Utah Weed Supervisor’s Association

Grant Request Form for 2012

Contents

Grant Request Summary

Project Worksheets

Estimated Cost Share Breakdown

Allowed Cost Share Fees

Attach a List of Partners (required)

Grant Request Summary

1. Date of Application
2. Name of Organization / 3. Contact Person
4. Mailing Address / 5. Contact Phones
6. E-mail (optional) / 7. Federal ID # (if available)
8. Financial/Book Keeping Organization / 9. Financial/Book Keeping Contact Person
10. Financial/Book Keeping Mailing Address / 11. Financial/Book Keeping Contact Phone

Total Grant Budget

Qualifying Expenses / Explanation / Requested
Herbicide
Supplies
Labor
Education
Administrative
Total Amount Requested

Summary of All Estimated Costs and Contributions

12. Total Amount Requested from UWSA
13. Non-Federal Matching Contributions
13a. Private
13b. City, County, State Government
13c. Other
14. Subtotals for Non-Federal Matching Contributions
15. Federal Matching Contributions (not UWSA)
16. Subtotal of Project Costs Minus Federal Contribution
17. Total Project Costs & Capital Outlay

Summary of Estimated Activity

18. Total Estimated Acres to be Treated
19. Total Estimated Acres to be Monitored
20. Total Estimated Acres to be Inventoried
21. Total Estimated Acres to be Revegetated
22. Total Estimated Biocontrol to be Released
23. Protected Acres (Critical acres, forest, watershed, etc.)
24. Total Human Outreach (newspaper articles, fairs, etc)


Project Worksheets

Project #1 (Forms are available for 3 projects, if you need more forms, please copy them)

25. Project Name / 26. Treatment Method
27. Estimated Acres Treated / 28. Estimated Acres Seeded / 29. Estimated Acres Monitored
30. Estimated Acres Inventoried / 31a. Estimated Number of Bio-control Used / 31b. Bio-control Type
Estimated Grant Expenditures
32. Estimated UWSA contribution
33. Estimated Non-Federal Contribution
33a. Private
33b. City, County, State Government
33c. Other
34. Subtotal Estimated Non-Federal
35. Non-matching Federal Contribution (not UWSA)
36. Total Estimated Cost of Project
36. Describe Proposed Activities (do not exceed window)
37. How does this program enhance Early Detection and Rapid Response in your area?
38. How does your project benefit non-federal forested land (land with at least 10% canopy cover)?
39. Will you map* your project area?
Will map data be sent to the Utah Automated Geographic Reference Center?
40. How does your project coordinate with the Utah Noxious Weed Control Plan?
41. How does your project coordinate with your local strategic weed control plan or annual plan?
42. Explain how your project utilizes multiple treatment methods of Integrated Pest Management.
43. How will you measure (monitor) the outcomes of this project?

*Map should include at least 1 GPS point, acreage and density for each project area.

Project #2

44. Project Name / 45. Treatment Method
46. Estimated Acres Treated / 47. Estimated Acres Seeded / 48. Estimated Acres Monitored
49. Estimated Acres Inventoried / 50a. Estimated Number of Biocontrol Used / 50b. Biocontrol Type
Estimated Grant Expenditures
51. Estimated UWSA contribution
52. Estimated Non-Federal Contribution
52a. Private
52b. City, County, State Government
52c. Other
53. Subtotal Estimated Non-Federal
54. Non-matching Federal Contribution (not UWSA)
55. Total Estimated Cost of Project
56. Describe Proposed Activities (do not exceed window)
57. How does this program enhance Early Detection and Rapid Response in your area?
58. How does your project benefit non-federal forested land (land with at least 10% canopy cover)?
59. Will you map* your project area?
Will map data be sent to the Utah Automated Geographic Reference Center?
60. How does your project coordinate with the Utah Noxious Weed Control Plan?
61. How does your project coordinate with your local strategic weed control plan or annual plan?
62. Explain how your project utilizes multiple treatment methods of Integrated Pest Management.
63. How will you measure (monitor) the outcomes of this project?

*Map should include at least 1 GPS point, acreage and density for each project area.

Project #3

64. Project Name / 65. Treatment Method
66. Estimated Acres Treated / 67. Estimated Acres Seeded / 68. Estimated Acres Monitored
69. Estimated Acres Inventoried / 70a. Estimated Number of Biocontrol Used / 70b. Biocontrol Type
Estimated Grant Expenditures
71. Estimated UWSA contribution
72. Estimated Non-Federal Contribution
72a. Private
72b. City, County, State Government
72c. Other
73. Subtotal Estimated Non-Federal
74. Non-matching Federal Contribution (not UWSA)
75. Total Estimated Cost of Project
76. Describe Proposed Activities (do not exceed window)
77. How does this program enhance Early Detection and Rapid Response in your area?
78. How does your project benefit non-federal forested land (land with at least 10% canopy cover)?
79. Will you map* your project area?
Will map data be sent to the Utah Automated Geographic Reference Center?
80. How does your project coordinate with the Utah Noxious Weed Control Plan?
81. How does your project coordinate with your local strategic weed control plan or annual plan?
82. Explain how your project utilizes multiple treatment methods of Integrated Pest Management.
83. How will you measure (monitor) the outcomes of this project?

*Map should include at least 1 GPS point, acreage and density for each project area.

Estimated Cost Share Breakdown

For All Projects / Funding / %
84. UWSA Estimated Award
85. Estimated Non-Federal Contributions
85a. Private
A. Labor (Value of actual wages and benefits)
B. Equipment
C. Herbicide
D. Funding
E. Other
85b. City, County, State Government
A. Labor
B. Equipment
C. Herbicide
D. Funding
E. Other
85c. Other Entities
A. Labor
B. Equipment
C. Herbicide
D. Funding
E. Other
86. Subtotal Estimated Non-Federal Contributions
87. Total Estimated Award and Matching Contributions / 100%
88. Non-Matching Federal Contributions (not UWSA)
89. Total Project Costs & Capital Outlay

Authorization

90. Print Authorized Name / 91. Authorized Signature

Be sure to make a copy for your records.

Allowed Cost-Share Fees*

Utah 2012-2013

Cost Share Item Hourly 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.