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Modification of Assistance Agreement Form
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Modification of Assistance Agreement Form
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Last modified
1/26/2010 4:39:26 PM
Creation date
6/23/2009 10:23:51 AM
Metadata
Fields
Template:
Water Supply Protection
File Number
8561.650
Description
Finance ā(Billing, Suspense Docs, Ectr)ā
State
CO
Basin
South Platte
Water Division
1
Date
1/1/3000
Author
US Bureau of Reclamation
Title
Modification of Assistance Agreement Form
Water Supply Pro - Doc Type
Contract/Agreement
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34e7-2278(02-02) <br />Bureau of ReGamation <br />UNITED STATES DEPARTMENT OF THE INTERIOR <br />BUREAU OF RECLAMATION <br />MODIFICATION OF ASSISTANCE AGREEMENT <br />PAGE 1 OF <br />1. MOD/FlCATION NUMBER 2. TYPE OF AGREEMENT 3s. AGREEMENT NUM9ER <br /> I 1 GRANT <br /> [ j COOPERATNE AGREEMENT Jb. AGREEMENT DATE <br />1. ISSUING OFFICE (MaME, ADDRESS) S. RECIPIENT (NAME, ADORES$ TBEPHONE) <br /> DUNSl: EN i: <br />8. ADMINISTRA7IVE POINT OF CONTACt (NnME, nDDRESS,'rF1EPHONE, E-Mat) T. REC1PfENT PROJEC7 MRNACaER (NAufE, aDDRESS, 7BFaHOtaE, e-mua) <br />S. TECHNICAL REPRESEN7ATIVE (ninx+E, aooRESS, TeEvHoNE E-tiun.) 9. EFFECTiYE DA7E OF MODIFICATION See Bluk 78a <br /> 10. COMPLETION DATE OF AGREEMENT <br />11. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TD AUTHORITY OF <br />R motllks Me aboN-nunbaetl asefspnn aprawment aa aet /aYh !n Bloek 3. <br />12. FUND/NG INFORMATION RECIPIENT/OTHER RECLAMA7/ON 13. REQUISITION NUMBER <br />THISOBLAGA7ION E $ <br /> <br />PRewOUSOeuG.anDN E $ 1I⢠ACCOUNTINGANDAPPROPR/ATIONDATA <br />roracoeLIcannN $ $ <br />COST SNARE RATIO 'R % <br />15. DESCR/PTION OF MODIFICATION (Attach add?lhna/ pages N needed) <br />Exeept aa provftlM hwnM, all hma md contltlons of fM tloemwt /shnncad M Bloek 3, as Mreto/on chanpad, remaM unchanpad and In fWl force antl sNaet. <br />76. RECIPlENT IS . IS NOT . REQUiRED TO SIGN 7HlS DOCUMENT AND RETURN COP/ES TO THE /SSU/NG OFF/CE. <br />17a. Aeceptance o/ thls Modlftcatlon !n accordance wfth the terms 18a. Aeceptance o/ th/s ModiRcaUon !n aecordance wlth Me totms <br />and condHlons contained herein is here6y made on behal/ of the and condlUons contained hereln fs hereby made on behal/ o/ the Unked <br />above-named reclplent SWtes o/Amerka, Bureau o/ReclamaNon <br />BY DATE BY OATE <br />17b. NAME, TITLE, AND TELEPHONE NUMBER OF SIGNER (Type a pKnt) 18b. NAME OF GRANTS AND COOPERATNE AGREEMENTS OFFICER (Type a print) <br />? Addttlonsl slpnafusa na attacMd <br />DOUMENTS INCORPORATED HEREIN BY REFERENCE.
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