Exhibit 3,

264 FW 2
Sample Memorandum for Approval of Agreement with a Private Entity

Supersedes Exhibit 3, 264 FW 2, October 9, 2009

Date: September 24, 2015

Series: Finance

Part 264: Cost Recovery and Reimbursable Agreements

Originating Office: Division of Financial Management



PDF Version


Microsoft Word Version





To:                   Director -or- Supervising Directorate Member


Through:          Assistant Director - Business Management and Operations -or-
      if the Supervising Directorate Member is the approving authority, provide a copy of the memorandum to the Assistant Director - Business Management and Operations after it’s signed


From:               Supervising Directorate Member -or- Deputy/Assistant Regional Director


Subject:            Request for Reimbursable Authority with [name of private entity]


In accordance with Service Manual Part 264, chapter 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 office/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.


 _______________ is requesting the Service's expertise because ___________________.

Provide a summary of scope of work and cost of agreement.


After both parties accept this agreement, [name of private entity] agrees to make an advance payment to the U.S. Fish and Wildlife Service for $______.





 _____    Approved                                                                                                                               
 _____    Not Approved               Director, U.S. Fish and Wildlife Service                        Date

                                                -or- Supervising Directorate Member [see sections 2.5, 2.12, and 2.18 for                                                conditions of approval]



For information on the content of this exhibit, contact the Division of Financial Management. For information about this Web site, contact Krista Bibb  in the Division of Policy, Performance, and Management Programs.  

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