Utah Weed Supervisors Association
USFS Year-End Report Form for 2012
Attach:
Reimbursable Receipts
Matching Documentation
Before and After Photographs
Due December 1, 2012
Grant Report
Date of Report / Contract NumberName of CWMA / Contact Person
Mailing Address / Contact Phones
E-mail / Federal ID # (if available)
Financial/Bookkeeping Organization / Financial/Bookkeeping Contact Person
Financial/Bookkeeping Mailing Address / Financial/Bookkeeping Contact Phone
Financial/Bookkeeping Federal ID # (required) / Financial/Bookkeeping email
Grant Budget
Qualifying Expenses / Explanation / ExpendedHerbicide
Supplies
Labor
Education
Administrative
Total Amount Expended
Summary of Actual Activity
Total Actual Acres TreatedTotal Actual Acres Monitored
Total Actual Acres Inventoried
Total Actual Acres Revegitated
Total Actual Biocontrol Released
Protected Acres (Critical acres, forest, watershed, etc.)
Total Human Outreach (newspaper articles, fairs, etc)
Project Worksheets
Project #1
Project Name / Treatment MethodActual Acres Treated / Actual AcresSeeded / Actual Acres Monitored
Actual Acres Inventoried / Actual Biocontrol Used / Percent of project funds used for bio
Actual Grant Expenditures
ActualUWSA Award
Actual Non-Federal Contributions:
Private
City, County, State Government
Other ______
Subtotal Actual Non-Federal
Total Actual Cost of Project
Narrative of Actual Activities (do not exceed window)
How does this program enhance Early Detection and Rapid Response in your area?
Project #2
Project Name / Treatment MethodActual Acres Treated / Actual Acres Seeded / Actual Acres Monitored
Actual Acres Inventoried / Actual Biocontrol Used / Percent of project funds used for bio
Actual Grant Expenditures
Actual UWSA Award
Actual Non-Federal Contributions:
Private
City, County, State Government
Other ______
Subtotal Actual Non-Federal
Total Actual Cost of Project
Narrative of Actual Activities (do not exceed window)
How does this program enhance Early Detection and Rapid Response in your area?
Project #3
Project Name / Treatment MethodActual Acres Treated / Actual Acres Seeded / Actual Acres Monitored
Actual Acres Inventoried / Actual Biocontrol Used / Percent of project funds used for bio
Actual Grant Expenditures
Actual UWSA Award
Actual Non-Federal Contributions:
Private
City, County, State Government
Other ______
Subtotal Actual Non-Federal
Total Actual Cost of Project
Narrative of Actual Activities (do not exceed window)
How does this program enhance Early Detection and Rapid Response in your area?
Project #4
Project Name / Treatment MethodActual Acres Treated / Actual Acres Seeded / Actual Acres Monitored
Actual Acres Inventoried / Actual Biocontrol Used / Percent of project funds used for bio
Actual Grant Expenditures
Actual UWSA Award
Actual Non-Federal Contributions:
Private
City, County, State Government
Other ______
Subtotal Actual Non-Federal
Total Actual Cost of Project
Narrative of Actual Activities (do not exceed window)
How does this program enhance Early Detection and Rapid Response in your area?
Actual Cost Share Breakdown
For All Projects / Funding / %UWSA Actual Award
Actual Non-Federal Contributions
Private
Labor
Equipment
Herbicide
Funding
Other:
City, County, State Government
Labor
Equipment
Herbicide
Funding
E. Other:
Other Entities
Labor
Equipment
Herbicide
Funding
Other:
Subtotal Actual Non-Federal Contributions
Total Actual Award and Matching Contributions / 100%
Other Non-Matching Federal Contributions
Total Project Costs & Capital Outlay
Authorization
Print Authorized Name (CWMA) / Authorized Signature (CWMA)Print Authorized Name (Financial Rep.) / Authorized Signature (Financial Rep.)
ATTACH: Reimbursable receipts, matching documentation, before and after photographs
Be sure to make a copy for your records.
Allowed Cost-Share Fees*
Utah 2012
Cost Share ItemHourly Fee
Labor
Weed Supervisor$32.00
Full Time Sprayer$24.00
Seasonal/Volunteer$12.00
Equipment
Sedan$12.00
Truck 2x4$15.00
Truck 4x4$18.00
Truck 4x4 w/spray rig$25.00
ATV 4x4$15.00
ATV 4x4 w/spray rig$20.00
ATV 6x6 w/spray rig$22.00
Trailer single axle$12.00
Trailer double axle$15.00
Backpack sprayer 2-5 gal$5.00
Boat$10.00
Boat w/motor$20.00
Boat w/motor and trailer$25.00
GPS non-corrected$5.00
GPS differential correction$10.00
Sweep Net$2.50
Computer$8.00
*If your cost-share fees differ from the chart please attach supporting documentation and/or references.