Instructions:
Items to be Completed by IMET at Incident:
Box 1: Full name of IMET.
Box 2: IMET’s home office.
Box 3: Dates of Service including travel days. The starting date is the day the IMET leaves his/her home office and the ending date is the date the IMET arrives back at his/her home office.
Box 4: Agency Served: Underline or highlight the lead agency. This information should be obtained from the Resource Order.
It is very important that this is correct, so the proper accounting codes can be applied.
Box 5: Incident Name. This information should be obtained from the Resource Order. For example, Halstead Fire.
Box 6: Agency Unit/Division Served. Fill in the lead agency’s unit or division served. This information should be obtained from the Resource Order. For example, Big Horn National Forest.
Box 7: Agency Unit/Division Finance Officer. For
all fires where the USFS is the lead agency the address should be:
USDA Forest Service
101B Sun Avenue NW
Albuquerque, NM 87109
Attention: Elizabeth Martin
Phone: 505-563-7937
Email: asc_ipc@fs.fed.us
For all other agencies, the IMET must obtain the information at the incident. Contact information should include email and/or phone number.
Box 8: Resource Order Number. This can be found in box 12 of the Resource Order. Example: “O-85”.
Box 9: Incident Number and/or P Number. This should be obtained from the Resource Order.
Box 10: Departure Date and Time. Date and time the IMET left his/her home office.
Box 11: Return Date and Time. Date and time the IMET arrived back to his/her home office.
Box 44: BGAN used? Check yes or no.
Box 45: Dates Used. If BGAN used, list dates.
Box 46: Gov’t Cell Phone Used. Indicate if a government cell phone was used at the incident.
Box 47: Gov’t Cell Phone Number. If a government cell phone was used, fill in the phone number.
Items to be Completed by IMET, ASA and/or MIC:
Box 12: 14-Day Dispatch. The arrival and departure times to and from the incident should be noted on the FTR. If the IMET arrives at the incident camp before noon, count this as day one of the dispatch and not a travel day. If the IMET arrives after noon, this day should be considered a travel day. If the IMET is released after noon, this should be counted as the last day of the dispatch and not a travel day. If the IMET is released before noon, this is considered a travel day. Add up the number of days of dispatch, not including the travel days. If the total is 14 days or greater check, “Yes”. If the total is less than 14 days, check “No.”
Box 13: Rest Period Dates. If this was a 14-day or longer dispatch the IMET is entitled to up to 2 days of Administrative Leave beginning the next calendar day following their return from the incident before being inserted back into the WFO fixed schedule. The rest period is allowed only if the IMET has regular work days scheduled upon return, not regular days off. If the IMET returns to a regular day(s) off, one or both days of administrative leave is forfeited. If Admin Leave is taken note the dates here.
Box 14: Hours of Reimbursable Admin Leave Used. Indicate the number of hours taken in accordance with the rules listed in Box 13 above.
Box 17: Overtime Hours Worked. The ASA should determine the total number of OT hours the IMET worked using the WFO fixed schedule and the FTR. See further instructions and examples in section 5 of the RER Handbook.
Please verify that all numbers are correct!
Box 20: Hazard Pay Hours Worked. If hazard duty was authorized and worked, indicate the total number of hours worked here. This information can be found on the FTR. This number
must match the hours listed on the FTR and the T&A.
Box 24: Employee Name(s). Using full legal names, indicate each person in the home office who worked overtime hours to cover vacated shifts due to the dispatch.
Box 25: Dates OT Worked. For each employee listed in box 24 above indicate the dates each employee worked. If any of the dates listed here do not fall within the “Dates of Service” range indicated in box 3 include a separate sheet of paper explaining why these hours are eligible for reimbursement.
Box 26: Hours Worked. For each employee listed in box 24 above indicate the number of hours of overtime each worked.
Box 29: IMET Regular Days Off. Indicate the IMET’s regular scheduled days off. Obtain this information from the home office fixed schedule. Confirm that other employees’ overtime hours do not fall on the IMET regular days off, this would not be reimbursable.
Top of Page 2: Travel Order#. Put the NWS travel order number here.
Box 31: Days of Travel To and From and Layover. The days of travel to and from the incident are paid at 3/4 per diem. Fill in these two boxes with “.75”. If it takes more than one day to travel
to or
from the incident, use the Layover line.
Box 32: Travel Rate. Use the GSA per diem rates at the time of the incident based on the location indicated on the Resource Order.
Box 33: Multiply box 31 by box 32 on To, From and Layover lines.
Box 34: Incident Meals. If the IMET was not provided meals at the incident fill in “0”. If the IMET was provided meals at the incident indicate the cost of each of the meals provided based on the GSA per diem meal rate at the time of the incident for that location. The meals provided should also be listed on the travel voucher.
Box 35: Subtract the lines of box 34 from lines of box 33. If this number is 5 or less, fill in “$5.00”. The IMET is entitled to the incidentals amount regardless of the travel per diem rate and meals provided.
Box 36: At Incident Days. Indicate the number of days at the incident. Do not include the travel days here.
Box 37: Rate. In most cases the IMET is provided all meals at the incident in which case the daily rate is $5.00. If meals are not provided, this should be the GSA per diem rate at the time of the incident for the location of the incident. If the rate varies (i.e. meals provided on a few days, but not others) attach a separate sheet with the breakdown for each day and only fill in the total amount in box 38.
Box 38: If special conditions apply as outlined in box 37 above, indicate the total amount here. Otherwise, multiply box 36 by box 37 for the amount of per diem earned
at the incident.
Box 39: Add the lines in box 35 and box 38 for the
total amount of per diem to be reimbursed.
Box 40: Other Directly Related Costs. Common costs are listed, but not all will be used for each incident. Add additional items that are eligible for reimbursement, as necessary. Nearly all costs associated with an IMET dispatch should be claimed on the reimbursable form. For example:
-
Airline tickets including service fees if air transportation not arranged by requesting agency, including (excess) baggage fees for the AMRS/ATMU equipment
-
Rental car, if required
-
Fuel costs for rental car or mileage if POV is used, if a government vehicle is used fuel cost is not reimbursed
-
Lodging expenses during travel to and/or from the incident and at the incident, if not provided
-
Shipping costs for AMRS/ATMU equipment, if required
-
ATM fees
-
Travel card cash advance fees
-
Equipment purchased solely in support of the incident
Box 41: Include amounts for each applicable item in box 40 above. The amounts should match the amounts on the travel voucher. Include legible copies of all receipts when submitting the form (fire agencies will reject receipt copies that are illegible).
If in doubt on whether to claim a travel cost for reimbursement, please contact your regional office.
Box 42: Add all lines of box 41 for the total amount of other reimbursable costs.
Check that boxes 39 + 42 equal Travel Voucher, section 4. If not, there is a problem, please recalculate.
Box 48: Signatures. Once the IMET/ASA/MIC have completed their sections of the form the IMET should review for accuracy and sign. Then the MIC should review for accuracy, sign and date.
Box 50: Project Code. Use the table on page 8.
Box 51: Task Code. Use the table on page 8.
The following items should be submitted to your Regional Fire Weather Program Manager and/or budget office within 5 business days of availability of the IMET’s verified T&A(s) applicable to the entire dispatch period:
-
Correct, completed and signed IMET Reimbursable Expenses Form
-
Legible copies of:
-
Resource Order
-
Fire Time Report
-
Certified T&A for IMET with correct project code used
-
Certified T&A(s) for WFO employee(s) who worked overtime to cover shifts of dispatched IMET, don’t forget to include overtime for authorized rest period
-
If needed, signed Pay Cap Waiver Request for IMET and/or other appropriate WFO employees
-
Copy of travel voucher
-
Copy of receipts for reimbursable expenses
Items to be completed by Regional Headquarters:
Box 15: Hourly Pay Rate. IMET’s hourly wage at the time of incident. RH Budget personnel will fill in this information.
Box 16: Multiply box 14 by box 15 to get the total amount reimbursable for admin leave.
Box 18: Hourly Pay Rate. IMET’s hourly wage at the time of the incident. RH Budget personnel will fill in this information.
Box 19: Multiply box 17 by box 18 for amount of overtime pay to be reimbursed.
Box 21: Hazard Pay Rate. The hourly pay rate for hazard pay is the base hourly rate multiplied by
25%. See http://cfr.regstoday.com/5cfr550.aspx#5_CFR_550p901, Section 550.907 for details.
Box 22: Multiply box 20 by box 21 for amount of hazard pay to be reimbursed.
Box 23: Add box 19 and 22 for total amount of IMET pay to be reimbursed.
Box 27: Hourly Pay Rate. For each employee listed in box 24 indicate their hourly wage at the time of the incident. RH Budget personnel will fill in this information.
Box 28: Multiply box 26 by box 27 for each employee.
Box 30: Add all the lines in box 28 for the total amount of home office employee overtime pay to be reimbursed.
Box 43: Add boxes 16, 23, 30, 39 and 42 for the subtotal reimbursable amount.
Box 49: Cell Phone Expense. This should be filled in for
Alaska Region only.
Box 52: Incident Total. Add box 43 and box 49 for the total cost of the incident to be reimbursed.
Box 53: Signature. After reviewing the document for accuracy the Regional Program Manager should sign and date.
APPENDIX B: Reimbursable Codes for 2014
In order for the NWS to be reimbursed by fire agencies for IMET costs, several tracking numbers must be placed on the reimbursement form in addition to the Resource Order number. This is done so that a cost can be matched to an incident/project. It is important to use the appropriate Task Numbers listed in Tables 1 and 2 below and on the next page for all overtime associated with IMET services. There is a Project Code for each NWS Region and Headquarters.
Table 1: Federal Fire Dispatch Project Codes
Region
|
Agency
|
Project Code
|
Task Code
|
Eastern Region
|
USDA Forest Service
|
47MFEFS
|
For all federal fire agencies, the Task Code for IMET services is P2V.
|
DOI Bureau of Land Management (BLM)
|
47MFEBL
|
DOI National Park Service (NPS)
|
47MFENP
|
DOI Indian Affairs (IA)
|
47MFEIA
|
DOI Fish & Wildlife (F&W)
|
47MFEFW
|
Southern Region
|
USDA Forest Service
|
47MFSFS
|
For all USFS IMET dispatches, Block 7 on the Reimbursement form always uses:
USDA Forest Service
101B Sun Avenue NW
Albuquerque, NM 87109
Attention: Elizabeth Martin Telephone: 505-563-7937
Email: asc_ipc@fs.fed.us
|
DOI Bureau of Land Management (BLM)
|
47MFSBL
|
DOI National Park Service (NPS)
|
47MFSNP
|
DOI Indian Affairs (IA)
|
47MFSIA
|
DOI Fish & Wildlife (F&W)
|
47MFSFW
|
Central Region
|
USDA Forest Service
|
47MFCFS
|
DOI Bureau of Land Management (BLM)
|
47MFCBL
|
DOI National Park Service (NPS)
|
47MFCNP
|
DOI Indian Affairs (IA)
|
47MFCIA
|
DOI Fish & Wildlife (F&W)
|
47MFCFW
|
Western Region
|
USDA Forest Service
|
47MFWFS
|
DOI Bureau of Land Management (BLM)
|
47MFWBL
|
DOI National Park Service (NPS)
|
47MFWNP
|
DOI Indian Affairs (IA)
|
47MFWIA
|
DOI Fish & Wildlife (F&W)
|
47MFWFW
|
Alaska Region
|
USDA Forest Service
|
47MFFFS
|
DOI Bureau of Land Management (BLM)
|
47MFFBL
|
DOI National Park Service (NPS)
|
47MFFNP
|
DOI Indian Affairs (IA)
|
47MFFIA
|
DOI Fish & Wildlife (F&W)
|
47MFFFW
|
Pacific Region
|
USDA Forest Service
|
47MFPFS
|
DOI Bureau of Land Management (BLM)
|
47MFPBL
|
DOI National Park Service (NPS)
|
47MFPNP
|
DOI Indian Affairs (IA)
|
47MFPIA
|
DOI Fish & Wildlife (F&W)
|
47MFPFW
|
OCWWS
|
USDA Forest Service
|
47MFKFS
|
DOI Bureau of Land Management (BLM)
|
47MFKBL
|
DOI National Park Service (NPS)
|
47M7KNP
|
DOI Indian Affairs (IA)
|
47M7KIA
|
DOI Fish & Wildlife (F&W)
|
47M7KFW
|
Table 2: State Dispatch Project Codes
The following states have reimbursable agreements with the NWS for IMET services. For IMET services to state-managed incidents in states
other than those listed here, payment is usually made to NOAA via an agreement between that state and a federal agency in Table 1, most often the USFS. For those state dispatches, put the USFS code on the IMET travel voucher and T&A. Your regional office will make any needed updates later in coordination with you and the fire agencies.
State
|
Project Code
|
Expiration Date
|
Task Code
|
Oregon
|
47M2W01
|
6/30/14
|
The single task code to be used for all IMET services/costs for these state-managed incidents is P4H.
|
California
|
47M2WCF
|
9/30/14
|
Washington
|
47M3WFE
|
6/30/15
|
Texas
|
Contact Paul Witsaman
|
A copy of these tables is included as part of the IMET Reimbursement Form.
APPENDIX C: Biweekly Pay Cap Waiver Request Form
APPENDIX D – USFS Training Reimbursement Form AD-672
USFS REIMBURSEMENT OR ADVANCE OF FUNDS AGREEMENT
|
1. AGREEMENT NUMBER (25)
|
2. FISCAL YEAR (4)
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3. ESTIMATED AMOUNT (11)
|
4. AGY. BILL IND. (1)
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5. TRANS CODE (1)
|
6. ACTION CODE (1)
|
7. AGENCY REQUESTING SERVICE
|
8. AGENCY PERFORMING SERVICE
|
NAME (32)
|
NAME (32)
|
1ST LINE ADDRESS (32)
|
1ST LINE ADDRESS (32)
|
2ND LINE ADDRESS (32)
|
2ND LINE ADDRESS (32)
|
CITY (21)
|
STATE(2)
|
ZIP CODE (9)
|
CITY(21)
|
STATE (2)
|
ZIP CODE (9)
|
9. SERVICE TO BE PERFORMED (Give brief explanation and basis for determining cost of services. Attach additional sheet if needed.)
|
10. LIST REFERENCES TO CORRESPONDENCE RELATIVE TO THIS WORK (Requesting Agency only.) (50) IN ACCORDANCE WITH THE ECONOMY ACT OF JUNE 30, 1932, SECTION 601, 31 U.S.C. 1535
|
|
11. DURATION OF AGREEMENT
|
12. METHOD OF PAYMENT
|
EFFECTIVE DATE (From)
|
CONTINUING THROUGH
|
REIMBURSEMENT
|
ADVANCE OF FUNDS
|
|
BILLING FREQUENCY
|
|
TYPE OF ACCOUNT
|
13. FINANCING (REQUESTING AGENCY - WHEN NOT SERVICED BY NFC)
|
APPROPRIATION SYMBOL AND TITLE
|
PROJECT, ALLOTMENT, OR WORKPLAN NO. (As applicable)
|
14. FINANCING (REQUESTING AGENCY - WHEN SERVICED BY NFC)
|
AGENCY
CODE
|
FUND
CODE
|
ACCT.
STATION
|
ACCOUNTING CLASSIFICATION
|
OBJECT
CLASS
|
AMOUNT
|
A
|
B
|
C
|
D
|
E
|
|
|
|
|
|
|
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|
|
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|
|
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|
|
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|
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|
|
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|
|
|
|
15. FINANCING (PERFORMING AGENCY)
|
AGENCY
CODE
|
FUND
CODE
|
ACCT.
STATION
|
ACCOUNTING CLASSIFICATION
|
OBJECT
|
AMOUNT
|
A
|
B
|
C
|
D
|
E
|
CLASS
|
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|
|
|
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|
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|
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|
|
16. LEAVE FACTOR
|
17. FICA FACTOR
|
18. OVERHEAD FACTOR
|
|
|
|
19. REQUESTING AGENCY APPROVAL
|
20. PERFORMING AGENCY APPROVAL
|
SIGNATURE
|
DATE
|
SIGNATURE
|
DATE
|
TITLE
|
TITLE
|
PERSON TO CONTACT
|
PHONE (Area Code and No.)
( ) -
|
FTS
|
COMM
|
PERSON TO CONTACT
|
PHONE (Area Code and No.)
( ) -
|
FTS
|
COMM
|
INSTRUCTIONS FOR FORM AD - 672 (Revised 9/86)
|
1. AGREEMENT NUMBER - Enter the Performing Agency's Agreement Number. Enter up to 25 Positions Alpha/Numeric,
|
12. METHOD OF PAYMENT
|
First 6 Positions must be
|
BILLING FREQUENCY - Enter 0, 1, 2, 3, 4, or 5
|
1 - 2 - Agency Code
|
0 - Immediately
|
3 - 4 - Fund Code
|
1 - Monthly
|
5 - 6 - Fiscal Year
|
2 - Quarterly
|
|
3 - Semi-annually
|
2. FISCAL YEAR - Enter 4 Positions, e.g. 1984
|
4 - Upon completion of work
|
|
5 - Upon demand
|
3. ESTIMATED AMOUNT - Enter up to $999,999,999.99
|
|
omit commas and decimal point.
|
TYPE OF ACCOUNT
|
|
|
4. AGENCY BILLING INDICATOR - Enter 1,2,3, or 4
|
0 - Transfer of Appropriation Account
|
|
1 - Consolidated Working Fund
|
1 - Requesting Agency is an agency serviced by NFC's MISC system
|
|
2 - Requesting Agency is a Government Agency, Bill SF 1081
|
13. FINANCING (Requesting Agency- When NOT serviced by NFC)
|
3 - Requesting Agency is a Government Agency, Bill SF 1080
|
Complete this block only when the requesting agency does not participate
|
4 - Requesting Agency is other than Federal Government. Bill AD-631
|
in the Central Accounting System processed by the USDA's National
|
|
Finance Center
|
5. TRANSACTION CODE - Enter 0, 1, 2, A, B, C
|
|
|
14. FINANCING (Requesting Agency - When serviced by NFC)
|
0 - Revenue - Government
|
Complete this block only when the requesting agency does
|
1 - Refund - Government
|
participate in the Central Accounting System processed by the USDA's
|
2 - Reimbursement - Government
|
National Finance Center.
|
A - Revenue - Public
|
|
B - Refund - Public
|
Agency Code - Enter 2-digit NFC assigned agency code
|
C - Reimbursement - Public
|
|
|
Fund Code - Enter 2-digit NFC assigned fund code
|
6. ACTION CODE - Enter 1,2,3, or 4
|
|
1 - Add New Agreement
|
Accounting Station - Enter assigned accounting station code.
|
2 - Change Existing Agreement
|
|
3 - Delete Existing Agreement
|
Accounting Classification Code - Enter accounting classification code
|
4 - Issue Bill for Method of Payment upon demand or upon completion of work
|
of requesting agency
|
7. NAME AND ADDRESS OF REQUESTING AGENCY
|
Amount - Enter the estimated agreement amount allowable to each
|
|
accounting classification
|
Name (32 positions)
|
|
1st Line Address (32 positions)
|
15. FINANCING (Performing Agency) - Enter agency code, accounting
|
2nd Line Address (32 positions)
|
station, accounting classification code object class and amount
|
City (21 positions)
|
stated in 14 above. Accounting codes used in this agreement
|
State (2 positions)
|
cannot be duplicated in any other agreement number
|
Zip Code
|
|
|
16. LEAVE FACTOR - If leave is to be considered in billing
|
8. NAME AND ADDRESS OF PERFORMING AGENCY -
|
the Requesting Agency for services, enter the leave factor. Enter 10.6%
|
Same as item number seven.
|
as 010/60 or 10/6
|
|
|
9. SERVICES TO BE PERFORMED - Enter brief narrative.
|
17. FICA FACTOR - If FICA taxes paid are to be considered in billing the
|
|
Requesting Agency for services, enter the FICA factor. Enter 6.85%
|
10. LIST REFERENCES FOR CORRESPONDENCE - Enter reference
|
as 006/85 or 6/85
|
data that the Requesting Agency requires for Correspondence or Billing
|
|
(e.g. Requesting Agency Agreement Number) or authority for Agreement
|
18. OVERHEAD FACTOR - If overhead is to be considered in billing the
|
(e.g. Public Law 97-212).
|
Requesting Agency for services, enter the overhead factor. Enter 18%
|
|
as 018/00 or 18/0.
|
11. DURATION OF AGREEMENT
|
|
EFFECTIVE DATE - Enter month, day, year.
|
19. APPROVAL FOR REQUESTING AGENCY - Self explanatory.
|
CONTINUING THROUGH - Enter month, day, year.
|
|
|
20. APPROVAL FOR PERFORMING AGENCY - Self explanatory.
|
APPENDIX E: Department of Interior Training Reimbursement Template
|
UNITED STATES DEPARTMENT OF THE INTERIOR
INTER/INTRA-AGENCY AGREEMENT (IAA)
|
1. Period of Performance
|
START
|
END
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Buyer has work performed for them by the Seller named in item 6b.
|
Seller to perform work as described herein for the agency named in item 6a.
|
SEE INSTRUCTIONS ON PAGE 2
|
2. Common Document Number (Agreement Number)
|
3. Check appropriate box
|
|
Original
|
Modification No.
|
4. Under the authority of (Cite authorities):
|
43 U.S.C. 1701 et seq., (FLPMA)
|
Working Capital Fund (WCF)
|
Department of the Interior Appropriation Act for FY
|
Other: __________________
|
31 U.S.C. 1535 (the Economy Act)
|
|
5. Description of Work (If more space is needed, attach additional sheets):
|
PROJECT TITLE:
|
|
|
Buyer
|
Seller
|
6a. Agency:
|
|
6b. Agency:
|
|
Address:
|
|
Address:
|
|
Address:
|
|
Address:
|
|
Administrative POC
|
|
Administrative POC:
|
|
Email:
|
|
Phone
|
|
Fax
|
|
Email:
|
|
Phone
|
|
Fax:
|
|
Technical Point of Contact:
|
|
Technical Point of Contact:
|
|
Email:
|
|
Phone
|
|
Fax
|
|
Email:
|
|
Phone
|
|
Fax:
|
|
ACCOUNT DATA
|
BUYER
|
SELLER
|
7. Agency Location Code
|
7a.
|
7b.
|
8. BPN Number (DUNS #) FSN
|
8a.
|
8b.
|
9. Treasury Account Symbol (TAS)
|
9a.
|
9b.
|
10. Standard General Ledger
|
10a.
|
10b.
|
11. Cost Structure/Account
|
11a
|
11b.
|
12. Business Event Type Code
|
12a
|
12b
|
13. Requisition Number for Buyer/Project Account for Seller
|
13a
|
13b.
|
14. Contract Line Number for Buyer/ Proposal Number or other data for Seller
|
14a.
|
14b.
|
15. Buyer provide Expiration of Funding Source (Date or indefinite)
|
15a.
|
15b. NOTE: Seller, ensure project completion by this date (Seller must not incur additional costs) See Block 15a
|
16. Amount Obligated by Buyer
|
17. Bill To (Name and Address, including zip code of Finance Office):
|
a. Initial or current obligation:
|
$
|
Name:
|
|
b. Modification Amount (check one)
|
$
|
Address:
|
|
Increase
|
Decrease
|
Address:
|
|
c. Total obligation:
|
$
|
|
18. Billing for Federal Agencies and DOD will be processed via IPAC. (billing will be done bi-weekly monthly quarterly in advance)
|
|
Upon Approval, this agreement constitutes an obligation against Buyer requesting the work; or authority to proceed with work by Seller for the herein named agency in anticipation of reimbursement.
|
19. Approved for Buyer: ______________________________________________
(Contracting Officer or other Authorized Signature) *other only for WCF
|
20. Approved by Seller:
__________________________________________________________
(Seller’s Authorizing Signature )
|
19a. Name (Type):
|
20a. Name (Type):
|
19b. Title:
|
19c. Date:
|
20b. Title:
|
20c. Date:
|
INSTRUCTIONS FOR INTER/INTRA-AGENCY AGREEMENT (IAA)
NOTE: Information highlighted is to be completed by, or obtained from, the Seller Agency
IAA – BUYER TO HAVE WORK PERFORMED BY A PARTICIPATING (SELLER) AGENCY
*Note: Complete Items below for a single funding line – continuation page is required for multiple lines of funding
The Buyer executes this form, completes and obligates information under Buyer data elements.
1. Enter the start and end date (period of performance) in which work will be completed.
2. Enter the Common Document Number (Inter/intra Agency Agreement number).
3. Check “Original” if first submission, “Modification” and enter modification number if modification.
4. Check 31 U.S.C. 1535” unless another specific legislative authority exists, in which case that authority is shown under “other”. If 31 U.S.C. 1535 is checked, an Economy Act Determination must be prepared by the project manager and approved by a warranted Contracting Officer with delegated authority.
5. Provide a Project Title and description of the work to be performed in accordance with Acquisition, Section 1510-17.5.
6. Enter the Buyer Agency office name, city, state, zip code, Buyer technical and administrative contact names and phone nos. with area code, also include fax and Email address.
6a. Enter the Seller Agency office name, city, State, Buyer technical and administrative contact names and phone nos. with area code, also include fax and Email address. These fields can be completed by the Seller if unknown to the Buyer.
This data will be referenced on your Treasury IPAC bill
7a. Provide your 8 digit Agency Location Code (ALC) assigned by Treasury.
8a. Type your Business Partner Network Number (DUNS No.) as registered in Federal Register, this is also referred to as the FSN for Dept. of Defense.
9a. Provide the Treasury Account Symbol (TAS) for this funding line.
10a. Determine the Treasury Standard General Ledger accounts (SGL) for this funding request.
11a Enter the account cost structure for your Agency. This may include an office identifier, program and budget object class.
12a Provide the Business Event Type Code (BETC) for this action.
13a Type the Requisition Number referenced to support this Agreement.
14a Contract Line Number for this funding.
15a. Provide the Fund Expiration date, or type ‘Indefinite’ (for no year funds).
*Items 9a – 14a are specific for each line of funding on the obligation document. See * above.
7b-14b. Seller Agency completes these items.
This data will be used to cross-reference the IA with the Seller’s reimbursable account.
16. For an original IA; enter the amount to complete items a, c, and d. For modification; complete items a, b, c, and d.
16a. Enter the Initial or current obligation amount
16b. Enter the Modification Amount
16c. Check appropriate box to indicate if the funding is being increased or decreased by this action.
17. Enter the Buyer Agency, Bill To - Finance Office address, include office name, city, state, and zip code.
Forward a copy of this draft Agreement for completion of the Seller Agency account data.
Obtain a signed, accepted copy of this Agreement from the Buyer Agency.
Ensure that the data elements in 7b-14b have been completed.
18. Check the preferred billing schedule for the Buyer Agency and ensure that the term is acceptable for both Buyer and Seller.
19. IA must be signed by a warranted Contracting Officer with delegated authority. IA is not signed by the Buyer until approved in block 20 by the participating agency.
20. Signature of approving official for the participating agency.
Send a fully executed copy of this Agreement to the Seller Agency after obligation is recorded in the Financial System via the IDEAS/PRISM system.
PARTICIPATING SELLER AGENCY TO SUPPORT THE BUYER AGENCY
The Draft IAA is received for completion by the Seller Agency.
This data will be used to cross-reference the IAA with the Seller Agency’s reimbursable account in FFS or SAP.
APPENDIX F: State Training Reimbursement Template
AGREEMENT No. __________
THROUGH WHICH
[STATE: _____________________________]
[Describe State Entity]
IS PURCHASING Fire Services From
National Oceanic and Atmospheric Administration (NOAA) National Weather Service (NWS)
1. NWS SERVICES & DURATION OF ACTIVITIES:
Services: (hydrometeorological on-site; training; other special service)
Start date: _____________________ End date: _______________________
2. AUTHORITY:
A. The Intergovernmental Cooperation Act, 31 U.S.C. §§ 6501-6508, authorizing NWS to conduct statistical and other studies and compilations, development projects, technical tests and evaluations, technical information, training activities, surveys, reports, and other similar services to a STATE or local government
1 when (1) a written request is made by the STATE or local government; and (2) The STATE or local government pays all identifiable NWS costs.
B. NWS program authority includes 15 U.S.C. § 313; 15 C.F.R. § 946.4; and NWS Instruction 10-405.
C. STATE authority (if desired): ____________________________________________ ___________________________________________________________________________
3. TERMS:
STATE will pay NWS $___________, (monthly, quarterly, in advance), to NWS's estimated cost for providing fire services. Cost adjustments must be made to reflect actual costs. Under Office of Management and Budget Circular A-97, STATE certifies that the services requested cannot be procured reasonably and expeditiously by ordinary business channels. Should disagreement arise on the interpretation of the provisions of this agreement that cannot be resolved at the operating level, the area(s) of disagreement shall be stated in writing by each party and presented to the other party for consideration. If agreement on interpretation is not reached within thirty days, the parties shall forward the written presentation of the disagreement to respective higher officials for appropriate resolution.