Forest Service Application Form

Forest Service Application Form

WHEREAS — RECITALS

WHEREAS, Applicant Name: (hereinafter "Applicant") seeks authorization to perform certain work, improvements, or activities on National Forest System lands under the administrative authority of Forest Unit: .

WHEREAS, the Forest Service has authority to grant limited authorizations, permits, or agreements subject to terms and conditions that protect resources, public safety, and compliance with applicable statutes and regulations; and

WHEREAS, Applicant proposes the Project Title: located at Project Location: and agrees to comply with the terms set forth in this application and any resulting agreement.

APPLICANT INFORMATION

Individual Corporation Nonprofit Other:

PROJECT DETAILS / SCOPE OF WORK

Brief description of proposed activities (work to be performed, methods, equipment, and anticipated impacts). Provide sufficient detail to evaluate resource effects.

PAYMENT TERMS

Total Estimated Cost: $ . Applicant acknowledges that final compensation is subject to invoice approval and adjustment for change orders authorized in writing by the Forest Service Representative.

Deposit or Initial Payment: $ . Payments are due within days of invoice. Late payments shall accrue interest at or the maximum allowed by law, whichever is less.

TERM AND TERMINATION

This authorization, if granted, shall commence on Start Date: and expire on End Date: unless earlier terminated in accordance with this section.

Either party may terminate this authorization for cause upon written notice if the other party materially breaches any term and fails to cure within Notice Period: days after receipt of such notice. Forest Service may immediately suspend or terminate the authorization for reasons of public safety, protection of resources, or noncompliance.

INSURANCE, INDEMNIFICATION, AND COMPLIANCE

Applicant shall maintain insurance coverage as required by the Forest Service, including general liability and, where applicable, automobile and workers' compensation insurance. Applicant agrees to indemnify, defend, and hold harmless the Forest Service, its officers, agents, and employees from any claims, liabilities, losses, or expenses arising from Applicant's activities under any authorization resulting from this application, except to the extent caused by the sole negligence of the Forest Service.

Applicant shall comply with all applicable federal laws, regulations, and Forest Service policies, including environmental protection requirements. Prior to commencing work, Applicant shall secure any permits or consents required by law and furnish proof of such permits when requested.

CONFIDENTIALITY

Except as otherwise required by law or regulation, the parties agree that information clearly designated in writing as confidential by Applicant and provided in connection with this application shall be protected from public disclosure to the extent permitted by law. The Forest Service retains discretion to disclose information where required by law, and no designation by Applicant shall be construed to limit statutory disclosure obligations.

ATTACHMENTS & ENVIRONMENTAL DOCUMENTATION

Applicant has included the following documents with this application (check all that apply):

Site map / plan Biological surveys Insurance certificate Other permits / approvals

GOVERNING LAW

This application and any authorization, permit, or agreement that results from it shall be governed by and construed in accordance with federal law and the laws of the state in which the project is located to the extent applicable and consistent with federal jurisdiction.

ENTIRE AGREEMENT

This application, together with any attachments, representations, and any subsequently executed authorization or permit, constitutes the entire understanding between the parties with respect to the subject matter and supersedes all prior agreements and understandings, whether written or oral.

CERTIFICATION

By signing below, Applicant certifies under penalty of perjury that the information provided in this application and accompanying documents is true, complete, and accurate to the best of Applicant's knowledge; that Applicant has the authority to submit this application; and that Applicant consents to inspections and monitoring necessary to verify compliance with the terms of any authorization.

Applicant Representative Name:

Title / Position:

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