
(2) Is in addition to all other remedies for noncompliance that are available to us 
under this award.  
3. You must include the requirements of paragraph A1 of this award term in any subaward 
you make to a private entity.  
  
D. Definitions. For purposes of this award term:  
1. "Employee" means either:  
(1) An individual employed by you or a subrecipient who is engaged in the 
performance of the project or program under this award; or  
(2) Another person engaged in the performance of the project or program under this 
award and not compensated by you including, but not limited to, a volunteer or 
individual whose services are contributed by a third party as an in-kind 
contribution toward cost sharing or matching requirements.  
2. "Forced labor" means labor obtained by any of the following methods: the recruitment, 
harboring, transportation, provision, or obtaining of a person for labor or services, through 
the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, 
peonage, debt bondage, or slavery.  
3. "Private entity":  
(1) Means any entity other than a State, local government, Indian tribe, or foreign 
public entity, as those terms are defined in 2 CFR 175.25.

_______________________________________________________________________________________________________________________  
ATTACHMENT C 
v.DFFM - Federal 10/2022                                                                                                                 Page 7 of 7  
(2) Includes:  
i. A nonprofit organization, including any nonprofit institution of higher 
education, hospital, or tribal organization other than one included in the 
definition of Indian tribe at 2 CFR 175.25(b).  
ii. A for-profit organization.  
4. "Severe forms of trafficking in persons," "commercial sex act," and "coercion" have the 
meanings given at section 103 of the TVPA, as amended (22 U.S.C. 7102).  
  
DRUG-FREE WORKPLACE   
Compliance with the Drug-Free Workplace Act of 1988 (Public Law 100-690, Title V, Subtitle D, as 
amended) requires that all organizations receiving grants from any federal agency agree to maintain a drug-
free workplace.  
  
INVALIDITY OF PART OF THIS AGREEMENT  
The parties agree that should any part of this AGREEMENT be held to be invalid or void, the remainder of 
the AGREEMENT shall remain in full force and effect and shall be binding upon the parties.   
  
COUNTERPARTS  
This AGREEMENT may be executed in any number of duplicate originals, photocopies or facsimiles, all of 
which (once each party has executed at least one such duplicate original, photocopy, or facsimile) will 
constitute one and the same document.  
  
INTERPRETATION  
This AGREEMENT is not to be construed or interpreted for or against either of the parties on the grounds of 
sole or primary authorship or draftsmanship.  
  
PARAGRAPH HEADINGS  
The paragraph headings in this AGREEMENT are for convenience of reference only and do not define, limit, 
enlarge, or otherwise affect the scope, construction, or interpretation of this AGREEMENT or any of its 
provisions.  
  
GOVERNING LAW  
This AGREEMENT is made under, and is to be construed in accordance with, the laws of the State of Arizona.    
  
ENTIRE AGREEMENT  
This AGREEMENT contains the entire agreement and understanding of the parties hereto.  There are no 
representations or provisions other than those contained herein, and this AGREEMENT supersedes all prior 
agreements between the parties, whether written or oral, pertaining to the same subject matter of this  
AGREEMENT.

ATTACHMENT D 
 
Grant Reimbursement and Documentation Requirements 
__________________________________________________________________________________________________________ 
ATTACHMENT D 
v.DFFM 10/2022                                                                                                                                                                                                             Page 1 of 3 
 
Arizona State Forestry grants are based on reimbursement for actual costs incurred. Actual costs may vary 
slightly from the project plan budget, but must be used to calculate final reimbursement amounts.  Sub-
grantees are typically required to provide a portion of the total project cost as MATCH contribution to 
show local investment in the project or program. Match investment cannot be used as a match for any 
other State or federal cost-share programs. Specific match amount is identified in each grant agreement. 
All costs and match should conform to the approved project plan and budget contained in the grant 
agreement – and all reimbursements are subject to Arizona State Forestry approval. 
 
Only project expenses incurred during the term of the signed grant agreement are eligible. (See Term of 
Agreement) 
 
All documentation submitted for reimbursement must have the correct project name and/or State 
Forestry grant number, date work was completed, and proof of payment from the Sub-grantee. 
 
All reimbursements to Sub-grantees shall be calculated on the “Grant Reimbursement Form” (Attachment 
E2). By signing the form, the Sub-grantee assumes full and implied responsibility for all grant costs incurred 
and submitted on the form. By signature, the Sub-grantee accepts full liability that the work and costs 
incurred were in accordance with the agreed scope of work and/or approved detailed project plan and in 
accordance with all applicable Federal and State laws. By signing the “Grant Reimbursement Form”, the 
Sub-grantee is claiming that costs were incurred following the established procurement process for its own 
organization and that their process is documented, administered and managed with the correct accounting 
and administrative procedures and is in accordance with all applicable Federal and State laws. 
_____________________________________________________________________________________________________________ 
 
INELIGIBLE COSTS – Any expenses submitted for reimbursement that are not properly documented shall 
not qualify for reimbursement. It shall be the Sub-grantee’s sole responsibility to submit the required and 
accurate support documentation for all project costs. In the event an audit determines that ineligible costs 
were charged to the project, the Sub-grantee accepts full liability for such costs. 
 
● 
Expenses not included in an approved project plan or that are unnecessary for the completion of the project 
are ineligible for reimbursement or as match. 
 
● 
NO FOOD or BEVERAGE purchases or donations to others are eligible for reimbursement or as match, unless 
included in the project plan as budgeted travel costs, and pre-approved by State. 
 
● 
Capital Equipment costing $5,000 or more per unit cannot be included as reimbursable costs, but may be 
included as match with prior approval. State Forestry recommends renting equipment as needed. 
 
● 
NO purchase of equipment or supplies for individuals are eligible for reimbursement or as match (though 
purchase of supplies and small equipment by the Sub-grantee organizations for ongoing community use may 
be eligible). 
 
● 
Poorly documented match or volunteer hours with insufficient support documentation will not count towards 
the required match. It is the Sub-grantee’s responsibility to keep all project/grant records pertaining to 
matching requirements. In the event an audit determines that ineligible match was credited to the project, the 
Sub-grantee accepts full liability for such costs.

ATTACHMENT D 
 
Grant Reimbursement and Documentation Requirements 
__________________________________________________________________________________________________________ 
ATTACHMENT D 
v.DFFM 10/2022                                                                                                                                                                                                             Page 2 of 3 
 
REIMBURSABLE PROJECT EXPENSES – are direct, out-of-pocket expenditures for eligible project 
activities that are supported by paid invoices, canceled checks, signed receipts, or official payroll records. 
Examples include: 
 
● Labor (Administrative and Personnel)- may include paid staff, or documented reimbursement from 
Sub-grantee to others for services. Related expenses such as employee benefits or required travel 
costs are also eligible if properly documented. 
○ 
Administrative labor includes general project oversight, while personnel labor includes work done on 
the ground 
○ 
All staff/labor hours must be accompanied by an employee time sheet detailing the hours worked on 
the grant project. We must be able to determine, for each staff member, the hours contributed, the rate 
of pay, the work completed, and the total amount being requested. 
○ 
The time sheet must clearly have the State grant ID number, an employee signature, and the dates work 
hours were contributed towards the grant. A supervisor’s approval signature should also be included. 
*Note, for auditing purposes, an auditor will most likely want to see all hours worked in addition to those 
charged to the grant.* 
○ 
Required documentation should include some combination of: payment receipts, timesheets, payroll 
records (paystubs), job sheets, canceled checks, or signed letters detailing paid staff time, dates, and 
services or work provided. 
● Contracted Services – Contracting for services from outside organizations or businesses is permitted 
if included in the approved project plan and budget. Such services could include contracted fuels 
crews, arborists, trucking, waste disposal, and other costs. 
○ 
Required documentation will include original invoices with sufficient detail of work performed, dates of 
work performed, and proof of payment, such as canceled checks or credit card receipts. 
● Supplies - may include operating supplies, office supplies, and small equipment purchased by the 
Sub-grantee and necessary for the completion of the project. 
○ 
Required documentation should include proof of purchase via payment receipts, canceled checks, or 
official accounting records detailing expenses and goods and service provided. Original quotes or 
incomplete invoices are not sufficient. 
● Travel - may include mileage reimbursement 
○ 
Documentation should include mileage logs with beginning and ending odometer readings and 
reference the grant project number. 
● Equipment - may include the cost of renting equipment, fuel, operational costs or repairs at an 
accepted rate 
○ 
Documentation should include invoices and proof of payment, receipts, or equipment logs. 
○ 
If using FEMA or negotiated CFRA rates, the non-emergency rate (½ of negotiated rate) must be used. 
○ 
Take into consideration that if the rate provided is a "Wet Rate,” it already includes fuel and 
maintenance for the equipment. 
● Other 
○ 
Other costs as necessary must include proper support documentation demonstrating that the Sub-
grantee has incurred the costs. 
○ 
Indirect Costs – Agreed upon indirect costs can be included for reimbursement. No more than 
10% of the indirect costs may come from the grant share. 
■ 
Indirect costs may cover general operating expenses such as those negotiated at the time of 
the grant agreement and other overhead costs; therefore supporting documentation is not 
required, but detailed specifics about what is covered under the indirect cost must be included 
in the detailed project plan budget narrative. 
■ 
If Sub-grantee has a Negotiated Indirect Cost Rate Agreement (NICRA), State Forestry must 
receive this agreement before the rate can be used in the project budget.  If the NICRA is 
greater than 10%, anything above this is allowable as match only. 
■ 
De Minimis: If no NICRA rate is available, Sub-grantee can include the 10% de minimis cost rate 
to cover other general operating expenses.

ATTACHMENT D 
 
Grant Reimbursement and Documentation Requirements 
__________________________________________________________________________________________________________ 
ATTACHMENT D 
v.DFFM 10/2022                                                                                                                                                                                                             Page 3 of 3 
 
ELIGIBLE MATCH – Grants may require some level of MATCH investment from the Sub-grantee 
organization. Matching investment may only be included if goods or services are provided during the term 
of the agreement and are necessary for the completion of the project. The matching investment may be in 
the form of dollars expended and/or in-kind contributions used toward the project. The Sub-grantee share 
(match) cannot be used as a match for any other cost-share program. As with reimbursable costs, eligible 
match expenses only include those that are reasonable and necessary for the completion of the grant 
funded program or project and must meet the approved Cost Principles. 
 
Matching investments will not be directly reimbursed. 
 
Examples of possible match include: 
 
● Hard Dollars - Matching investment can include actual costs incurred as documented above.  
o 
A hard dollar match includes anything directly purchased for the grant work with costs incurred by the 
grantee where money has changed hands, including time spent by employees on grant related activities. 
Time spent by employees on eligible project activities must include the same documentation as listed 
above for the Labor category for grant share. 
o 
Required documentation will include payment receipts, canceled checks, or official accounting records 
detailing expenses and related goods and service provided. Physical cash transactions are unallowable 
with DFFM grants. 
 
● In-kind Contributions - includes the use of the sub-grantees’s or their partners’ on-hand supplies, 
use of third party donations of supplies or equipment, or the value of professional services provided 
at the professional rate. 
o 
Use of in-kind contribution of goods or services from another business or organization may be counted 
as in-kind match with proper documentation. Property or use thereof shall be assigned a fair market 
value per applicable Cost Principles and should include a letter of documentation from the donating 
party, if necessary. Use of donated equipment shall consist of signed time logs, detailing day(s) or hours 
of use, accepted rate, and project specific function. 
 
● Volunteer - Volunteer labor hours shall conform to documented standard operating procedures for 
the Sub-grantee organization with established pay rates. 
o 
Required documentation for volunteers will include signed time logs/sign-in sheets with volunteer 
name, date, time, place, and type of volunteer service provided. Volunteer sign in sheets must include a 
supervisor’s signature. Volunteer timesheets should be filled out and signed on the day work was 
completed. 
o 
Volunteer time may be valued at the local market rate for equivalent work (children at minimum wage). 
Hourly rates exceeding $20 per hour will require specific support documentation for justification and 
approval. If you use consultants, forestry professionals, planners, etc., who donate their professional 
services, appropriate hourly rates may be documented in a letter from the individual or their 
organization, but will still require accurate timesheets.

Quarterly Performance Report 
Arizona Department of Forestry and Fire Management  ‐ Quarterly Report (Ver‐4.18)
Attachment E1
Page 1
GRANT INFORMATION: 
Grant Number: 
Grant Award $: 
Project Name: 
Award End Date:  
Organization: 
County: 
DFFM District: 
REPORT INFORMATION: 
Calendar Year: 
Calendar Quarter   Q1 (Jan‐Mar), Q2, Q3, Q4: 
Name of person completing report: 
Submittal Date: 
PROJECT OBJECTIVES ACCOMPLISHED: (During this quarterly reporting period, what progress has
been made toward meeting the project objectives stated in the Project Plan? Provide quarterly and cumulative 
numbers for key criteria, such as acres completed, trees planted, educational programs delivered, etc.) 
PLANNED OVERALL 
ACTUAL 
    Project Objectives 
Total Project 
Goal 
Previously 
Reported 
+
Current  
Quarter  
= 
Cumulative 
Total 
  Program‐Specific Reportables (if applicable) 
1 
2 
3 
4 
5 
Is this Project On Track?   (Yes / No)
Use the following sections to describe activities for this quarter and for the overall project status. 
Additional items may be enclosed or attached, such as added narrative, detailed tables, pictures, maps, or other items.  
(Please list any additional items in the narrative to assure they are recorded.)

Quarterly Performance Report 
Arizona Department of Forestry and Fire Management  ‐ Quarterly Report (Ver‐4.18)
Attachment E1
Page 2
NARRATIVE REPORT / THIS QUARTER:  What progress has been made THIS QUARTER in
accomplishing the project objectives?  Describe activities for the quarter to support the status reported in the tables 
above. Include comments regarding accomplishments for employees, contractors, and volunteers; and describe the status 
of planning or purchasing activity if applicable.  (MAX: 1400 Characters – attach additional materials if needed) 
NARRATIVE REPORT / OVERALL PROJECT:   What is the success in meeting the OVERALL
measurement criteria identified in the Project Plan?  Describe the overall project status to support the numbers 
listed in the tables above.  What major milestones have been achieved and what are the next major activities planned?  If 
the project is not on track or goals are not being met, please provide an explanation. If there are any factors that have, or 
will have, a significant impact on the successful project completion, provide details and explain the actions being taken or 
assistance that may be needed.  (MAX: 1400 Characters – attach additional materials if needed)

USDA, Forest Service
OMB 0596-0217
FS 1500-35
Revised 11-25-2013 
CERTIFICATION REGARDING LOBBYING
Lobbying 
The undersigned certifies, to the best of his or her 
knowledge and belief, that: 
(1) No Federal appropriated funds have been paid or 
will be paid, by or on behalf of the undersigned, to 
any person for influencing or attempting to 
influence an officer or employee of any agency, a 
Member of Congress in connection with the 
awarding of any Federal contract, the making of any 
Federal grant, the making of any Federal loan, the 
entering into of any cooperative agreement, and the 
extension, continuation, renewal, amendment, or 
modification of any Federal contract, grant, loan, or 
cooperative agreement. 
(2) If any funds other than Federal appropriated 
funds have been paid or will be paid to any person 
for influencing or attempting to influence an officer 
or employee of any agency, a Member of Congress, 
an officer or employee of Congress, or an employee 
of a member of Congress in connection with this 
Federal contract, grant, loan, or cooperative 
agreement, the undersigned shall complete and 
submit Standard Form-LLL, 'Disclosure Form to 
Report Lobbying.' in accordance with its 
instructions. 
(3) The undersigned shall require that the language 
of this certification be included in the award 
documents for all subawards at all tiers (including 
subcontracts, subgrants, and contracts under grants, 
loans, and cooperative agreements) and that all 
subrecipients shall certify and disclose accordingly. 
This certification is a material representation of fact 
upon which reliance was placed when this 
transaction was made or entered into. Submission of 
this certification is a prerequisite for making or 
entering into this transaction imposed by section 
1352, title 31, U.S. Code. Any person who fails to 
file the required certification shall be subject to a 
civil penalty of not less than $10,000 and not more 
than $100,000 for each such failure. 
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above applicable 
certification.
SIGNATURE
APPLICANT’S SIGNATURE (BY)
 
TITLE/RELATIONSHIP OF THE INDIVIDUAL IF 
SIGNING IN A REPRESENTATIVE CAPACITY
     
DATE SIGNED
(MM-DD-YYYY)
       
 
 
 
Applicants should also review the instructions for certification included in the regulations before completing this form. Signature on 
this form provides for compliance with certification requirements under 4 CFR Part 418 Appendix A, Certification Regarding 
Lobbying. The certifications shall be treated as a material representation of fact upon which reliance will be placed when the U.S. 
Forest Service determines to award the covered transaction, grant, or cooperative agreement.

USDA, Forest Service
OMB 0596-0217
FS 1500-35
Revised 11-25-2013 
 
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.  The time 
required to complete this information collection is estimated to average 9 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 U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, 
disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, 
reprisal, or because all or part of an individual’s income is derived from any public assistance.  (Not all prohibited bases apply to all programs.)  
Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact 
USDA’s TARGET Center at 202-720-2600 (voice and TDD). 
 
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or 
call toll free (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.

AD-1048
OMB No. 0505-0027 
Expiration Date: 09/30/2025 
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion 
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 CFR §§ 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 
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 
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. 
SIGN

Form AD-1048 
Page 2 of 2 
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 must 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 CFR 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 may 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 General Services Administration’s System for Award 
Management Exclusions 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.