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~ , ti <br /> p P <br /> PAGE 1 Of 3 <br /> Eons 1511-1 <br /> (February resv>United States Department of the Interior <br /> Bureau of Land Management <br /> ASSISTANCE AGREEMENT <br /> NOTE: By signing this document, the recipient accepts this agreement and agrees to perform in accordance with all the enclosed terms, conditions, and <br /> documents attached hereto. <br /> 1. AGREEMENT NO. <br /> HAA031 M00 <br /> 2. TASK ORDER NO. <br /> HEFO51 M 11 <br /> 3. TYPE OF AGREEMENT (C'heck oneJ <br /> _ GRANT <br /> X COOPERATIVE AGREEMENT <br /> 4. NAME, ADDRESS AND PHONE NO. OF ASSISTANCE OFFICER 5. NAME, ADDRESS AND PHONE NO. OF RECIPIENT <br /> Arlene A. Stone Eric Wold <br /> Bureau of Land Mana ement Ci of <br /> g ty Eugene <br /> Eugene District Office Parks and Open Space Division <br /> <br /> I P.O. Box 10226 1820 Roosevelt Blvd. <br /> Eugene, OR 97440-2226 Eugene, OR 97402 <br /> (541)683-6970 Tele hone (541)682-4888 <br /> 6. NAME, ADDRESS AND PHONE NO. OF ASSISTANCE REPRESENTATIVES 7. NAME, ADDRESS AND PHONE NO.OF RECIPIENT'S OPERATIONS MANAG <br /> Pat Johnston Eric Wold <br /> Bureau of Land Management Wetlands Program Supervisor <br /> P.O. Box 10226 City of Eugene <br /> Eugene, OR 97440-2226 1820 Roosevelt Blvd. <br /> (541) 520-2159 Eugene, OR 97402 <br /> Telephone (541) 682-4888 <br /> 8. PROGRAM STATUTORY AUTHORITY FLPMA, JITW,CCI, WYDEN, 9. STARTING DATE Date set forth in block 17c. <br /> SRS, TPIA, NFP. <br /> I0. EFFECTIVE DATE Date Set forth In B10Ck 17C. I1. COMPLETION DATE Se tember 30, 2006 <br /> 12. TYPE OF RECIPIENT (('heck one) 13. FUNDING INFORMATION <br /> _ STATE <br /> X LOCAL GOVERNMENT Recipient BLM <br /> INDIAN TRIBAL GOVERNMENT ' <br /> This obligation $ X00 <br /> _ EDUCATIONAL INSTITUTION <br /> _ INDIVIDUAL Previous obligation $ ~.0 $ 0.0 <br /> _ FOR-PROFIT ORGANIZATION <br /> _NON-PROFIT ORGANIZATION <br /> _ OTHER (SPECIFY) Total obligation $ $rJ, 000 <br /> Share Ratio <br /> 14. ACCOUNTING AND APPROPRIATION DATA <br /> OR095/6650JE/252Z= $5,000.00 ASAP DUNS #931267301 <br /> I5. PROJECT TITLE AND BRIEF SUMMARY OF THE PURPOSE AND OBJECTIVES <br /> ROAD MAINTENANCE ASSISTANCE FOR THE WEST EUGENE WETLANDS PROJECT (See attached Statement of Work). <br /> **Sall Ville as, West Eu ene Wetlands Natural Resource S ecialist, 541) 683-6790, will be the District's contact for this Task Order. <br /> 16a. NAME AND TITLE OF SIGNER (Type or print) 17a. NAME AND TITLE OF ASSISTANCE ORDERING OFFICER (Type or print) <br /> _ 1 Johnn R. Medlin, Director, Parks and O en S ace Arlene A. Stone <br /> `I~~ ~f/ 16c. DATE SIGNED 17c. DATE SIGNEI <br /> 16b. RECIPIENT ~~`~~~~~~j~~~~ ~ f 17b. D STATES OF RIC <br /> BY 7 C~ lq/./~~7jtJ BY /7 OG <br /> l ~ <br /> (Authorized Si rnlure) (Sigiealu of . s~i; once 0.(yicer) <br /> <br />