Memorandum
To: Director (or supervising Directorate Member (i.e., Assistant Director, Regional Director), if allowed)
Through: Assistant Director – Management and Administration
From: Supervising Directorate Member (i.e., Assistant Directors, Regional Directors) (or Deputy/Assistant Regional Director, if allowed)
Subject: Request for Reimbursable Authority with [name of private entity]
In accordance with U.S. Fish and Wildlife Service Manual chapter 264 FW 2, I request your approval to enter into an agreement with [name of private entity] for reimbursable work.
Consistency with the Service’s Mission
The [name of private entity] requested that the Service’s [Region/field station/program] perform the following work:
Summary of services or product that we will provide and estimated reimbursement.
We estimate that completion of this work will help to [benefits to be achieved], consistent with the Service’s mission.
[Name of private entity] is requesting the Service’s expertise because [Provide a summary of scope of work and cost of agreement].
[Name of private entity] is not prohibited as defined in section 2.19, 264 FW 2.
After both parties accept this agreement, [name of private entity] agrees to make an advance payment to the U.S. Fish and Wildlife Service in the amount of $[dollar amount].
Attachment(s)
_____Approved
____________________________________________________
_____Not Approved Director, U.S. Fish and Wildlife Service/Date
(or supervising Directorate Member, if allowed) (see sections 2.5, 2.13, and 2.18 of 264 FW 2 for conditions of approval)
Comments: